It's over 3 weeks since schools reopened in England after summer - what's happening in the #COVID19 data?
I'll be honest with you, it's a mess
I've got no idea what's going on - the data is a bit baffling
Lets take a look... 🧵
1/
The headlines are mostly about PHE cases data
These have been increasing in most age groups since early August, with a slight flattening after reopening of schools, now rocketing in 10 - 15yo
Interestingly, sloping downwards in the <5s
Maybe a school effect on cases?
2/
We know the start of school based testing does botch the trends somewhat, which was always going to be difficult to disentangle
In contrast to case numbers, positivity is actually tanking, especially in people reporting symptoms
Increases in Rhinovirus etc boosting testing?
3/
More confusingly, the ONS paints a different picture again (although a week behind)
Rates didn't fall much in primary age children over summer at all, and are maybe up, or maybe flat?
Secondary school age dropped for summer and bumpy, but not going up since schools opened
4/
But the plot thickens further
Hospitalisations (which have been least labile to testing bias) *FELL* ~25% after schools opened (?recent uptick)
We don't have the disaggregation to see how this is influenced by the >15s rates dropping, but shouldn't be enough to explain it
5/
The concern has been from the increase in parent aged adults cases matching increases in those of school aged children, but increase office mixing and testing given circulating cold viruses could interfere?
The data is not conclusive
6/
So there you have it, clear as mud
We saw cases peaked very quickly in this age in Scotland, and with ~50% estimated to have already been infected, we may see the same in England
ONS will be interesting over the next few weeks
7/
Vinay points correctly to the bias prone endpoint of self reported URTI symptoms and implies the entire difference between groups could be due to “the placebo effect”
The problem is, this is almost
certainly not a result of placebo
It’s detection or ascertainment bias
2/
Vinay describes as much in his piece, when he mentions different interpretations of vague symptoms between people with or without masks depending on their beliefs
Wear a mask and wake up tired? Probably nothing
Not been wearing a mask? Could be the start of something…
3/
The rationale behind this is that some have postulated PASC could be due to viral persistence - SARS-CoV-2 hanging around when it should have been cleared
Anti-virals might help clear the virus and resolve symptoms
2/
The evidence base behind this theory is far from clear, but given the general mess of evidence in the field this seemed like a reasonable trial
It could also serve as possible therapeutic diagnosis (if it works, it gives evidence towards the possible cause)
3/