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Dr Duncan Robertson Profile picture
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13 Jun, 6 tweets, 2 min read
We should not move to Step 4 on 21 June. A few extra weeks will allow more data to be gathered on hospitalizations

Test 4 (Variant test) is clearly not met
Test 3 (Infection Rates) may not be met as the *risk* still remains of a surge in hospitalizations

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The Delta variant changes the calibration of the response and needs to be taken very seriously.

We should also go back to the Roadmap to see what the plan is.

There is nothing in the Roadmap for Step three-and-a-half.

Any additional lifting of restrictions over Step 3 will create extra mixing and will increase the *risk* of moving backwards to more stringent restrictions including Lockdown 4.

As ever, this is a political choice.
The link between cases and hospitalizations has not been broken:

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More from @Dr_D_Robertson

Dr Duncan Robertson Profile picture
14 Jun
Here is the LSHTM paper on Roadmap Step 4
assets.publishing.service.gov.uk/government/upl…

A central scenario (assuming a delay of 4-5 weeks) bearing in mind there is still uncertainty.

But: a projection in this wave:

*43,500* (between 31,200-62,900) deaths

Peak deaths *500* (between 300-800) per day
Here is a thread giving more detail of the modelling used by LSHTM

Here's the Warwick projection
assets.publishing.service.gov.uk/government/upl…
Read 7 tweets
Dr Duncan Robertson Profile picture
14 Jun
Let's look at the SAGE 92 minutes that would have informed the Government's thinking.

A thread.
assets.publishing.service.gov.uk/government/upl…
Additional material has also been released from meetings the previous week.

gov.uk/government/pub…
But back to the SAGE 92 consensus statement.

"R is now estimated to be 40–80% higher for delta than for alpha (B.1.1.7), although a figure higher or lower than this cannot be ruled out. "

*40 to 80%*
Read 17 tweets
Dr Duncan Robertson Profile picture
14 Jun
Here is my @SkyNews interview with @skynewssarah on the delay to Step 4 of the Roadmap
- cases rising exponentially
- so are hospitalizations with a delay & a low starting point
- less than 1/2 the population have had 2nd dose
- Delta doesn't play fair

The Roadmap was calibrated against the Alpha/Kent variant. That's why the last two Roadmap tests were included: variants and hospitalizations
We knew before Step 3 was taken that Delta/B.1.617.2/the 'India' variant was more transmissible.
Read 18 tweets
Dr Duncan Robertson Profile picture
11 Jun
I want to talk about 'decoupling'.

A thread.

The Government's reason for proceeding with the 17 May Step 3 unlocking was that vaccination means that cases are 'decoupled' from hospitalizations.

Here's the quote in Hansard.

hansard.parliament.uk/Lords/2021-05-…
The problem is: it's not clear to me that cases and hospitalizations *have* become decoupled.

It's worth reading this in conjunction with the SPI-M advice available to Government prior to Step 3 unlocking.

SPI-M's projection based on a variant (e.g. Delta/B.1.617.2) being more transmissible.
Read 18 tweets
Dr Duncan Robertson Profile picture
9 Jun
Here are some charts showing what is going on with Covid cases and hospitalizations in England.

A thread.

Firstly, cases. In order that the graph doesn't get too spiky, we smooth it by taking the average cases in the previous 7 days. Here it is.
We're only really interested in what's happening now (and in the future), so let's look at the right hand bit. Cases are rising exponentially.
To show this, we can plot the case numbers on a logarithmic plot. If there's an exponential rise, this line should be straight.
Read 11 tweets
Dr Duncan Robertson Profile picture
8 Jun
Let's look back at the SPI-M consensus statement from before Step 3 of the Roadmap.

A short thread.

assets.publishing.service.gov.uk/government/upl…
Read 12 tweets

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