1/4 Latest modelling from Sage is out. Key points:

➡️Relaxation on 21 June threatens a large resurgence in infections and admissions
➡️In all scenarios, even a short delay results in a drop in hospitalisations and deaths
➡️4wk delay cuts peak in admissions by 33-50%
2/ Looking at Warwick, there's a focus on vax effectiveness against Delta. Like transmission, it makes a big difference. Default assumptions take us close to 1st peak, pessimistic ones well over it...
3/ Here is the impact of delaying Step 4 by different periods. Moving back 4 wks (yellow line) takes us below 1st wave peak for all vax effectiveness scenarios
4/ Some will say this a cautious approach. But keep in mind the number of hospitalisations and deaths we are talking about is NOT low. This summary table is from the London School. Going back to Step 2 is the only way you cut deaths dramatically...
5/ And here are the conclusions drawn by Imperial. Note how sensitive those deaths counts are to small changes in the assumptions used...

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More from @PaulNuki

1 Jun
1/ Some great infographics in this piece for those interested in the challenge of vaccinating the world. A quick thread...
telegraph.co.uk/global-health/…
2/ First, the extent to which vaccine manufacturers overestimated early supply is horribly marked - and explains many a dashed expectation...
3/ On the other hand, we will - by the end of the year - have enough vaccine for everyone on Earth. No small achievement...
Read 9 tweets
30 May
1/ Lots of debate as to why ~40,000 vulnerable people died of Covid in care homes in England and Wales and who was to blame. Yet the road to this particular tragedy is well documented. A thread...
2/ First, it's important to note the cull of care home residents is a failure on the gov's OWN terms. As detailed below, Whitehall never planned to stop a new virus. But it was, from 2017, supposed to have plans in place to protect care homes
3/ How do we know there was supposed to be a plan? Because it is one of the key recommendations to have come out of Excercise Cygnus, the 2016 dry run for a pandemic. In short, Whitehall ordered itself to produce a plan for care homes assets.publishing.service.gov.uk/government/upl…
Read 19 tweets
25 May
1/ Gosh, I see tomorrow's Commons spectacular is to be co-chaired by Jeremy Hunt. This is odd because in the field of pandemic planning (which he ran between 2012-2018) he is best styled as not so much as grand inquisitor but *chief defendant* ...
2/ Mr Hunt is huge on the "everything-would-have-been fine-if-it-had-been-flu" defence. This after all was the title of our plan - the UK Influenza Pandemic Preparedness Strategy 2011....
assets.publishing.service.gov.uk/government/upl…
3/ But this is tosh. It's no defence at all and it is important to understand why.
First, influenza comes in a huge range of different forms. It can be fast or slow, mild or devastating. This is true of seasonal flu but especially so for pandemic varieties ...
Read 8 tweets
24 May
1/ There's a lot of balls circulating about the UK's pandemic response and specifically *herd immunity*. Yet most of it is fully documented. Here's a thread pulling together some of the key points...
2/ Did the UK have a herd immunity strategy? YES, it was always the default. We had no other plan. The idea of suppressing the virus via lockdown etc was made up on the hop in late March when it became clear the NHS would be overwhelmed. Everyone knows that.
3/ Why did we not have a suppression plan? This is more interesting and the answer is that the DH/PHE/Cab Office explicitly rejected the idea when it reviewed the nation's pandemic strategy in 2010/11 assets.publishing.service.gov.uk/government/upl…
Read 17 tweets
22 Apr
BREAKING: New data on UK variants out from PHE....

1/ South African up 70 on last week, as results of surge testing in London start to come through...
2/ India up 55 to 132 total. Rapid growth, albeit from a low base...
3/ P1 from Brazil up 20 to 60
Read 4 tweets
18 Apr
Revealed: Why Britain’s regulator missed the link between the AstraZeneca jab and rare blood clots telegraph.co.uk/global-health/…
2/ We confirmed the first three cases of CVST+H happened in Jan and Feb. Two life-changing events and one death. The first Yellow Card came in, say the MHRA, on 8 Feb - the day the vax launched in Europe. Why were these and other early signals missed?
3/ We identified three reasons. First, the "sensitivity" of the algorithms/processes used by MHRA were lower than in parts of Europe. We tracked against background rates, while others turned the sensitivity dial up to 11... Image
Read 9 tweets

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