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Prof. Christina Pagel Profile picture
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16 May, 6 tweets, 5 min read
THREAD:
Spread of B.1.617.2 ("India") variant could have been prevented.

It's not "Captain Hindsight" @MattHancock to highlight our leaky border policy & red list delay in particular. thetimes.co.uk/article/indian…

Here are some early warnings from SAGE, @IndependentSage & me! 1/6
SAGE on *21 January* said red list countries would not prevent importation of new variants. If used, they'd need to be imposed quickly.

Most effective would be quarantine for all arrivals (as AUS & NZ).

Israel closed its borders while vaccinating.
assets.publishing.service.gov.uk/government/upl… 2/6
@IndependentSage called for comprehensive border measures on 24 January (independentsage.org/independent-sa…)

@GabrielScally of @IndependentSage wrote that comprehensive quarantine was needed to prevent importation of new variants on 28th January

theguardian.com/world/commenti… 3/6
Strict border measures were pillar 5 of @IndependentSage 's sustainable suppression strategy in February
independentsage.org/wp-content/upl…

In fact, strict border measures were discussed back in our very meeting a year ago in May 2020!
ft.com/content/08b7b3… 4/6
I highlighted how leaky our border controls were on 27th January as part of this article.
theguardian.com/world/2021/jan…

In February I spoke to @BBCNewsnight about the summer and highlighted the massive risk of new variants
5/6
In fact, I (& *many* others) have warned about variants repeatedly over the past months.


Finally, on 14th April, I said it was crazy that India was not yet on the red list.


India's red list status started 2 weeks later. 6/6

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Prof. Christina Pagel Profile picture
17 May
1.THREAD on latest Sanger data on B.1.617.2 (new variant of concern).

Remember Sanger use all sequenced cases for England (about 50% all cases) and remove data from travellers and surge testing - so approx community cases.

covid19.sanger.ac.uk/about

TLDR: nothing encouraging.
2.Continued rapid increase of B.1.617.2 (a so-called "India" variant) to week ending 8 May. Other variants not doing much.

But B.1.617.2 now almost 30% of sequenced cases in England (!).
3.Regionally, it almost dominant now in North West and getting there (but more slowly) in London.

High proportions in SW and SE, but overall cases here v low. Need to keep an eye on the Midlands & East of England.
Read 5 tweets
Prof. Christina Pagel Profile picture
17 May
1. THREAD on vaccines, "Indian" variant, Bolton and the summer.

Bolton currently has 18 patients in hospital with Covid, 12 no jab, 5 one jab, 1 both jabs (who was frail).

What are the implications?
bbc.co.uk/news/uk-571341…

11 tweets.
2. Hancock apparently said the "vast majority" of unvaccinated patients were eligible. I don't know what "vast majority" of 12 is, but let's say it's 11.

About 95% of over 50s have had 1 dose and about 90% of over 70s have had 2 doses in England.
3. Eligible is over 40s and health care workers - so can't say too much *precise* about vax efficacy without knowing more (inc exposure).

We also don't know which variant but >70% of cases in Bolton from recent Sanger data were new variant (B.1.617.2).

so what can we say?
Read 13 tweets
Prof. Christina Pagel Profile picture
13 May
SHORT THREAD:
I was on Sky News earlier where I explained why I thought test 4 (new variant test) for the next stage of the roadmap had not been met, because of B.1.617.2 (the so called "Indian" variant of concern). 1/5
I then also said what I, personally, thought that meant for next steps.

Added to these must be much more support for local teams to beat outbreaks *and* proper financial & practical support for those who test positive & contacts. Once in place, could enable safer opening. 2/5
@markaustintv pointed out that people would be shouting at the telly hearing me suggest delaying Monday's opening... this is what I said about that. 3/5
Read 5 tweets
Prof. Christina Pagel Profile picture
12 May
THREAD - my thoughts on variant situation:

I've been tweeting about it a lot but much has happened in last day.

@guardian today quoted me saying that my personal feeling was we should delay next stage of Roadmap.

theguardian.com/world/2021/may…

Let me explain why... 1/18
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
Read 18 tweets
Prof. Christina Pagel Profile picture
10 May
THREAD on latest data on B.1.617.2 (an "India" Variant) in England.

The Sanger Institute released its latest sequencing data for variants in England today
covid19.sanger.ac.uk/about

TLDR: it's not looking good at all. 1/6
Sanger removes cases from travellers to England & from surge testing to get a picture of what is happening in the community.

In England, within TWO weeks to 1 May, B.1.617.2 (the new variant of concern) went from 1% to 11% of cases. Other variants <1%.

A massive increase. 2/6
This is concentrated in a few regions: London, the NW (quickest rise), East of England and then E Midlands & SE.

PHE also highlighted London and NW as particularly concerning in its Friday report
assets.publishing.service.gov.uk/government/upl… 3/6
Read 7 tweets
Prof. Christina Pagel Profile picture
7 May
THREAD on new Variant of Concern (VOC), B.1.617.2:

PHE released its report on B.1.617.2. It has loads of info - some quite disturbing.

I'll try to go through the key bits in this thread.

Full doc is here: assets.publishing.service.gov.uk/government/upl…

all graphs use their data. 17 tweets.
It's become a VOC because it's been spreading so fast - and in the community.

PHE are pretty sure (MODERATE) it's *at least* as transmissible as our dominant "Kent" variant (B117) (RED rating). They are worried (AMBER) it might have some immune escape but don't know yet (LOW)
First, note that as overall cases have come down, we're sequencing *more* community cases - since early March about 50% of all postive PCR cases. This means estimates of spread are pretty good. And less bias from traveller data (all traveller +ves sequenced).
Read 18 tweets

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