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Eric Feigl-Ding Profile picture
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23 May, 24 tweets, 17 min read
⚠️PAY ATTENTION to rising #B16172 crisis in UK—crucial because India variant affects us all. It is now ~50% of all cases in England, surging fast, especially in kids. Hospital #COVID19 ward in Bolton🇬🇧 filling up. “It’s too late to contain” @chrischirp 🧵
assets.publishing.service.gov.uk/government/upl… ImageImage
2) And key worry is that the surge in #B16172 is domestic community transmission. Not related to international travel. Image
3) And look at the growth rate! #B16172 variant is by leaps and bounds growing faster than any other variant. The previously fast #B117 is growing much much slower—5x slower than B16172.

There can be 2 reasons—higher transmissibility, or more reinfection / vaccine breakthroughs. Image
4) In Northwest England, #B16172 is now 65-70% of all #COVID19 cases! And it achieved such dominance in mere weeks from 0% very recently earlier.

This is why we all need to care what’s happening in Uk 🇬🇧 damnit! It can happen to any of us. Image
5) Also remarkable—look how much secondary attack rate (initial case infecting another person) is versus other variants and how it is among community (not travel).

➡️despite 56% of people in UK 🇬🇧 with at least 1 shot and 32% with two shots. Vaccines work—but #B16172 is fast!! Image
6) UPDATED efficacy for #B16172 — AstraZeneca vaccine, used by 2/3rd of UK, has a 2-dose efficacy of 60% (32% of UK residents with 1 shot), but 1-dose efficacy of just 33% for the 24% in UK with 1 shot.

Remaining 44% have zero shots.
7) to be clear—these new efficacy numbers for the variants are *not* from more rigorous trials— they are from a quick and dirty case control study. Other experts like @trishgreenhalgh are not impressed either. Bottomline—These efficacy % are not reliable.
?
8) Reinfections with #B16172 is also approximately ~4x more with B16172 versus #B117 if we compare the rates of reinfections / variant cases found. 4x…. Is a lot. Image
9) As result, @PHE_uk had just updated the RISK ASSESSMENT of #B16172– for worse. It has now put two categories now in red warning level.

🔴Transmissibility between humans (higher than old strain)

🔴Vaccines: “Evidence of reduced vaccine effectiveness”
assets.publishing.service.gov.uk/government/upl… Image
10) Worse, this #B16172 was held up for several days, and Boris Johnson’s office directly intervened to muzzle and censor the extra analysis on #B16172 outbreak in schools. That part is still missing despite original inclusion! This got countless people infuriated.
11) Where is the hospitalizations, some of you ask? Here it is… Bolton 🇬🇧 regional hospital had to open up a new Covid ward.
12) Show me the pediatric surge data? Here it is right here… @IndependentSage created this heat map… clearly school age kids most affected. the surge in #B16172 variant from India in Bolton Uk seems especially hard in children. Schools in UK don’t mandate masks. Big mistake! Image
13) ignore the Royal headline… focus on the bottom over flowery headline… “beating” a virus 6/10 times with 2 doses is not truly beating it. 60% on an exam is a D letter grade in school.

Also, Bolton UK hospital ward filling up with COVID and kids infected is proof not enough. Image
14) let’s revisit SECONDARY ATTACK RATE data—this is very key… a high value means the variant successfully infects more close contacts. @K_G_Andersen once said he won’t believe #B16172 is faster than #B117 transmission speed until he sees B16172 faster on secondary attack rate. Image
15) UK is seeing pockets of pediatric #COVID19 surge as #B16172 grows in dominance. Where else is this seen? Singapore… where its MOH also sent a warning about #B16172 variant risk for kids… see thread 🧵
16) Still don’t believe the data from Singapore MOH or from UK’s own CDC-equivalent PHE? Well let’s look at India then, origin of #B16172… pediatric infection also a major concern there too… including potentially more severity possible.
17) Was the PHE (England’s CDC) risk assessment warning levels upgraded for #B16172? Oh yes.

Faster transmission speed upgraded to “High”, and Vaccine efficacy reduction elevated to RED in just the span of weeks!!
18) And keep in mind that UK is currently an 8-12 week second dose delay country (like many other countries), which @chrischirp agrees is too long of a period to have merely 33% efficacy for AstraZeneca vaccine amid a #B16172 surge. AZ is also 2/3 of all vaccines shot in UK.
19) depending on how much faster #B16172 is than #B117 (already 50% faster), the people of UK have a few upcoming choices to make…
20) Sooo… overall (see above), just how bad are the new #B16172 variant’s transmission speed and vaccine efficacy against it?

It’s somewhere between:

“This is bad” << >> “this is quite bad but not terrible” says Dr @ArisKatzourakis.

Ummm, that’s bad.
21) Let’s examine the #B16172 variant surge in Bolton UK 🇬🇧 closer… it’s uniquely in two age groups… kids & parents of school-age kids. It’s no a coincidence damnit. Large studies previously have shown its more kids in a house, the more transmission in a house to adults. Image
22) so then chicken 🐓 & the egg 🥚 question… which came first—infection in the parents of school age kids or the kids themselves?

➡️ it was the infection in the kids that came first. Naturally. The proof is in the temporal data of the surge timing.
23) Holy shit— look how #B16172 more than doubled in one week in several cities across England (right column). Like this is insane surging growth!!
24) but but but… are hospitalizations increasing as result in the leading epicenter of the #B16172? Yes. There are other areas with rising cases, but Bolton 🏴󠁧󠁢󠁥󠁮󠁧󠁿 is fastest at now over 70% of all cases being #B16172 from India. Image

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More from @DrEricDing

Eric Feigl-Ding Profile picture
25 May
“The Queen has spoken” - the TV anchors when @Simone_Biles landed the Yurchenko Double Pike!

(This is the one so difficult that the Olympics refuses to award extra difficulty points for)
Image
2) NYT: Simone Biles executed a vault considered so dangerous that no other woman has attempted it in competition. For now, gymnastics limits the scoring rewards for trying it.

When the Olympian was asked why she does it, she answered, “Because I can.”
nytimes.com/2021/05/24/spo…
3) Biles is known for moves so difficult that several have been named after her. Her latest signature skill is called a Yurchenko double pike. She executed it with such speed that even "gravity seems to have been taken by surprise," writes @JulietMacur.  nyti.ms/3yBYcmg
Read 4 tweets
Eric Feigl-Ding Profile picture
24 May
Residents in the epicenter of UK’s #B16172 variant outbreak, in Bolton 🇬🇧, told not leave the city unless it is essential, under new guidelines  published. Hospitalization soaring along with cases. 90% of all #COVID19 in Bolton is the worrisome #B16172. 🧵
theboltonnews.co.uk/news/19325835.…
2) look how much cases in Bolton has increased… 113% in one week. But many other places too. Bolton just the largest so far. Image
3) this is part of the bigger nationwide surge in the UK driven mostly by #B16172. See detailed thread 🧵 for more details of the outbreaks… ⬇️
Read 4 tweets
Eric Feigl-Ding Profile picture
24 May
Hospitals in Osaka, Japan buckling under a huge wave of #COVID19, running out of beds, ventilators, and even intubation medicine—as exhausted doctors warn of a "system collapse", and advise against holding the Olympics. Even only ~half of HCW vaccinated. 🧵reuters.com/world/asia-pac… Image
2) The speed at which Osaka's healthcare system was overwhelmed underscores the challenges of hosting a major global sports event in two months' time, particularly as only about half of Japan's medical staff have completed inoculations.
3) "Simply put, this is a collapse of the medical system," said Yuji Tohda, the director of Kindai University Hospital in Osaka.
Read 12 tweets
Eric Feigl-Ding Profile picture
23 May
It’s sickening to watch UK’s CDC equivalent (Public Health England) now being an outlet of Boris Johnson administration’s propaganda. Yesterday, Johnson’s office censored PHE from publishing #B16172 outbreak data in schools—and then hails 33-60% 1&2 dose efficacy as a win for AZ.
2) to be clear, while 60% 2-dose efficacy is good, it’s not great. And asymptomatic infection likely lower. And 33% 1 dose is tricky too given how many countries rely on one dose strategy.
3) Many scientists are shocked by the recent actions of PHE to muzzle and coverup school outbreak data on #b16172.
Read 4 tweets
Eric Feigl-Ding Profile picture
23 May
NEW—UK reports that 2 doses of AstraZeneca vaccine efficacy for #B16172 India variant: just 60%. And latest study says #B117 efficacy just 66% (lower than before). 1-dose efficacy 33% for #B16172.

Clearly #B16172 problematic in 🇬🇧 when 2/3 of shots is AZ
gov.uk/government/new…
2) that said, the Pfizer-BioNTech vaccine was 88% effective against symptomatic disease from the B.1.617.2 variant 2 weeks after the second dose, compared to 93% effectiveness against the B.1.1.7 variant
3) “both vaccines were 33% effective against symptomatic disease from B.1.617.2, 3 weeks after the first dose compared to around 50% effectiveness against the B.1.1.7 variant”
Read 10 tweets
Eric Feigl-Ding Profile picture
23 May
Staggering—at least 3 million excess deaths in 2020–which is **1.2 mil** more than the 1.8 mil official numbers: WHO estimates that is the excess in the America & Europe alone (data not yet including Asia, Africa, Middle East).

I’m also imagining India 😢
who.int/data/stories/t…
2) “Excess mortality is defined as the difference in the total number of deaths in a crisis compared to those expected under normal conditions. COVID-19 excess mortality accounts for both the total number of deaths directly attributed to the virus as well as the indirect impact”
3) what about undercount? “A recent assessment of health information systems capacity in 133 countries found that the percentage of registered deaths ranged from 98% in the European region to only 10% in the African region.” Damn! who.int/data/data-coll…
Read 7 tweets

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