QUICK THREAD ON LATERAL FLOW DEVICE (LFD) TESTS:

LFD tests are mainly used for testing people without symptoms and PCR tests are used for those with (new) symptoms.

LFD tests now outnumber PCR tests every week. 1/4
Unsurprisingly positivity rates for PCR tests are much higher than for LFD tests. Reassuringly positivity rates are coming down in both cohorts.

BUT if we are relying more on more on LFD tests then we *must* use them carefully! 2/4
Firstly, they should NEVER be used as a "green light" to indicate no infection - only as a "red light" to indicate that you've got Covid and should isolate.

Do a confirmatory PCR for positive LFDs to minimise false positives & ENSURE support for isolation! 3/4
this messaging at the moment is the wrong way round and dangerous as pointed out by @ReicherStephen .

He also highlighted the importance of supported isolation here 4/4
PS I do think that used very carefully with proper confirmatory testing & support for isolation, they could be a valuable public health tool in some high traffic settings.

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More from @chrischirp

15 Feb
THREAD ON UK VACCINATION PROGRAMME:

TLDR: At 3 mill doses/week expect a big slowdown in *first* doses in April/May. But then summer ramp up to vaccinate all adults by early September.

Increasing to *6 mill/wk* for *6 wks* in April/May could vax everyone by mid July. 1/6
This is where we are now (latest weekly data to 7 Feb). Almost all vaccinations are first dose now.

Vaccination numbers levelling out at about 3 million a week.

But in early March we need to start giving 2nd doses... 2/6
*If* we stay at 3 mill/wk doses, by May ALL those 3 mill doses will be spent giving 2nd doses to people vaccinated in Feb.

In June 1st dose ramps up again & all adults offered 1st dose by end July. Using 3 mill/wk for 2nd doses means all offered 2 doses by early Sept

BUT 3/6
Read 8 tweets
12 Feb
1. THREAD on latest UK Covid Numbers:

A reasonably detailed dive into the latest numbers & (some) implications.

TLDR: things going in right direction but don't think unlocking will be easy.
2. Confirmed cases are still falling & we are back at levels last seen in early December. Positivity rates (accounting for changes in numbers of tests) are also falling in all 4 nations (and in all age groups).

ONS infection survey entirely consistent with this picture.
3. Cases and positivity rates also falling across all English regions & LAs. However, E. Mids, Yorks & Humber and N.East falling slowest.

Obviously falls are GOOD, BUT the green diamonds show where we were at the end of Aug last year.

There is a LONG way to go.
Read 20 tweets
9 Feb
MINI THREAD: One way in which the Kent (B117) variant might help us vs SA variant... Both are more transmissible that older variants & so quickly become dominant.

BUT SA not more transmissible than Kent (we think) - so Kent, already dominant in UK, should stay dominant. 1/2
This is good because all vaccines work well against Kent (B117) & it doesn't seem to be re-infecting people who've already had covid.

But SA can re-infect people & evade (somewhat) AZ vax. Unknown is how that might help SA over time as it has more people it can spread to. 2/2
Read 4 tweets
6 Feb
THREAD ON FLU:
Just an attempt to start a conversation about annual flu.

I'm not an expert on this at all and welcome people's thoughts and insights...

Basic question is: how many annual flu deaths are acceptable? 1/7
In a "normal" year there might be c. 10,000 deaths from flu in England & Wales, mostly in people over 65.(greenwichccg.nhs.uk/News-Publicati…),

Timing & number varies depending on flu strain, how good that year's vaccine is & vaccine uptake.

Flu is also LESS infectious than Covid. 2/7
And the measures that work against Covid, work against Flu -> so this year we've seen HARDLY ANY flu.

The chart below compares English hospital flu admissions - but same picture for GP swabs, 111 calls etc.

Same across Europe (flunewseurope.org) 3/7
Read 7 tweets
29 Jan
SHORT THREAD ON SCHOOLS:
When schools go back is a tricky issue. I'm not going to get into it here BUT wanted to highlight a couple of data points from PHE surveillance & ONS infection survey this week. 1/5
Firstly, since early Jan, there have been a number of outbreaks at nurseries (open) & special need schools (30% attendance) (and yes - Covid).

A few at primary schools (20% attendance) and v few at 2nd-ary schools (5% attendance). 2/5
Added to that among young school age kids, case rates going down for primary school ages but UP in pre-school and nursery age children.

Secondary school age going down (not shown). 3/5
Read 5 tweets
29 Jan
MINI THREAD ON HOSPITALISATIONS:

The number of people in hospital with Covid is either flat or coming down in all 4 nations - excellent and a sign that infections really are going down (at least in older groups).

BUT they are still higher than April peak everywhere 1/4
In England, hospital admissions are now coming steadily down from 12th Jan peak and are now below the April peak too... good! 2/4
This is true for all regions of England (good!). You can see that they started going down in previous tier 4 regions (London, SE, EoE) about 7-10 days earlier than other regions. 3/4
Read 4 tweets

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