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Prof. Christina Pagel Profile picture
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19 May, 7 tweets, 4 min read
SHORT THREAD: Discussed the spread of B.1.617.2 (the variant first sequenced in India) on @BBCRadio4

First off, the data just don't support vaccine hesitancy as reason for spread 1/5
Data on vaccine uptake by age group in Bolton and Blackburn (via @doctor_oxford from NHS England data) 2/5
Data on younger age groups being infected from @jburnmurdoch this time for Bolton and Bedford 3/5
Secondly, the data do support greater transmissibility of the new variant B.1.617.2 over the current dominant strain in the UK (B.1.1.7 ("Kent")).

But we don't quite know yet how much more transmissible and it really matters. 4/5
Thread on increased transmissibility from @TWenseleers

SAGE minutes on it here:
gov.uk/government/pub… 5/5
oops - here is the Bolton vaccine uptake by age
(again from @doctor_oxford )
Ack - the vaccine data comes from @rachaelfrclarke and not @doctor_oxford - too many Rach(a)el Clarkes!

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More from @chrischirp

Prof. Christina Pagel Profile picture
20 May
THREAD about Nepal - *please read & share*:

India had the eyes of the world upon it a couple of weeks ago as the scale of its covid crisis became clear.

Nepal's crisis is worse. The UN says Nepal now has the highest transmission in the world
reliefweb.int/sites/reliefwe… 1/7 Image
Cases may look like they're plateauing but testing is at capacity and positivity rates are almost 50% (1 in 2 people testing positive!!).

This is the world's highest positive rate. 2/7 Image
Very few people have received even one dose of vaccine.

Nepal's healthcare system is also weaker than India's. 3/7 Image
Read 7 tweets
Prof. Christina Pagel Profile picture
19 May
THREAD on schools, kids & Bolton:

I think we need to talk again about making schools safer as B.1.617.2 (new variant) spreads.

Case rates in school age kids in Bolton are very high - higher in 5 - 14 yr olds than they've ever been.

Surge testing likely some of it, but not all
Cases in over 20s are going up steeply in younger adults - mostly not vaxxed.

Over 50s (mostly partially vaxxed) going up steeply but lower rates and over 60s (mostly fully vaxxed) the least.

Vaccination is helping & cases rates in all over 20s much lower than Oct & Jan peaks Image
But if we look at under 20s (unvaxxed) it looks different. Over 15s (some in school, some not) going up steeply but not yet at Oct peak.

5-9 & 10-14 yr olds a *lot* higher than they've ever been.

Under 4's climbing steeply but not higher yet than previous peak. Image
Read 11 tweets
Prof. Christina Pagel Profile picture
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).
Read 11 tweets
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
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

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