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

13 Aug
THREAD: I wrote a piece for the @guardian today about seven popular Covid myths in the age of vaccination.

theguardian.com/world/2021/aug…
MYTH 1: I don’t have any symptoms, so even if I have Covid I won’t give it to anyone else

Yes you can - both if you never get symptoms and in the few days before you get symptoms.
MYTH 2: I won’t pick up or transmit the virus because I’m fully vaccinated

Being vaccinated means you are less likely to catch Covid and probably less likely to transmit, but you certainly can still catch it and pass it on, esp in the early days of your infection.
Read 8 tweets
12 Aug
THREAD on Schools:
The problem with the reporting around the PHE/LSHTM school data is that it's being used to say that schools aren't a problem and don't need mitigations.

e.g.
bmj.com/content/374/bm…
1/8
But it's based on comparing rates in June 2021 vs Nov 2020. ONS infection survey agrees that rates in school kids were lower in June 2021 (<1%) compared to Nov 2020 (~2%). So what's wrong with the headlines?

They wrongly imply that we don't need to make schools safer. 2/8
Firstly, rates were accelerating from June and by July 2021, rates were over 3% in ONS in school age kids - matching the peak last December. This survey did not include these periods. 3/8
Read 9 tweets
9 Aug
QUICK THREAD ON VACCINES & DELTA: Friday's @PHE_uk report said that viral load in infected vaccinated people was similar to that of uninfected people.

As has been pointed out by others, this does *not* mean all is lost and vaccines don't work.

10 tweet thread explaining why!
1. when you get a PCR test, they measure how many "cycles" you need before getting a positive signal. The more cycles you need, the weaker the original signal.

Lower numbers for "cycle threshold" (CT value) are thought to indicate higher viral load at the time test was taken.
2. In Friday's report, PHE report that CT values were similar between vaccinated and unvaccinated cases for both Alpha and Delta.

They conclude that once infected there "is limited difference in viral load" bewteen vax & unvax.

So how bad news is this?
Read 12 tweets
8 Aug
QUICK THREAD on English Covid situation (6 tweets).

1. Overall cases have stopped going down and have been flat over the last week.
2. Most regions are flat, but NE continuing to decline a lot from its large peak and some regions Yorks, E Midlands, SW) are going up slightly.

Similar patterns nationally & regionally in positivity rate.
3. Cases are now very concentrated in young adults. Cases in under 15s have dropped a lot since end of term - partly fewer cases and partly less testing.

Cases dropping older adults too but more slowly than in children.
Read 6 tweets
30 Jul
QUICK THREAD on Vaccines:

Vaccinations have slowed down, esp 1st doses. About 6 million adults left without a first dose & 9 million on just one dose.

Will take about 6-8 weeks to give those 9m a second dose. And we need to work on making it easy for 6m to get their 1st.
Overall we still have 30% ish of population unprotected by vaccination. Note that about 20% of pop are children not eligible for vaccines (yet!).

Wales furthest ahead with its vax programme, followed by Scotland.
67% of 18-24 yr olds in England have had their first dose which is promising.

But more worryingly quite a lot of 40-49 yr olds still need their 2nd jab.

In younger adults, women more likely to take up vax than men.
Read 5 tweets
30 Jul
THREAD: latest covid situation in UK (mainly England) and what I think is going on...

TLDR: I *do* think there has been a recent drop in transmission, due to combo of different things. Might not be quite as big as seems and might not last.

(22 tweets)
2. UK cases have dropped quite a bit since 19 July, but gone up a bit again over last couple of days. 29K cases today keeps it higher than it was earlier in week but lower than last week.
3. Different patterns for each nation. But Scotland has been dropping consistently since early July in cases & positivity rate. Positivity rates still quite high though.

England dropping since 19 July & also seeing declines in positivity rate. It's not just fewer tests.
Read 23 tweets

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