The UK faces a third wave of coronavirus fuelled by the <a href="https://www.thenationalnews.com/world/europe/coronavirus-europe-warned-over-contagious-indian-b-1-617-covid-19-variant-1.1220652">rapidly spreading Indian variant</a> and new strains introduced by international travel, a leading public health expert said on Wednesday. Dr Sakthi Karunanithi, Lancashire director of public health, called on the government to introduce targeted vaccinations in Covid hot spots to combat the infectious double mutant. His warning came as the World Health Organisation said the B.1617 <a href="https://www.thenationalnews.com/world/europe/indian-b-1-617-2-covid-19-strain-declared-variant-of-concern-in-uk-1.1218384">"variant of concern"</a> is present in 44 countries, of which Britain has the largest caseload outside India which has been <a href="https://www.thenationalnews.com/world/asia/dozens-of-suspected-covid-19-corpses-found-floating-in-indian-rivers-1.1220264">brought to its knees by a severe escalation in cases</a>. Whether a third wave will cause similar problems to the UK’s first and second waves rests on vaccines preventing nasty infections, Dr Karunanithi said. “There's a real uncertainty in terms of the variants and how severe they are going to be," he told the BBC. One of the areas in England experiencing a sharp rise in cases is Bolton, a town in the north-west that falls under Dr Karunanithi’s jurisdiction. Bolton has a high proportion of British Asians, many of whom visited friends and family in India and returned before the <a href="https://www.thenationalnews.com/world/europe/india-caught-off-guard-by-britain-s-surprise-travel-ban-decision-1.1206597">UK's Indian travel ban on April 23</a>. Dr Karunanithi said it was likely this accounted for the current surge in Bolton and said that international travel could cause further problems, especially with the government’s traffic light system scheduled to launch on May 17. “There is a bit of a safeguard for red-listed countries in quarantine,” he said. “But we anticipate the volume of traffic to be higher in amber-listed countries and this is where we need to focus.” Those coming back from amber countries are not required to quarantine in hotels, effectively meaning the UK government is devolving public health responsibility to returnees. With the situation around the world "very fragile and dynamic", Dr Karunanithi is aware of the risk and outlined the worst-case scenario. He said it was most likely there would be “a surge in the younger population that's not vaccinated, and that they are going to be infected with many more symptoms, and we will have to catch up very fast with the vaccination”. He said it was a risk that could be mitigated now, however, and called for a “specific policy objective” to ensure vaccination rates match case rates in Covid hot spots. His plea was echoed on Wednesday by former Labour leader Ed Miliband who told <em>Sky News</em> that targeted vaccinations could combat hot spots such as his own constituency of Doncaster where fewer people work from home and so are more exposed to the virus. "There is an issue about transport services for people, so people have been more likely to share cars, for example, and also at workplaces infections have spread,” he said. He stopped short of calling for local restrictions like the government's <a href="https://www.thenationalnews.com/world/europe/how-does-england-s-three-tier-covid-alert-system-work-1.1094330">unsuccessful tier system of last year</a> but said "the right and responsible thing to do" was to be led by the science. Environment Minister George Eustace, when asked on Wednesday about using regions rather than age to govern the vaccination programme, told <em>Sky News</em> that "nothing was off the table".