Wales’ leading public health doctor on the Delta variant and our fight against it

A prominent public health expert has warned that the Delta variant of the coronavirus is “growing and growing rapidly” across Wales.

Dr Giri Shankar, pandemic incident director at Public Health Wales, confirmed that the more transmissible strain is now responsible for 97% of new cases in some parts of the country.

Although there were initial concerns about B.1.617.2 in Cardiff a few weeks ago, it soon became clear that the largest clusters of cases were to be found in the seaside towns of North Wales.

Read more: Wales at start of third wave, Welsh government says

In the Wales Covid hotspot of Conwy, the current seven-day infection rate is approaching 100 cases per 100,000 (91.3) and Denbighshire – which had no positive cases between April 25 and May 1 – now has the second highest at 77 , 3. In neighboring Flintshire, the test positivity rate has now reached 6.1% – well above the Wales average of 2.6%

Although case rates remain well below the peaks of April 2020 and January 2021, it appears that the Delta strain is now present in all Welsh health boards, with built-in community transmission.

Disturbingly, an analysis in Scotland found that the risk of being hospitalized with Delta appears to be double that of the Alpha (Kent) variant which spread to Wales last winter. There are currently 12 people hospitalized with the Delta strain in Wales, half of whom are not receiving a Covid vaccine.

Dr Shankar, who received an MBE last month in recognition of his service to public health in Wales, said the growth of the Delta variant was “not unexpected” due to the epidemiology “in delay on England “by two to three weeks.

He said daily cross-border travel between Wales and England – where positive cases have now reached 70,000 – was a major factor in the spread of the virus, along with an increase in population movements and the activity during the mid-term break.

The senior doctor also said there had been a significant increase in positive cases among people in the younger age categories who had not yet received one or both doses of the vaccine.

“It’s a combination of people movements, a more transmissible virus and a largely susceptible population of young adults,” he said.

Dr Shankar pointed out that NHS hospitals in Wales are currently very busy with non-Covid patients as the routine service begins to be reintroduced.

“They might not have a lot of Covid patients right now, but due to the backlog of all other treatments, hospital beds are full,” he explained.

“Whenever community cases increase, inevitably at some point, some of them will unfortunately end up in hospital either because their immune systems are not able to fight the virus effectively or because they have underlying medical conditions that predispose them to contracting a more serious form of infection, ”he added.

“The big unknown now is whether this will result in a huge number [of additional admissions] or manageable numbers. We are watching it carefully.

“The capacity of the NHS is always state-of-the-art throughout the year, so if we see more patients entering our hospitals that would mean some of the elective work that is not urgent will have to be suspended or postponed again.

“It’s like an airtight container with different compartments. If you squeeze one part of the system, it will appear elsewhere.”

According to an analysis done last week, Dr Shankar said almost all new positive Covid cases in North Wales were the Delta variant.

“It’s also over 75-80% at Aneurin Bevan UHB and Cardiff and Vale UHB, so overall we’re seeing a ‘strain replacement.’ The Kent (Alpha) variant has already been replaced by the Delta variant. “

Dr Shankar said he was in favor of the Welsh government suspending the easing of lockdown restrictions for a month in a bid to get more first – and especially second – doses of the vaccine in the arms of the people.

“We are vaccinating around 20,000 to 22,000 people every day in Wales, so each week we can look at getting around 150,000 more vaccines. In four weeks we could do 500,000 more injections, which is definitely beneficial.” , did he declare.

“It will also give us time to examine the level of translation from community activity to hospital activity. If community activity increases, but there is not a proportional increase in admissions to the hospital. hospital, it means that most of those infected get less serious illness. “

The latest research shows that Pfizer and AstraZeneca vaccines are very effective in reducing death and serious illness from Covid-19.

“What is still not certain, however, is their effectiveness in preventing symptomatic infections, and these estimates vary between 40% and 60-70% depending on different brands of vaccine,” said Dr Shankar.

“But having a higher proportion of our population vaccinated [than other parts of the UK] is definitely an advantage. Even with the increase in Delta cases, our public health message is still going strong telling people to come forward to get both doses of their jab whenever their turn comes.

“And for those who have refused their vaccination in the past, for whatever reason, it’s never too late to say ‘yes’ again.”

Dr Shankar reiterated the Prime Minister’s “powerful” advice earlier this year when he urged people not to “push themselves within the rules”.

“You always have to be careful with who you meet, how many different people you meet, where you meet and for what purpose,” he said.

“A large portion of the population obeys the law and follows the guidelines. We have occasional reports of non-compliance, but current data shows it is a minority.”

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UK and Welsh government science advisers say 80% of people need to be immune to Covid-19 for herd immunity to be achieved.

When asked if this was feasible, Dr Shankar added: “We have reached even higher levels than certain groups, for example the elderly population and people living in nursing homes.

“But we need this level of coverage for all age groups, and that’s why our efforts to get all young people immunized is so crucial in the weeks and months to come.”

Dr Shankar said the “hallmark” of respiratory viruses was their ability to change their structure, shape and properties. He admitted that the Delta variant definitely wouldn’t be the last strain we come across.

“That is why it is important to have a very sensitive and very effective surveillance system,” he said.

“In Wales we are in a particularly advantageous position as our genome sequencing capacity is one of the best in the world. We can understand new viruses, new strains and their behavior in real time.

“At some point in the future, as vaccine technology develops and adapts, we might see more multivariate vaccines that cover more than one strain in circulation. Therefore, we can fit them into annual boosters. “