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Adam Kucharski Profile picture
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2 Jul, 4 tweets, 2 min read
Schools, workplaces, pings from COVID app… Having high UK case numbers over summer will have huge implications for quarantine burden. A few thoughts… 1/ bbc.co.uk/news/business-…
Because vaccines reduce onwards transmission, contacts are becoming less risky on average - which means that for a given value of R, each case will typically have far more contacts than they would have had last year. 2/
Under pre-pandemic contact patterns, a typical case will have 25+ contacts while infectious (thelancet.com/journals/lanin…). That’s a lot of people who could potentially be quarantined per case. 3/
It could effectively lead to an outcome much like a rolling lockdown at individual level - we made a similar point last year: 4/4

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More from @AdamJKucharski

Adam Kucharski Profile picture
18 Jun
Any discussion of daily testing vs quarantine for contacts of cases in schools needs to address the key epidemiological question: if a child in a school tests positive, what do you do next? 1/
Encouraging ventilation etc. to reduce transmission risk is important, but you still have to decide what to do about a positive result. Do you quarantine their contacts or not? 2/
If you decide to abandon quarantine because you think ventilation etc. has sufficiently reduced risk, then this still means accepting higher transmission risk than if quarantine had remained in place. 3/
Read 8 tweets
Adam Kucharski Profile picture
11 Jun
How long could UK cases continue to rise? And how might hospitalisations increase alongside? A thread... 1/
Despite relatively high vaccination rates compared to other countries, cases are growing and in many areas R is now above 1.5. Remember, immunity is already 'priced in' to this number - without vaccination and the social distancing still in place, R would be *much* higher. 2/
If R is 1.5 and contacts/control remain the same, then we'd need remaining part of the population who could potentially spread COVID to shrink by at least 33% before R drops below 1 & epidemic peaks. This would require additional immunity, either from infections or vaccines. 3/
Read 9 tweets
Adam Kucharski Profile picture
5 Jun
A common Q: “how can COVID hospitalisations in UK still grow if vaccine % high?” Answer: look at the data. Average was ~120 daily COVID admissions over past week. These would have been infected about 2-3 weeks earlier, when case numbers ~2000 per day. This shows two things... 1/
First, there was still a group at risk of hospitalisation a few weeks ago. And second, this risk was large enough to show up as hundred of admissions in recent data, even though cases were at relatively low levels. 2/
So the key question here: if case numbers were to grow X times larger, why wouldn’t hospitalisations also grow X times larger? 3/
Read 4 tweets
Adam Kucharski Profile picture
25 May
One thing that has hugely shaped countries' response to COVID, and which I don't think gets enough discussion: genuine constraints and perceived constraints. A thread... 1/
Some apparent local constraints have persisted throughout the pandemic. For example if you look globally, there are still notable differences in approaches to surveillance and quarantine... 2/

It's worth reading these papers on the response in Taiwan (jamanetwork.com/journals/jama/…) and Korea (jamanetwork.com/journals/jama/…). Should more countries include these data-intense approaches in future pandemic plans? Or does reluctance to date reflect an immovable constraint? 3/
Read 9 tweets
Adam Kucharski Profile picture
23 May
Preliminary UK data on vaccine effectiveness against B.1.617.2 (originally detected in India) now available: khub.net/documents/1359…. A few things to note... 1/
First and foremost, it’s another reminder that *second doses matter*. By Aug/Sep, UK will be in much better position against B.1.617.2, but there’s a risk of substantial transmission in meantime as things reopen. 2/

Also remember that when vaccine effectiveness high, small absolute differences can have big effect. E.g. a drop from 95% to 90% would double number at risk (and probably more than double outbreak size given non-linear nature of transmission). 3/
Read 6 tweets
Adam Kucharski Profile picture
18 May
In real-time, epidemic data streams are patchy, delayed, biased and often contradictory. That's why scientists use terms like 'realistic possibility', 'medium confidence' etc. Uncertainty is inevitable (although will reduce over time) - and yet decisions still need to be made. 1/
B.1.617.2 has been spreading fast in some areas, and people are working hard to disentangle causes & quantify exactly what it means for wider transmission. Control measures are now both going in (e.g. testing, vaccination) & being relaxed, which making analysis even trickier. 2/
For more info, people like @kallmemeg @arambaut @jburnmurdoch @erikmvolz @TWenseleers have been posting some useful summaries recently: 3/
Read 4 tweets

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