Kent Covid variant became rampant in care homes at the end of last year, research suggests

Kent’s Covid variant was quietly tearing through England’s care homes in December, a study has found. 

Researchers from University College London found the strain accounted for 60 per cent of positive cases in care home staff and residents analysed between November 5 and December 17.

It proved especially virulent in the South East where it was already spreading rapidly, accounting for four out of five positive test results.  

Experts said the timings suggested care home staff may have passed on the variant to residents and seeded outbreaks, with the majority of older people struck down with the mutant strain testing positive for it later in the year.    

The B117 strain was first found in Kent back in September 2020, after which it quickly become the dominant type of the virus circulating in the UK. 

It had evolved to become more transmissible and Exeter University-led research last week suggested the ‘variant of concern’ is up to twice as deadly.

But all current vaccines are thought to work against it and overall case numbers have now dropped to levels not seen since September, before the second wave spiralled out of control. 

Dr Laura Shallcross, from the UCL Institute of Health Informatics, said: ‘Our findings suggest the UK variant spread just as quickly in care homes as it did in the general population.

‘This shows the importance of public health measures to reduce transmission in the country as a whole.’

Researchers from University College London found the strain accounted for 60 per cent of positive cases in care home staff and residents analysed between November 5 and December 17. It proved especially virulent in the South East where it was already spreading rapidly, accounting for four out of five positive test results

Graphs from the study show that the proportion of positive coronavirus tests in care home staff and residents accounted for by the Kent variant (green) surged massively during late November and December as it pushed older strains of the virus out of competition

Graphs from the study show that the proportion of positive coronavirus tests in care home staff and residents accounted for by the Kent variant (green) surged massively during late November and December as it pushed older strains of the virus out of competition

 

 

UCL researchers analysed 4,442 positive test swabs taken from care home residents and staff and processed during two weeks at the end of last year. 

The majority of the samples were taken from care homes in the South East, West Midlands, London, or the East Midlands. 

Scientists said this meant the results did not apply to the entire UK but just those regions.

The Kent variant can be easily detected because, of the three parts of the virus that the test usually targets, only two show up in a standard swab test. 

This means any test where only two out of three parts of the virus are detected can be classed as the variant. 

The variant accounted for around 12 per cent of positive care home tests in the week starting November 23, which shot up to 60 per cent in the week of December 7.

Over the same period in the South East, positive tests due to the variant rose from 55 to 80 per cent and in London increased from 20 to 66 per cent. 

But the trend was not seen in the East Midlands or the North. There were not enough cases in the West Midlands to prove a trend in the area.

The study also showed that residents had a higher proportion of Kent Covid cases (85.7 per cent) than staff (63.1 per cent) by the third week of December.

But earlier in the second wave, the cases started rising in staff from mid-November before then creeping up in the residents, suggesting carers may have passed on the strain to the older, more vulnerable group.  

What do we know about the Kent variant? 

Name: B.1.1.7, formerly VUI-202012/01

Where did it come from? The variant was first found in Kent and can be traced back to September 2020. Scientists noticed that it was spreading in November  and it was revealed to the public in December.

What makes it new? The variant, which is a version of the SARS-CoV-2 coronavirus that causes Covid-19, has a series of mutations that change the shape of the spike protein on its outside. The main one is known as N501Y. This appears to make it better able to stick to the cells inside the body and makes it more likely to cause infection and faster to spread.

How did that happen? Viruses, particularly ones spreading so fast and in such huge numbers, mutate all the time. To reproduce they basically force living cells to copy and paste the viral genetic code, and this can contain errors that lead to slightly different versions of the virus. Often these mutations make no difference but, if they make the virus stronger, they can stick around for further generations and become the norm. 

What can we do about it? Nothing much. People who catch the virus won’t know which type they have, and it will still cause the same symptoms and illness. Officials can try to contain it by locking down the areas where it is most prevalent, but if it is stronger than other versions of the virus it will eventually spread everywhere and become dominant as long as people continue to travel.  

Will our vaccines still work? Yes, it’s very likely they will. Scientists on SAGE are fairly sure the mutations the Kent variant carries do not significantly affect how well the immune system can handle it. People who have a vaccine modelled on an older version of the virus, or who have been infected with Covid-19 before, are likely to be immune to it. This is because the main mutations are only on one part of the spike protein, whereas the immune system is able to target various other parts of the virus. 

And colleague Dr Maria Krutikov added: ‘Our results are consistent with national trends, suggesting that the UK variant was present in care homes from early on, although our sample did not fully represent all care homes in England.

‘As we carried out this work in December, we were able to inform public health decisions at the time.

‘To see how viruses like Covid-19 are changing and to respond quickly and appropriately, it is really important we have an advanced surveillance system, with gene sequencing that can identify new variants as early as possible.’

The research was conducted as part of the Vivaldi study looking at Covid-19 infections in care homes, and received funding from the Department of Health and Social Care. It is published as a letter in the New England Journal of Medicine.

Professor David Leon, professor of epidemiology at the London School of Hygiene & Tropical Medicine, said: ‘The steep increase in the percentage of positive Covid cases occurring in care homes that are made up of the B117 variant in this study shows that despite awareness of the risks and efforts of the care sector, it is extremely difficult to uncouple and isolate care homes and their residents from high levels of infection in the surrounding community. 

‘However, data published weekly by the Office for National Statistics shows that since mid-January the number of Covid deaths in care homes has been falling steeply, as has been the case for Covid deaths in hospitals and private homes. 

‘This positive trend will have reflected both social distancing measures in the community and more recently the impact of the vaccination roll out particularly among those aged 80-plus years. 

‘Fortunately, for now at least, these two factors have been more than sufficient to counter-act the greater case-fatality that appears to be associated with the new variant.’

It comes as a Covid variant which may be able to fully evade current tests was spotted in France last night

Eight cases of the ‘Breton variant’ were detected in a hospital in Lannion, a town in the northwest region of Brittany.

The French health ministry revealed that despite being infected with the virus, the PCR test results were negative. They were only spotted through genomic sequencing of the samples.

It is thought to be the first time any variant has slipped past the gold-standard PCR tests, which are critical for keeping track of the pandemic. 

While PCR cannot diagnose other variants, including the Brazil and South African versions, it still gives a Covid positive result. 

Scientists at the Institut Pasteur who discovered the Breton variant said it does not appear to be more transmissible or deadly than the original virus.

They revealed the new strain carries nine mutations on its spike protein, but also in ‘other viral regions’. They did not provide any further details.

UK’s dominant Kent Covid variant is up to TWICE as deadly as older versions of the virus, study claims 

The Kent coronavirus variant is more deadly than original strains of the virus, another study has claimed.

Researchers analysed the lethality of the highly transmissible strain — the dominant type circulating in the UK which has rapidly spread across the world.  

Data from around 55,000 Britons revealed the B117 variant was 64 per cent deadlier than earlier versions of the coronavirus. But scientists admitted the risk of dying may actually be twice as high for people infected with the Kent strain. 

Academics calculated this equated to the disease killing 0.41 per cent of everyone it infected in the study group — or one in 250 people. 

For comparison, the original Covid strain had a lethality rate of around 0.25 per cent – one in 400 people — in a separate cohort matched by age and other factors which affect the risk of dying. 

The research, carried out by academics at the universities of Exeter, Bristol, Warwick and Lancaster, was published in the British Medical Journal

Despite the finding being worrying for the UK, scientists are certain that the current vaccines will work just as intended against the strain.  

The SAGE paper published in January cited three studies of the Kent strain: A London School of Hygiene and Tropical Medicine study (left) based on 2,583 deaths that said the hazard of death within 28 days of test for the mutant strain compared with non-mutant strains was 35% times higher An Imperial College London study (centre) of the Case Fatality Rate of the new mutant strain that found the risk of death was 36% times higher A University of Exeter study (right) that suggested the risk of death could be 91% higher. Both the Exeter and the Imperial studies were based on just 8% of deaths during the study period

The SAGE paper published in January cited three studies of the Kent strain: A London School of Hygiene and Tropical Medicine study (left) based on 2,583 deaths that said the hazard of death within 28 days of test for the mutant strain compared with non-mutant strains was 35% times higher An Imperial College London study (centre) of the Case Fatality Rate of the new mutant strain that found the risk of death was 36% times higher A University of Exeter study (right) that suggested the risk of death could be 91% higher. Both the Exeter and the Imperial studies were based on just 8% of deaths during the study period

Boris Johnson, Sir Patrick Vallance and Professor Chris Whitty told a Downing Street press conference in January that early data suggested the variant could increase the risk of death for a man his 60s from 1 per cent to 1.3 per cent.

But confusion mounted following the claims, with a senior Public Health England boss playing down the fears and insisted it was not ‘absolutely clear’ if it was any deadlier.

SAGE then published the papers they used to make their estimate, which showed estimates of the death risk varied wildly.

Now, a detailed study has suggested that the risk of death increases by 64 per cent and potentially as much as 100 per cent.

A 64 per cent increase in risk does not mean that 64 per cent of people die, but that the much smaller relative risk rises by that much. 

For example, a group with a one per cent risk of death would then have a 1.64 per cent risk.

No10’s top scientists believe Covid kills around 0.5 per cent of people. But the disease poses a much greater threat to the elderly and weak. 

The researchers looked specifically at members of the public, who have a much lower death rate than care home residents and people already in hospital. 

Author of the study Dr Robert Challen, a mathematician from the University of Exeter said: ‘In the community, death from Covid-19 is still a rare event, but the B117 variant raises the risk.

‘Coupled with its ability to spread rapidly, this makes B117 a threat that should be taken seriously.’

Researchers looked at death rates among people infected with the new variant and those infected with other strains.

The Kent variant dates back to September 2020, and was responsible for most of the second wave, while older variants from Wuhan and Spain caused the first wave. 

The study found that the Kent variant led to 227 deaths in a sample of 54,906 patients – compared to 141 among the same number of similar patients who had the previous strains. 

Because of this increased risk of death and the fact that the variant infects people faster, those who might have been considered relatively low risk before were at higher risk now.

This chimes with official Government guidance, which saw an extra 1.7million people added to the shielding list and advised to stay at home during the vaccine rollout.   

In January a paper from SAGE advisers NERVTAG (New And Emerging Respiratory Virus Threats Advisory Group) said there was a ‘realistic possibility’ that the variant was associated with an increased risk of death.

But scientists warned there was a lot of uncertainty around the data.

Mutations of the virus have raised concerns about whether vaccines would be effective against the new strains, including the now-dominant Kent strain.

But research suggests the Pfizer jab is just as effective against the Kent variant of coronavirus as it was against the original pandemic strain, while other data indicates the Oxford/AstraZeneca jab has a similar efficacy against the variant.