- James Gallagher
- BBC science and medical correspondent
3 July 2022
You may not be blamed if you sigh wearily. There is so much going on around us, from the war in Ukraine to the rising costs of everything – and now Covid is rearing its head.
Recent statistics indicate that the number of people infected with the virus in the United Kingdom has more than doubled since the beginning of last June, with regarding 2.3 million people testing positive. You may know someone who has had it.
So is summer vacation in news? We’re back two and a half years following the pandemic with new mutations, a rise in infections and questions like will the NHS be able to handle cases and what that means for all of our lives. It also gives us a clearer picture of what life will be like with Covid.
“We’re in a bad quagmire right now,” says Linda Bauld, professor of public health at the University of Edinburgh.
She adds, “It is a very confusing situation in society and some suffer from severe effects, but this is still a drop in the ocean of what we used to be.”
The driving force behind the sudden rise in infections is the double action of PA4 and PA5. These two mutated forms of the virus are technically sub-copies of the omicron. The original version of Omicron has the ability to spread and bypass the immune defenses that the body has built to keep the virus away. Even the PA4 and PA5 mutant have better power than the Omicron. Their rise began before big summer events like the country’s platinum jubilee celebrations or the Glastonbury music festival, it’s not like we’re entering a new wave with partying.
It is “shocking” to what degree the virus can change to continue infecting us, says Danny Altman, a professor of immunology at Imperial College London. He recalls seeing for the first time a scientific analysis of Omicron last winter: “It felt like I had just seen the worst horror movie on Earth and yet it still kept dumping its worst mutant.”
The upshot is that we are now entering – perhaps a third – omicron wave of the year and we are still only in the month of July.
picture released, Getty Images
The rise in Covid cases began before the platinum jubilee celebrations.
elusive virus
Research published in the “New England Journal of Medicine” showed that PA4 and PA5 mutants can “significantly elude” the protection provided by vaccination or previous infection with the virus. Another study published in the scientific journal “Science” showed that the original mutant Omicron was a “ghost virus” that left limited protection from infection once more.
The evasion skills of the new mutants and our weakened immunity mean that stories regarding people who have contracted Covid many times are becoming more common. In addition, a surprising number – one in five people – has somehow evaded Covid throughout the pandemic.
Professor Mark Woolhouse, who studies outbreaks at the University of Edinburgh, says: “This virus continues to surprise us in an unpleasant way, so perhaps the hope was that there would be greater protection as we moved from one omicron mutant to another.”
But the most important form of protection— once morest major illness, hospitalization, and death—is evidently resilience. If there had been 2.3 million cases of infection in the period before vaccinations, the NHS would have been unable to handle them and tens of thousands of people would have died. Obviously that does not happen.
But even with that protection, PA4 and PA5 still have the potential to cause severe symptoms.
“I think it’s different from a bad cold,” says Professor Susan Hopkins, from Britain’s Health Security Agency. People “feel sick for seven to 10 days.”
And that takes a knockout effect if you have to work – and NHS workers get sick is another way the virus can pile up on health services – or if we’re planning a nice vacation abroad.
“What would you do if your school had no teachers or airlines had no pilots? How would you understand that?” asks Professor Altman.
The rise in cases will have a disproportionate impact on people with health problems and on cases with long-term Covid symptoms.
The question of danger
There is no evidence that this virus is more or less dangerous than the original Omicron, but we don’t know for sure.
So far, only lab studies and animal experiments are available. A study in Japan showed that PA4 and PA5 might grow more easily in lung cells. And the hamsters showed worse disease symptoms than previous forms of Covid.
And the British Health Security Agency reported that there has been a “slight” increase in the proportion of those needing hospital treatment since last April. But the cause is not clear and may include a weakening of protection once morest the virus or some mutation within the person who catches the virus.
“We haven’t seen conclusive data” on PA4 and PA5 because we’re not collecting the same amount of information now, says Professor Woolhouse, who was one of the scientists who demonstrated that the original Omicron was lighter.
But the mutant doesn’t need to be worse to affect the NHS – all it has to do is infect enough people.
The number of people being treated in hospital for Covid across the UK is 10,081 – an increase of regarding 2,500 in a week. More than half of these will be hospitalized for other reasons, such as a broken bone or cardiac arrest, but they still need to be managed.
Prof Hopkins, chief medical advisor to the UK’s Health Security Agency, says: “I remain concerned that another doubling or more in numbers would put the NHS up to a major challenge.”
The hope remains that the UK will follow a similar path for countries like South Africa and Portugal as well.
“I think we have to be optimistic,” says Professor Bauld. “In those countries that are ahead of us, things are starting to settle down. These things just burn themselves out when you don’t find people to hit them.”
But the idea that Covid will just become a winter virus seems either wrong or somehow off the mark.
Professor Woolhouse warns: “We say this every year and then the virus causes a wave in the summer, driven by new mutations that come more than once a year.”
The virus may look like the flu virus in terms of severity, but the difference at the moment is that the flu comes only once a year.
There is no political will to return to any of the restrictions that were previously imposed. The big decision will be regarding the vaccination program before the coming winter season – regarding who is vaccinated and, just as importantly, what is being vaccinated?
Both Pfizer and Moderna have announced updated vaccines that target the original Omicron mutant, but this mutant is a thing of the past.
