Amazing education settings outbreak data from the Delta #COVID19 outbreak in NSW 🇦🇺

Primary/Secondary schools mostly closed, so limited info to draw on (Attack rate v low, <2%)

BUT early years settings fully open with no masks!

What happened? 🧵

ncirs.org.au/covid-19-in-sc…

1/
There was secondary transmission in 16/32 settings

If the index was an adult, decent amounts of transmission - 17% AR to adults, only 8.1% to the kids

If the index was a child, minimal transmission - 1.3% to an adult, 1.8% to another child

Over 95% of contacts tested

2/
Once cases were back home, as you would expect with Delta, there was a lot of transmission

70% of all household contacts became infected

In 57% of households, everyone got infected (overdispersion in action)

3/
Take home messages:

- In early years settings, children have very low transmission risk (even with no masks) - vaccinating adults is key
- Household attack rates with Delta are very high (if someone in your house has it, assume you have it/will get it too)

4/
Forgot to mention - this household transmission data is in the setting of very low rates of adult vaccination

We can safely assume these rates would be significantly lower with vaccinated household members

5/
Great coverage in @guardian of the study and input from some of the specialists involved in Australia

Hopefully reassuring for our Aussie friends during a difficult time in their pandemic

Note how studies often don't back up early anecdotes...

6/
theguardian.com/australia-news…

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More from @apsmunro

16 Sep
The best data by far on #LongCovid is out from the ONS

For kids, the news is incredibly reassuring - parents minds should be put to rest

Rates of common symptoms after #COVID19 at 12 w for kids are extremely low (0% to 1.7%) compared to controls

ons.gov.uk/peoplepopulati…

1/ Image
Previous ONS statistics have been widely misused, and difficult to interpret due to unavailable methods

This is all put to bed now. Excellent, transparent comparisons with a suitable control group.

Importantly, it includes COVID cases which would be missed by NHS testing

2/
One statistic stands out

At both 4 and 12 weeks, MORE children aged 2 - 11y in the control group were experiencing symptoms than in those who tested positive for #COVID19

3/ Image
Read 9 tweets
14 Sep
Loads of people will now have heard of RSV for the first time

Here is a quick thread on the disease it causes (bronchiolitis) and why we DONT use salbutamol inhalers/nebulisers to treat it - they can even make it worse!

1/
Bronchiolitis does what is says on the tin

It’s infection with a virus (usually RSV, but can be others) affecting the small airways (“bronchioles”) causing inflammation (“itis”)

It causes wheezing, coughing, and difficulty breathing

2/
Usually it affects babies <1y of age (although in the US definitions are a bit different…) and is seasonal, coming in waves every winter

It is the most common cause of hospitalisation of children, usually for breathing support, extra oxygen, or help feeding

3/
Read 10 tweets
6 Sep
Because England has excellent population data on #COVID19, we can make pretty accurate estimates of risk to children 🧵

Fortunately, these risks are extremely low

1/
Note when possible that we want to know rates *per infection*, not per positive test

This is because tests are contingent on how much you test, which is different across time and places

Risks per infection are much less changeable, and what we really care about

2/
Let's take the first 12 months of the pandemic up until Feb 28th 2021

Estimates based on seroprevalence are around 25% children <18 were infected by this point (16+ was >30%, younger will be a bit lower)

There are 12mil children in England, so this is 3mil infections

3/
Read 8 tweets
1 Sep
The worlds biggest study of post acute #COVID19 symptoms in children is out as a pre-print - the CLoCK study!

Fortunately results are very reassuring regarding symptom frequency and impact

Some important lessons, let's take a look 🧵

1/
bbc.co.uk/news/health-58…
The study compared people who tested positive for SARS-CoV-2 to those who tested negative

They looked at symptoms at the time of testing, and then 3 months later

The differences are then presumably due to one group having covid

They surveyed children aged 11 - 17

2/
What did they find?

At time of testing, 35% of test positives had symptoms compared to only 8% of test negatives

Astoundingly, 3 months later 67% of test positives had any symptoms, and *53% of test negatives* had symptoms

3/
Read 12 tweets
20 Aug
Kids #COVID19 sit rep from England🧵

I've seen some completely incorrect comments about the current situation with kids cases and hospitalisations in England, so let's clear up where we're at!

1. Cases in children started falling well before schools closed for summer

1/
Cases acquired in the last week of school would not become symptomatic and get tested until the following week

Any changes in trends due to schools closing should show up the week AFTER schools closed, not the week before (obviously)

2/
2. Cases are not falling in children due to summer holidays

Cases are actually relatively flat (or rising) in most age groups, although there was a small uplift in young adults before others

Possibly a new rise coming in older teens secondary to a large surfing festival 🏄

3/
Read 8 tweets
9 Aug
Something I think we’ve been very bad at separating when trying to help people understand risk during the pandemic, especially for kids, is:

1. Risk of getting covid
2. Risk of being seriously ill IF you get covid

When we talk about risk, these things are very different

1/
The first is a product of:

-Prevalence (how many people are infected)
-Exposure (where are you that’s likely to get you infected)
-Variant (per exposure, more by Delta than others)
-Immunity (best by vax, or else infection)

These things change over time, so risk does too

2/
The latter is really a product of:

-Age (risk increases exponentially)
-Comorbidities (e.g. for children, neurodisability or cardiac diseases)
-Immunity

It is not clear whether variants significantly impact this risk - they may somewhat, but it is very uncertain

3/
Read 10 tweets

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