ONS data just out- as expected, clear rises in SARS-CoV-2 prevalence in Scotland. Levelling off in all other regions, and rises in several regions in England. Positivity highest among primary & secondary school children across all age groups & trending upwards. Thread.
Rises in overall infection prevalence in Scotland earlier than other regions are in line with earlier openings of primaries, and rises in confirmed cases in the 0-14 yr age group, as discussed earlier on this thread.

This means R has crept above 1 in Scotland, is likely at 1 in other regions, as declines are no longer being seen. In fact, we're seeing increases in some parts of England as well.
In terms of age-distribution, consistent with impacts of schools fully opening, positivity is highest among 0-9 yr olds and secondary school age groups- showing increases in these groups and possibly 35-49 yr olds, with declines in other groups.
Those who've repeatedly claimed that schools don't drive transmission, and children don't play a large role in community transmission should look at the very consistent evidence that has shown these patterns again and again with school re-openings.
These patterns are replication in our symtom-based testing pillar 2 data from PHE, where the highest rates of positivity are among primary school and early years settings children, showing clear platueauing of declines among the primary school age group.
These patterns are also reflected in outbreak investigation from PHE. Numbers of outbreaks associated with primary school settings appear to be highest, consistent with the general lack of mitigations in this setting across England, and the rest of the UK.
As I've said repeatedly, the data are quite clear that both primary and secondary school settings are contributing to transmission. Unfortunately the lack of recognition of this means we don't have adequate protections in schools - in any part of the UK.
In Scotland, while schools were opened in a staggered way, very little was done to mitigate transmission in primaries, as the role of primaries in transmission was consistently underestimated.
Despite seeing evidence for increases in community transmission & infection in children, Scotland has continued to open up further on the 15th March, again without putting further mitigations in place. Why?

This can only be described as completely negligent at this stage.
And other regions, including England having had the advantage of seeing the impact of even partial reopenings without mitigations in Scotland have done nothing to prevent increases in transmission- which are now clear in England as well.
If a third wave is inevitable for the UK, as our CMO seems to think it is, it is inevitable because our govt and scientific leadership did absolutely nothing to mitigate it- despite all the evidence and advice that was at their disposal. Their denial will be costly.
Also worth noting that the ONS data, and the primary school age and EYS PHE data are not biased by lateral flow tests. ONS data relies on random surveys of a population, irrespective of symptoms. And LFTs or contact based testing have not been deployed in primaries in England.

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More from @dgurdasani1

26 Mar
A thread on the general nationalisation of pandemic control, and rhetoric around pandemic control in the UK- by our govt, some advisors, and media - which is misinformed, unfair, politicises science, and is putting pandemic control in other regions at risk. Thread.
Over the past week, I've been asked to comment repeatedly on summer vacations and how it is dangerous to travel because of the 'third wave in Europe', and bringing back new variants back into the UK. Our PM has talked about 'Europe's third wave washing up at our shores'.
Let's look at what's actually happening. Europe is in a 3rd wave that is linked closely to the spread of the B117 variant that has spread across Europe from the UK.

Regarding variants- all 4 major variants of concern across the world are now in the UK - 2 likely originated here
Read 20 tweets
25 Mar
This is very concerning- & shows how it's hard to get a handle on controlling community transmission of variants once they've entered the country. Our border restrictions and quarantine policy have been woefully inadequate. We're seeing rapid rises in frequencies of several VOCs
The so-called SA variant (B.1.351) is among these, as are other variants whose properties we don't even understand yet. Given vaccination is what our entire policy seems to hinge on - one would think we'd do more to be protecting our vaccine resources.
Novavax & J&J both show lower efficacy against symptomatic disease with B.1.351, although efficacy against severe disease seems higher for Novavax. Efficacy for Astra also seems low at least against symptomatic disease- not known against severe disease.

Read 6 tweets
24 Mar
An update on where we are with cases in the UK, and regionally, and the impact of school openings which is now observable across the UK. Confirmed cases rising in primary & secondary school age groups in England & Scotland- cannot be explained by rapid tests alone. Thread.
Below is the confirmed case by age distribution in the UK - 5-9 yrs olds (blue) and 10-14 year olds (red), with other age groups shown in grey. While cases in most age groups are declining, we see clear rises in *confirmed cases* among primary & secondary age children.
This pattern is even clearer when we look at how these groups behave as a proportion of all cases - it's very clear that we're seeing primary, secondary school age children rapidly rising as a proportion of all cases, as well as 15-19 yr olds. Almost all other groups show decline
Read 16 tweets
23 Mar
I find this piece by @apsmunro quite interesting, given his conduct toward several researchers, particularly women, when they've tried to challenge him on the evidence he's presented. Short thread on my experiences & what I've observed of others' experiences with him.
I've generally tried to engage people on the evidence behind their claims, although this is consistently been interpreted by some as 'personal attacks'. In this piece, Munro writes: 'unkind, mocking or aggressive commentary' is wrong.
I wrote a long thread on schools a while ago, summarising the evidence on childhood transmission at the time. Munro was critical of the thread, as expected, as it critiqued some of his claims, and here was a response to the thread from @MugeCevik that was RTed by him.
Read 19 tweets
22 Mar
@educationgovuk is planning to review mask policy in schools which is in place only up to Easter.

The review must consider overwhelming evidence for the need for mitigations in both primaries & 2ndaries rather than stripping these back further which would be beyond negligent🧵
The review appears to ask unions/staff questions leading questions about adherence to mask use, difficulties faced by children, harms etc. and benefits. It looks like unions/staff are being given under a day to respond to these questions.
Key concerns here: Given the importance of this key issue, why are staff/unions only being given a day to respond to the review? Given our govt has repeatedly stated education is a priority, this seems somewhat rushed and last minute.
Read 20 tweets
21 Mar
Framing this as a 'semantic discussion' is disingenuous - especially when the difference isn't semantic, has informed policy - specifically, the lack of protections in many settings where aerosol transmission was not acknowledged & mitigations against this not prioritised still.
We know that talking and coughing can actually generate more aerosol than 'AGPs'. And having suggested that physical distancing was adequate for most purposes is not a 'semantic difference' at all. Such rhetoric can lead to lack of sufficient protections.
You can't argue something is just semantics when you've argued for that certain protections weren't required on the basis of this. Physical distancing alone does not protect against aerosol transmission- especially in certain contexts. Multilayered approaches are needed.
Read 14 tweets

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