So R is staying stubbornly high in England, and maybe even drifting upwards. Why is this? I’m not really sure, but as usual I think the age-stratified case data is the first place to look for clues. And the changing growth probably isn’t quite where you’d expect it to be. 1/7
Your first suspects might be unvaccinated young adults, out partying and watching the football? Well, their case rates continue to be high and growing, but R seems to have settled down to a new level around 1.3, so it’s not them that’s caused any recent uplift in R. 2/7
Your next suspects might be schoolchildren – we know they spiked up about a week ago, and again growth continues, but there isn’t strong acceleration (although maybe a bit in the 10-14s). Still, there could be a mix effect happening here: 3/7
…although the growth rate in schoolchildren may not have moved much, since it’s higher than average, they will be forming an increasing % of the total cases over time. Which means the contribution of their R to the total R will also be increasing, pushing it upwards. 4/7
But I’m not convinced that’s the whole story. So let’s look up the age distribution a bit, into the 30-60 year olds. Ah. Their R rate seems to be sliding upwards, from about 1.2 to nearer 1.3-1.4 over the last week. This is odd; we’d expect second doses to be pushing 5/7
…growth in this group down, not up. Again, there may be a bit of a mix effect going on, but on a regional rather than age-group basis. Or it may be that poorer weather has driven people indoors, or that compliance with restrictions is weakening. Ideas very welcome…. 6/7
One piece of good news is that there isn’t much change in the growth rate of the over-60s, who are the most vulnerable (but also the most vaccinated). So the wall is holding, and we can retain hope that hospitalisations and deaths will grow only slowly. 7/7
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if you're using PHE's latest analysis of Secondary Attack Rates to work out an advantage for Delta vs. Alpha, it's worth looking at table 7, as well as table 5. while table 5 suggests the advantage has fallen to +35%, table 7 suggests it's probably still 40-45%. why is this?
table 7 splits out the data into household contacts (which imply an advantage for delta of 40%) and non-household contacts (advantage 43%). If you're wondering how the combined (household and non-household) figure can show an advantage of only 35%, it's because delta has...
...a higher proportion of non-household contacts, and these tend to have lower SARs. the most obvious explanation for this is that delta's cases have a lower average age than alpha's, and hence are more sociable, with more non-household contacts.
If you're looking for a source for the surprisingly large number of cases reported in England today, I'd focus on school-age children. For example, this is the case series for 5-9 year-olds:
... and here are 10-14 year-olds:
there is continued growth in the 15-29 year old groups as well, but I'd say it's more in line with existing trends, rather than starting a new one.
So here’s an interesting stat from the case data: over the last month, the case rates in England for men and women have been roughly the same. Which is unusual. (short thread, with thanks to @RufusSG for accidentally prompting me to look at this)
Over the last year, there has been a noticeable (c. 10%) bias towards higher case rates in women. Why is that? I’m not sure. Are women more sociable? More likely to work in key-worker roles? (health/care, retail etc.) Or just more likely to get a test when they are ill?
We can get a bit more insight by looking at the ratio by age group: it’s roughly the same in under-15s, biased towards women in working-age groups (15-65), towards men in the younger retired groups (65-85) and back to women in the elderly (85+).
I’ve updated the model with all the latest data, and it’s mostly good news – at least for what happens over the next few months. There might be a bit of a ‘sting in the tail’ in the winter, but I think there are ways of dealing with that. Summary conclusions as follows: 1/
1. In my central case, the summer 2021 wave should be relatively small compared to previous waves (peaking around 5k hospitalisations per week) 2. Even in downside scenarios with higher R0 for Delta or a larger Step 4, there should be little risk of overwhelming the NHS 2/
3. However, opening earlier than 19th July would significantly increase those risks, and is not recommended 4. Assuming things go well in the summer (i.e. with a small wave), we may yet face the challenge of finding a few more % points of immunity in the autumn. 3/
I think this deserves an explanation: why is it that countries that have already completed their epidemics with Alpha (or similar variants) might have an easier time with Delta than the UK, which was still in the process of opening up when Delta hit? 1/n
The answer has all to do with “overshoot”. For most epidemiological concepts there is an @AdamJKucharski thread to go with them, and overshoot is no exception, so I’ll leave you to explore here if you’d like a reminder of how this works: 2/n
Now for the purposes of this illustration, let’s assume we have two variants:
A, which has R0 of 4.0 and therefore -in a simple model- a herd immunity threshold (HIT) around 75%,
and B, which is 67% more transmissible than A, and so has R0 of 6.7, and HIT of ~85%. 3/n
I know I’m meant to be reading the details of the SPI-M papers but there’s only so many coloured curves on a chart you can stare at before they all start blending into one. I’ll re-convene on that tomorrow, but in the meantime I found something interesting in the case data. 1/7
This is plotting the growth rates for the 5-year age groups up to 30 over the last 3 weeks. You can see the explosive growth in the 20-24s and 25-29s following Step 3, and then a significant deceleration (falling growth rates) over the last few days. 2/7
On the other hand, the growth rate in school-aged children (5-9 and 10-14) looks to be resurging, having taken a short break over half term – suggesting that we might have a rocky few weeks ahead in the last few weeks of the school summer term. 3/7