THREAD on EUROPE:
Many headlines today about Europe's third wave, what it means for us and, in particular, international travel.

thetimes.co.uk/article/surge-…

Some thoughts about what it means... 1/11
Firstly, the current increases in Europe are because B117 (the Kent strain) has become dominant there - move than 70% in Denmark, NL, 50-70% in France, Belgium, Itlay, Germany & Austria. 2/11
As with us in Dec, they didn't act decisively to stop its spread - instead they've been in semi-restrictions (similar to our tier 3) - enough to bring *down* cases of old variant but not enough to stop B117.

B117 was only 5-10% in EU early Feb 3/11
As long as you have more old than new variant it LOOKS like cases are under control, but as soon as B117 becomes dominant cases start rising. This is what has happened & it was predictable. In fact, I said in early Feb that March could be bad in EU.

4/11
Low vaccination isn't helping either. If anything, cases have risen more slowly in EU than in UK because they hospitality has largely been shut there for months & many places have curfews, mixing restrictions and strong masks mandates. But B117 is a tricky beast to control. 5/11
So what does that mean for us? Well, we're not going to get a new wave *because* of the current wave in EU in that we already have 98% of cases being B117 - we've had our B117 wave. If we get a new wave it will because of one of two things: 6/11
1) we open up too quickly without enough mitigations (and it will need more than just the vaccines) so that B117 surges again - as I said it's a tricky beast to keep contained. I'm worried that we've forgotten that because lockdown has been so effective. 7/11
2) we import new variants from EU that can resist our vaccines & start a wave of a new variant in what would effectively be much less "vaxxed" pop'n.

The SA variant (5-10% of cases in France) is already semi-resistant & SAGE are v worried about it.
theguardian.com/world/2021/mar… 8/11
As there are tens of thousands of new cases every day in Europe over next few weeks *and* millions of people vaxxed, conditions are created for new, more resistant, variants to emerge and spread. We definitely don't want to import those... 9/11
This is why international travel this summer is not a good idea.

If we can get people fully vaxxed, keep variants out this yr & give scientists time to produce boosters for new variants, we can boost people over winter ready to travel next year.

bbc.co.uk/news/uk-564678… 10/11
That is the best bet for avoiding another wave here - and avoiding illness, death & more restrictions.

Restricting our travel will mean much more chance of an open life here in the UK for this year. 11/11

PS thanks to @lukemshepherd for the plots!
PS Europe also shows why half measures just don't work - they damage the economy a lot but are just not enough to stop the new more transmissible strains (SA and Brazil also more infectious than the old variant) - and so things just drag on and on.

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More from @chrischirp

20 Mar
THREAD on SCHOOLS:

It's now 4 weeks since Scotland & Wales started a phased return to primary schools (secondary schools went back last week) & 2 weeks since all schools in England went back.

What is happening? 1/15
First let's look at Wales. They started sending young kids back to nursery and primary schools 22nd Feb. Older primary school kids & secondary school went back last week.

Wales publish new Covid incidents in schools - and (unsurprisingly) incidents are increasing. 2/15
Secondly, Scotland. There we have case data by age.

Primary school kids only get a test if they get symptoms. School staff can get tested without symptoms if they want. All positive cases from lateral flow device tests (LFDs) are PCR confirmed.

Testing has stayed flat. 3/15
Read 18 tweets
20 Mar
THREAD on vaccine effectiveness:

Public Health England released its updated report on real world effectiveness of Pfizer & AZ in England this week.
assets.publishing.service.gov.uk/government/upl…

I thought would be helpful to explain what they found...

TLDR: pretty good! 1/9
Firstly, both vaccines work almost equally well, so going to treat them as one in below.

Secondly, will focus on effect of ONE dose in OVER 80 year olds (most data!).

Effectiveness is higher in younger people and after second dose. 2/9
Right, so let's consider two lots of over 80s - 100,000 people in each group.

One group is unvaccinated and the other is more than two weeks out from their first dose.

(There seems very little real world protection for first two weeks after vaccination!!) 3/9
Read 10 tweets
17 Mar
THREAD on vaccination slowdown story:

TLDR: Don't panic!

Tonight a reduction is vaccine supply is being widely reported leading to a pause in rolling out vaccination to the under 50's... bbc.co.uk/news/uk-politi… 1/5
Basically, we gave about 11 million people their first dose mid Jan - mid Feb. They need their 2nd dose by end April.

We've been vaxxing about 2.5m/wk last few weeks, but let's say vax supply drops to about 2m/wk for April. Then we need ALL those doses to honour 2nd doses. 2/5
Once most of those are done, we can start rolling out vaccination to new people again (adults under 50) in May.

Assuming we can ramp up to 3.5m/wk from May, we can still offer everyone a 1st dose by mid July. 3/5
Read 6 tweets
17 Mar
THREAD on schools in England so far & what next:

Context:
A few million people already do Lateral Flow Device tests (LFDs) for work each week.

On 8th March schools reopened and secondary school students were asked to 3 LFDs at school - 2 last week and 1 early this week.
People with symptoms of Covid continue to get a single PCR tests.

People who test positive after taking LFDs at *home* or for health & care work can also get a PCR test to confirm the result.

People taking LFDs at work, at school or in a test centre do NOT get confirmatory PCR
IMPORTANT: PCR test results take a while to come through, so we can only ever use positive results from 4 or more days ago.

LFD test results report immediately, and so, where there is no confirmatory PCR, we can use test results up to yesterday.
Read 12 tweets
13 Mar
THREAD on Lateral Flow Device tests (LFDs):

They are being used more and more in England.

Thread about how they're used, why you NEED confirmatory PCR testing, how it will make interpretating case figures difficult as we open up.

#NerdyThread 1/19
LFDs are used to test people who don't have Covid symptoms - they give results in about 30 minutes.

The govt reckons about 30% of people with Covid don't have symptoms & this article suggested that asymptomic spread might account for 50% of cases.
jamanetwork.com/journals/jaman… 2/19
So the point is to find people who have Covid but don't know they have Covid & stop them mixing with, and potentially infecting, other people. 3/19
Read 23 tweets
12 Mar
THREAD on VACCINATIONS: how are we doing in England?

Although this week has seen fewer jabs, we've still given a dose to 2.5 million people over last 7 days.

It's also good to see 2nd doses starting to take off & 42% of people over 16 have had a dose.🍾

BUT some concerns 1/6
There are differences in coverage by deprivation. For over 70s, the differences are definitely there but high coverage in all groups.

The differences are starker by ethnicity, with black populations having the lowest coverage. 2/6
As ages get younger, the disparities by deprivation & ethnicity get more pronounced. Although coverage is still increasing for 65-69 year olds, it seems likely that coverage in most deprived populations will stay much below that of the least deprived & lower than 70+s. 3/6
Read 6 tweets

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