Thread on Covid & UK (mainly England).

TLDR the two epidemics theme continues and the impact of summer infections on long covid is becoming evident... 1/13
On vaccination, we've started on 12-15s but roll out is slower than it was for 16-17s... and in younger age groups we are substantially behind Scotland who have been using walk in clinics for teens.2/13
For boosters, we've now given a quarter of 80+ their booster and rollout is progressing. When the programme started, 3.5m people were already elgibile for their booster - we've got a bit of work to catch up to all the eligibles as soon as we can! 3/13
In terms of cases, UK has gone quite a bit last 2 days. Age, region etc are lagged by a few days (date of test) so I'm not sure why at the moment!
By nation for date of test (lagged), looks like cases flattening in all countries.
Positivity flattening in NI and England. 4/13
For hospitalisations, occupancy is declining in each nation (good).

For admissions, the persistent much higher admissions in the North & Midlands vs the South East continues. As we go into winter the NHS covid pressures are not being felt equally. 5/13
Deaths have started going down now which is good news. This reflects the shift of cases into children who are at much lower risk of death.

Case rates have been declining/flat in 60+ for past few weeks and this is now leading to fewer deaths. 6/13
Cases in children remain far higher than in adults. It looks as if cases might have peaked for now but they are still incredibly high - the most recent ONS infection survey (random testing) found *7%* of secondary school kids had Covid in week to 2nd Oct.
7/13
We are also seeing climbing hospital admissions in 6-17 year olds (but rates much much less than adults).

That said, children are in the eye of the pandemic still from their point of view. 8/13
ONS released its latest long covid report of people self-reporting symptoms for longer than 4 weeks after getting Covid.

ons.gov.uk/peoplepopulati… 9/13
There has been a big jump in people reporting Long Covid who were infected over the summer (<8 weeks before 5 September).

This is the consequence of high cases over July & early August 10/13
Age group that has seen the biggest rise are 17-24 yr olds - the exact group that had the higest infections in July.

People working in hospitality also reported big increases - hospitality is high risk and people working their have little control over their environment. 11/13
Unfortunately with continued high cases, we are likely to see more increases in people reporting Long Covid, and will be disproportionately in people exposed to infection. Risky workplaces are part of that.
That said, hopefully increasing vax rates will reduce long covid. 12/13
Internationally, case and death rates are much lower in much of West & Northern Europe than in UK / England.

@martinmckee & I discuss possible reasons here
theguardian.com/commentisfree/… 13/13
PS thanks as ever to Bob Hawkins for his help in collating data and preparing charts!

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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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