PHE report on variants just out. Highlights:
->90% of cases across England now delta
-delta ~66% more transmissible
-Most cases are in school age children
-30% deaths were among fully vaccinated and 17% in partly vaccinated
-cases of delta sublineage with K417N mutation
PHE still hasn't released data on delta cases in cases linked to schools over time- but we finally get an age distribution (after over a month of long technical reports!!)-

Guess which age group infections are the highest in?

Still, no masks in schools, no focus on ventilation
It's now widely prevalent everywhere in England with >90% frequency in almost all regions - whether we look at sequencing or spike drop out data.
Unfortunately 42 deaths from the delta variant, of which 30% (12) are among fully vaccinated & 17% among partly vaccinated (21 days after 1 dose). Note: this doesn't tell us about level of vaccine efficacy, except it's less than 100%. Take precautions even if fully vaccinated.
Rapid growth of delta continues- it's still growing about 2x (1.93 times to be exact) faster than B.1.1.7 (alpha) at this point in time. Shows the much higher level of fitness of this variant, and the difficulty in containing spread.
No of outbreaks of delta in in educational settings seem to have increased from 140 in the last report to 217 in the last week- suggesting there were *77* outbreaks in educational settings just in the last week.
Data on common exposure (2 or more children with delta variant attending educational settings) shows *almost 1000* such events of 2 or more infected children attending the same educational setting in the *last wk alone*. Shows the likely huge level of transmission in schools.
Case-control analysis examining secondary attack rates (proportion of contacts infected) in households suggests 66% higher transmission of delta variant compared to alpha (B.1.1.7).
There's been another sub-lineage of delta emerging (AY.1) that has the K417N mutation (also found in the beta variant or variant first identified in SA). This mutation has been associated with immune escape, and is concerning. So far 36 cases identified.
We need to remember evolution of the virus isn't likely to end here. This to me is one of the biggest dangers of letting transmission continue at high levels. Even if this doesn't result in the same level of deaths as before, it will result in more long COVID & virus mutation.
And allowing virus mutations to continue at high rates as the virus replicates, alongside vaccination is a recipe for disaster - as this is the most favourable condition for selection towards escape. It isn't enough to surveil virus adaptation- we *must* prevent it.
There's no doubt delta will change the shape of the pandemic in the UK, and possibly across the globe, given it's level of fitness. It was really negligent of the govt to allow this into the country, & then do very little to prevent spread.
Remember we opened up on 17th May despite fully knowing that cases of this variant were doubling every week even at that time, & that it was likely to become dominant in a matter of weeks. Against advice from SAGE. Fully knowing that this could lead to hosp levels similar to Jan.
Our govt removed mask recommendations from schools, in May. There's no doubt schools have been a major area of spread, and played an important role in this variant gaining dominance in the UK. Delta cases (& infection rates) now highest among children.…
This variant poses a serious risk to public health. While the media continues to focus on 'freedom day', the question is what do we do now to prevent what is likely a large 3rd wave, which will lead to significant long COVID, hospitalisations & completely preventable deaths
And how to we prevent this happening again- due to new variants or sub-lineages emerging as transmission continues at high levels, or importing these from the next place they emerge (or have already emerged)? What happens if the next variant renders vaccines much less effective?
Just want to add that while these data don't tell us much about vaccine efficacy, previous estimates from PHE show reasonable protection against symptomatic disease with 2 vaccine doses. So taking that 2nd dose is critical for high levels of protection.
Want to thank @sanerefrain for pointing out that the increased transmissibility estimate should be 64% (the adjusted estimate) rather than 66% (the unadjusted one)

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More from @dgurdasani1

13 Jun
This from the Telegraph gives us an idea of new false dichotomies the govt is setting up: 'six wk window to open up' or 'restrictions up to Spring' - this is being rationalised by some scientists putting forward the same irrational thinking from March. 🧵…
The article reflects a false narrative that our only options are restrict now until 4 wks or 'be in restrictions until spring'. The key part of this narrative is rejection of 'zero COVID' as this would lead to us being 'shut down permanently'. ImageImage
It's precisely our rejection of elimination and 'living with the virus' that's led us to spawning and importing, not one but two highly transmissible & severe variants, with the second having significant escape against vaccines- leading directly to the situation we're in.
Read 20 tweets
11 Jun
Wow. No.10 blocked data on variants in schools before dropping masks. Later PHE asked if they could release data & were told "release some information but keep it vague & release alongside everything else to make the situation look not as bad as it is.”🧵…
This makes perfect sense now to anyone following this. We've been asking for these data repeatedly. Unions, scientists, MPs- but it isn't being released. Last week PHE released a tech report which reported 'outbreaks', and 'common exposures', claiming these data had been released
This *was not* the data that were requested. Clusters can mean 2 cases or 100 cases- while we've clearly had hundreds of clusters, we have no idea how much spread this translates to in schools - which is important for policy. Similarly there was data on common exposures released.
Read 7 tweets
10 Jun
Report from @PHE_uk shows *huge* rise in positivity among primary & secondary school in the week ending 6th June. Positivity appears to have doubled in some age groups in a single week. Notably, this is prior to when children were asked to undertake LFDs before return to school.
Govt still doesn't seem to have plans to put in even the most basic mitigations in schools- despite the rapid spread among school age children, with all of it's consequences, including long COVID. Last week we know 1 in 3 children were absent in Bolton for COVID related reasons.
What will it take for government to do this? It's not complicated- countries all over the world have put stronger mitigations in place in schools. What possible reason could justify not bringing our policy in line with basic recommendations from the CDC on this?
Read 4 tweets
10 Jun
'schools don't drive transmission' is the new 'COVID-19 isn't airborne'

This OpEd cites a 2 page Dec UNICEF, that cites a few reviews that only examine biased symptom-based case studies. No mention of the many less biased studies across hundreds of countries that show otherwise
If you don't think substantial transmission happens in schools and then back into the community, why do you then support mitigations in schools? Isn't that in itself a contradictory stance? I agree with keeping schools open with safety measures. But denying evidence doesn't help.
These are the same narratives that many countries use to suggest that mitigations aren't needed because there isn't much of a risk. Ultimately, it's this denial that leads to school closures. The paradox of stating you want schools to be open while denying the reason they close.
Read 4 tweets
10 Jun
Is Hancock actually suggesting in his testimony that he was advised that it was *safer* for people to be discharged to care homes without testing? That clinical advisors felt it was safer for people to isolate in care homes (where isolation just isn't possible) than in hospital?
"I've got out of bed every morning with the view & the attitude that my is to I could do everything I could to protect lives"... "I've tried to do this with honesty, integrity"...
Absolutely astonishing.…
Hunt asking Hancock why we stopped community testing on 12th March. Hancock says that this was down to PHE for lack of capacity for testing. Interesting, given this was presented very clearly by Jenny Harries as an evidence-based policy, rather than due to capacity limitations.
Read 23 tweets
9 Jun
Completely shocking & negligent if true.
From @NafeezAhmed at @BylineTimes
“PHE’s original advice was that people shouldn’t be released from homes and hospitals without being tested”
"Health Minister Helen Whately – leaned on PHE” to alter the advice"…
This is precisely why we need public health organisations to be able to stand independently from govt. Govt shouldn't lean on public health bodies on decisions that involve public health- doing this can cost lives. In this case it looks like PHE may have been overruled.
We already know govt leaned on PHE to block release data on delta variant in schools. It's unacceptable for govt to interfere with PHE advice and puts lives at risk. If govt did indeed alter PHE guidance on care homes, they must be held to account.…
Read 5 tweets

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