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

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
Dec 21, 2023
Beyond a shadow of a doubt that England is in its biggest Covid wave for well over a year now, with latest ONS infection survey results published.

I've written about it here
1/7 tinyurl.com/ru7h3m28
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The UKHSA have now published their modelled estimates of what percentage of English population has Covid. And as of a week ago it's high (4.3%) and rising.

Read all about it here!
2/7
It's highest in London, South East and East & in young and middle aged adults.
The main thing is it's going up and fast, so prevalence will already by significantly higher now than it was last week. 3/7
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Read 8 tweets
Nov 30, 2023
Short thread on what I said on Channel 4 news tonight.

1. Did I find Hancock a sympathetic witness?

A: I find it hard to have sympathy for someone who repeatedly claimed to have thrown protective ring around care homes, while discharging covid+ patients into them.

1/5
There were *28,000* excess deaths in care homes Apr-May 2020.

Harries thought it was "clinically reasonable" not to treat covid +ve residents in hospital. Even it was, it was NOT reasonable to return them somewhere they could infect so many other very vulnerable people. 2/5
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2. Did I think scientists bear blame for not emphasising asymptomatic transmission?

A: No, because they very clearly did advise there could be asymptomic transmission before March 2020 - sources in next tweet. 3/5
Read 5 tweets
Nov 30, 2023
Hancock: "there was no way we could allow the NHS to become overwhelmed"

Except, the NHS WAS overwhelmed

Here is what NHS staff said about that time - Pls read whole 🧵
"Heartbreaking"
"Horrific"
"It broke my soul"
"We cried, we came home exhausted. We were overwhelmed"

1/16
"Overnight we were told that all “safe working rules” were gone. There was no choice, we were forced to do it"

"It felt like a death sentence. It felt out of control"

"We were put on wards with no senior support, sometimes makeshift ... with little of the right equipment"

2/16
"Terrifying. A huge sense of duty ... but also terror. We were unprepared & ovt clearly had no plan"

"We had patients on wards on 19 litres of oxygen - this would never happen under normal circumstances - they’d have come to Intensive Care but we didn’t have the space"

3/16
Read 17 tweets
Aug 31, 2023
THREAD: England Covid update

TLDR: modest August wave with flatlining hospital admissions, but expect a bigger wave later this autumn 1/12
Hospital admissions with Covid in England are still quite flat for 3rd week in a row and at a level below previous troughs.

Number of people with covid in critical care & primaril yin hospital because of Covid also flat & low.

Deaths ⬆️, from case rises few weeks ago 2/12


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However, Zoe symptom tracker app estimating significant increases recently. Very hard to know how reliable Zoe trends are, given far fewer people reporting, but it's worth bearing in mind.

So what could happen next? 3/12 Image
Read 14 tweets
Aug 29, 2023
THREAD: Various new or expanded cancer screening programmes have been announced recently and coverage has been overwhelmingly on the pros. But there are cons too.

So let's explore some of the pros and cons...

expansion of my @guardian article


1/24 theguardian.com/commentisfree/…



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First a screening recap : a relatively simple test that flags potential cause for concern. If flagged, you are offered more, gold standard, testing, often in a hospital (e.g. MRI scans, blood tests, other diagnostic procs). If those +Ve too, you are offered cancer treatment. 2/24
The benefits are clear: If you have undiagnosed serious cancer, screening can save your life if it leads to earlier treatment.

In this case massively beneficial to you *and* to NHS which can save on longer, more expensive treatment from later diagnosis 3/24
Read 26 tweets

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