Yikes, hospital cases are starting to look like the start of a #Covid19Ireland 5th wave - now really is the 2nd best time to get vaccinated if you've been putting it off.
8th of March was the last time we had 400 hospital cases so yes this is a Monday high but still a high
Vaccination is doing a great job of reducing our mortality - Eastern European counties with low vaccination rates are starting to get hammered as cases surge again but UK mortality being twice our rate is a warning that cases still come with a mortality cost /2
I abandoned posting detailed daily updates a few weeks back & switched to one big weekly one but I'm still checking the key data every day & taking notes in case the exit goes seriously wrong quickly - I'm not too happy with trends of the last few days /3
This is another stat I don't like, New Hospital Cases in a week as a percentage of new cases in the week to 6 days back have been slowly climbing since Sept 1st, now its 3.6%. Hard to be certain why but one possibility is fewer mild cases coming forward for testing /4
The 'hospitalisation' rate is now twice its lowest August days of 1.6-1.7% so it could be that 1 detected case now would have been 2 in August (the silver lining to this being more survival based population immunity which at least slows the pandemic & gives some protection) /5
Quite a large increase in positive swabs just came in, last 3 days are 132% same day last week. That will turn into New Hospital Cases over next weekend & into ICU admissions a few days later /6
I did an update to the NPHETs Exit plots last night where on all 3 measures we are approaching or have crossed the Reduced Transmission curve (a reminder that we are still doing better than expected even if thats about to end) /7
HSE 14 day tables to 10/10 show case increase had been in older groups with expected case reduction in under 12s as CC testing in schools ended. Over 85s up 28% between the two weeks adds urgency to completion of booster shot program. Not much increase in student age /8
Under 18 cases may be down but hospitalisations rose a lot, from 18 to 30. And as contact tracing ends for 5-12 age case hospitalisation rate rose by a factor of 3 to a still low 0.4%. But that may hint at number of cases infections now not being detected as cases /9
County table shows 9 counties improving and its notable that the disimprovement is not happening in just one or two places but across the island so its a trend rather than a couple of large outbreaks. All the above tweets being bad news /10

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More from @andrewflood

11 Oct
Le Sigh - an early update of the NPHETs Exit #Covid19Ireland cases plot confirms what looks like the start of the 5th wave with
1358 cases 152% last Monday
9999 cases this week at 113% previous
With the end of contact tracing in schools we should have seen a missed case drop /1 Image
The potential emerging 5th wave is also clear on the New Hospital Cases Plot - the doubling of case severity in the last 2-3 weeks is an unexplained concern
400 hospital is 120% last Monday
308 new hospital cases this week is 116% last week
NHC were 3.65% cases in previous week/2 Image
Likewise ICU shows a rise when NPHETs Exit expected a fall - we did well for 2 months, now its at least doubtful
75 ICU is 117% last Monday
36 ICU admissions is 109% previous week
ICU admissions are 12.5% NHC
/3 Image
Read 5 tweets
11 Oct
A 'how can we have a new wave with 75% of the population vaccinated' thread. Short answer is Delta is a nightmare, way, way nastier than old school Covid19 because one person on average will infect 6 with no measures in place rather than 3. /1
Imagine a 100% effective vaccine that stopped transmission completely. With old school Covid once 2 in 3 are vaccinated then the virus finds 2 of its 3 previously successful jumps to other people blocked. Above 66% vaccination 1000 cases only become 900, 750, 580 etc /2
We don't know for sure but it looks like Delta infects 6 other people without measures in place. To reduce that to 1 person 5 of those would have to be blocked by 100% effective vaccine. 5/6 is 83%. So at our 75% vaccination Delta is still getting to more than 1 person /3
Read 10 tweets
11 Oct
Last 3 days of #Covid19Ireland confirms bad news of what may be the start of wave 5. Swabs over those 3 days are 132% of the same days last week & positivity now up to 10% confirming this isn't an impact of more testing
Sat 1722, 144%
Sun 1523, 118%
Mon 1449, 136%
/1 Image
We are also seeing that potential 5th wave in New Hospital Cases
400 hospital is 120% last Monday
308 new hospital cases this week is 116% last week
NHC were 3.65% cases in previous week /2
And if not yet as strong in ICU
75 ICU is 117% last Monday
36 ICU admissions is 109% previous week
ICU admissions are 12.5% NHC
/3
Read 9 tweets
11 Oct
Latest HPSC deaths from vaccine breakthrough allows calculation that c55% of Covid deaths in Aug/Sept were of fully vaccinated people.
BT deaths / Total / Percentage
Aug. 48 / 71 / 68%
Sept 56 / 117 / 48%
Both 104 / 188 / 55%
/1
Note with pretty much everyone over 65 fully vaccinated & vast majority (91.3%) of pre vaccine deaths in that age group this actually shows a very very high vaccine protection - but not 100% (high 90s at least). But 50 post vaxx deaths a month from endemic Covid happened /2
The HPSC report itself has a vaccine breakthrough deaths percentage of 36.5% however I think thats artificially low in terms of what we can expect because it includes a period where a large segment of the population was not yet vaccinated - Sept may be incomplete /3
Read 5 tweets
9 Oct
#SaveTheCobblestone now at the council buildings after marching via Merchants Arch - quite a crowd - it appears the pandemic exit may well see a significant return to street protest as we contest what that world will look like. Wall to wall hotels not being a popular option
Oró Sé Do Bheatha 'Bhaile at #SaveTheCobblestone /3
Read 5 tweets
8 Oct
A general comment - high levels of vaccination has allowed the risk of moving on from significant restrictions with 1/4 of the population unvaccinated (2/3 not eligible to be). In the Irish HCare context the main role 18 months of NPIs had was buying time for vaccinations /1
Our health system was too under resourced for 'flatten the curve' to have been sustainable as a route to population immunity. With too few ICUs that would have taken 5 years of switching between some opening & lockdown to avoid high excess deaths when ICUs ran out. /2
It would also have involved in the region of 40k deaths over those years - thats the IFR for a population with our age structure and where hospital oxygen does not run out. If the curve is not flattened it probable doubles or worse. But we mostly stalled Covid till vaccination/3
Read 13 tweets

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