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Christina Pagel Profile picture
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22 Feb, 5 tweets, 2 min read
This article by @bealelab explaining the different Covid variants, possible impacts on vaccine effectiveness & future of the pandemic is quite simply one of the best I've ever read. lrb.co.uk/the-paper/v43/…

Some key bits highlighted below!!
This bit explains how vaccines tartget lots of different bits of Covid to provide protection - so that even if the virus gets better at one bit, vaccines can still work by stopping other bits. This is what the case with B117 (the Kent strain).
this section highlights the success of the UK vaccination programme so far
While this bit explains perfectly the danger of allowing uncontrolled spread through younger people (inc kids). A vaccine resistant mutation might be as unlikely as winning the lottery, but if you buy millions of tickets (each infection a ticket) then it gets much likelier!
And finally this bit compares a "flu" endpoint to a "measles" endpoint...

Anyway go read the whole thing! It's brilliant! lrb.co.uk/the-paper/v43/…

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More from @chrischirp

Christina Pagel Profile picture
23 Feb
1. LONG THREAD ON COVID, LOCKDOWN & THE ROADMAP:

TLDR: There’s a lot to like about the roadmap – but it could be & should be made much more effective.

Because this will be tying current situation to the roadmap, I’m concentrating on English data

Read on… (22 tweets - sorry)
2. Firstly, cases across England are falling. This is good news but the pace of reduction is slowing.

England has the highest case rate in the UK and the nations with lower case rates (on the order of 100 cases/100,000 pop/week) are plateauing even more ImageImage
3. The worry is that the more transmissible new strain + many people still out at work, often in non-Covid safe workplaces, means it might be hard to get much below 100/100K/wk , esp in deprived areas, even under current restrictions.

The new strain now dominant everywhere. Image
Read 23 tweets
Christina Pagel Profile picture
21 Feb
THREAD ON LONG COVID & KIDS:

TLDR: I don't think we should ignore it.

ONS Infection survey updated its estimates for Long Covid a couple of weeks ago.

assets.publishing.service.gov.uk/government/upl…
It showed that 13% of under 11's and about 15% of 12-16 yr olds reported at least one symptom 5 weeks after confirmed Covid-19 infection.

ONS samples households randomly - so positive cases do not depend on having had symptoms & being tested.
Many have criticised this data because there is no comparator group of kids who had *not* tested positive for Covid and because some of the symptoms are common in childhood. (e.g. fever, cough)

These are perfectly valid criticisms and ideally we would have that.

BUT
Read 16 tweets
Christina Pagel Profile picture
18 Feb
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
Read 5 tweets
Christina Pagel Profile picture
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
Christina Pagel Profile picture
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
Christina Pagel Profile picture
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
PS source for reinfecting people for SA:
Read 4 tweets

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