Adam Briggs Profile picture
12 Nov, 15 tweets, 11 min read
PHE's weekly surveillance report covering 2/11 to 8/11, short thread.

tl,dr - still lots of COVID, and still no flu.

gov.uk/government/sta…
Lots happened during this week
- schools back after half term
- Liverpool's mass testing started on 6th Nov
- national restrictions (second lockdown-ish) started 5th Nov
Number of cases continued to rise, but overall positivity dipped for the first time suggesting more testing now being done.

As mass testing starts, gets increasingly important to separate asymptomatic from symptomatic testing.
Case rates rising in EVERY age group. And still highest in 20-29y/o, but rising relatively quickly in some of the older age gps, esp 80+
Decline in case rates in NW really encouraging, but the continued steep rise across the Midlands is concerning.

Case rates generally much lower (and more stable) across S and E, compared to N and Midlands.
Note, that these data (and nor will the following two weeks) reflect the impact of current lockdown, but regional tiered restrictions will be having an effect.
In inequalities by ethnicity and deprivation remain marked.
Probably the best two figures in the report.

Zero cases of flu detected through national surveillance, and one flu (A) related hospital admission.
As would expect, post half-term the number of clusters/incidents for primary/secondary educational settings continues to fall, but also look at college/uni. Almost none.

Despite this, most cases are still among student age cohort, but numbers falling.
More concerning, relatively large jump in incidents in care homes.

The vaccine can't come fast enough for these settings pre-winter.
Finally, again as expected, hospital admission rates go ever upwards.

NE particularly hard hit, East Midlands also rising - there's a 10-14 day lag b/w infection and admission, so current infection rates in those >60yrs directly translate to admissions down the line.
This then translates to intensive care admissions.
These are rising everywhere as increasing numbers of older people are infected
Trends in deaths still upwards (interpret most recent week with caution as deaths are registered).

And clear excess mortality, especially NW.
I really hope that current restrictions translate into slowing of rates of hospitalisations & deaths, but won't know for 3-4 weeks, earliest.
Fall in case rates in NW is encouraging, and suggests that restrictions may be having some impact in among everything else going on.

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More from @ADMBriggs

12 Nov
Week 23 Test & Trace data summary. 29/10/20 – 04/11/20.

It's getting better but there's still a way to go.

Summary in pictures, detail in thread 👇

gov.uk/government/pub… Image
>1.5m people tested this week, 2% more than last week.

So whilst testing capacity's grown, it's not translating into more people being tested.

Number of positives up 8% as well to 149,253, across both pillar 1 and pillar 2. ImageImageImageImage
So despite more capacity, positivity ⬆️this wk (to 11.5% in P2, 5.1% in P1). Although today's PHE data suggests this rise may be stalling.

And still not separating symptomatic vs non-symptomatic testing, plus these results are before L'pool mass testing. ImageImage
Read 15 tweets
11 Nov
This is v helpful thread from @ScienceShared.

One thing missing is positive predictive and negative predictive values (PPV and NPV) that crucially depend on what proportion of people being tested have disease - the prevalence.
Take recent ONS survey - 1.1% of pop infected: PPV is 73%, meaning around 1 in 4 positive tests are false positives
(NPV is 99.7% - if you test -ve, you are)

Test 1000 people: there will be 8 true positives, 3 false positives, 3 false negatives, and 986 true negatives.
If in NW where prevalence is 2.2%, PPV rises to 84% (about 1 in 6 positive tests are false)

BUT in SE, prevalence is 0.5% meaning PPV is 55%, i.e. every other positive result is a false positive.
Read 8 tweets
5 Nov
Week 22 Test & Trace data summary. 22/10/20 – 28/10/20.

Tests⬇️, cases⬆️

Turnaround times much better, but overall performance unchanged meaning over 24,000 cases and 131,000 contacts still not reached.

Summary in pics, detail in thread

gov.uk/government/pub…
There were 1,482,528 individuals tested this week, which is actually 3% lower than the week before.

However, number of positive tests up by 8% to 137,180 (similar % increase for P1 and P2)

Plus now >10m people in Eng have been tested at least once - that's quite something.
Positivity rates climbing ever higher, and is now 10.9% in pillar 2 (9.9% the week before) and 4.8% in pillar 1 (4.2% the week before).

To make full sense of the picture, need to separate symptomatic vs asymptomatic testing. But shows STILL unlikely to be testing enough.
Read 22 tweets
5 Nov
PHE weekly flu and covid surveillance report for cases between 26/10 and 1/11.

Some takeaways.

TL;DR: hospitals are filling up, and not from flu.

assets.publishing.service.gov.uk/government/upl…
Slight drop in cases wk on wk, but positivity rate still rising. This essentially means we're still not doing enough tests.

(note, ONS survey to 23/10 suggests community cases still rising fast, at 52,000/day, approx 3 times as many)
Case rates falling in <40y/o (but still account for a little over half of cases), but rising in >40y/o.

Positivity rates for pillar 2 upwards of 15% for 10-19y/o. This is really high (WHO said in May should be <5% for easing lockdown measures).
Read 11 tweets
5 Nov
Latest update to our @HealthFdn Test and Trace performance tracker, with @cfraserepi:

health.org.uk/news-and-comme…
-Nearly 140,000 cases were handled in the most recent wk, 16% more than the previous week & a nine-fold increase since the start of September.

-The system has consistently been able to reach over 80% of cases, however the percentage of contacts reached stubbornly remains at 60%
-So, whilst 115,000 cases & 196,000 contacts were reached & advised to isolate, over 24,000 cases and 131,000 contacts weren’t.

The system is still far from achieving the 80% of contacts needed for the effective system recommended by the government’s SAGE.
Read 4 tweets
29 Oct
Week 21 Test & Trace data summary. 15/10/20 – 21/10/20.

Tests⬆️, cases⬆️, positivity⬆️, contacts⬆️.

And whilst performance on contact tracing is similar to last week in many areas, it's taking ever longer.

Summary in picture, detail in thread 👇

gov.uk/government/pub…
More individuals than every are being tested each week. Over 1.5m in the for the most recent week.

This is no small achievement.
Case numbers are also rising. Up 23% to 126,065 in 15/10-21/10.

Positivity also rising for both pillar 1 (NHS/PHE labs) - now 4.1%, and pillar 2 (community) - now 9.9%.

Today's PHE surveillance report to 25/10 shows very similar data.
Read 25 tweets

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