Prof. Christina Pagel Profile picture
Jul 2, 2021 25 tweets 10 min read Read on X
THREAD: Where are we in UK with cases, where are we going and should we care?

TLDR: nowhere good, somewhere worse, absolutely yes.

1/24 (yes, I know, another long one. Still worth a read I hope!)
We are at almost 30,000 daily cases again - numbers last seen in mid December.

Cases are climbing steeply. 2/24 Image
They are climbing in all nations now - over the last week growth in all nations was about 70%.

This is clearer when looking at the same plot on a log scale (2nd chart).

It's not just testing- positivity is rising too (note that positivity chart only to 26 June) 3/24 ImageImageImage
What does this mean? 70% growth is about 9 day doubling time & 18 days left till 19 July.

Growth has accelerated recently but projecting forward at current 70% gives 90K 7 day average & over 100K cases a day by 19 July.

Charts show same thing on log and normal scales. 4/24 ImageImage
This may seem unbelievable - but we have about 25 million people likely still susceptible to covid (only 50% of pop fully vaxxed).

Schools have another 3 weeks of term.

Most things are open, inc pubs and each other's houses.

The football is on, England is winning. 5/24 Image
Vaccination will slow growth but unlikely to have massive impact in next 18 days.

Even if growth slows to 50% a week, that's still 80K daily cases by 19 July. To get to "only" 50K daily cases you'd need to suddenly slow down a lot.

Today's week on week rise is 74%. 6/24 ImageImage
So who is getting infected?

Well mainly younger people - particularly school age children and twentysomethings.

While cases are highest in 15-29 yr olds, they are rising fastest among 5-14 year olds. 7/24 ImageImageImage
In England, the number of school outbreaks is almost back to where we were last December and almost 400,000 children were off school due to Covid in week to 24 June.

There are still 3 weeks left of term in England. 8/24 ImageImage
In Scotland, cases are highest in 20-24 year olds and much lower in under 14s. School term has ended in Scotland which is a good thing.

Two thousand recent cases in Scotland were linked to football, particularly the England/Scotland match.
bbc.co.uk/news/uk-scotla… 9/24 Image
Covid is everywhere but cases are highest in Scotland and North of England (and Cornwall!).

Looking at regional English data, once again the North is disproportionately affected by covid.

But almost *every* local authority saw increases last week. 10/24 ImageImageImage
So that's where we are and where we are going over next 18 days.

And then on 19th July, we open a lot more. Will this matter?

What about hospitalisations & deaths? 11/24
The number of people in hospital is still low - much much lower than it would be without vaccination and compared to where we were in Nov with similar case rates.

But hospitalisations are rising - especially in Scotland and England and that growth is also increasing now. 12/24 ImageImage
In England, hospital admissions are rising in every region but are highest in the North. 13/24 Image
Daily reported deaths have started rising a bit but are still very low - much much lower than compared to last autumn with similar case numbers. This is a good thing and largely due to vaccines. 14/24 Image
So why should we care?

Many (inc govt) are saying infections don't matter any more, that the link between cases and hospitalisations / deaths is broken. That it's fine if kids & young people get it and we shouldn't worry about it.

I disagree. Strongly. Five reasons. 15/24 Image
1. Hospitalisations & deaths are far lower than they would be without vax. But they are rising - and if we get to over 100K cases a day, many will still get very sick and some will die.

Plus hospitals are already stressed and don't need more stress! 16/24 Image
2. Long covid. ONS reports 1 million people a year living with long covid, and 385K have had it for over a year. 634K said it adversely affected their daily lives.

Even 7-8% of 2-15 yr olds & 12% of 17-24 yr olds reported symptoms for over 12 weeks.
ons.gov.uk/peoplepopulati… 17/24 Image
Sooo... for every million new infections, we might expect 100K-200K (mostly young) people living with long covid.

Many will find their ability to work or study affected.

The longer term impact of covid on the organs are unknown - but we know covid can damage the body. 18/24 Image
3. Deprivation.

Cases are highest & vax rates lowest in deprived areas, and people more likely to need hospital and get long covid.

Children in deprived communities suffer more from education disruption.

Letting infection rates soar will exacerbate inequalities. 19/24 Image
4. Variants

Every new case provides chance for further mutation.

Delta went from 0% to over 90% of cases in 10 weeks.

As children get infected, any mutation that can better infect their vaxxed parents (and their parents' friends) will have a selection advantage. 20/24 Image
5. We can prevent cases!

We have safe & effective vaccines. Pfizer is approved for over 12s & vax for under 11s are being trialled.

We have an excellent vax programme, it *just isn't quite finished yet*.

We are letting things rip for the sake of a couple more months. 21/24 Image
We also need to support vaccines through public health measures *which govt is not doing*:
- excellent (rapid!) contact tracing
- support for isolation
- better ventilation
- better communication of symptoms, testing, isolation, vaccines 22/24
Instead, govt is planning to remove the few measures that we do have: social distancing, masks, isolation and allowing mass events & venues such as nightclubs without testing or other measures.

This is a deliberate choice to allow millions of young people to get infected. 23/24
With our excellent vax programme + better public health measures we can vaccinate instead of infect - and avoid the negative consequences of infection.

Instead govt has given up and plan is to "live with" soaring infections.

It's a terrible plan. 24/24
PS thank you to Bob Hawkins for his help in preparing the charts as ever!

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More from @chrischirp

Jul 23
THREAD:
I wrote about Baroness Hallett's Inquiry Module 1 report for @bmj_latest .

She found that there was *never* a plan to keep a pandemic death toll down - I discuss this and what it means going foward.

Main points below: 1/14 Image
The headline most seen is that the UK planned for the wrong pandemic.

While it is true that was far too narrow a focus on a flu pandemic, that is not the most telling bit.

To me the most telling bit, is what the plan did NOT do 2/14


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The issue is less the wrong disease, but that there was never a plan to prevent one at all – of any disease type.

The plan was *never* about reducing the number of pandemic deaths. 3/14 Image
Read 14 tweets
Jul 19
Quick thread on current Covid situation in England and Long Covid.

I have Thoughts about the Inquiry Report published yesterday but am still trying to organise them.

TLDR: high Covid levels remain, Long Covid remains 1/11
This wave is not over. While the number of admissions with Covid remains lower than the autumn/winter waves, it has now remained highsh for several weeks.

This means there are a lot of people out there getting sick - and having their work, plans and holidays disrupted. 2/11 Image
Scottish wastewater data to 9 July shows a sharp decrease, suggesting that prevalence might be on its way down.

Obviously Scotland and England can have different dynamics, but it’s the best we’ve got as long as England refuses to analyse its own wastwater. 3/11 Image
Read 12 tweets
Jul 3
THREAD: Given tomorrow's election, I've been thinking about our nation's (poor) health, the wider determinants of health and how these have worsened and what it means for policy....

TLDR: worrying only about NHS & social care is missing the point

let's dive in... 1/25
The UK has a health problem. After steady gains in life expectancy for decades, it flatlined during the austerity years and fell for the first time this century with the Covid pandemic.

The number of people out of work for long term sickness is near record levels. 2/25
There are huge inequalities between rich & poor. Boys born in the most deprived areas can expect to die almost 10 years earlier than their peers in the least deprived areas.

Even worse, they can expect to spend 18 fewer years of their life in good health (52 vs 70 years) 3/25 Image
Read 38 tweets
Jun 4
As ever, I am getting lots of pushback.
Here is a compilation of the European countries I've found with recent wastewater data. Some are going up a bit, some down a bit, some are flat, none are anywhere near previous peaks.
I can't see anything here to be panic anyone. 1/3
Image
I can't find the dashboard for Spain, but others saying it is in a wave. Perhaps it is. England has just had one - the last data we had (a couple of weeks ago from Bob Hawkins) looked as if our wave had peaked.
So, I'm not seeing reason to think things are terrible here! 2/3 Image
Yes there are new variants growing right now. They are not growing faster than JN.1 grew in December and that wave did not end up as bad as feared.
Clearly it remains true that Covid is NOT a seasonal disease (unlike Flu and RSV)
3/3
Read 5 tweets
May 8
Quick thread on the Astra Zeneca (AZ) covid vaccine since it's been in the news today.

TLDR there isn't a new "smoking gun", the AZ vax was one of first and cheapest, it saved millions of lives globally, there are better vax out there now, adapted to new variants 1/9
the AZ vaccine was one of the first approved at the end of 2020, cheaper than Pfizer, and - importantly - easier to administer in lower resource settings as it didn't require super low temperatures for storage 2/9
In most countries it was first rolled out in older adults. As it was rolled out in younger adults, a *very rare*, serious, side effect was noticed - it could cause deadly blood clots

This was spotted quickly and studied. Vax monitoring did its job. 3/9 Image
Read 11 tweets
Apr 2
A short thread on why this is not a scary chart and why all the evidence suggests that there is not much Covid around right now. 1/6 Image
the above chart is recorded covid hospital admissions / reported covid cases. It is close to 100% now *because basically only hospitals can report cases since Feb 2024*

It is to do with changes in case reporting and NOT hospital testing
2/6
In fact hospital testing has been steady since the change in testing a year ago (only symptomatic patients get tested now).

The % of people PCR tested who have Covid is 4% - there is no evidence that there are loads of symptomatic people in hospital being missed. 3/6
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Read 6 tweets

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