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Prof. Christina Pagel Profile picture
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23 May, 6 tweets, 2 min read
I disagree. Let's look at the last 3 crucial weeks:

6th May: PHE very concerned about B.1.617.2 & about to make a VoC. Report delayed because of local elections, pubished 7 May. PHE bounced into announcement by Guardian & Channel 4 coverage.

theguardian.com/world/2021/may… 1/5
13th May: Report was ready on Thursday afternoon with a page on schools data (seen by Observer) - report published hours later in the evening with just the schools page removed.
Observer has seen evidence this removal was at Num 10 request.
theguardian.com/world/2021/may… 2/5
20th May: PHE told journalists report would be released on Thursday (when it was due). it was not. Then Friday lunchtime - it was not. Then Friday sometime. It was not.

Finally released Sat night - no press release (unlike vax report released at same time). No school data. 3/5
*If* this was just difficulty issue then wait till Sunday, release it *with a press briefing* and explain to the public what is in it.

Or is it suddenly not news that B.1.617.2 is now "high risk" for transmissibilty & vax escape AND likely dominant in England? 4/5
This is politics not public health and it's not OK. /END

Risk assessment:
assets.publishing.service.gov.uk/government/upl…

Report
assets.publishing.service.gov.uk/government/upl…
PS I don't doubt that PHE scientists are working round the clock. And their reports are really good.

But I think if anything they should be more concerned and angry that their hard work is being spun to minimise concerns and help number 10.

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More from @chrischirp

Prof. Christina Pagel Profile picture
24 May
SHORT THREAD ON SCHOOLS:
As we open up, schools are becoming the biggest places where large groups of unvaccinated people mix.
This makes them more vulnerable to outbreaks if local cases increase.
But data on what is happening in schools is sparse.
Firstly, twice weekly lateral flow device tests (LFDs) - the government's main mitigation in secondary schools now that they've removed masks - are not really being done.

There should be about 8 million LFDs a week in secondary schools. But we are only seeing 2 million. Image
Numbers picked up a bit after Easter holidays but are now back to where they were in mid April & at ~25% of expected tests (and that's not counting school staff)

Regardless of how effective an intervention it is, this is the government's main strategy. And it's not being done.
Read 10 tweets
Prof. Christina Pagel Profile picture
24 May
THREAD: I know many people are thinking "but how can this new variant be scary when overall case numbers are flat?"

Here's how.

(Numbers that follow are illustrative but based on case data & sequenced proportion data from Sanger: covid19.sanger.ac.uk/downloads) 1/6
Cases of B117 ("Kent") variant have been falling every week, while cases of B.1.617.2 (1st sequenced in India) have been growing. Total cases are B117+B.1.617.2.

We've had two epidemics at once. During early days for B.1.617.2, its growth is entirely masked by fall in B117 2/6 Image
As proportion of cases that are new variant grows, overall cases start to creep up - but not by much. Not at first.

In this example, it's an 11% increase week ending 22nd May. 3/6 Image
Read 6 tweets
Prof. Christina Pagel Profile picture
23 May
LONG THREAD on B.1.617.2 & latest PHE data covering:

1) latest tech report on B.1.617.2 (aka "India" variant)
2) vaccine efficacy against B.1.617.2
3) consequences for roadmap
4) avoidability... or not.
2. So first off, PHE tech report released late last night.

Can detect B.1.617.2 by direct sequencing OR by using "S gene" in a PCR test (now 99% of these are B.1.617).

BOTH these methods now estimate that as of 15th May B.1.617.2 was on cusp of being dominant English variant.
3. There is no evidence that B.1.617.2 causes more severe illness than B.1.1.7 (aka "Kent" variant). This is good news but data still quite sparse.
Read 36 tweets
Prof. Christina Pagel Profile picture
22 May
THREAD on vax study for B.1.617.2 (new "Indian" variant):

@jburnmurdoch broke a story from PHE data with the first real world analysis of AZ & Pfizer vaccine efficacy against B.1.617.2.

I am less convinced this is great news than some. Here's why.
ft.com/content/a70d42… 1/16
The study estimates that both vaccines are 33% at preventing symptomatic B.1.617.2 disease after 1 dose (vs 51% against B117 ("Kent")) and 81% effective after 2 doses (vs 87% for B117).

Too little data on preventing severe disease to say much but v likely to be better. 2/16
So the vaccines do mostly work against B.1.617.2 - especially after 2 doses. That's good news - but not surprising.

We already had evidence from a care home outbreak, & Bolton hospital. Early lab studies suggested less escape than B.1351 "S Africa"
blogs.bmj.com/bmj/2021/05/18… 3/16
Read 16 tweets
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
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
Very few people have received even one dose of vaccine.

Nepal's healthcare system is also weaker than India's. 3/7
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
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.
Read 11 tweets

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