Is the UK prepared

With the worrying Pirola variant, limited vaccine rollout, vastly reduced testing and a creaking health service, experts are predicting a tough few months ahead. reports

long-term health problems under the umbrella term long Covid”, says Stephen Griffin, professor of cancer virology at the University of Leeds and a member of Independent Sage. “The NHS is buckling from continued underfunding and staff shortages.”

Pirola began raising red flags when first detected in Israel in July, with cases confirmed now in more than a dozen countries, including Denmark and the US. While the EG.5.1 (Eris) and XBB variants account for most Covid infections globally (and most of the more than 1m symptomatic Covid cases currently in Britain), Pirola, which descended from Omicron, is heavily mutated. This follows a pattern seen with Sars-CoV-2 since the beginning of the pandemic, explains Andrew Pekosz, professor of molecular microbiology and immunology at Johns Hopkins University. “They accumulate a few mutations that allow them to evade some of the antibodies induced by prior infection or vaccination, they spread for a few months, then they are supplanted by a variant that has picked up a few different mutations that also function to evade preexisting immunity, and the cycle continues.”

With more than 30 mutations, Pirola is “very unique”, adds Pekosz, with the potential to be “more concerning” than the other circulating variants.

The government started its Covid vaccine rollout last week for over-65s and immunocompromised people, earlier than planned, as a “precautionary measure” in response to the World Health Organization declaring Pirola a “variant of interest”. Still, concerns remain about the efficacy of the jab for Pirola, with studies so far producing mixed results. Both Pfizer

Lessons learned in the early part of the pandemic, and before it, do seem to have been forgotten

and Moderna last week said their jabs offered “strong responses” to the spike protein (which they target). However Griffin says “multiple preprint studies posted by reputable labs show this [Pirola] to be equally, or perhaps more, antibody evasive compared to the XBBs” – which “are among the most antibodyevasive strains ever encountered”.

The consensus is that it is too early to tell how useful the vaccine may prove, though some MPs are pushing for 50- to 64-year-olds to be immunised, either as part of the rollout or privately. With Covid becoming “more of a value-formoney exercise” for the government, according to Duncan Robertson, senior lecturer in management sciences at Loughborough Business School, they may be playing a risky game by reducing eligibility for “financial savings”.

Planning is all the more challenging given that the UK’s surveillance and testing regimen is now the thinnest since the pandemic began. This is “frustrating” says Robertson, as “the UK’s ability to detect new variants has been compromised by the effective ending of the Office for National Statistics Coronavirus Infection Survey. Not only did that give a very good indication of the level of Covid in the population, it also allowed the proportions of variants … to be estimated, which could have meant that the emergence of BA.2.86 could have been better tracked.”

The UK Health Security Agency has promised that Covid testing will be increased, “although details at the moment are scant”, says Griffin. He says that “lessons learned during the early part of the pandemic, and before, do seem to have been forgotten.”

Susan Michie, professor of health psychology at UCL and another Independent Sage member, agrees that as we find ourselves in a position where “we really can’t see