Adam Briggs Profile picture
Oct 1, 2020 24 tweets 14 min read Read on X
Week 17 Test & Trace data summary. 17/09/20 – 23/09/20.

Not a pretty picture.

Cases ⬆️61%.
Tests ↔️
Test positivity rate ++⬆️from 3.3% to 5.3% (+ some useful detail by age)

Test and Trace performance worse.

gov.uk/government/pub…

Summary in picture, detail in thread 👇
Despite no change in number of tests,

- cases in pillar 1 ⬆️34% from 3,653 to 4,898 (NHS/PHE labs – outbreaks/hospital)
- cases in pillar 2 ⬆️67% from 15,853 to 26,475 (community)

Means positivity for pillar 2 ⬆️from 3.3% to 6.7%
And pillar 1 ⬆️from 1.8% to 2.5%
And like @PHE_uk surveillance, they now give data by age

Case numbers still dominated by 20-29/yr olds, but growth in cases across all ages (except 90+)

And there are big differences by age, steep rises across all age gps b/w 20-70yrs
0-19yrs much less change in positivity rate
And despite smaller numbers, older people are now in hospital and intensive care

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.

In terms of T&T performance, it’s not great.

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.
@TimHarford @devisridhar @FurberA @andrewleedr @Dr_D_Robertson
Tagging a few additional people who may be interested. Do say if not the case.
And also linking in our explainer on T&T in case it's useful for those who haven't yet seen

health.org.uk/publications/l…

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More from @ADMBriggs

Jun 28, 2023
Out in @Telegraph today (no ££-wall)

Tl,dr: Scotland has shown that minimum unit pricing works but as deaths from alcohol rise, the government remains silent on alcohol policy in England.

telegraph.co.uk/global-health/…
Yesterday, the Scottish government published the final Minimum Unit Pricing (MUP) evaluation report.

It showed:
- alcohol deaths ⬇️13%
- hospital admissions ⬇️4%
-⬇️inequalities
- no obv impact on business

publichealthscotland.scot/publications/e…
Public Health Scotland now supports MUP and Wales implemented it in 2020.

But England hasn't had a national alcohol strategy since 2012.

gov.uk/government/pub…
Read 16 tweets
Jun 17, 2023
I know I'm late to this news and shouldn't be in any way surprised, but it is still so utterly infuriating.

Delayed again until 2025 pending a review.

Very short🧵

bbc.co.uk/news/uk-659367…
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. Image
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.
Read 11 tweets
Mar 10, 2023
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. ImageImageImageImage
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.

health.org.uk/news-and-comme…
Read 19 tweets
Oct 27, 2022
This week's @UKHSA COVID and Flu surveillance report came out today.

tl,dr: COVID rates are falling but Flu case rates on the up, as is RSV.

gov.uk/government/sta…
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
Read 12 tweets
Oct 26, 2022
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. 🧵

ifs.org.uk/publications/d…
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.

It's entirely avoidable.
Read 22 tweets
Sep 13, 2022
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. 🧵

theguardian.com/politics/2022/…
Rates of obesity and overweight among children took a huge jump during the pandemic - particularly among more deprived communities.

In an average yr 6 class of 30, 12 will have overweight or obesity.

This thread discusses the data in detail 👇
Image
The government is aiming to halve childhood obesity by 2030 and reduce inequalities.

As have said previously, obesity is complex and multifaceted. No one policy will do it and instead it needs a multifaceted solution.

health.org.uk/publications/r…
Read 13 tweets

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