Short THREAD on Covid-19 Variants in ENGLAND:

The Sanger Institute has just released webpages that let you explore genomes that they sequences every week...

I had a look - two variants are currently growing "S Africa" and "India" but v small numbers. 1/7
This chart show the numbers of potentially worrying variants sequenced each week.

The recent rapid growth of the India variant (B1617) & the highish, steadier, numbers of S African variant (B1351) are clear (not great).

Brazil variant (P1) almost negligible (good!). 2/7
These are small numbers.

But S African & Indian variants are growing in the context of overall numbers going down. So the *proportion* of sequenced cases that are these two variants is going *up* - and for the Indian variant - going up A LOT.

Should we be worried? 3/7
We know that we are sequencing all incoming traveller cases & we know from PHE report last week that most of the Indian variant cases so far are in travellers (~75%).

Nonetheless the growth is astonishingly steep. 4/7
The worry is these cases might leak out into community.

Hopefully, the introduction of the red list will prevent this -> if so, we'll see the numbers that are Indian variant hopefully shrink *and* the next PHE report showing *almost all* cases in travellers. 5/7
The S. Africa variant (B1351) is more entrenched in the community - mainly London. The % of sequences that are B1351 has been growing fast.

Best case: increase a result of surge testing of S London cluster that has contained this outbreak.
Worse case: variant is spreading. 6/7
So to sum up:
1) this is a great new resource! covid19.sanger.ac.uk

2) No need for panic stations just yet

3) But beware complacency. We need to keep an eye on these numbers even though still small.

I'll check back in a couple of weeks... /END
PS thank you to @theosanderson for tweeting about the web resource!
PPS it does make sense for traveller cases of Indian variant to increase as sharply and on similar timescale as cases have in India. But worry is people are meant to test negative just before travel!

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More from @chrischirp

26 Apr
In Dec, SAGE behavioural subgroup warned that people might reduce adherence to measures once vaccination programme under way and recommended a govt communication strategy to pre-empt this...

assets.publishing.service.gov.uk/government/upl… 1/3
However, this has not happened. Govt messaging around a cautious opening has been counterbalanced by the focus on the dates of the roadmap, lack of emphasis on protective behaviours & (partial!) vax numbers.

And sure enough, adherence is dropping - particularly in over 50s. 2/3
Yes, numbers are ok here right now - but soon we open up a LOT more indoor mixing.
Chile shows how opening too fast, even with high vax, can cause bad surges requiring new lockdown.

We need better communication - esp after THAT daily express letter.

theguardian.com/world/2021/apr… 3/3
Read 4 tweets
23 Apr
SHORT THREAD on JAPAN / OLYMPICS:

Japan is going through a major new Covid wave and this potentially puts the Olympics later this summer at real risk... (and of course Japan's large population!) 1/4
The sequencing data for Japan is sparse, but it does seem as if B117 (the "Kent, UK" variant) has become dominant there over last couple of months and that this might be behind the recent increase. 2/4

reuters.com/business/healt…
The other thing is that Japan is being very slow to vaccinate compared to other high income regions - Just over 1% of its population has received one dose of Covid vaccine so far.

This leaves it more exposed to surges from B117 (vaccines work brilliantly against B117). 3/4
Read 4 tweets
18 Apr
THREAD on VARIANTS, VACCINES & POTENTIAL FUTURES:

I’ve been looking at data on sequenced variants. I’ve also been thinking about our vax programme & India.

TLDR: the Indian variant needs to trigger surge testing in England. And India needs to be on red list. 1/23
Some dates: while over 60% of adults have had 1 dose of vax, we've got another ~15 weeks before *all* adults could have immunity from at least 1 dose.

And another 20+ weeks before all adults could be fully vaxxed. And we don't yet know what uptake will be in younger adults. 2/23
So what can variants do while we are vaxxing people?

We already know that B117 can infect some partially vaccinated people and (far far) fewer but still some fully vaccinated. edition.cnn.com/2021/04/14/hea… 3/23
Read 26 tweets
15 Apr
The latest PHE variant of concern update is out...

TWO KEY things:

1) B1351 ("South African") variant continuing to spread (as we've seen in the headlines!)

2) 77 cases (!) of the new B1617 "double mutant" variant discovered in India .

B1617 is worrying because... 1/3
It has some potentially worrying mutations NOT seen in SA, Kent or Brazil strains.
forbes.com/sites/williamh…

This variant *might* escape both T-cell and antibody action. India going through a big surge - mix of B117 & new B1617 (location dependent)
science.thewire.in/health/sars-co… 2/3
As I tweeted yesterday, India should be on the red list (as should many other countries that currently aren't btw) *and* Johnson should *not* go on a trip to Delhi this month! madness!

Read 4 tweets
15 Apr
THREAD on VACCINATION & EQUITY in ENGLAND:

I know I've tweeted about this before, but now we can look at how gaps by deprivation and ethnicity change with age groups and what that might mean...

TLDR: widening gaps but access and communication will be key I suspect 1/5
By deprivation:
Vax coverage gaps *widen* markedly as we move to young ager groups. This is not just a time effect - coverage has flattened off for all these age groups.

Access (able to leave work to get vaccinated, travel, internet access) & communication likely issues 2/5
By ethnicity:
Much larger gaps for all age groups by ethnicity but less impact by age.

Different but overlapping reasons driving ethnicity gaps compared to deprivation gaps? 3/5
Read 5 tweets
14 Apr
THREE TWEETS:

1. The situation in India is very bad and worsening.
theguardian.com/world/2021/apr…

It is frankly insane that Bangladesh and Pakistan are on the UK travel red list countries but India is not.

gov.uk/guidance/trans…
2. Globally we are back in a pandemic that is as bad as it has been and no sign of peaking yet.

Deaths are trailing cases by a few weeks as expected but they are also rising steeply - this isn't just more testing or ok because we have vaccines & better treatments.
3. Out of control covid anywhere is a danger everywhere.

We need to address vaccine inequality ASAP. This is urgent - morally for global fairness & self-interestedly to stop future UK waves.

We'll be covering this in Friday's @IndependentSage
briefing - join us!
Read 4 tweets

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