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

Oct 19
Important 🧵on our new peer-reviewed paper:

The pandemic is as bad as it ever was for babies - in year to Aug 2023, 6,300 babies under 1 were admitted to hospital wholly or partly BECAUSE of Covid.

They are ONLY age group where admissions have NOT gone down over time 1/17 Image
Our study, led by Prof @katebrown220, looked at all hospitalisations in England in children with a Covid diagnosis or positive test from Aug 2020-Aug 2023.
We then *excluded* all admissions where a Covid diagnosis was incidental (ie not why they were in hospital)
2/17 Image
Infants (babies under 1) are generally at higher risk from respiratory infections, plus they are the age group that, if infected, are overwhelmingly meeting the virus for the first time.

They are not vaccinated and have not had it before. 3/17
Read 18 tweets
Sep 26
Prof @Kevin_Fong giving the most devastating and moving testimony to the Covid Inquiry of visiting hospital intensive care units at the height of the second wave in late Dec 2020.

The unimaginable scale of death, the trauma, the loss of hope.
Please watch this 2min clip.
And here he breaks down while explaining the absolute trauma experienced by smaller hospitals in particular - the "healthier" ICU patients were transferred out, leaving them coping with so much death.

They felt so alone.
Here Prof Fong explains how every nurse he met was traumatised by watching patients die, being only able to hold up ipads to their relatives and how it went against their normal practice of trying to ensure a dignified death, with family there.
Read 5 tweets
Aug 28
THREAD: I asked what the point of Public Inquiries is for @bmj_latest

We've spent hundreds of millions of £ on Inquiries over last decades, generating deep understanding of failures & 1000s of recommendations.

But v few recommendations get implemented!
What is going on?

1/12 Image
E.g. Covid-19 Inquiry has cost £94 million so far - and is projected to cost over £200m by its end (it still has years to go).

1st report published (out of at least 9) found major flaws and proposed 10 recommendations.

Chances are low that they will be implemented :-( 2/12


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Inst for Government looked at 68 Inquiries from 1990-2017.
The Inquiries cost over £630 million and made 2,625 recommendations.

Only 6/68 Inquiries have received full scrutiny by a parliamentary select committee on implementation of recommendations. 3/12 Image
Read 12 tweets
Aug 9
🧵War causes direct civilian deaths but also indirect deaths over the following years.

Recent paper estimates eventual total direct & indirect deaths in Gaza attributable to the war - 10% of entire pop'n.

I want to explain these estimates and why deaths must be counted. 1/13 Image
Why count casualties from war anyway? For moral, legal and strategic reasons.

1 - owe it to those who have died
2 - International law says must count & identify dead as far as possible
3 - monitor progress of war & learn from tactics

2/13 Image
There are direct and indirect casualties of war. Direct deaths include those who killed by fighting or bombs.

Indirect deaths are those that die when they would otherwise have lived because of one or more of: lack of food, healthcare, housing, sanitation, income, hope. 3/13 Image
Read 14 tweets
Aug 1
THREAD: the summer Covid wave in the UK continues.
Basically, there is a LOT of Covid around and not a lot of other respiratory viruses.

If you have cold or flu symptoms, it's probably Covid.

The latest hospital data from England shows steady, quite high levels. 1/8 Image
But admissions don't tell us how much virus is circulating more generally. The best (but imperfect) measure we have is wasterwater measurements, and only in Scotland and not England.

Scotland's wastewater is showing a huge July peak - highest since Omicron's 1st yr in 2022 2/8 Image
Because different people shed different amounts of virus and variants can matter too, you can't for sure infer how many people were infected between different wasterwater peaks. BUT given the size, I'd say it's pretty likely this is the largest peak since 2022 in Scotland 3/8
Read 8 tweets
Jul 23
THREAD:
I wrote about Baroness Hallett's Inquiry Module 1 report for @bmj_latest .

She found that there was *never* a plan to keep a pandemic death toll down - I discuss this and what it means going foward.

Main points below: 1/14 Image
The headline most seen is that the UK planned for the wrong pandemic.

While it is true that was far too narrow a focus on a flu pandemic, that is not the most telling bit.

To me the most telling bit, is what the plan did NOT do 2/14


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The issue is less the wrong disease, but that there was never a plan to prevent one at all – of any disease type.

The plan was *never* about reducing the number of pandemic deaths. 3/14 Image
Read 14 tweets

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