Have digested the latest excellent technical briefing from @PHE_uk on variants and Delta (the variant formerly known as B.1.617.2) in particular. as ever, all findings are context dependent and should be interpreted with care, but this is serious and deserves a wide audience 1/?
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First, read all about it yourself (don't take my word for it!). Briefing here https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/991268/Variants_of_Concern_VOC_Technical_Briefing_14.pdf … and Risk Assessment https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/991135/3_June_2021_Risk_assessment_for_SARS-CoV-2_variant_DELTA.pdf … 2/?
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This is from the risk assessment. Yes there is a lot of red. There is now very good evidence of increased transmissibility (will come back to that) compared with Alpha/B.1.1.7 (already quite transmissible). This is important. There is also... 3/?pic.twitter.com/xS04cg5EbF
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Clear evidence of reduced vaccine effectiveness vs Delta. It is *not* clear how much of the apparent increase in transmission is due to this, and it is not clear what breakthrough cases look like right now. My own expectation is that they are milder than they would have been 4/n
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(that's also a finding in this recently dropped preprint. I've not had time to fully assess it though, to figure out what it is based on so hoping someone else will!) https://www.medrxiv.org/content/10.1101/2021.06.02.21258076v1.full.pdf … 5/?
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somewhat counterintuitively, more transmissible is MUCH worse than mild immune escape going forward, so unraveling this will be important especially for places with little current immunity and low vaccination 6/?
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The data on vaccine effectiveness in the report is not broken down by vaccine unfortunately, but the assessment specifically states this. I can see several sources of bias and wouldn't call either way on this now. But nailing down the answer to this is going to be important 7/?pic.twitter.com/1UwMmRIU1S
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It is also possible that the reduced effectiveness might be consistent with much milder infection in vaccinees. But we don't know right now. Quite a lot of younger people in the UK, and indeed people in general in some places, are yet to receive any shot! 8/?
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Next thing. Early data, but consistent between England and Scotland, suggests Delta is more likely to lead to hospitalization than Alpha. This is less secure than the other findings and as yet does not seem to have been broken down by vaccine status 9/?
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They do control for vaccination status, but no paper yet as far as I know. (Cox regression etc. but we only have hazard ratios).
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