Dr Rachel Glover, a woman who needs little introduction, has spoken to Gef about the island’s Covid situation and explained how the new variant of Covid came to exist. Dr Glover spoke to Gef after the announcement of new cases of Covid on New Year’s Eve but before the second lockdown and further cases were announced.
How might Covid have got round quarantine?
The exact circumstances which led to a person testing positive for Covid-19 after their 14 day isolation period is not clear, but one theory is they caught the virus from a member of their household who had previously had it. For Dr Glover, this is why she had previously called for additional testing for arrivals to the island.
Dr Glover said: ‘I already said something to this effect back in November this was another reason to introduce day 13 testing before a household is released because if this exact scenario happened then we would end up with positive people going out into the community.’
Simply put what could happen is person A travels to the island and isolates at home with person B. Person A has no symptoms but is Covid positive which they then pass to Person B during the isolation period. After 14 days, that household is released, Person A is now clear of the virus but Person B could be on their sixth or seventh day of their incubation period and just about to become infectious. That means that through Person B, Covid could develop spread outside of the household, potentially without either person ever being symptomatic, despite the person who travelled now being clear of the virus.
Dr Glover said: ‘That was always my concern with there being no testing carried out before the whole household is released from isolation. I’ve said this publicly, both at the time and before then because a big part of my annoyance with the day seven testing ending was because we could see the people testing positive on day seven. You have to think how many more were coming in that were not tested, so that when that was taken away we were losing that bit of information of surveillance.’
The UK variant
Before working on the island, Dr Glover worked for a team which carried out genome testing and surveillance for the British government and wanted to use that experience for the benefit of the island’s fight against Covid-19. She explained that while we’ve all become used to the term ‘UK variant’ for the more transmissible type of the disease, it could have originated anywhere but because the UK does extensive work on genome testing, scientists were able to identify its’ spread throughout the UK rapidly.
She said: ‘The reason we can actually identify that we have all these variants is because of the genome sequencing that is happening in the UK. The UK has become a powerhouse for genome sequencing and for many years I was part of those same scientific groups which did that. Then of course I come back to the Isle of Man, set up a genomics company and well here we are. The people that I used to work with and that I used to have a lot of collaboration with are heavily involved in the UK genome sequencing project and the UK, Denmark and Australia have been particularly good at sequencing patients who have tested positive.’
The UK variant came about because of a change in the virus’ RNA (a single strand molecule, similar to DNA, which carries the virus’ genetic instructions). Dr Glover explained that basically what happens is as the virus passes through Person A to Person B to Person C, the virus picks up changes to its RNA. Most of these won’t affect how it works but occasionally the change will happen in the right place in order to change the virus’ biology which is ‘advantageous’ to the virus.
Dr Glover said: ‘So in this case, it is increasing the transmissibility of the virus. Now that’s not to say that in two months time, that lineage won’t die out and be replaced by another one that is completely different so it could be less or more transmissible, less or more dangerous, there are all different effects to these accumulated changes.’
What we don’t know is why the new variant’s code changed but Dr Glover said there are a lot of theories scientists are working on to improve our understanding of the virus.
Dr Glover said: ‘The mutation that is in the new variant, is in something called the spike protein. That’s the protein that interacts with human cells and goes “let me in” -once it’s in the cell, the virus hijacks the molecular machinery and makes copies of itself. ‘So the virus is like a terrorist… all it wants to do is make copies of itself and this causes the havoc we call disease.’
Dr Glover also shared with Gef three ways we can get out of the pandemic, just to repeat at this point, she spoke to Gef before lockdown and the new cases were announced.
1. We need to be more cautious, as a nation, reverting back to asking where the hand sanitizer is, just keeping on top of that level of caution, keeping on top of habits like hand washing and just not getting complacent. Even with vaccination, we’re going to be dealing with Covid-19 for a long time, it’s not something that is going to be magically fixed by June.
2. We need to vaccinate as many arms as we can jab that into, starting with the healthcare workers and the high risk, nobody wants to see an outbreak on the island and least of all nobody wants to put frontline staff at risk when there is a vaccination available.
3. We still need to look at contingency planning, I think there has been a lot of stalling and treading water but if we don’t have contingency plans in place for how we could ramp up testing overnight should it be needed or what we do if 3,000 people call 111 in one day. It seems to me there isn’t a contingency plan for the what ifs? And I think that came across in the rolling out of the surveillance testing after the New Year’s weekend. It seemed a little bit like that hadn’t been thought through before with contingency plans in place, otherwise the testing offered would have been day 10 post-exposure tests, rather than testing anyone who rang 111 before a time-point cut-off.
This is a constantly evolving situation and who knows what is going to happen in 2021. Six months ago nobody would’ve thought there would be a new more transmissible variant but here we are, so who knows what the next mutation might bring. Prior contingency planning will be critical to prevent reactionary responses.