Potential further case of new variant

An individual who travelled from Rio de Janeiro to Edinburgh via Paris on 19 February has tested positive for Coronavirus (COVID-19), with initial laboratory findings suggesting the case may be an example of the Variant of Concern first identified in Japan but associated with Manaus, Brazil. 

This case, which is currently being investigated by further confirmatory genomic sequencing, is separate to the three cases of the same Brazil variant identified in the North East of Scotland in February. After enhanced contact tracing no further cases were detected from the cases detected in the North East.

Of the 22 passengers on board the Air France Flight from Paris to Edinburgh on 19 February, 11 passengers including the provisional positive case went into managed quarantine at an Edinburgh airport hotel. The remaining 11 passengers were exempt from quarantining in the hotel and self-isolated at home. 

Negative test results for both day two and day eight were recorded for 13 individuals. The National Contact Tracing Centre are following up with the other eight passengers and will take all necessary steps to protect the public more broadly. No further positive cases have been detected in Scotland.

Clinical and trial data continues to be assessed to examine how this new variant may respond to current COVID-19 vaccines.

First Minister Nicola Sturgeon said:

“A possible - although still unconfirmed - further case of the P1 variant in Scotland has now been identified. It involves an individual who travelled to Scotland from Rio de Janeiro, via Paris, and arrived on 19 February. The individual followed the procedures for managed self-isolation, and we currently have no reason to believe that this case presents any risk to the wider community. However we are of course continuing to undertake all necessary follow-up work.”

BACKGROUND

For most international travellers, self-isolation is required immediately on return to Scotland. Those self-isolating at home are being contacted by Public Health Scotland to be offered advice. Further contact tracing measures will take place in the event of a positive test. It then takes time for sequencing to take place and for all the data to be gathered and verified before accurate publication on the designation, variant type and case numbers can be made.

Timeline of Variant of Concern cases first identified in North East Scotland:

• 29 January - variant of concern enters Scotland on flight BA1312 from London Heathrow to Aberdeen
• 27 February - sequencing identifies new variant
• 28 February - three cases of new variant announced and enhanced contact tracing of close contacts begins
• 6 March - confirmation that no further cases of new COVID-19 variant identified in North East Scotland

Timeline of provisional positive Variant of Concern case identified in Edinburgh:

• 19 February – passenger arrived in Edinburgh on Air France flight from Paris. 22 passengers, 11 of whom entered quarantine including the index case and 11 self-isolated at home
• 21 February - day 2 test undertaken which came back positive on 23 February
• 24 February - NHS Grampian contacted the individual for contact tracing, self-isolation already in place as individual in quarantine
• 25 February – international health regulations invoked for Rio to Paris leg of journey
• 27 February -  day 8 test undertaken which came back positive
• 3 March – third test undertaken
• 4 March – passenger allowed to leave as fully completed isolation in managed quarantine
• 6 March - PHS informed of provisional Variant of Concern
• 7 March – Scottish Ministers informed of provisional result and further sequencing taking place

Latest technology means we are now able to provisionally determine some variants by PCR testing through the use of specialist labs. The adoption of this technology means we can test large numbers of samples for certain important variants quickly and easily. In situations where a Variant of Concern is indicated by the PCR test, the samples then undergo sequencing so the variant can be fully characterised. The variant result is currently described as ‘provisional’ after the PCR test and ‘confirmed’ after sequencing. Public health interventions will still be activated where necessary on the discovery of ‘provisional’ cases.

The P1 “Brazilian” variant is a descendent of B.1.1.28 and was first detected in Japan but is most closely associated with the second wave epidemic in Manaus, Brazil. This variant has been designated ‘of concern’ as it shares some important mutations with the variant first identified in South Africa (B.1.351), such as E484K and N501Y. It is possible that this variant may respond less well to current vaccines but at this time there is a high degree of uncertainty and we await clinical and trial data is awaited to understand this better.

There is some data to suggest that this variant may be more likely to cause COVID-19 infections in people who have been vaccinated or who had been infected with one of the earlier strains of “wild-type” COVID-19.

Genomic sequencing of Scottish samples is undertaken as part of a UK programme. This programme continues to develop to ensure faster turnaround times.