Adam Briggs Profile picture
19 Nov, 15 tweets, 10 min read
Latest PHE flu & COVID surveillance report, up to 15th Nov.

- ⬆️Case rates in over 70yrs.
- ⬆️hospitalisations, ICU admissions & deaths.
- Big variation by region, ethnicity, age, and deprivation.
- (+ some good news on flu & flu jabs)

gov.uk/government/sta…
Confirmed cases of COVID plateaued this week, and positivity rates dropping.

Still probably a little early to see results of 6th Nov restrictions, but local restrictions likely important. And new use of lateral flow tests (pillar 2) may be contributing to lower positivity rates.
And case rates falling across most aged but crucially NOT among age 70yrs+
The North + Midlands vs South divide still v marked, but (generally) things improving in the N/Mids, and getting worse in the S.
Inequalities by ethnicity and deprivation are as stark as ever.
Also note differences by ethnicity b/w first wave and second. Other ethnic groups v over-represented in both, but people of Black ethnic groups far more likely to get infected in the first wave cf the second, and vice versa for ppl of some Asian ethnic groups.
Number of COVID outbreaks in primary and secondard schools has pretty much doubled this week (two wks after half term). Although ONS data suggest community case rates in school age children still flat or falling.
Tomorrow's ONS survey data by age will be interesting.
Also alongside the increase in cases over 70yrs, more outbreaks in care homes being reported.
After a slight pause last week, hospitalisations continue to climb across most of the country.
Although note NW where 4 weeks(ish) of falling case numbers seems to have slowed hospitalisations
And ICU admissions also still climbing, but more regional variation (look at East Mids).
Sadly deaths and excess mortality also following suit
But to finish on a more positive note. No flu-related hospital admissions this week, and just one case picked up through routine surveillance.
And flu vax uptake is the HIGHEST EVER at this stage for age 65+ & age 2-3years.

This is brilliant news and shows just how hard GPs & the teams involved have worked on this.

If you're eligible, please get vaccinated. You (and the NHS) really don't want flu right now.
In summary, whilst overall case numbers might be stabilising, they're still rising in over 70yrs+, the health system remains under huge pressure, and it's still likely to get worse before it gets better.
Please stay at home where you can.

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More from @ADMBriggs

19 Nov
Week 24 Test & Trace data summary. 05/11/20 – 11/11/20.

After two weeks of improvement, performance has stalled whilst the number of people testing positive continues to rise.

As ever, summary in pictures, detail in thread👇

gov.uk/government/pub… ImageImageImageImage
12% increase in people getting tested which is good (now 1.74m in a week(!)), but note from 6th Nov, pillar 2 now includes people having the rapid lateral flow tests (e.g. Liverpool pilot) and this will only increase in numbers.
The knock-on impact is lower P2 positivity rates. ImageImageImage
The implications of this is that it makes it far harder to interpret positivity rates, esp if you don't separate out test device, or asymptomatic vs symptomatic testing.
Read 19 tweets
18 Nov
Irrespective of the fact that 50,000 of 5,000,000 is 1% rather than 0.1%, here's a v short selection of data that might help to clarify some of the differences between flu and COVID-19.

Short thread.
Fortunately, @PHE_uk have a flu surveillance programme.

Over past 5yrs, the worst flu season saw an estimated 22k deaths in Eng (2017/18).

So far ONS have recorded 55k deaths including COVID. Gov.uk estimate 46k.

It's not yet December.

assets.publishing.service.gov.uk/government/upl…
Hospital admission rates from flu in the past five years peaked in 2017/18 at around 10/100,000.

In the first week of November, it was already >14/100,000 and >25/100,000 in the NE.
Read 5 tweets
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
12 Nov
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.
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

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