@ADPHUK Explainer: COVID-19 Vaccination

Be in no doubt of the scale of the challenge on this
Credit to the enormous effort of many who have made huge effort to get this one going

More to do

My take on the key challenges from perspective of jobbing DPH

1 Commitment to shared owenship of the strategy.
With co ownership completely happy with co accountability
Some of same issues re central v local balance remain.
Need close involvement of LA and VCS as partners in delivery. Can do things the NHS cant, cant get to places the NHS cant.
LA & VCS has to have input to make it max successful in the time frame
2 Need a single place based story and narrative on the programme.

Single briefing
3 Much more up front ownership of inequalities. We risk exacerbating inequalities by focus only on numbers
We will do the easy stuff
Not wrong but easy to forget the vulnerable
Dont need to rewrite the priority criteria but LOTS of tried and tested health prom to get coverage high in high priority groups
4 Data
We need granular data on who has been vaccinated with identifiers so as we can do analysis of coverage by groups we are most worried about. A national (or even CCG / LA or ICS) level numerator number is excellent, and helpful. But needs denominator.
The numerator alone is great. but we need by geography, AND with denominator AND ability to be on top of which groups within our population ARE and AREN'T getting vaccinated. And thus ability to flex our interventions to address inequality in uptake
5 confidence on supply
Know and accept it's hard but need as much info as poss to operationally plan
6 Comms
Locally flexed and nuanced
Use of community opinion leaders
Where there is a void it will be filled by less than helpful stuff
There are vacuums building, into that void will go antivax nonsense. Really need a locally driven approach to this as well as national
People have concerns about safety andwe need to address them head on. A single apprioach driven nationally wont cut it
None of these are insurmountable
And as I say I dont underestimate the giant effort thus far
Together we can achieve more

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More from @felly500

25 Oct 20
North / South epidemiology and the economic implications 

A thread 

A few have asked why the north has far higher rate of infection and why take off faster

(It is one for the epidemiologists to sort

Probably no single answer)

Why sooner & faster in north

timing lockdown release in June & differential impact

London had earlier peak (more concentrated pop, more connected city, travel related seeding) but had subsided to lower level of infection than rest of country (particularly north) by mid June
Was once a good BBC analysis on the impact of release of national lockdown on deaths in the north 

Argument was lockdown end was timed to epidemic curve in London

Read 24 tweets
24 Oct 20
Genomic evidence for reinfection with SARS-CoV-2:
*a case study*

These findings suggest that the patient was infected on 2 separate occasions by a genetically distinct virus
previous exposure to SARS-CoV-2 might not guarantee total immunity in all cases

All individuals, whether previously diagnosed with COVID-19 or not, should take identical precautions to avoid infection with SARS-CoV-2.

The implications of reinfections could be relevant for vaccine development and applicatio
What reinfections mean for COVID-19

This information is key to understanding which vaccines are capable of crossing that threshold to confer individual and herd immunity

Read 4 tweets
24 Oct 20
Adherence to the test, trace and isolate system
September 2020

42,127 responses from 31,787 people 
21 survey waves

48.9% of participants identified key symptoms 


Self-reported adherence to test, trace & isolate behaviours was low
self-isolation 18.2%
requesting an antigen test 11.9%
intention to share details of close contacts 76.1%
quarantining 10.9%

largely stable over time

*intention* to adhere to protective measures much higher
Non-adherence associated 
with: men, younger age, having a dependent child, lower income, greater hardship during the pandemic, & working in a key sector

Read 4 tweets
23 Sep 20
herd immunity crops up a lot in my inbox over recent days

a thread

a lot now seem of the view that we should just simply do a rebalance of our approach to strategy on harm to individuals vs harm to the economy

the line of argument is we have got the balance wrong.

blunt tools (lockdown and whatever that means) we have supressed the virus but only delayed the point at which it comes back (as we are now seeing).

Read 16 tweets
23 Sep 20
Sheffield briefing on COVID 19 and Q&A with the Outbreak Management Board
book here

Booking a COVID-19 Test at a Sheffield Testing Centre

Read 5 tweets
19 Sep 20
ONS survey

clear picture that infection rates are growing in September, and this is driven by infection in people aged 17-34

12-16s show no increase yet, this is not evidence that schools are part of the current infection problem

expert reaction to latest R number and growth rates published by the government

ONS estimates that infections doubled in almost all age groups apart from 70+ & 12-16, so the trend is shifting from mainly young people testing +ve that we saw recently

only a matter of time before the infections start spreading to the most vulnerable populations

Read 7 tweets

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