Adam Briggs Profile picture
25 Mar, 23 tweets, 13 min read
This week's PHE surveillance report is now out, covering 15-21 March. 🧵

- increasing case rates among 5-9y/o and 10-19y/o
- important geographic variation
- hospital data still improving
- vax going strong
- and inequalities persist.…
Number of PCR and LFD tests done similar to the previous week, but positivity (percentage of tests that are positive) for PCR still trending down and is now 2.1%

For LFDs it's 0.19% compared with 0.15% the week before.
Case rates are falling less slowly, but they're still falling across all ages...

*except* 5-9y/o where they're up 59% to 63.5/100,000, and 10-19y/o where they're up 26% to 100.7/100,000.

Case rates lowest in vaccinated cohorts.
LFD testing among school children will have a role in higher case rates among 10-19y/o but don't tell the whole story.

5-9y/o aren't (or at least, shouldn't) be being tested with LFDs, so more likely higher case rates are due to PCR symptomatic testing.
As @chrischirp summarised yesterday, it's consistent with some school spread & is expected.

If/how much this leads to infections in other age gps over coming weeks will be more important, & how much regular testing/masks etc have helped limit transmission
The change in case rates by age differs by region.

Yorkshire and Humber now have the highest case rates and you can see how this is driven by rising case rates among 10-19y/o.
And as lock down begins to ease, some really stark differences by local authority

Esp N vs S, with highest rates in Barnsley at 185/100,000 and the lowest in Devon at just 14/100,000
Many places that have had high ongoing case rates since last summer continue to have high rates now - places like Bolton, Leicester, Wigan, Blackburn with Darwen all still have rates of >100/100,000.
These are places where many people can't work from home, with high levels of job insecurity, crowded housing, caring responsibilities, high levels of deprivation.

This means more exposure to the virus and it being hard, if not impossible, to comply with isolation guidelines
The very places impacted most by lockdown will take the longest to recover because of the long term structural drivers of poor health and inequalities - housing, employment, poverty, healthy places.
It's a huge issue of social justice. And it effects everyone.

Without addressing areas of enduring transmission, gov cannot level up, there will still be outbreaks and emergent variants.
Just on Weds, Matt Hancock said "levelling up health outcomes is the most important levelling up of all".

Meaningful change will need action on inequalities across gov, in every decision in every dept

Otherwise we risk another @MichaelMarmot lost decade…
There are still some differences in case rates by ethnicity, more prominent when looked at at the regional level.
And differences in case rates by deprivation remain as evident as ever.
In terms of outbreaks/incidents reported to PHE.

Really great to see another big drop in care homes.
But an expected step up in schools.

The trends here are what's important rather than absolute amounts and this is still just the second wk back.
Next wk's data for school age cases and outbreaks will be a far better indicator of impact of schools opening than this wk.
Still v low numbers of outbreaks reported to PHE among hospitals and importantly in workplaces as well.
Whilst case rates might be mixed, the hospital situation is looking really positive.

Admission rates still falling in all ages (incl. not vaccinated cohorts) and regions. And numbers in hospital at around a quarter of the first wave.
ICU data equally positive, albeit with a little more wk by wk fluctuation.
And the impact of falling case rates plus the vaccination on the numbers of deaths is dramatic.
On the vaccination front, encouragingly the *vast* majority of people being offered are taking it up as we move down through JCVI cohorts.

And same as last wk, it's important to say that those who haven't yet been vaccinated in priority groups are more likely to be from more deprived, vulnerable & minority groups.

Groups most impacted by COVID.

It's therefore critical that efforts to reach these people continue.

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More from @ADMBriggs

27 Mar
If this is true, it is so disappointingly shortsighted.

I hope that @MattHancock and @Jochurchill4 will reconsider.

A quick walk through the evidence. 🧵
Nearly one in four reception age children and one in three children at year 6 are overweight or obese.

And there are stark inequalities - children in yr 6 are *more than twice* as likely to be obese if living in the most deprived areas compared to the least. ImageImage
The government is aiming to halve childhood obesity by 2030 and reduce inequalities.

You can't do this with one or two policies here and there. Obesity is complex and multifaceted. To make any kind of dent, you need a multifaceted solution.…
Read 19 tweets
25 Mar
And most recent T&T data, 11/3 to 17/3. 🧵

- More testing
- Fewer cases
- And the numbers of non-household close contacts is rising again.

This week, just a short thread to pull out main points.… Image
Small increase in number of people tested but rise of 1.3m in number of LFDs used, driven by secondary schools. ImageImageImage
And case rates generally still falling, except among school age children

Read 10 tweets
24 Mar
Matt Hancock speaking at #LGAPublicHealth21.

The language has officially changed from health protection to health security - with the launch of the UK Health Security Agency, or UKHSA.
Will cover pandemic prevention and response, communicable disease, and external threats.

Chief Exec will be Dr Jenny Harries (Dep CMO with hugely impressive public health background)
Chair is Ian Peters, current Chair of @NHSBartsHealth
The challenge (as ever) will be maintaining interest and funding for the agency in between crises.

Stresses importance of relationships with DsPH, although no mention yet of local PHE Health Protection Teams who have also been critical in local response as well.
Read 8 tweets
18 Mar
This week's PHE surveillance report, covers 8th-14th March. 🧵

- cases falling but LFDs making it a harder to follow trends
- Still important inequalities by local authority, ethnicity, & deprivation.
- And good news on vaccines and seroprevalence…
case rates continue to drop, but increasingly difficult to interpret pillar 2 data (community testing) here as it includes both lateral flow devices (LFDs) for those without symptoms, and PCR tests for those with symptoms.
This is laid out here - LFD test use over 5m in the most recent week reported, with positivity 0.15% compared with 2.4% among PCR tests.
Read 22 tweets
17 Mar
The Test & Trace budget for 2021/22 is £15bn.

There's no specific remit letter and whilst a new strategy is awaited (see @CommonsPAC report), the most recent T&T business plan from Dec 2020 covers four key priority areas.…
Unpacking these.

For 'Team of Teams' - it's a lots of local gov led programmes: community testing, local contact tracing, support for self-isolation, and local outbreak management.
Read 11 tweets
11 Mar
This week's T&T report. Covers 25th Feb - 3rd March.

More LFDs - esp in secondary schools,
fewer cases,
more close contacts per case,
and fewer of them from the same household as the case.

Detail in 🧵…
A pretty astonishing 3.13 million people tested in the week.

This is the most since T&T launched. Until next week's data.
This is because of the large scale roll-out of LFDs.

There were 2.76m used in week ending 3rd March, compared with 2.23 the week before, with 2/3 of the increase in use coming from secondary schools.

PCR use dropped slightly over the same period.
Read 18 tweets

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