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?
4. Firstly, very likely that vaccination *does* protect well against severe illness (if it didn't, you'd expect hospital vax-eligible patients to be more vaxxed than not, because there are many more eligible people who are vaxxed than not).

Also clear that 2 doses better than 1.
5. BUT, it's not perfect.

A small percentage of vaxxed people end up in hospital after 1 or 2 doses - particularly if already frail.

Key thing about the SAGE models is that if you have a LOT of infection in population, this smaller percentage can still overwhelm hospitals.
6. A small percentage of a very big number is big.

Doesn't mean the vaccines don't work (they do), but it's not enough if you have enough spread (and we don't have enough fully vaccinated people yet to prevent that).
7. The added complication of this variant is that it might transmit better through vaccinated people (even if it doesn't make them sick) - making it even harder to keep infections down.
itv.com/news/2021-05-1…
8. There is also the 1 (??) person in Bolton hospital who wasn't eligible for a vaccine - presumably someone under 40.

If infections do run rampant, many younger unvaxxed people could end up in hospital.

Again - a small percentage of a very large number is still big.
9. The other thing is inequality in vax coverage. Vaccine uptake is lower in more deprived areas.

Deprived areas are also more *exposed* to infection from work & housing and to severe illness once infected cos more likely to have other health problems.

blogs.bmj.com/bmj/2021/04/09…
10. So this combo of lower vax rates, higher exposure *to* infection and higher chance of getting ill once exposed also likely leads to seeing more unvaxxed people in hospital than you might without these disparities.
11. So yes, take the breakdown of patients by vax status in Bolton hospital as a sign that vaccines are protective against severe illness.

But do not think that this makes everything "fine" cos it doesn't. /END
PS to the heartless argument that unvaxxed people are to blame if they don't get vaxxed... 1) full hospitals are full hospitals 2) SAGE models suggest most deaths are in vaxxed people in a bad surge 3) dividing people in "deserving" and "undeserving" is wrong and dangerous.
PPS as @KateCushing2 reminded me - having loads of infections in younger, unvaccinated, people also means a lot of long covid which is a terrible thing.

• • •

Missing some Tweet in this thread? You can try to force a refresh
 

Keep Current with Prof. Christina Pagel

Prof. Christina Pagel Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @chrischirp

18 May
1 THREAD on latest COG data on B1.617.2 (so called "India" variant) in England

COG sequences positive tests from the community (~50% of them), all travellers to UK & from surge testing. Data is updated almost every day.

What does it tell us about spread?
sars2.cvr.gla.ac.uk/cog-uk/#shiny-…
2 COG data is not entirely representative because it over-represents surge and traveller cases.

Sanger data removes traveller and surge cases to try to get a picture of community transmission, but Sanger only updates once a week.

What if we compare the two?
3 This compares the number of sequenced tests of B.1.617.2 that appear in COG (black) and Sanger (blue).

Over time there is much more overlap between the two showing that community cases are growing and that COG is becoming more representative of community cases (Sanger). Image
Read 11 tweets
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
16 May
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
Read 6 tweets
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
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
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

Did Thread Reader help you today?

Support us! We are indie developers!


This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal Become our Patreon

Thank you for your support!

Follow Us on Twitter!

:(