The govt set out 4 tests for proceeding each stage of the roadmap. Tests 1 & 2 relate to vaccination, test 3 is hospitals in no danger of being overwhelmed and test 4 is that there are no new variant concerns.
Test 1-3 have been (easily) met, but I don't think Test 4 has. 2/18
Last Friday, Public Health England designated B.1.617.2 (an "Indian" variant) as a variant of concern because of worries that it was more transmissible than B.1.1.7 ("Kent") and cos we didn't know much about its response to vaccines.
What has happened since? 3/18
Yesterday new modelling from SAGE SPI-M was released. While they showed that risks of stage 3 of roadmap was much lower with current Kent variant (given high efficacy of vaccines), those risks could *return* for a new variant. assets.publishing.service.gov.uk/government/upl… 4/18
In particular, Warwick model (link above) estimated that moving to step 3 of the roadmap risks hsopitals being overwhelmed as in January for a variant just as susceptible to the vaccines *but* 50% more transmissible than our dominant "Kent" variant. 5/18
Having some vaccine escape (even if still protective for severe disease) can also lead to damaging new surges.
SAGE SPI-M emphasise the importance of stopping the spread of any such variant.
There have been some estimates that B.1.617.2 is up to 60% more transmissible than Kent (B117)
Admittedly these are based on not great international sequencing data - but it is all we have to go on + we know that much of S Asia in a dire situation.
The UK Covid genomics consortium (COG UK) released latest data today. It includes sequenced cases from travellers to UK & surge testing, some duplicates & about half of community cases.
Week to 1 May in England, there were 678 cases compared to 365 prev week - almost double 8/18
Proportionally, B.1.617.2 was 14% of sequences cases in England. The incomplete data since 1 May is showing the same trend continuing.
In the last week B.1.617.2 was 4% cases in Scotland and 2% in Wales. (No data on NI). 9/18
The Sanger Institute takes COG UK data and removed traveller and surge testing data to try to get at what is happening in community. This removes c. half of cases of B.1.617.2.
But exactly the same pattern persists - over 10% of cases in England are B.1.617.2 w/e 1 May. 10/18
Regionally in England these are concentrated in NW, London and East of England.
Daily average cases in England overall have started consistently going up over the past week as well. 11/18
In areas where B.1.617.2 is most concentrated, cases are going up particularly rapidly - e.g. below is Bolton where in most recent week B.1.617.2 was almost 70% of cases.
(HT to @dgurdasani1 for highlighing this chart) 12/18
So England growth is entirely consistent with increased transmissibility & a situation where B.1.617.2 is rapidly gaining dominance.
We don't yet know enough about vax & B.1.617.2 but there are reports now of some breakthrough symptomatic cases channelnewsasia.com/news/singapore… 13/18
And @GuptaR_lab was quoted in Byline Times today suggesting a delay to the roadmap over concerns about vaccine effectiveness - he stressed that we need to learn more.
Meanwhile, same Warwick SAGE model estimated that if we stayed at stage 2 of roadmap (i.e now) any summer surge would be *much* lower (max ~200 hospital admissions a day instead of over 4000).
SAGE also emphasised that the more people are vaccinated, the lower any surge. 15/18
To me, this means that the assessment of the risks IS fundamentally changed by new variants of concern - and so test 4 is failed.
I think we need to either be sure that B.1.617.2 is not a threat OR stamp it out while (if) we still can & vax more quickly. 16/18
This means much stronger contact tracing and supported isolation, wider list of symptoms for PCR tests, support for local communities in tackling outbreaks inc maximising vax uptake there.
I also think moving to stage 3 of roadmap right now risks adding fuel to the fire. 17/18
Personally, I would like to slow down now to reduce chance of reversing the map later risking more uncertainty, more damaging closures and longer recovery from a worse situation.
We need to learn from previous experience. 18/18
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Quick thread on current Covid situation in England and Long Covid.
I have Thoughts about the Inquiry Report published yesterday but am still trying to organise them.
TLDR: high Covid levels remain, Long Covid remains 1/11
This wave is not over. While the number of admissions with Covid remains lower than the autumn/winter waves, it has now remained highsh for several weeks.
This means there are a lot of people out there getting sick - and having their work, plans and holidays disrupted. 2/11
Scottish wastewater data to 9 July shows a sharp decrease, suggesting that prevalence might be on its way down.
Obviously Scotland and England can have different dynamics, but it’s the best we’ve got as long as England refuses to analyse its own wastwater. 3/11
THREAD: Given tomorrow's election, I've been thinking about our nation's (poor) health, the wider determinants of health and how these have worsened and what it means for policy....
TLDR: worrying only about NHS & social care is missing the point
let's dive in... 1/25
The UK has a health problem. After steady gains in life expectancy for decades, it flatlined during the austerity years and fell for the first time this century with the Covid pandemic.
The number of people out of work for long term sickness is near record levels. 2/25
There are huge inequalities between rich & poor. Boys born in the most deprived areas can expect to die almost 10 years earlier than their peers in the least deprived areas.
Even worse, they can expect to spend 18 fewer years of their life in good health (52 vs 70 years) 3/25
As ever, I am getting lots of pushback.
Here is a compilation of the European countries I've found with recent wastewater data. Some are going up a bit, some down a bit, some are flat, none are anywhere near previous peaks.
I can't see anything here to be panic anyone. 1/3
I can't find the dashboard for Spain, but others saying it is in a wave. Perhaps it is. England has just had one - the last data we had (a couple of weeks ago from Bob Hawkins) looked as if our wave had peaked.
So, I'm not seeing reason to think things are terrible here! 2/3
Yes there are new variants growing right now. They are not growing faster than JN.1 grew in December and that wave did not end up as bad as feared.
Clearly it remains true that Covid is NOT a seasonal disease (unlike Flu and RSV)
3/3
Quick thread on the Astra Zeneca (AZ) covid vaccine since it's been in the news today.
TLDR there isn't a new "smoking gun", the AZ vax was one of first and cheapest, it saved millions of lives globally, there are better vax out there now, adapted to new variants 1/9
the AZ vaccine was one of the first approved at the end of 2020, cheaper than Pfizer, and - importantly - easier to administer in lower resource settings as it didn't require super low temperatures for storage 2/9
In most countries it was first rolled out in older adults. As it was rolled out in younger adults, a *very rare*, serious, side effect was noticed - it could cause deadly blood clots
This was spotted quickly and studied. Vax monitoring did its job. 3/9
A short thread on why this is not a scary chart and why all the evidence suggests that there is not much Covid around right now. 1/6
the above chart is recorded covid hospital admissions / reported covid cases. It is close to 100% now *because basically only hospitals can report cases since Feb 2024*
It is to do with changes in case reporting and NOT hospital testing
2/6