European Countries Ban Travel From South Africa And UK – Following Appearance Of More Infectious COVID-19 Variants
The UK has backtracked on its easing of holiday restrictions, joining a number of European countries spending the season in near-lockdowns. Travel restrictions imposed so close to Christmas are likely to cause upset.

European countries rushed to impose travel bans on UK and South African travellers after both countries reported individual new variants of SARS-CoV-2, thought to be much more infectious than the ones already circulating worldwide.

In the past few days, there have been reports of new variants of the COVID-19 virus in South Africa and the UK, particularly around London. While these variants have developed independently of each other, they are both similar in that they appear to be more transmissible. WHO has reported that the UK’s new variant’s transmissibility is up an estimated increase of between 40% and 70%.

Even so, WHO officials have stressed that there was no evidence that these variants would result in more severe illness or have an impact on vaccine efficacy, during a media briefing on Monday 21 December. The UK reported its variant on 14 December, with South Africa confirming a notable variant was in circulation 4 days later, on 18 December.

Speaking at a press briefing Monday, Dr Maria Van Kerkhove, WHO’s Clinical Lead on COVID-19, said that although the UK had reported in an increase in transmission of this variant from 1.1 to 1.5, scientists “are trying to determine how much of that is associated with the variants itself and how much was related to the behavioural differences in individuals that this variant test affected”.

She added: “The information that we have so far is that there isn’t a change in the clinical presentation or severity from this variant, but again the work is still underway, and they’re looking at a number of factors, including patients who are hospitalised with this variant, as opposed to the wild type.”

The variant identified in South Africa “has one of the same mutations, this 501Y mutation, but it’s a different variant”, she clarified.

“They’ve arisen at the same time so it sounds like they’re linked but this is actually a separate variant,” she said. She confirmed that South Africa is working with WHO ‘s virus evolution group.

Yesterday, WHO Director-General Dr Tedros Adhanom Ghebreyesus said that it is natural for viruses to mutate over time and that the WHO is “working with scientists to understand how these genetic changes affect how the virus behaves”.

“The UK has reported that this new variant transmits more easily but there is no evidence so far that it is more likely to cause severe disease or mortality,” said Dr Tedros. “The bottom line is that we need to suppress transmission of all SARS-COV-2 viruses as quickly as we can. The more we allow it to spread, the more opportunity it has to change.

“I can’t stress enough – to all governments and all people – how important it is to take the necessary precautions to limit transmission right now.”

Dr Tedros Adhanom Ghebreyesus, WHO Director General, at the WHO press briefing on Monday.
New Wave Of Travel Bans Hit Holiday Season

Throughout Europe, countries slapped travel bans on both South Africa and the UK in an effort to head off the spread of the more infectious viral strains – just ahead of the Christmas holidays as well as the pending initiation of mass vaccination campaign.

Ireland, Italy, Switzerland and Belgium banned arrivals from the UK, with France suspending travel for 48 hours. In the latter’s case, this resulted in the closure of the Eurotunnel, which is used by freight lorries. The UK Transport Secretary stated, however, that this would not impact vaccine distribution. Switzerland  has banned arrivals from South Africa while Germany is considering such a ban.

Outside of Europe, Israel was one of the first countries to react to the new virus variant by closing its borders to all foreign nationals who are non-residents, another blow to already muted celebrations of the upcoming holidays in the holy land.

Facing a rapid domestic rise in infections, Israel already had closed its skies to travelers from Britain, Denmark and South Africa yesterday. Now, returning Israelis will also be forced to go into quarantine in designated coronavirus hotels once they arrive.

This mutation could be coronavirus two,” Prime Minister Benjamin Netanyahu told reporters on Monday. “Therefore, I decided last night – and we implemented today – to close the skies of the State of Israel. Foreign nationals will not enter the country, other than exceptions such as diplomats.”

The new orders, coming into effect on the day before Christmas Eve, could have a particular severe impact on Christian communities in Israel and in the Palestinian Authority.

Extended family members living abroad often return to the region via Israel’s Ben Gurion Airport for the holiday season, but many lack the Israeli residency or citizenship documents guaranteeing them entry under the new policies.  It was unclear if returning Palestinians could still enter from Jordan via the West Bank’s Allenby Bridge. The Palestinian Authority has currently placed areas in its jurisdiction under a strict lockdown as a result of soaring Palestinian infection rates.

UK government U-Turns

U-Turns in domestic policies in the UK and other countries were also evidence of the deepening COVID-crisis sweeping Europe.

In the weeks building to Christmas, the UK government, like many of its counterparts on the continent,  had announced an easing of COVID restrictions almost unheard of since March 2020: for a five-day period, up to three households would be able to meet indoors, with permitted travel across the country.

UK Health Secretary Matt Hancock.

On Wednesday 16 December, however – 48 hours after Health Secretary Matt Hancock confirmed the appearance of a more transmissible viral variant in the capital – Prime Minister Boris Johnson was forced to backtrack. But it took him another four days before he  cancelled Christmas easings, by which point cases had risen significantly.

Named ‘VUI (Virus Under Investigation) – 202012/01’, the UK variant had infected more than 1,000 people when Hancock first confirmed the investigation was underway.

Similar lockdowns, restrictions and curfews were introduced across Europe last week, in Germany, France and Greece respectively.

Meanwhile, South Africa – already under curfew with restrictions on beaches, in restaurants and on alcohol sales – announced no new measures.

“It is still very early, but at this stage, the preliminary data suggests that the virus that is now dominating in the second wave is spreading faster than the first wave,” said Professor Salim Abdool Karim, co-chair of South Africa’s Ministerial Advisory Committee on COVID-19.

“We would expect it to be a less severe virus, but we do not have clear evidence at this point. We have not seen any red flags looking at our current death information,” he said. It is not clear if the second wave will have “more or less deaths”.

Karim confirmed that in South Africa, this variation accounts for around 80-90% of cases.

South Africa’s Health Minister Zweli Mhize appealed  to the media and medical and scientific community to “focus on the facts and avoid entering into speculation or issue unproven statements and generate panic and disinformation”.

He provided a stark reminder: “Many countries experienced a second wave that was more severe than the first – even where no mutations were reported.”

Behind the Variants: How Do The Two Differ?

Both virus variations are believed to be similar in that they appear to be transmitting far more rapidly than previous strains, with Karim noting scientists had been surprised by how “this variant has become dominant” in South Africa’s second wave.

The appearance of both at the same time in separate countries, has caused some confusion, however. Despite those similarities, and very similar mutations to the key proteins in the virus, there is little doubt that the two are unique in origin.

The COVID-19 Genomics UK Consortium (COG-UK) identified that the virus contains a substantial number of mutations, including an N501Y mutation existing in the spike protein’s receptor-binding domain. This is also true of the South African strain.

This mutation has created a change at the point at which the spike first contacts our bodies’ cells. A mutation here means the virus is more easily able to enter cells, allowing it to spread more quickly.

A more recent UK study has identified up to 16 additional potential mutations. The most notable here is a “H69-70” spike deletion. The study notes it has “been described in the context of evasion to the human immune response”, noting that it has also occurred a number of times in other variants, like the one discovered in mink populations in November.

WHO: PCR Tests Reportedly Less Effective

Given the relative novelty of the variants, advice provided by WHO is somewhat limited, with the Organization urging countries to be transparent, to share epidemiological, virological and full genome sequence information, to assess levels of local transmission, and to continue taking a risk-based approach.

It did flag a reported loss of performance in PCR assays that target the spike protein, however. If this is the case, a country’s detection capacity could become limited, with potentially severe consequences: all the more concerning as the variant appears to be quickly becoming the dominant strain in regional epidemics.

Laboratories using commercial kits for which the targeted viral genese are not labelled or identified should contact the manufacturer, WHO advised in a statement on Tuesday.

“Laboratories using in-house PCR assays that target the S gene of the virus should also be aware of this potential issue,” it said. “In order to limit the impact on the detection capacities in the countries, an approach using different assays in parallel or multiplex assays targeting different viral genes is also recommended to allow the detection of potential arising variants.”

Image Credits: Nathan Rupert, WHO, Andrew Parsons.

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