Hope after a grim week

Last week I wrote about receiving my first dose of the Covid-19 vaccine – as a healthcare worker, I am one of the first in line. 

A host of side effects lingered the following day: optimism, hope, gratitude. But hours later, Boris Johnson announced news of the mutant corona variant sweeping across the nation and cancelled most Christmas plans.

And, still, I remained upbeat.

I’ll admit, things have suddenly appeared gloomier over the past week or so.

I’m hearing of more and more patients struck down with the virus, who tell me their grandparents, aunts or elderly neighbours have sadly fallen victim to it.

Not to mention the mutant virus – which made for unsettling conversation around many Christmas dinner tables, I’m sure.

But please don’t be despairing. There are still plenty of reasons why I am – dare I say it – optimistic about 2021.

Pictured: Dr Ellie Cannon with Dr A Sohrabe as she received the first of her two Covid-19 jabs

First, the vaccine. In just over two weeks, half a million Britons received their first Pfizer jab. By the end of January, most of this group will be protected against the virus. This is just one vaccine so far.

On Wednesday, Sir John Bell, Regius Professor of Medicine at the University of Oxford and a Government adviser, told BBC Radio 4’s Today programme the approval of the Oxford AstraZeneca vaccine is expected imminently – it could well happen this week.

But will it work against this new variant too? Scientists already have evidence to suggest it will.

Prof Stuart Neil, a virologist at King’s College London, said medics have been busy testing its unique genetic combination and investigating if antibodies produced by the vaccine destroy it. And the good news is, they do seem to.

Earlier last week the Turkish scientist behind the Pfizer vaccine confirmed the same. Dr Ugur Sahin said the mutation, called B117, is 99 per cent genetically identical to the original SARS-Cov-2 virus, which the vaccine was designed for.

Prof Neil explains: ‘Vaccines generate something called polyclonal antibodies, which specifically attack the virus, and general fighter immune response T cells.

Pictured: Dr Ellie is administered the first Covid-19 vaccine on December 18 in London

Pictured: Dr Ellie is administered the first Covid-19 vaccine on December 18 in London

Last week I wrote about receiving my first dose of the Covid-19 vaccine – as a healthcare worker, I am one of the first in line, writes Dr Ellie. Pictured: Stock image

‘This means vaccines give us several lines of defence.’

But say the worst did happen, and the vaccine isn’t as effective at protecting us against B117. Even then, it wouldn’t be a catastrophe. It is not uncommon for viruses to mutate as they replicate. 

Covid-19 has undergone about 20 genetic mutations before this latest discovery. And vaccines can be adapted accordingly, often in very little time.

Dr Elisabetta Groppelli, a virologist at St George’s Hospital in London, likens it to the process we undertake every year for the flu vaccine. 

‘Making alterations just means a few days of tweaking in the lab,’ she says. Also, the vaccine may already have been tested – unintentionally – against this new variant. 

Trials of the Pfizer and AstraZeneca vaccine involved more than 100,000 participants from all over the world, in countries including Brazil and South Africa where, we now know, this variant has been circulating for months. 

It may simply appear more widespread in Britain because we have been looking for it.

The UK is one of the only nations to forensically investigate genetic changes in the virus when we test people. 

We use pioneering screening technology called Taqpath, which quickly flagged this new variant when it appeared in September. 

More recently, it helped researchers notice a pattern – that B117 now accounts for more than 60 per cent of cases.

As Dutch health minister Hugo de Jonge wrote in a letter to Parliament: ‘Other countries may well have the variant. The United Kingdom may have picked it up first because that country has the most sophisticated genomic monitoring in the world.’

So that’s another thing to be celebrated – the UK has spotted it, which means we have a head-start in tracking it.

We’ve undoubtedly seen an uptick in cases. Rates have doubled in some parts of the South East in just a month, with many hospitals reaching capacity, and public heath experts are fairly confident it’s due to this variant being more infectious. 

Covid-19 has undergone about 20 genetic mutations before this latest discovery. And vaccines can be adapted accordingly, often in very little time. Pictured: The vaccine is administered in York

Covid-19 has undergone about 20 genetic mutations before this latest discovery. And vaccines can be adapted accordingly, often in very little time. Pictured: The vaccine is administered in York 

But so far B117 doesn’t appear to be more deadly, which is another reason for optimism.

In fact, there are some early suggestions that it may be less severe than other variants.

Viruses ‘want’ to reproduce, and they do this by infecting as many people as possible. Killing their host makes this harder. So they evolve, over time, to further their spread without causing death.

‘Mutations often cause the immune system to be less stimulated by the virus, which would lead to more asymptomatic cases,’ says Dr Julian Tang, consultant virologist at Leicester Royal Infirmary. 

‘It’s too early to tell if this is definitely the case here, but we see it in flu and other respiratory viruses. Half of people with flu will have the virus without knowing it, because it’s adapted to our immune system, causing few symptoms.’

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Still, we’re dealing with the same virus, so we must be prepared to expect the same disease. 

So in terms of the virus itself, not much has changed. But, thanks to tier 4 lockdowns and new shielding rules, the national mood has shifted into an especially dark place. 

Once again, I am nervous for my most frail patients, shut indoors alone without the spring sunshine of the first lockdown.

So how do you power through this monumental hump?

My first piece of advice is to limit your intake of online news to once a day. It is too easy to get sucked into what I call ‘doom scrolling’.

Second – please try to get out and exercise. I know it is cold and wet, but if you spot a weather window, take it. If you are shielding, get moving at home every day. 

Choose an online workout – there’s lots on the NHS website or YouTube, or call up your local gym and see if they run Zoom classes.

It’s obvious, but talking to friends is one of the best ways to prevent a mood slump.

If you’re really struggling, call your GP or local mental health service – most are around over the holiday season.

There’s also a list of apps on the NHS App Library website which guide users through evidence-based strategies such as cognitive behaviour therapy, which I often recommend to my patients.

None of us could have imagined back in January that 2020 would end like this. But we are vaccinating as fast as we can. The future can, and will, only get better.