Shamez Ladhani Profile picture
Jul 11, 2021 9 tweets 6 min read Read on X
1/9. In England, #SARSCoV2 infection rates in school-aged kids & #COVID19 outbreaks have both ⬆️ in recent weeks (latest data 4 July) but that does not change the narrative on kids & their role in infection/transmission in school

Here’s why … 🧵

👉 assets.publishing.service.gov.uk/government/upl…
2/9. No one has claimed that kids don’t get infected or don’t transmit #SARSCoV2 to others. But the data suggest that lower risk with kids than adults. Eg. We don’t see two-thirds of staff/students infected in a single outbreak as we do in care homes 👉 thelancet.com/journals/eclin…
3/9. We & others have shown that #SARSCoV2 cases & outbreaks reflect community infection rates. Cases in kids generally follow adults *unless* adults are in lockdown & kids continue to go to school. This happened in Nov/Dec 2020 & Mar/Apr 2021. See👇👇

👉 journalofinfection.com/article/S0163-…
4/9. After the Jan 2021 lockdown, schools opened on 08 March for 3 weeks (black circle). Cases were highest in secondary school children when mass LFD testing was implemented before they were allowed back in school, but then declined & remained low (they also wore masks in class)
5/9. After the Easter holidays, too, infection rates remained low in all school-aged children for *6 weeks* since mid-April (blue circle), when most of the adults were still in national lockdown & despite the emergence of the Delta variant in England - outbreaks too were limited
6/9. From 17 May (week 20), we eased into step 3 of opening lockdown & cases ⬆️ rapidly in all ages, esp 20-29 & 10-19 year-olds. Only 1 of these groups was in school.

Opening lockdown likely increased contacts & transmission chains outside schools

👉 assets.publishing.service.gov.uk/government/upl…
7/9. Interestingly, infections by age are better seen in ONS Survey (community testing, random households). Infections in primary & secondary school-aged kids remained low & only started ⬆️ after cases started increasing in year 12 to age 24 (~mid-June) 👉ons.gov.uk/peoplepopulati…
8/9. School outbreaks have also increased, especially after 17 May (red circle), although important to remember there are ~24,000 schools & <300 outbreaks (1-2% of schools). Also, outbreaks are defined as 2+ cases but these cases don’t have to be linked or infected in school 👇
9/9. In conclusion, #SARSCoV2 cases/outbreaks in schools remained ⬇️ when adults were in lockdown. This changed when lockdown eased (17 May). Vaccines will help keep community infection ⬇️ but we need more evidence-based mitigations in schools not just 4 #SARSCoV2 but all viruses

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More from @ShamezLadhani

Jan 30, 2023
1/ Remember all the media coverage of #omicron causing so much severe #COVID19 in young kids?

We extended our @UKHSA #COVID19 deaths surveillance in kids & found:

ONE #COVID19 fatality per MILLION #Omicron infections in children aged <20 yrs …🧵

👉 sciencedirect.com/science/articl…
2/ We assessed all fatalities within 30 days of a positive #SARSCoV2 test in <20 year-olds during Jan-Mar 2022 when national testing was still available. We collected detailed clinical data from multiple sources to ascertain cause of death for each child
3/ During Jan-Mar 2022, there were 46 deaths within 30 days of a positive #SARSCoV2 test & 11 were due to COVID-19

👉All 11 #COVID19 deaths occurred after primary SARS-CoV-2 infection

👉 8/11 (73%) had underlying comorbidities, including 4 with severe neurodisabilities Image
Read 9 tweets
Dec 30, 2022
1/ This is so mportant - thank you @kerpen for tagging me

The US with all its mitigations, vaccine & booster mandates has the same proportion of kids already exposed to #sarscov2 as the UK, which as been accused of “letting the virus rip”

90.3% (US) vs 86.7% (UK)

…🧵
2/ In England, among 1-17 year-olds, we recently reported that by Sep 2022

➡️ 86.2% (95%CrL 81.1-91.6) had infection-induced #SARSCoV2 N antibodies

➡️ 97.2% (95% CrI 93.7%–98.9%) had #SARSCoV2 S-antibodies (infection and/or vaccine)

👉 journalofinfection.com/article/S0163-…
3/ According to US CDC, #SARSCoV2 antibody seroprevalence in 6m-17y by Sep-Oct 2022 was no different:

➡️ 90.3% (95%CI 89.8-90.8) had infection-induced N antibodies

➡️ 95.9% (95%CI 95.5-96.3) had S-antibodies (infection and/or vaccine)

👉 covid.cdc.gov/covid-data-tra…
Read 5 tweets
Dec 28, 2022
1/ Our @UKHSA paper on paediatric #SARSCoV2 antibody prevalence in England is now published

By Sep 2022, 97.2% of 1-17 year-olds had #SARSCoV2 antibodies

Our findings are critical for future #COVID19 vaccine/booster recommendations for kids

…🧵

👉sciencedirect.com/science/articl…
2/ Methods: We used residual samples from kids aged 1–17 years having a blood test as part of their clinical management in 44 hospital trusts in England. Samples were processed using Roche Elecsys assays for i) nucleocapsid (N) antibodies and ii) spike RBD (S) antibodies
3/ The overall national prevalence estimate of #SARSCoV2 antibody seropositivity in 1-17y, weighted by age & NHS region, based on Spike protein (vaccine or infection) increased from

➡️ 48.5% (95% CrI 40.8%–55.1%) during Sep-Oct 2021
to
➡️ 97.2% (95% CrI 93.7%–98.9%) by Sep 2022 Image
Read 8 tweets
Dec 5, 2022
1/ Our latest paper on longitudinal follow-up of teens with long covid (CLoCk) is a game changer:

Different teens report the same post-covid symptoms at 0, 6m & 12m after their #SARSCoV2 PCR , irrespective of whether they tested + or - for the virus

👉 sciencedirect.com/science/articl…
2/ Method: we followed up 11-17y with a PCR-positive #SARSCoV2 test compared with matched PCR-negative controls for 12 months after their test. The final cohort included 2,909 cases and 2,177 controls
3/ We found that teens reporting a symptom at baseline (PCR-testing) improved by 6m, with new teens reporting the same symptoms at 6m, who then improved by 12m, with new kids reporting the same symptoms at 12m and so on …. you catch the drift .. 👇
Read 9 tweets
Nov 18, 2022
1/ It’s really sad that, when we report that a disease (eg. #covid19) is more severe or fatal in kids with underlying conditions (eg neurodisabilities, immunocompromised), this is taken to mean that such kids are less valued

The truth is exactly the opposite…🧵
2/ It is really important that we identify kids at increased risk of severe outcomes after any condition (eg #COVID19) so we can raise awareness among clinicians, parents & policymakers to be extra vigilant & implement additional strategies protect them 👉journals.plos.org/plosmedicine/a…
3/ When kids with severe neurodisabilities were identified as high-risk in the 1st pandemic wave, the UK recommended #COVID19 vaccines for 12+y kids with severe neurodisabilities as soon as vaccines were licensed in adults - way back in Jan 2021 👉 adc.bmj.com/content/106/12…
Read 7 tweets
Nov 17, 2022
Remember that recent US paper on #covid19 vaccination for 5-11y?

We didn’t agree with the conclusions (h/t @ProfAsmaKhalil)

So, we wrote to @NEJM to explain why US data do NOT support BOOSTERS for kids irrespective of their previous infection status

👉 nejm.org/doi/full/10.10… Image
2/ We pointed out that there was very little difference in protection against omicron infection between vaccinated & previously infected 5-11y, while infection plus 2 vaccine doses might provide slightly better protection after 4 months (79.4% vs 62.9%)

👉nejm.org/doi/full/10.10…
3/ We then pointed out that #COVID19 hospitalizations were v low in 5-11y irrespective of vaccination status (0.3-0.5%), although we still aren’t sure how these were calculated because numerator/denominator in their table give lower percentages (0.1%)🤷🏻‍♂️

👉nejm.org/doi/suppl/10.1…
Read 6 tweets

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