Prof. Christina Pagel Profile picture
Oct 16, 2021 23 tweets 13 min read Read on X
1.THREAD on Covid, children, failure, bafflement and anger.

TLDR: English policy has failed children, and then everyone else, I am baffled why people aren't angrier. I am angry.

23 tweet rant.
2. By the time schools broke up in July, cases in children were incredibly high, there was mass education disruption and we were going through a massive delta surge (aided by the Euros).
3. US, Canada, France & Israel were already vaccinating 12-17 year olds to protect them from Covid *and* to protect their education in the autumn.

From June onwards, data was firming up, mainly from USA, about the v low risk of the vaccine & higher risks of Covid
4. Over July and August, almost all European countries followed suit - and most cited the need to protect education *and* the benefits to the child given the expected wave coming in Autumn.

Germany was one of the last ones to change its mind in mid August - on clinical benefit.
5. In August, the US saw large surges in child Covid cases - particularly in states where vaccination rates were low and school mitigations were few.

By September, US had clear evidence how vaccinated teens were 10x less likely to need hospital vs their unvaccinated peers
6. From US & Israel, it was obvious that delta could rip through schools.

It was obvious that that vaccines PLUS other mitigations (e.g. masks, ventilation) could address that.

Over the summer both US & European CDCs recommended vaccines+mitigations in schools.
7. Many people in the UK (and elsewhere) were begging govt to put mitigations in for the new term *and* vaccinate teens.



blogs.bmj.com/bmj/2021/08/20…
8. Meanwhile, JCVI released a series of vague statements - eventually ok-ing vax for 16/17 yr olds in mid August - *just in time* for school but did not recommend vaccination for all teens.
The CMOs did recommend vax for teens but not until 13 Sept.
9. I say "vague statements" because so far there is no detailed evidence or analysis provided for their recommendations.
Contrary to their code of conduct, there are no minutes of Covid meetings since Feb.
There is no evidence / analysis provided for the 1 dose strategy
10. These incredibly consequential decisions, contrary to global practice, remain shrouded in secrecy.

Our peer-reviewed paper in @EditorJRSM provided a detailed risk benefit analysis of full vax course in teens & showed large benefit at current levels.
rsm.ac.uk/media-releases…
11. We should demand no less tranparency from JCVI.

Instead, we had (and still have) high profile members of JCVI warning of vaccine risks but *not* covid risks and wrongly downplaying importance of vax in reducing transmission thetimes.co.uk/article/childr…
12. The upshot is that despite knowing full well of the risks of a large new wave in children in September, we did nothing.

Schools were promised CO2 monitors - where are they? where are the resources to *act* on poor ventilation?
13. Once vaccines were approved for teens, their roll out has been abysmal.

England is only offering vaccine through schools - Scotland also has walk in centres.

We are far behind. Neither supply nor demand are the issue - it's a failure of planning or lack of urgency or both
14. And we are seeing the costs right now. Infections have soared in our children - 8% had Covid in the week to 9th October.

Hospitalisations in 6-17 year olds are rising steeply, despite vaccination in 16 & 17 yr olds.
15. 2 weeks ago, ~200,000 children were off school due to Covid - who knows how many now.

Long Covid cases are already increasing in young people after summer surges. Kids will suffer too - Israel seeing high demand now for its child long covid clinics after high summer cases
16. We also still don't yet know the long term impacts of Covid on health - but we know it can affect other organs.

Covid can cause heart damage, it can cause long term breathlessness and it has been linked to increased risk of developing diabetes - inc in children.
17. Unions are begging for safer schools.
fenews.co.uk/press-releases…

The impact of vaccination in 16/17 yr olds vs 11-15 yr olds is barn door obvious from official govt data.
18. And not only are rates in 10-14yr and 5-9 yr olds rising again and higher than they've been, but all age groups are now rising.

In fact cases are rising *fastest* in the over 60s. And hospital admissions are rising a lot again.
19. And incidentally the booster programme is still going slowly - we are doing maybe 150K doses a day, compared to the 400K doses a day we were doing in Jan/Feb.
We're getting there but too slowly.
And inequalities in vax coverage persist. Of course.
20. So we are heading into winter with huge numbers of infections in children and glacial vax roll out, vulnerable over 60s where cases are already going up, increasing numbers of people living with long covid and a super stressed NHS.

What the fuck are we doing?
21. Absolutely none of this was inevitable - instead it was entirely preventable.

We needed to vax teens, put mitigations in schools and keep some mitigations for adults too.

Half term will help - let's use that opportunity!

ft.com/content/345825…
22. As we head into winter with v high cases I think we need to use half term to:
accelerate vax in teens
roll out CO2 monitors everywhere & HEPA filters where necessary
resintate masks in secondary schools
tell parents what symptoms of covid in kids are (!)
start govt plan B
23. Finally - where is the accountability? where is the anger?

Our govt, the JCVI & public health officials downplaying spread in schools, have failed our children and they've failed us.

And yes, I'm fucking furious. And no, I'm not sorry for swearing. /END

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More from @chrischirp

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
Jul 19
Quick thread on current Covid situation in England and Long Covid.

I have Thoughts about the Inquiry Report published yesterday but am still trying to organise them.

TLDR: high Covid levels remain, Long Covid remains 1/11
This wave is not over. While the number of admissions with Covid remains lower than the autumn/winter waves, it has now remained highsh for several weeks.

This means there are a lot of people out there getting sick - and having their work, plans and holidays disrupted. 2/11 Image
Scottish wastewater data to 9 July shows a sharp decrease, suggesting that prevalence might be on its way down.

Obviously Scotland and England can have different dynamics, but it’s the best we’ve got as long as England refuses to analyse its own wastwater. 3/11 Image
Read 12 tweets
Jul 3
THREAD: Given tomorrow's election, I've been thinking about our nation's (poor) health, the wider determinants of health and how these have worsened and what it means for policy....

TLDR: worrying only about NHS & social care is missing the point

let's dive in... 1/25
The UK has a health problem. After steady gains in life expectancy for decades, it flatlined during the austerity years and fell for the first time this century with the Covid pandemic.

The number of people out of work for long term sickness is near record levels. 2/25
There are huge inequalities between rich & poor. Boys born in the most deprived areas can expect to die almost 10 years earlier than their peers in the least deprived areas.

Even worse, they can expect to spend 18 fewer years of their life in good health (52 vs 70 years) 3/25 Image
Read 38 tweets
Jun 4
As ever, I am getting lots of pushback.
Here is a compilation of the European countries I've found with recent wastewater data. Some are going up a bit, some down a bit, some are flat, none are anywhere near previous peaks.
I can't see anything here to be panic anyone. 1/3
Image
I can't find the dashboard for Spain, but others saying it is in a wave. Perhaps it is. England has just had one - the last data we had (a couple of weeks ago from Bob Hawkins) looked as if our wave had peaked.
So, I'm not seeing reason to think things are terrible here! 2/3 Image
Yes there are new variants growing right now. They are not growing faster than JN.1 grew in December and that wave did not end up as bad as feared.
Clearly it remains true that Covid is NOT a seasonal disease (unlike Flu and RSV)
3/3
Read 5 tweets
May 8
Quick thread on the Astra Zeneca (AZ) covid vaccine since it's been in the news today.

TLDR there isn't a new "smoking gun", the AZ vax was one of first and cheapest, it saved millions of lives globally, there are better vax out there now, adapted to new variants 1/9
the AZ vaccine was one of the first approved at the end of 2020, cheaper than Pfizer, and - importantly - easier to administer in lower resource settings as it didn't require super low temperatures for storage 2/9
In most countries it was first rolled out in older adults. As it was rolled out in younger adults, a *very rare*, serious, side effect was noticed - it could cause deadly blood clots

This was spotted quickly and studied. Vax monitoring did its job. 3/9 Image
Read 11 tweets
Apr 2
A short thread on why this is not a scary chart and why all the evidence suggests that there is not much Covid around right now. 1/6 Image
the above chart is recorded covid hospital admissions / reported covid cases. It is close to 100% now *because basically only hospitals can report cases since Feb 2024*

It is to do with changes in case reporting and NOT hospital testing
2/6
In fact hospital testing has been steady since the change in testing a year ago (only symptomatic patients get tested now).

The % of people PCR tested who have Covid is 4% - there is no evidence that there are loads of symptomatic people in hospital being missed. 3/6
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Read 6 tweets

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