Rising test positivity may be due to prioritising tests for those with symptoms alongside the known large rises in cases in the community....
...REACT-1 survey (up to 26th Sept) says positivity rate in community is 0.55%, 411,000 people; ONS says it is about a quarter of this (104,000 people, up to 19th Sept) but that's still 9,600 new cases a day. Age profile largely similar to T&T.
Would be v interesting to see case numbers by age for each pillar separately to see if sheds any light on hospital use/outbreaks etc. PHE data suggest that still care homes and educational settings main settings for managed outbreaks.
First, of 29,037 cases transferred to the system, just 71% were reached compared to 80%+ for the preceding 4 weeks.
And the geographical variation is worrying. Currently T&T don’t publish that as weekly data by UTLA, but plan to look into this in more detail with colleagues soon. It’s really important for understanding how T&T impacts local transmission, case rates, lockdowns.
(AGAIN @DHSCgovuk, *PLEASE* provide data on cases managed by local authority led contact tracing systems. These are being introduced across the country and we need to know their impact as well as potential barriers to further success)
Of cases reached, just 624 are complex (outbreaks, high risk settings) and 20,077 are non-complex.
Yet – 4,898 cases were pillar 1 - NHS and PHE labs (those in hospital, health and care workers). 🤔
This either means complex cases are harder to reach than non complex, which I think is unlikely.
OR the lines between who is being tested under pillar 1 and 2 are getting increasingly blurred as test capacity - esp P2 - is stretched.
More people again provided details of contacts. Now 84%. This is great.
Total number of contacts is up just 5% on last week to 87,587, compared to 24% increase in number of cases giving details of contacts.
This is because there are relatively more non-complex cases being reached compared to last week, and they have fewer contacts per case.
Contacts per case for complex and non-complex are pretty much the same as past week at 30.5 and 3.4 contacts per case respectively.
The fall in the %age of total contacts reached to 71% (76% last week) is entirely explained by relatively more non-complex cases being managed.
The percentage of contacts reached for complex and non-complex has stayed the same at 98% and 64% respectively.
BUT again look at the geographic variation. This difference (esp NW) is marked. What role does this play in the current high case rates there??
The test turnaround time is actually BETTER this week for pillar 2. This represents a real achievement after previous trends.
But there is potential first sign in a while of pillar 1 performance dropping - to watch closely as may represent their capacity maxing out.
However, once a case is in T&T, significant drop in percentage of cases reached within 24hrs, as well as small drop in close contacts reached within 24hrs.
And finally, underlying all this "71% of cases reached ➡️85% give contact details ➡️72% of contacts reached" is the fact that current data suggest <20% of cases and just 11% of contacts isolate for the required time anyway.
So whilst T&T is part of what's needed to limit spread, it's clearly just one bit. We need clear communication, to trust the system, support when isolating.
And masks, distancing, and handwashing remain a far better way to control spread than isolating after diagnosis.
Gov data shows how price promos are more likely to be applied to unhealthy junk food rather than healthier foods.
And rather than saving people ££, they can lead to around 22% *more* purchases than would otherwise happen, with *more* money spent and *more* consumption.
That's why companies use these promotions.
That's also why the policy was in the obesity strategy in the first place. The irony being that it is more likely to help than hinder the impact of the cost of living crisis on individuals and families.
In today's @Telegraph, Sally O'Brien & I discuss @HealthFdn / @IpsosUK polling results on public attitudes to gov policy on alcohol, tobacco, & unhealthy food (no £-wall🔓)
🧵Tl,dr: While gov has a preference for individual responsibility, the public still think gov should act.
Gains in healthy life-expectancy have stalled, childhood obesity continues to rise, alcohol-related hospital admissions are up, and tobacco still causes over 500,000 admissions a year.
And there are huge inequalities with more deprived areas disproportionately impacted.
Yet the recent trend of unwinding public health policy continues.
The tobacco control plan is unpublished, junk food ad bans have been delayed, plans for a national approach to health inequalities have gone & there's been nothing on alcohol since 2012.
First the good news. COVID cases in hospital clearly falling, in all ages, regions (except perhaps still plateauing in Yorkshire and Humber).
There's still a lag on cases in intensive care and on deaths, but they'll drop soon as well.
Flu, however, seems to be on the rise.
Overall case & admission rates are relatively low, but trending up.
And with a higher % of lab respiratory samples (sent in by dr from people with chest symptoms) testing for flu than at the same time in the past 5 yrs. i.e., it's early
This is a really helpful and timely piece of work by @davidfinchthf.
Along with last week's @TheIFS report on how government ££ are spent, it's clear that we need to do more to align public health funding with local needs. 🧵
Over the last decade, gains in life expectancy in England have stalled.
And it will be no surprise that the impact has not been felt evenly by everyone.
While life expectancy continues to increase for people living in the least deprived parts of the country, people from the most deprived communities are dying earlier.
This type of shortsighted policy review has reared its head again.
Health is an *asset* & the types of obesity policies being looked at here are exactly the ones that are both most effective AND most likely to narrow inequalities. 🧵