15 Tweet THREAD on current cases & trajectory:

Cases this week have been bit lower than many expected (inc me!). Have we peaked?

Here are my thoughts for what they're worth...

TLDR: lots of possible things combining. I don't think this is the peak.
2. we know PCR testing capacity is stretched. Test & Trace reporting longer test turnaround times and results taking longer to make it to the dashboard.

Looking at results by date of test to 5 days ago (17 July), things still increasing everywhere but Scotland.
3. Looks as if the combined dampening effect of Scotland being knocked out of Euros, school term ending and final opening delayed has helped bring cases down. Which is very good news.

Term ended in Wales on 16th July and today in England. That will bring cases down from now.
4. NOTE school holidays bring cases down mailny cos less transmission but also cos less routine testing in school children. Tests are lower in Wales this week for instance in 1st week of holidays.
5. England's football journey ended 11th July. Week after is when we'd see a football bump - and we did see high cases last week, highest in young men.

That effect will be easing this week.
6. We've also had a heatwave over past week across almost all UK - driving people outside where it's safer. Despite the handwringing photos of beaches, that's much safer than hanging out indoors!
7. Then, is there a behaviour effect? Are some people increasingly restricting their behaviour due to high cases (eg me!)? Note that cases post 'freedom day' have yet to hit the system.
8. If those out and about are also less worried about covid or are less able to work from home (retail, hospitality, transport etc) then may also be less likely to get tested if symptomatic - esp if symptoms are mild or cold-like.
9. Plus of course there's the pingdemic caused by the pandemic. If you get positive LFD are you less likely to report it (even if you then isolate) to avoid passing on the ping? If you're setting off on holiday soon, are you more cautious to avoid the ping?
10. But in terms of immunity, we're not at population immunity yet (if we can even get there with current vaccines & delta). 31% of pop have no vaccination.
Wales doing best (perhaps why their case rises have been slower?).
11. The govt and SAGE modellers all expect cases to keep going up after step 4 (19 July) and to stay high for August.

The impacts of school holidays (dampen) and Step 4 (speed up) won't hit till next week.

12. Case rates highest ever in 20-29 yr olds last week and they are group most likely to have taken advantage of no limits socialising this week... #justsayin
13. And then there is some evidence now of waning immunity several months after 2nd jab, both from real world data in Israel

and lab studies (e.g. theguardian.com/world/2021/jul…)

If true, this will start having an impact at end of summer...
14. So I think English numbers this week are lower cos combo of: hot weather, football over, some cautious behaviour, testing lags, more reluctance to get tested.

I expect numbers will go up again though and it might be bumpy as different factors pull in different directions.
15. I'll join SAGE in not even trying to predict actual peak since too many uncertainties all clashing with each other!

And of course the ever present known unknown of new variant potential...

ONS infection survey & REACT study ever more vital to get handle on spread. /END

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More from @chrischirp

24 Jul
LONG THREAD: so I said yesterday I felt that the schools study in daily testing instead of isolation of pupils had been misreported. I don't think study tells you very much except that neither isolation or testing are working very well in schools.

Here is why...
What does study do? It takes 201 schools and assigns 99 to be "controls" - ie continue as normal, asking contacts of children with new confirmed covid to isolate for 10 days. The other 102 schools get assigned to "daily contact testing" (DCT) for contacts instead of isolation.
The hypothesis was that children in the DCT (testing) schools would miss fewer schools days than those in the control (isolation) schools without impacting 'too much' on transmission of covid.
Read 26 tweets
23 Jul

The people running the BBC Horizon "Great British Intelligence Test" challenge on over 80,000 people took the opportunity to see if they could detect any differences by whether people had had covid or not...
2. They did this because of increasing concern over reoprted cognitive impacts of long covid - but more evidence is badly needed. Image
3. What they found was significant cognitive deficit for people who'd had covid compared to people that hadn't, after controlling for things like age, education, sex, first language etc.

The degree of deficit was worse the more severe the initial covid infection had been. Image
Read 13 tweets
22 Jul
It is quite possible that we can't achieve herd immunity with Delta through (current) vaccines alone.

This makes being vaxxed even *more* desirable as you can't rely on enough others being immune to protect you by suppressing the virus as a population.
Regardless of herd immunity threshold, the more people vaccinated, the better it is - better for individuals as risk of severe illness is massively lower and better for everyone else as it brings down R since you are less likely to be infected or transmit.
And if/when we do reach some level of population immunity, I'd rather my immunity came from vaccination rather than infection which is why I am v pleased to be vaccinated!
Read 4 tweets
19 Jul
Maybe 2%+ of 20 somethings currently have covid. That's at least 1 in 50 people. Even removing the actively symptomatic or those isolating, pretty much every nightclub with more than a couple hundred people will still have *at least* 1 person there who has covid.
Repeat each day
I don't blame people for clubbing at all. I blame the government for putting us all in this situation of crazy high infections and all the guard rails removed.
Link to ONS infection survey on prevalence ons.gov.uk/peoplepopulati…
Read 4 tweets
16 Jul
THREAD NE: The ONS Infection survey today confirmed the really concerning situation in the North East - 2.6% pop estimated with Covid, much higher than elsewhere.

Cases there are now 28x higher than there were 1 June. 1/6
Why? Contact rates haven't been higher than anywhere else and home working is on a par with all regions apart from London 2/6
It's not people going out more or going to work differently. 3/6
Read 7 tweets
15 Jul
The other really important thing is the ages of who is getting infected.

Firstly, case rates are now over 2000/100,00/week for 16-19 year olds (!!). That's 2% of 15-19 yr olds in the NE testing positive in the week to 9 July.

Secondly cases going up steeply in ALL ages. 1/4
Case rates are higher now for *under 50s* than they've ever been. About 65% of 40-49yr olds in NE are double vaxxed.

50-59 yrs almost as high (449/100k vs 528/100k in Nov). Over 85% double vaxxed.

Over 60s at half peak & rising, >90% double vaxxed.
coronavirus.data.gov.uk/details/vaccin… 2/4
Vaccines are definitely keeping cases down & will be having big impact on reducing hospitalisations too - BUT high case rates in older people will translate into some hospitalisation.

Vaccines are fab (get vaxxed!) but not infallible in face of unmitigated spread. 3/4
Read 5 tweets

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