Thread by @ewanbirney

The REACT Study from Imperial is out. It is one of the pieces of solid ground to stand on in the COVID epidemic, so really worth digesting (UK Journalists - *do* read this paper and numbers!) imperial.ac.uk/media/imperial…

(First off - huge huge credit to Paul Elliott and Imperial team to realise that this is needed, focus on clean ascertainment, do *the right power calculations* to know how deep one needs to go and doing the logistics and the numbers well. Oh boy. so impressive)

Right - my takeaways - I am a data scientist and human geneticists/genomcist, not an infectious epidemiologist (though I hang with a number of them), so - this is one, semi-informed take. Journalists - I would get Paul Elliott on the phone as he has clearly lived these numbers.

First off infection levels are definitely higher than summer - by an appreciable amount, but the growth is slower than early september. Secondly the North West and the North East, somewhat Yorkshire and Midlands, are the places in England with higher infection

Worth pointing out that we're getting to near 1% infection in the NorthWest, which, for a snapshot is high. There is absolutely no way we're out of this storm in the North West or the North East yet, but nor have we completely lost control. (Stick at PHE teams and communities!)

London has gone up ~5 fold from low base, but in line with the country, some of this is age profile as the rise has been more in the 18-24 year old bracket. Healthcare workers +key workers are not obviously more at risk of infection (in this wave) compared to other professions.

There is evidence for strong "local" clustering, below this regional level in aggregate (clusterin is a hallmark of this epidemic) - so really we have lots of mini epidemics happening at a local local level, and those mini-epidemics are hetreogenously distributed.

Under 18s have similar infection risk as the reference age group of 35-44 or potentially less.

On BAME infection risk, people who self identify as "Black" or "Asian" (eye roll at the weird box ticking system we have for this, but this is what we've got) are at 2-fold more risk of infection, and when age is controlled for this risk goes up.

This is one of three bits of solid ground to stand on in my view - REACT, ONS survey and hospitalisation numbers. Although this is a better picture than two weeks ago, but no means is this not solved - and across the 4 nations I'd like to flag Northern Ireland as a concern

Getting balance between "it is all going to work out fine" to "we're on a bad course" is still hard. To be honest, we still have a variety of possible futures ahead of us; let's work together to select (one of) the ones with low deaths and low disease burden!