Prof. Christina Pagel Profile picture
Sep 27, 2020 11 tweets 3 min read Read on X
THREAD: as requested by absolutely noone here are some thoughts on COVID-19, the UK and exponential growth... (it's a positive thread though!) 1/11
Infectious diseases by their nature have exponential growth while lots of susceptible people are around (still case in UK) as each person infects others. Left to its own devices, COVID-19 cases would double every 4 days or so. With knock on increases for hospital admissions 2/11
But we've not left COVID-19 to its own devices. We've done lots of things to slow the spread (social distancing, masks, rule of 6 etc). This slows down the *doubling time* (how long it takes for cases to double) - effectively giving us longer to bring down transmission. 3/11
Because restrictions & our behaviour change by the day, hard to say where we'll be in 4 weeks or 4 months. BUT we can say how many "doublings" we are away from "peak" as judged from the Spring. 4/11
We are currently between 270-310 admissions / day in England - that gives us about 6 doubling rounds to peak admissions (which were ~17,000). Ditto for intensive care. 5/11
At the beginning of September we were at about 8 day doubling. @ONS latest infection survey suggested this had slowed to as long as 3 weeks (!) but Covid Symptom tracker app is now doubling at 6 days.. wide variation! 6/11
Looking at recent hospital admission data it looks as if we've gone from doubling time of 8 days down to somewhere between 12-18 days - this is GOOD. Means that instead about 6 weeks from April peak we are more like 3 months 7/11 Image
As you can see just extrapolating out another month. It buys us between 9 and 26 *more* days to get to 1000 admissions/day (where we were pre-March lockdown) compared to 8 day doubling time! That is *massive*. 8/11 Image
The *more* we can make the doubling time longer, the longer we give the govt to fix testing & tracing and the easier it will be for test&trace to stop further growth (which lets us reduce restrictions), *and* the fewer people get sick & need hospital. 9/11
Currently it looks as if restrictions in a lot of the country might be having an effect in slowing growth. Restrictions + our own behaviour can continue that slowing. Ideally we would halt growth completely and bend it back down. 10/11
We might need test & trace back to really reverse the trend (at least without more restrictions), especially as we start to see impact of uni & school transmission or more cases among elderly. BUT let's keep doing what we can *right now* cos it can make a BIG difference. 11/11

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More from @chrischirp

Jul 3
THREAD: Given tomorrow's election, I've been thinking about our nation's (poor) health, the wider determinants of health and how these have worsened and what it means for policy....

TLDR: worrying only about NHS & social care is missing the point

let's dive in... 1/25
The UK has a health problem. After steady gains in life expectancy for decades, it flatlined during the austerity years and fell for the first time this century with the Covid pandemic.

The number of people out of work for long term sickness is near record levels. 2/25
There are huge inequalities between rich & poor. Boys born in the most deprived areas can expect to die almost 10 years earlier than their peers in the least deprived areas.

Even worse, they can expect to spend 18 fewer years of their life in good health (52 vs 70 years) 3/25 Image
Read 38 tweets
Jun 4
As ever, I am getting lots of pushback.
Here is a compilation of the European countries I've found with recent wastewater data. Some are going up a bit, some down a bit, some are flat, none are anywhere near previous peaks.
I can't see anything here to be panic anyone. 1/3
Image
I can't find the dashboard for Spain, but others saying it is in a wave. Perhaps it is. England has just had one - the last data we had (a couple of weeks ago from Bob Hawkins) looked as if our wave had peaked.
So, I'm not seeing reason to think things are terrible here! 2/3 Image
Yes there are new variants growing right now. They are not growing faster than JN.1 grew in December and that wave did not end up as bad as feared.
Clearly it remains true that Covid is NOT a seasonal disease (unlike Flu and RSV)
3/3
Read 5 tweets
May 8
Quick thread on the Astra Zeneca (AZ) covid vaccine since it's been in the news today.

TLDR there isn't a new "smoking gun", the AZ vax was one of first and cheapest, it saved millions of lives globally, there are better vax out there now, adapted to new variants 1/9
the AZ vaccine was one of the first approved at the end of 2020, cheaper than Pfizer, and - importantly - easier to administer in lower resource settings as it didn't require super low temperatures for storage 2/9
In most countries it was first rolled out in older adults. As it was rolled out in younger adults, a *very rare*, serious, side effect was noticed - it could cause deadly blood clots

This was spotted quickly and studied. Vax monitoring did its job. 3/9 Image
Read 11 tweets
Apr 2
A short thread on why this is not a scary chart and why all the evidence suggests that there is not much Covid around right now. 1/6 Image
the above chart is recorded covid hospital admissions / reported covid cases. It is close to 100% now *because basically only hospitals can report cases since Feb 2024*

It is to do with changes in case reporting and NOT hospital testing
2/6
In fact hospital testing has been steady since the change in testing a year ago (only symptomatic patients get tested now).

The % of people PCR tested who have Covid is 4% - there is no evidence that there are loads of symptomatic people in hospital being missed. 3/6
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Read 6 tweets
Dec 21, 2023
Beyond a shadow of a doubt that England is in its biggest Covid wave for well over a year now, with latest ONS infection survey results published.

I've written about it here
1/7 tinyurl.com/ru7h3m28
Image
The UKHSA have now published their modelled estimates of what percentage of English population has Covid. And as of a week ago it's high (4.3%) and rising.

Read all about it here!
2/7
It's highest in London, South East and East & in young and middle aged adults.
The main thing is it's going up and fast, so prevalence will already by significantly higher now than it was last week. 3/7
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Read 8 tweets
Nov 30, 2023
Short thread on what I said on Channel 4 news tonight.

1. Did I find Hancock a sympathetic witness?

A: I find it hard to have sympathy for someone who repeatedly claimed to have thrown protective ring around care homes, while discharging covid+ patients into them.

1/5
There were *28,000* excess deaths in care homes Apr-May 2020.

Harries thought it was "clinically reasonable" not to treat covid +ve residents in hospital. Even it was, it was NOT reasonable to return them somewhere they could infect so many other very vulnerable people. 2/5
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2. Did I think scientists bear blame for not emphasising asymptomatic transmission?

A: No, because they very clearly did advise there could be asymptomic transmission before March 2020 - sources in next tweet. 3/5
Read 5 tweets

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