As winter approaches so does the cold and flu season. While we may no longer be getting the daily inundation of COVID-19 statistics, this does not mean that the virus has gone or that GP practices do not need to take it into consideration when planning for the upcoming winter period.
The New COVID-19 Variant
Evidence has been found in Scotland of a new variant of COVID-19. The BA2.86 strain, coined BA.X (“BA.X”), is not currently considered to be a variant of concern by the World Health Organization (“WHO”), but it does have a high number of mutations and derives from the Omicron strain of COVID-19. BA.X was first detected in the UK in Scotland via genomic sequencing of PCR samples collected on 16 August 2023, and has also been found in other countries including Canada, Israel and the US. The new strain was also detected in wastewater testing in a separate NHS Health Board area but Public Health Scotland (“PHS”), the body responsible for monitoring and managing the virus, says that these results should be treated with caution because the testing accuracy is variable.
WHO declared BA.X a Variant Under Monitoring (“VUM”) and also called for closer monitoring to understand its spread and severity after only three cases were identified due to the large number of mutations it possessed.
This comes shortly after the discovery of another variant of COVID-19, EG.5, commonly known as Eris (“Eris”), which is also deemed to be an offshoot of the highly contagious Omicron variant that afflicted the world over the winter months of 2021 to2022. Eris was first detected in February 2023 and WHO classified it as a VUM on 19 July 2023 after a surge in the number of cases. Eris was upgraded to variant of interest on 9 August 2023 by WHO.
Since the beginning of July 2023, the number of COVID-19 cases has been increasing and PHS reported 1,342 total cases in the week ending 27 August 2023. However, getting accurate data on COVID-19 cases is difficult because current figures only measure the number of patients in hospital with COVID-19 and there is very little testing/reporting among the wider public. Therefore, we do not actually know how much COVID-19 is circulating in the community.
Dr Antonia Ho, an infectious diseases consultant and senior clinical lecturer at the MRC – Centre for Virus Research (“Centre”), is worried about this, stating:
“We don’t really have a good sense of what’s happening in the community because we don’t have much in the way of community surveillance and largely testing isn’t happening anymore. That is a worry from a research point of view in terms of being able to look out for potentially more threatening variants.”
For GP practices in particular, this can lead to false security in terms of the pressure they may expect over the winter months. Without a realistic grasp of the level of COVID-19 in the community, there is potential for another collapse in the system if the number of cases continue to increase. This virus has proved to be resilient and is constantly changing, therefore current vaccines do not guarantee protection from fatal infections.
Impact of the New COVID-19 Variants on GP Practices
The Centre has played a key role in monitoring new variants. According, to Professor Massimo Palmarini, head of the Centre, BA.X does not appear to have dramatic differences from Omicron but we should still be wary. Dr Sarah Pitt, a virologist at the University of Brighton is also of the view that the differences are not necessarily a cause for alarm. However, according to Jesse Bloom, an evolutionary biologist at the Fred Hutch Cancer Centre, BA.X will have an equal or greater resistance to antibodies demonstrated by previous variants of COVID-19.
For GP practices, this means staying extra vigilant when it comes to symptomatic patients and/or staff. GP’s must remain compliant with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, which includes having in place effective measures to prevent and control infections. Much of this will be familiar, as the symptoms remain largely the same but GP’s will want to make sure they are not growing apathetic when it comes to managing COVID-19. Just because society has learned to cope with the virus does not mean that is does not pose a threat to the healthcare system, especially if BA.X proves to be resistant to current vaccines.
Eris, on the other hand, only appears to be incrementally different which may slightly increase its transmissibility, but there is nothing to suggest that it will be more resistant to vaccines than prior strains.
According to Dr Ho, as most people have hybrid immunity, either from vaccination of natural infection, the majority of cases are milder. Still, some people continue to experience complications, such as lung and heart clots and ‘long COVID-19’. Therefore, it is disputed whether or not we should be treating COVID-19 the same as the flu moving forward.
Chief Medical Officer, Sir Gregor Smith, vaccination is the best way to protect yourself. While work is ongoing to understand BA.X, as a precautionary measure, vaccination for those at the higher risk is being brought forward.
NHS England has said that anyone over 65, older adult care home residents and immunosuppressed people are to receive jabs from 11 September 2023, with the aim of jabbing as many people as possible by 31 October 2023. As in previous years, the NHS will let people know when bookings open and adult appointments will be available through the NHS App and website, or by calling 119.
This may add pressure to GP practices in the coming months so it will be important to ensure that the right systems and process are in place to handle the potential influx of patients seeking vaccination and/or treatment for COVID-19. There is also the threat of a vaccine resistant strain, which could pose serious health risks to those who are more vulnerable. GP’s will want to ensure that whatever measures they have in place, they enable them to effectively handle and care for patients experiencing COVID-19.
If you require assistance or advice in relation to regulatory issues which your GP practice is experiencing, our specialist solicitors can help. Please contact Ridouts Professional Services Ltd using the email address email@example.com or by calling 0207 317 0340.