Prof. Christina Pagel Profile picture
Jul 23, 2021 13 tweets 5 min read Read on X
LONG COVID THREAD:

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
4. This isn't just about long covid - this compares people who had had covid with those who hadn't, regardless of ongoing symptoms. Most people who had had covid reported being recovered, but about 25% with confirmed covid reported ongoing symptoms (ie long covid). Image
5. The cognitive deficits remained whether ongoing symptoms were there or not, and did not depend on time since covid either.

This seems to suggest it is a long lasting effect.

It also doesn't depend on pre-existing health problems . Image
6. The authors put the results into context - the average deficit experienced by hospitalised covid patients (0.47 for ventilator, 0.26 no ventilator) were worse than average deficit by people who'd suffered a stroke (0.24). Image
7. And the types of deficity found were consistent with the sorts of cognitive problems reported by people wth long covid Image
8. The authors conclude that their data support other studies showing cognitive problems after covid.

Evidence for long term neurological and other impacts of covid is growing. But govt position seems to be that infections don't matter as long as NHS not overwhelmed. Image
9. I worry that once again we are watching an unfolding disaster while waiting for unequivocal evidence. Unquivocal evidence on long term impacts will, by definition, take months or years.

Maybe it never will - but so far, trajectory is towards more certain evidence not less.
10. What if by the time there can be no doubt of long term problems in many people who've had covid, we've allowed millions more infections leaving hundreds of thousands more people affected.

ONS estimated 634K people with long covid that impacts their life in June. Image
11. For comparison, c. 260K people are diagnosed with diabetes & 500K with heart disease each year.

I worry that we are creating a chronic disease tragedy right now.

Please watch this @allthecitizens video about long covid to see what it can be like.
12. Lancet paper is here:
thelancet.com/journals/eclin…

/END
oh and today's @IndependentSage briefing was on Long Covid - please do watch!

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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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