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Dr Duncan Robertson Profile picture
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6 May, 13 tweets, 4 min read
There are several reasons why 'India' variants such as B.1.617.2 (in particular) are a concern.

A short thread.
The first is the growth of detected cases.

This is the data from last week. We were expecting this week's data at around 5pm today, but that was delayed, apparently due to the local elections.

Most of these cases were related to travellers. We have since required quarantine for people that have been in India. So this should (in theory) reduce significantly the import of B.1.617.2
But look at the proportion of cases that are sequenced in the UK.

That top right corner is B.1.617.2 - around 3% of sequences in the last 30 days.

Some may be related to travel. But it is clear that many are not.
Variants of Concern are declared *relative to the wildtype* ie. the original Covid strain before the more transmissible B.1.1.7 (Kent) variant that caused such concern before and after Christmas.

Variants are risk assessed red if they have greater transmissibility than wild type
And this is why
So, *if* (and we will know tomorrow) we have a more transmissible variant, the question arises whether this risks the dates in the Roadmap.

The 'not before' date for Step 3 is 17 May.

We are told we will need a week for businesses to be made aware of the decision, so the *actual* decision date is around 10 May, or this weekend or just after this weekend.

We do not have a fully vaccinated population.

13% of under-40s have not been vaccinated.

Many groups are disproportionately *not* vaccinated.

5% of the most vulnerable over-75s are *not* vaccinated.

A *political* decision will be made. Risk of Roadmap Step 3 is clear. It would be prudent to delay the reopening to see how outbreaks spread or do not spread in the weeks ahead.

Otherwise deprived, ethnic, urban communites may suffer disproportionately.

Correction. That should read [only] 13% of under-40s *have* been vaccinated.

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More from @Dr_D_Robertson

Dr Duncan Robertson Profile picture
7 May
VARIANTS update for the UK from PHE data released today (delayed from yesterday due to the local elections).

P.1.617.2 declared a Variant of Concern (in orange bold on the charts). Significant increase in cases.

Cumulative charts that can be affected by surge testing etc. Image
Here is the data on an exponential chart.

P.1.617.2 declared a Variant of Concern (in orange bold on the charts). Significant increase in cases. This chart includes the B.1.1.7 'Kent' variant.

Cumulative charts that can be affected by surge testing etc. Image
Here is the data on a heatmap showing new cases detected each week. Variants of concern highlighted.

P.1.617.2 is around 4.4% of the variant cases.

This ratio was around 2.3% last week (which included all cases to that time recorded last week) Image
Read 21 tweets
Dr Duncan Robertson Profile picture
6 May
Analysis of today's PHE surveillance report.

A short thread.

While Covid cases may be low in many parts of the country, there are still rates of over 70 cases per 100,000, in upper tier local authorities
Slow increase in number of outbreaks/incidents
Falling hospitalization rates
Read 10 tweets
Dr Duncan Robertson Profile picture
28 Apr
gov.uk/government/new…

Conclusions below.
Study document here

khub.net/documents/1359…
"In addition to the direct effects of preventing cases and reducing severity, we have shown that both the ChAdOx1 nCoV-19 and BNT162b2 vaccines are associated with reduced likelihood of household transmission by 40-50% from individuals diagnosed with COVID-19 after vaccination...
Read 6 tweets
Dr Duncan Robertson Profile picture
26 Apr
Travel is starting to split into countries with low Covid cases and countries without low Covid cases.

A short thread. Image
Singapore and Hong Kong have announced a travel bubble

"All passengers departing from Hong Kong are required to be vaccinated, and passengers from both cities are expected to take a test within three days of departure and again on arrival."

bbc.co.uk/news/business-…
This follows the Australia - New Zealand travel bubble

bbc.co.uk/news/world-aus…
Read 10 tweets
Dr Duncan Robertson Profile picture
22 Apr
Public Health England have updated their analysis of Variants of Concern and Variants under Investigation. It is great that this expert analysis has been published.

Some commentary.
Firstly, the India variant (B.1.617). This has been split. Only B.1.617.1 with E484Q is a Variant under Investigation.

Variants of Concern remain
B.1.1.7 (UK/Kent)
B.1.351 (South Africa)
P.1 (Manaus)
B.1.1.7 with E484K

Several other variants are being monitored.
This is PHE's chart of variant prevalence. As you can see, B.1.1.7 (Kent variant) dominates (purple)
Read 17 tweets
Dr Duncan Robertson Profile picture
22 Apr
The latest @PHE_UK variant data has been published for the UK. First, the heatmap of new cases.

Significantly:
P1 (Manaus) has increased from 40 to 60 total cases
B.1.617 (India) has increased from 77 to 132 total cases.
B.1.351 (SA) has increased from 600 to 670 total cases
Here is my Covid variants cumulative chart (excluding UK variant).

Note:
P1 (Manaus, red)
B.1.351 (South Africa, purple)
B.1.617 (India, light blue)

nb cumulative chart that depends on testing intensity, some will be cases at the border
And here is my cumulative chart on a log scale, including B.1.1.7 (UK variant)

There has been a great deal of surge testing that will have enabled greater detection.

However, increases in P1, B.1.351, and B.1.617 are all increases that need to be taken seriously.
Read 5 tweets

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