PHE COVID surveillance report out covering 22nd-28th Feb, plus also today's REACT data. 🧵

tl,dr. Things are getting better but inequalities continue to persist.

gov.uk/government/sta…
Case rates have continued to drop in all ages.

And check out how rates in 80+y/o were tracking with those aged 20-60yrs
but over the last few weeks the rate of decline has accelerated to track more closely with those aged 60-80yrs.
After positivity went a bit wild last week (half term and therefore far fewer LFDs being done) reassuring it's back to similar trends to the week before.

Having said this, pillar 2 positivity is really hard to interpret now as includes LFDs and PCR.
PHE do publish an overall chart of PCR and LFD positivity.

Can see the big drop in LFD use for half term week and how overall LFD positivity is just 0.3% compared with 3.6% for PCR tests
Case rates dropping across regions, with clear lower rates in the south (SE, SW, East Mid, London) compared with the north.

London picture here is different to today's REACT study prevalence data, so worth interpreting how PHE data might relate to pop'n prevalence with caution.
The deprivation data between REACT and PHE does correlate, however.

People from more deprived areas persistently have higher infection rates.
For brief summary of today's REACT study findings, see here
The differences in cases rates by ethnicity persist but are less striking that at the January peak.

REACT shows still important differences in infection prevalence (and note - REACT is a representative population sample whereas PHE is only people who choose to get tested)
Despite drop in cases among over 70y/o, there's no big change in number of outbreaks reported in care homes.

It may be that these result in less hospitalisations/deaths than before (see later in thread) but it's still v important to vaccinate any unvaccinated staff/residents
Reported outbreaks in hospitals and workplaces remain unchanged.
And there's a particularly striking fall in outbreaks reported to PHE in educational settings. Not sure why.
When it comes to hospital admission rates, these are still falling relatively quickly for all ages, and especially 75+.
Also falling in all regions although there's a lag in West Mids.
However, despite care rates falling, the total number in hospital is still only just dipped below the November peak.
For ICU, despite younger people generally being those admitted and much of that population unlikely yet to be vaccinated, the fall in admission rates is really encouraging.
Falling as fast among 45-64y/o as 65-74y/o.
It's also falling across all regions, although notably not as quickly in East Mids and Yorkshire and Humber
And whilst admission rates are falling, ICU bed use is still considerably higher than Nov peak.
Finally, deaths rates still plummeting and excess mortality suggests we may be getting closer to what would be expected this time of the year

(some caution - there is always a delay in the most recent death registrations and this year there's absolutely no flu)
All in all, it's a relatively good picture as we get closer to opening schools, although there are still a lot of people in hospital.

And until we meaningfully engage in the underlying structural drivers, inequalities will persist.

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More from @ADMBriggs

4 Mar
Latest T&T data out, covers 18-24th Feb.

Bit of a dive into testing and LFD use this week.

Tl,dr: Tests up (all LFDs), cases down, and performance relatively unchanged.

Summary in pic, detail in 🧵

gov.uk/government/pub…
There were 2.8m people tested, up 9% on the week before but still down from 3m two weeks' before.

This was all pillar 2 (community testing), up 14%. People tested using pillar 1 (HCWs and those in clinical need) fell 12%.
And more specifically, this was all lateral flow devices (LFDs) - rapid tests for people aiming to find cases among those without symptoms.

The number of LFDs used increased by 470k to 2.2m, whereas the number of pillar 2 PCR tests dropped slightly.
Read 19 tweets
4 Mar
Latest REACT-1 study now published suggesting prevalence of COVID in England of 0.5% between 4th-23rd Feb (round 9).

Two-thirds lower than the 1.6% reported over the same period in Jan (round 8).

But big variation by region, ethnicity, and deprivation. 1/4
Higher chance of infection among Asian ethnic groups, if more deprived, bigger households, and if health/care worker. 2/4
And whilst still declining everywhere, higher prevalence in NE, London, East Mids, with some signs that falls are stalling in London, West Mids, and SE.

Finally, lowest prevalence in 65+ but big drops across the board. 3/4
Read 4 tweets
26 Feb
This week's T&T update. Covers 11th-17th Feb.

Tl,dr
testing, cases, and contacts all down
performance steady
and a critical need to tackle inequalities.

gov.uk/government/pub…
First decent fall in number of people being tested this week (not including Christmas/NY).

Down 14% to 2.6m.
Lateral flow device (LFD) use for people w/o symptoms has fallen for the first time as well as PCR.

Part this will be because this week covers the first few days of the school half term (15-19 Feb) and much of LFD use is in schools.

Would expect this to bounce up again next wk
Read 19 tweets
25 Feb
This week's PHE surveillance report now out. Covers 15-21 Feb (half term).

Case rates falling, vaccinations increasing, but inequalities being exposed and still a lot of people in hospital and on ICU. 🧵

gov.uk/government/sta…
Fall in case rates beginning to level off except in 70-79yrs and 80+, the vaccine is playing it's part!
For regions, there is now a distinct and worrying split between low case rates in the south of England, and higher case rates in the north.
Read 22 tweets
23 Feb
I know others will have found these things before me but I've been home-schooling all day so only getting round to reading the roadmap now.

A few things stick out on first pass

(tl,dr: inequalities, testing, isolation support, social care, and inequalities).
There's a section on 'Test, Trace and Isolate' (who says NHS Test and Trace has a branding problem).

As expected, big focus on testing plus a further £400m for local gov through the contain outbreak mgmt fund - details tbc but likely much is for local testing/variant mgmt. ImageImage
As have said, there remains a big challenge of people not getting tested in the first place (fear of being unable to isolate, job insecurity, caring responsibilities etc). Surveys suggest just 1/3 get tested regularly if symptomatic.
Read 12 tweets
18 Feb
This week's PHE COVID surveillance report now out.

Most recent week covers 8th-14th Feb.

tl,dr: Things continue to improve but NHS bed/ICU situation has only *just* dipped below April peak. And some potentially worrying regional variation.

gov.uk/government/sta…
Case rates and positivity falling relatively fast. And across all ages.
Percentage of tests positive also falling, but this pillar 2 (community testing) graph has also been causing people some concern re young school children and returning to school - despite reported case rates being the lowest of all age gps.
Read 23 tweets

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