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Covid-19: UK officials try to trace unidentified case of Brazil variant

BMJ 2021; 372 doi: (Published 01 March 2021) Cite this as: BMJ 2021;372:n592

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  1. Gareth Iacobucci
  1. The BMJ

Public health officials are trying to trace an unidentified person in England who has been infected with the variant of SARS-CoV-2 first identified in Manaus in Brazil.

Lawrence Young, professor of molecular oncology at Warwick Medical School, warned that the Brazilian variant could pose a real danger, including to people who had been infected with other variants of the virus.

“Recent reports from Manaus in Brazil, where the P1 variant is fuelling a surge in infections, suggest that this variant is responsible for reinfecting people who were previously infected with a different variant of the virus,” he said. “That’s why it’s even more important to do everything to stop the spread of this virus and all other variants including strict border controls and an efficient test, trace, and isolate system.”

Three cases of the P.1 variant of concern had been identified in England as of 28 February. This includes two people in one household in south Gloucestershire who flew back from Brazil to London on 10 February.

But Public Health England (PHE) is also urgently seeking to identify a third, currently unlinked, person who did not complete their registration card after undergoing a covid test, meaning that their follow-up details are not available.

There have also been three cases of the P.1 variant identified in Scotland, but these are not linked to the three cases in England.

PHE appealed for anyone who had a covid-19 test on 12 or 13 February and hasn’t received their result or has an uncompleted test registration card to come forward immediately. The government’s vaccines minister Nadim Zahawi said PHE was also working with the postal service to “look at other data points” to try to locate the person.

PHE said its health protection teams rapidly followed up the two cases in south Gloucestershire, with cases and their contacts identified and retested.

Officials are also following up with all passengers on Swiss Air flight LX318 travelling from São Paulo through Zurich and landing in London Heathrow on 10 February, who were required to self-isolate at home for 10 days under the rules at the time.

PHE said the risk to the wider community in south Gloucestershire was considered to be low, but said precautionary surge asymptomatic testing and extra sequencing of positive samples were being deployed.

But the emergence of the cases prompted criticism that the government’s introduction of hotel quarantine measures for international travellers on 15 February came too late. The rules now state that any UK resident returning to England from 33 “red list” countries, including Brazil, has to pay to quarantine in a hotel for 10 days. In Scotland the rule applies to travellers from all countries. Before this date, UK residents returning from abroad only needed to self-isolate at home for 10 days.

Nick Thomas-Symonds, the shadow home secretary, said, “This is further proof that the delay in introducing a hotel quarantine was reckless and the continuing refusal to put in place a comprehensive system leaves us exposed to mutations coming from overseas.”

But Zahawi, speaking on BBC Radio 4’s Today, defended the “robustness” of the UK’s testing approach, adding, “The border controls that we have are pretty stringent. Even countries that had hotel quarantine from the start, like Australia, still have to deal with the variants challenging them. We’ve got one case where they didn’t fill in the test card details.”