Since B.1.1.7 was first identified in September in southern England, it has become the dominant variant in the United Kingdom and has spread to more than 30 countries. To investigate whether the lineage causes an increased risk of dying, Nicholas Davies, an epidemiologist at the LSHTM, and colleagues analysed data from more than 850,000 people who were tested for SARS-CoV-2 between 1 November and 11 January but who were not in hospital.

The authors analyse a large database of SARS-CoV-2 community test results and COVID-19 deaths for England, representing approximately 47% of all SARS-CoV-2 community tests and 7% of COVID-19 deaths in England from 1 September 2020 to 22 January 2021.

Fortuitously, these SARS-CoV-2 tests can identify VOC 202012/01 because mutations in this lineage prevent PCR amplification of the spike gene target (S gene target failure, SGTF).

The authors estimate that the hazard of death among SGTF cases is 30% (95% CI 9–56%) higher than among non-SGTF cases after adjustment for age, sex, ethnicity, deprivation level, care home residence, local authority of residence and date of test.

In absolute terms, this increased hazard of death corresponds to the risk of death for a male aged 55–69 increasing from 0.56% to 0.73% (95% CI 0.60–0.86%) over the 28 days following a positive SARS-CoV-2 test in the community.

Correcting for misclassification of SGTF, it’s estimated a 35% (12–64%) higher hazard of death associated with VOC 202012/01.

This analysis suggests that VOC 202012/01 is not only more transmissible than preexisting SARS-CoV-2 variants but may also cause more severe illness.