THREAD on current Covid situation in UK:

TLDR slow growth in cases & hospitalisations flat. But both cases and hospitalisations remain very high.

Plus some perspective internationally, over time and on kids.

19 tweets.
1. Cases have been creeping up across the UK for last few weeks. Positivity rates are going up in all nations except NI (but that's also where they are highest).

ONS says prevalence flat everywhere except Scotland so slightly different but represents infections a bit earlier.
2. Cases are highest in NI, SW (tourism?), North & Midlands.

All regions in England are going up except the NE which is still coming down from its massive peak.
3. Cases in England are concentrated in young adults but are falling in under 20s and going up in over 20s.

Worryingly cases in over 60s are going up quite a lot in all regions apart from NE. This is not great.
4. The most deprived communities are more likely to have very high case rates.

Once again the burden of high cases falls on disproportionately on those least able to isolate and more likely to get very sick or get long covid.
5. Overall in England, we've seen 1.6 million cases reported since 1st May in this Delta wave. But the wave isn't over yet, and we are going into September with very high cases compared to last year.
6. In terms of people in hospital, England and Wales are flat, Scotland is coming down still and NI is increasing - likely a result of rapid increase in cases a week or two ago.
7. In England, we've had 33,000 new admissions since 1st May & are adding ~5,000 new ones a week. That's a lot! Especially when NHS is struggling.

The percentage of reported cases than "turn into" admissions 7 days later is creeping up. Likely as cases shift to older groups.
8. UK deaths remain far below their January peak, but *are* going up. We're currently averaging 100 deaths a day - *10 times* higher than last August.

Vaccines are doing *a lot* but cases are also very high.
9. Speaking of vaccination, we are continuing mopping up second doses and doing about 20K first doses a day.

Uptake is lower for younger age groups but 18-29 year olds are catching up 30-34 year olds. Let's hope we can get all under 50s to 85% at least.
10. Compared to other countries, we have excellent vaccination coverage but we're not the highest. Most of Europe is now over 50% of population fully vaccinated.
11. I tweeted this earlier this week but it's worth repeating. Despite vaccination, cases are 25x higher than a year ago and hospitalisations are 10x higher.

Many more people are getting very sick this month vs last August. I don't think this is good public health policy.
12. Looking at hospitalisations by age... for Over 65s we can see far far fewer hospitalisations now compared to peaks. That's the massive benefit of vaccines.

That said, hospital admissions are still significantly higher than last summer.
13. For working age adults, admissions are still a long way below peak - again a consequence of vaccination (and mainly in the older groups), but are nonetheless a LOT higher than a year ago.
14. For kids... hospital admissions are *much much* lower than adults. But obviously there is no vaccine benefit. Kids are seeing the same pandemic peak as in January.

There were 1.3K <18 admissions in 1st wave and 4.2K in 2nd wave.

Since May, over 2K kids have been admitted.
15. We are one of the few high income countries not vaccinating 12-15 yr olds.

As well as the ones in the chart below, Israel, Singapore, Hong Kong, Denmark, Japan, Mexico, Chile, Canada, China, Philippines, Indonesia and Dubai are all vaccinating adolescents.
16. Cases in kids will go up when schools return.

We are also one of the few countries removing mitigations from schools instead of adding them in the face of Delta.

The European CDC & the US CDC both recommend mitigations to prevent transmission in schools.

Why aren't we?
17. ONS Schools study, widely reported this week, concluded that schools weren't hubs of infection.
They said partly because mitigations helped & partly cos infections depended on community rates.
gov.uk/government/new…
18. I was not convinced by their conclusions, but even if you take them at face value, those mitigations have now gone & next term will start with v high community rates.

I think we're only country doing NONE of mitigation, low cases, vaccination to keep kid infections down.
19. So to conclude, cases and hospital admissions remain high and are showing gradual increases in most UK nations.

We are definitely the international outlier in our approach to infections in children. /END
this is from 2 months ago
reuters.com/business/healt…
also the title on the chart should say "fully vaccinated" not one dose!

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More from @chrischirp

Oct 19
Important 🧵on our new peer-reviewed paper:

The pandemic is as bad as it ever was for babies - in year to Aug 2023, 6,300 babies under 1 were admitted to hospital wholly or partly BECAUSE of Covid.

They are ONLY age group where admissions have NOT gone down over time 1/17 Image
Our study, led by Prof @katebrown220, looked at all hospitalisations in England in children with a Covid diagnosis or positive test from Aug 2020-Aug 2023.
We then *excluded* all admissions where a Covid diagnosis was incidental (ie not why they were in hospital)
2/17 Image
Infants (babies under 1) are generally at higher risk from respiratory infections, plus they are the age group that, if infected, are overwhelmingly meeting the virus for the first time.

They are not vaccinated and have not had it before. 3/17
Read 18 tweets
Sep 26
Prof @Kevin_Fong giving the most devastating and moving testimony to the Covid Inquiry of visiting hospital intensive care units at the height of the second wave in late Dec 2020.

The unimaginable scale of death, the trauma, the loss of hope.
Please watch this 2min clip.
And here he breaks down while explaining the absolute trauma experienced by smaller hospitals in particular - the "healthier" ICU patients were transferred out, leaving them coping with so much death.

They felt so alone.
Here Prof Fong explains how every nurse he met was traumatised by watching patients die, being only able to hold up ipads to their relatives and how it went against their normal practice of trying to ensure a dignified death, with family there.
Read 5 tweets
Aug 28
THREAD: I asked what the point of Public Inquiries is for @bmj_latest

We've spent hundreds of millions of £ on Inquiries over last decades, generating deep understanding of failures & 1000s of recommendations.

But v few recommendations get implemented!
What is going on?

1/12 Image
E.g. Covid-19 Inquiry has cost £94 million so far - and is projected to cost over £200m by its end (it still has years to go).

1st report published (out of at least 9) found major flaws and proposed 10 recommendations.

Chances are low that they will be implemented :-( 2/12


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Inst for Government looked at 68 Inquiries from 1990-2017.
The Inquiries cost over £630 million and made 2,625 recommendations.

Only 6/68 Inquiries have received full scrutiny by a parliamentary select committee on implementation of recommendations. 3/12 Image
Read 12 tweets
Aug 9
🧵War causes direct civilian deaths but also indirect deaths over the following years.

Recent paper estimates eventual total direct & indirect deaths in Gaza attributable to the war - 10% of entire pop'n.

I want to explain these estimates and why deaths must be counted. 1/13 Image
Why count casualties from war anyway? For moral, legal and strategic reasons.

1 - owe it to those who have died
2 - International law says must count & identify dead as far as possible
3 - monitor progress of war & learn from tactics

2/13 Image
There are direct and indirect casualties of war. Direct deaths include those who killed by fighting or bombs.

Indirect deaths are those that die when they would otherwise have lived because of one or more of: lack of food, healthcare, housing, sanitation, income, hope. 3/13 Image
Read 14 tweets
Aug 1
THREAD: the summer Covid wave in the UK continues.
Basically, there is a LOT of Covid around and not a lot of other respiratory viruses.

If you have cold or flu symptoms, it's probably Covid.

The latest hospital data from England shows steady, quite high levels. 1/8 Image
But admissions don't tell us how much virus is circulating more generally. The best (but imperfect) measure we have is wasterwater measurements, and only in Scotland and not England.

Scotland's wastewater is showing a huge July peak - highest since Omicron's 1st yr in 2022 2/8 Image
Because different people shed different amounts of virus and variants can matter too, you can't for sure infer how many people were infected between different wasterwater peaks. BUT given the size, I'd say it's pretty likely this is the largest peak since 2022 in Scotland 3/8
Read 8 tweets
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

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