After claiming that the Kent variant was 70% more transmissible – still yet to be verified – the UK government has now gone one step further at a public press conference to claim that there is ‘evidence’ it could also be 30% more lethal. Let’s look at that ‘evidence’ and how it found its way into a government press conference just hours before the conference was aired to the nation.
Firstly, what is bizarre and quite frankly outrageous is the manner in which this news was conveyed to the public. The chain of events which led to Johnson announcing to the nation that the new variant is more deadly is disturbing, as reported here.
The story initially emerged on Twitter after ITV’s Robert Peston reported: “The government’s New and Emerging Respiratory Virus Threats Advisory Group (or Nervtag) has concluded that the new Covid-19 strain may be a bit more lethal than the existing strain.”
He was briefed about the story by the infectious disease modeller Neil Ferguson, who told Peston: “It is a realistic possibility that the new UK variant increases the risk of death… So for 60-year-olds, 13 in 1000 might die compared with 10 in 1000 for old strains.”
Given the uncertainty of the data, it is unclear why Ferguson, a controversial figure, thought it necessary to brief Peston before the relevant information had been properly disclosed. Critics may say that in a public health crisis, transparency and predictability in government decision-making is absolutely vital both to preserve public trust and to ensure proper accountability.
How in God’s name does Ferguson – who is not even supposed to be advising the government at all after he got caught with his pants down breaking lockdown rules back in the Spring to see his girfriend – get to brief an ITV reporter on issues directly relating to government policy, who then splashes it on social media, which is then communicated in very alarming tones to the nation by a Prime Minister who looks more like the Grim Reaper as each week passes? It’s an outrageous chain of communication and the scare-tactics employed are contemptible in the extreme, essentially giving justification to keep us all locked up for much longer. As Robert Dingwall, also a NERVTAG member, says in the article referenced above:
The government’s frightening and unproven claim that the new variant of the Covid-19 virus is 30 per cent more lethal is challenged by a leading member of the key body monitoring the disease. He says it is wrong to “exploit it to increase public fear.”
Professor Robert Dingwall, who sits on the New and Emerging Respiratory Virus Threats Advisory Group, told Reaction:
“The 30 per cent more lethal claim about the virus rests on a very fragile and uncertain base of evidence. NERVTAG has expressed limited confidence in this figure, which should not be the basis for public alarm.”
He continued: “It is right not to hide possibly bad news but it is also quite wrong to exploit it to increase public fear and to try to shut down debates about the exit strategy from the current restrictions.”
How can the public be expected to have any trust in the government and follow their ever changing rules ‘to save lives’ if they are being deceived and misinformed via such grubby collaborative exercises in spreading unjustifiable alarm occurring between two-bit journalists, discredited academics and Downing Street? They can’t. They won’t. They have surely gone over the top this time.
But let’s take a look at the NERVTAG report which forms the basis of Johnson’s press conference claim, but which he probably wasn’t even aware of at the time of the announcement.
The first point of the Summary is this:
The variant of concern (VOC) B.1.1.7 appears to have substantially increased
transmissibility compared to other variants and has grown quickly to become the
dominant variant in much of the UK
Well, as it happens, the areas in which the ‘70% more transmissible’ variant first appeared (London, East Anglia and the South East) and ‘took over’ are now experiencing a sharp downturn in infections compared to other areas and it seems that the main reason for this is that the initial sharp rise in VOC infections appears to have gone into reverse, with now more pronounced declines in VOC compared to the ‘old’ variant! This doesn’t exactly fit the script of a more transmissible strain which is rapidly becoming dominant.
But what is most remarkable is that the fall in infections in London, the East and South East seems to be down principally to a fall in cases of the new variant discovered in Kent in December. Said by the government at the time to be up to 70 per cent more transmissible than previous variants, it seems to be reducing at a far faster rate.
In total, the NERVTAG review report references 10 studies, with highly variable results, as below:
PHE reports and CO-CIN do not find an increased risk of death and actually report a decreased risk, which would in fact be compatible with the changes in the ORF-8 region as pointed out by Professor Racaniello [14′.10” onwards] in late December when the UK government cancelled Christmas because of this new variant. Back then, the government was saying there was no evidence of increased mortality, but I guess they done went and found some! Gotta think about Easter coming up. It would be a tragedy if families were to get together at Easter and actually enjoy some human company. I expect the Welsh government will be taping off the Easter eggs section in supermarkets as well.
The references for the 10 studies mentioned above are as follows:
1. Public Health England, 2020. Variant Of Concern 202012/01: Technical Briefing
2. Investigation of novel SARS-CoV-2 variant. [online] Available at: [Accessed 13 January 2021]. 2. Ferguson, N. 2021. Non-parametric analysis of fatal outcomes associated with B1.1.7. Imperial College London – unpublished analysis.
3. Davies, N., Diaz-Ordaz, K., Keogh, R. 2021. Relative fatality hazard in Pillar 2 tested individuals with VOC. LSHTM – unpublished analysis.
4. PHE, 2021. Unpublished analysis.
5. Docherty A., Harrison, E., Semple, C. 2021. Hospital case fatality and emergence of variant of concern B.1.1.7, rapid CO-CIN report to NERVTAG and SAGE. Unpublished analysis.
You’ll note that only the PHE analyses are published and accessible. All of the others are unpublished therefore not available for inspection by the public. That’s transparency for you! You will also note that Ferguson cites his own work in the review paper which he co-authors. It’s all rather incestuous and opaque, to say the least. It’s also anything but robust, definitive, conclusive. Here are some examples:
There are several limitations to these datasets including representativeness of death data (<10% of all deaths are included in some datasets), power, potential biases in case ascertainment and transmission setting.
It should be noted that the absolute risk of death per infection remains low.
An analysis of CO-CIN data has not identified an increased risk of death in hospitalised VOC B.1.1.7 cases. However, increased severity may not necessarily be reflected by increased in-hospital death risk.
Previously, preliminary results from a matched-cohort study conducted by PHE reported no statistically significant increased risk of hospitalisation or death in VOCinfected individuals compared to non-VOC 
The LSHTM paper used a Cox proportional hazards model to estimate change in risk of death within 28 days of test for individuals infected with the VOC 
The study was based on 2,583 deaths among 1.2 million tested individuals. 384 deaths were among SGTF individuals.
Focusing only on individuals with SGTF after 1 November 2020 (no adjustment for SGTF misclassification)
A PHE retrospective matched cohort study was also reported :
The odds of SGTF cases being admitted was not significantly different to non-SGTF cases (OR = 1.07, 95% CI 0.86 – 1.33).
There are potential limitations in these datasets:
The dataset used in the LSHTM, Imperial, Exeter and PHE analyses is based on a limited subset of the total deaths. This includes approximately 8% of the total deaths occurring during the study period. Of all coronavirus deaths, approximately 26% occur in individuals who have had a Pillar 2 test, and only 30% of these have S-gene data. The results of all studies may therefore not be representative of the total population.
Some laboratories only report SGTF if the PCR cycle threshold (ct) value is <30, since target gene failure can occur with low viral loads. For the LSHTM paper, no such ct threshold was applied to non-SGTF positive samples.
If there is an increase in the severity of infection with VOC B1.1.7, we would also expect to see an increase in the risk of hospitalisation. Currently, we do not have evidence of an increased risk of hospitalisation in individuals with VOC B1.1.7 but data are limited due to lags in the availability of hospitalisation data.
You get the idea. The take home message is that these studies are based on a very limited subset of deaths, they use a proxy SGTF measurement for the presence of the variant which does not account for misclassifications made due to low viral load, and they reveal that hospitalisations have not increased, but somehow deaths have. But this did not stop the government from stoking up the fear yet again by announcing that there is ‘evidence’ that the new strain is 30% more lethal as well as being more transmissible. OMG, Boris the Red tells us, you’re going to kill even more grannies if you don’t stay locked up in your home (and “wear a bloody mask in the supermarket!”) until we tell you it’s safe to come out again – which may not be until summer, by which time you’ll all be insane anyway. Haha.
Even the Fail is not that impressed:
Experts today played down fears a UK variant of the coronavirus is more deadly than the original strain after a ‘scaremongering’ Downing Street press conference last night.
Public Health England medical director Dr Yvonne Doyle said it is not ‘absolutely clear’ if a mutation of the virus first found in Kent is more dangerous.
Graham Medley, professor of infectious disease modelling at the London School of Hygiene and Tropical Medicine, said it is an ‘open question’ but not a ‘game changer’ in terms of dealing with the pandemic.
And Dr Mike Tildesley, a member of SAGE subgroup the Scientific Pandemic Influenza Group on Modelling, said it was still too early to be drawing ‘strong conclusions’ about the suggested increased mortality rate.
But evidence for increased mortality remains thin – Nervtag papers reveal the term ‘realistic possibility’ is used when scientists are only 40 to 50 per cent confident something is true.
The paper states ‘it should be noted that the absolute risk of death per infection remains low’. Chief Medical Officer Chris Whitty said if the evidence is correct it would mean three to four more deaths per 1,000 cases.
Chief Scientific adviser Sir Patrick Vallance even admitted during the press conference evidence the strain is more deadly is still ‘weak’.
If this new variant was indeed more virulent, you would expect an increased viral load. This paper, published on January 15th, which finds that it is moderately more transmissible (nowhere near 70% more transmissible) also reveals that there is no evidence of increased viral load or of increased transmission among children (as was also claimed by Ferguson in late December, which no doubt influenced the horrendous decision to close down schools). Professor Pantsdown is going to have a lot to answer for when this all over.
The relative difference in growth rates of SGTF vs no -SGTF had a similar distribution in those up to high-school age (i.e . ≤15 /16 years, 5% excess (95% C I 1-8%) ) versus older (6% (4 -9 %)) (Supplementary Figure 11, Supplementary Table 2), with no evidence that SGTF positivity rates were consistently growing faster or slower in those under and over high school age.
Multiple lines of evidence support B.1.1.7 /VOC202012/01 leading to higher infection rates in adults and children, and adding to, rather than simply replacing, existing strains. However, we found no evidence that Ct values (a proxy for viral load ) were intrinsically substantially lower in SGTF-positives, in contrast to initial reports17,18, but consistent with observations that B. 1.1.7 / VOC202 012/01 infection is not more severe.