THREAD on English vaccine supply & what this might mean for the roadmap.

It was reported the other day that England will have relatively restricted supply for the foreseeable future… 1/9
This is based on the recent SAGE SPI-M modelling where the central estimate for vaccine supply was 2.7m doses a week in England from April -July and then 2m doses a week. This compares to 3.2m doses a week in February & March & the previous plan of increased supply. 2/9
This means that most of April AND May will taken up honouring second doses for the over 50s.

Under 50s won't be getting their first doses in any big numbers until June and July...

What does this mean for the roadmap? 3/9
Well, it means that for at least half of the summer term, many teachers & parents of children in school will not have the protection from a first dose.

It means that when indoor mixing is due on 17th May, over 17 million adults will still not have had a dose. 4/9
By 21 June, there are likely to be still over 13 million adults without a jab.

The govt might push ahead regardless. But by then we can go almost full whack again on first doses. So waiting another 6-8 weeks means opening up once *everyone* has had a chance of a 1st jab. 5/9
That may seem like a long time, but it is definite - we know that (given supply) we can vaccinate millions of people every week. We will know there are only 13-15 million people left to do. It is safer for them *and* their elderly loved ones if opening more waits those weeks. 6/9
It would mean sticking at somewhere between April and May's restrictions (depending on case numbers) until August instead of mid June, but shops, hairdressers, gyms & museums would be open. Outdoor socialising and (hopefully) some indoor socialising would be open too. 7/9
It would also prevent much of the summer surge predicted by SAGE modelling subgroup this week, where their central estimates were ~15K-20K more deaths this summer even with excellent vax efficacy & uptake.

And reduces argument for vax passports… 8/9
If the situation looks much more promising in May and/or June then we can reassess, just as we should if it looks concerning (e.g. imported new variants or surging cases risking new variants emerging).

This is what data not dates should mean... 9/9
PS the more vaccine suppy is restricted, the longer the timelines gets.

Also - if uptake is poorer among under 50's then we can offer everyone a first jab faster (as there'll be fewer jabs in arms). But at the cost of a less effective vaccine programme!

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More from @chrischirp

3 Apr
Some key bits from latest PHE report on Covid variants currently under surveillance in England.

TLDR: v low levels of everything apart from our Kent strain (B117) but S. African & Brazilian strains spreading.

Full report:… 1/10
Variants with the "Eek" mutation (E484K) are of particular concern since this mutation is thought to help covid evade antibodies so that it can more easily infect people who have had covid already or (potentially) the vaccine.… 2/10
Two variants with this mutation (the Bristol strain which is our Kent variant+E484K, and the Brazilian P2) are *not* spreading, but four variants with this mutation *are*. 3/10
Read 10 tweets
1 Apr
The latest @ONS infection survey includes breakdown by age for all home nations.…

We're seeing two different epidemics by age (thx to @dgurdasani1 for phrase).

(expand gif to see corresponding dates and whole thing) 1/4
The increase in younger children after schools go back is very obvious in Scotland (after 22 Feb) and in England (after 8 March) while decrease in older ages continues.

So vaccination & restrictions offsetting opening of schools - this is good! BUT 2/4
With the release of latest long covid estimates from ONS infection survey today as well, I still don't think we should be complacent about lots of younger people reporting long covid (10%-13%).… 3/4
Read 5 tweets
31 Mar
Was briefly on @BBCOne News @ 6 last night discussing the (excellent) findings from the ONS Covid antibody survey that came out yesterday.

Clip is here but a couple of things to add:
Having so many people with antibodies is great news and will help keep cases (and severe illness) down, but we still have millions without antibodies.

Israel is showing that opening up with high vax, masks, social distancing, test & trace keeps cases going down sharply.
Antibodies declining in older people as they approach many weeks from first dose. Does *not* mean they are no longer protected but it does mean we need to concentrate on giving people their 2nd doses. Strong case for shorter interval for very vulnerable.…
Read 7 tweets
26 Mar
THREAD on concerning variants in England:

Some signs that they are spreading - slowly and from very low numbers - but spreading nonetheless.

Why I think this and what it means - let's dive in: 1/13
The Kent strain (B117) has been over 90% of cases in England since mid-Jan. It is 30-50% more transmissible than the old Covid strain and so came to dominate over about 2 months.

All existing vaccines work brilliantly against B117. 2/13
Vaccines work less well against some other Covid strains.

Particularly concerning are the South Africa (B1351) and Brazil (P1) strains.

Public Health England is tracking these (& similar) variants and doing surge testing to try to contain them.… 3/13
Read 14 tweets
24 Mar
I've been looking at latest English data by age.

Cases in school age children are definitely going up while other age groups are flat or falling (slowly).

Some of this increase is undoubtedly because of mass lateral flow device testing rolled out to schools. But NOT all. 1/7
*Primary* school age kids are *not* getting routinely tested - tests are still symptom based. We see little change in cases week of 8th March but we start seeing quite rapid increase 14th March onwards.

This is consistent with increased spread since schools opened. 2/7
*Secondary* school age cases started going up around 8 March - when mass testing started.

But if it was *only* mass testing, then you'd expect cases to flatten the next week (15th March onwards), as similar number of LFDs done both weeks.

But cases keep going up. 3/7
Read 7 tweets
22 Mar
THREAD: Boris Johnson is basically talking bollocks about the 3rd wave in Europe inevitably coming here and he must know it.

It's cynical opportunism to blame any resurgence in England on the European wave. It is frankly absurd. Here's why: 1/6…
The Europe wave is not coming here *because we've already have it*.

Instead, it's taken two months for our "Kent" strain (B117) to spread across the EU and start a new wave there. OLD restrictions work on the OLD strain but NOT Kent. So cases go up as soon it is dominant. 2/6
If cases start steadily going up here it will be for one of two reasons (or both!):

1) As we found out in Dec, OLD mitigations don't work on B117. But opening up with OLD mitigations relying on vaccination to help keep cases down & chaotic mass testing (esp schools). 3/6
Read 7 tweets

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