Prof. Christina Pagel Profile picture
Oct 23, 2021 20 tweets 9 min read Read on X
THREAD: overview of where we are with Covid.

TLDR: Things aren't looking great, SW hit hard by the Immensa lab scandal, admissions climbing quite fast.

Half term should help a lot in the short term. Esp if we accelerate vax. Clear case for Vax Plus. 1/20
On vaccination, home nations between 65 and 71% fulle vaxxed. Good but behind many other high income countries now.

England v slow on 12-15 rollout - 18% vs 36% in Wales & 50% in Scotland.

16-18 yr old data shows vax works 2/20
On boosters - firstly looks like Pfizer booster works phenomenally well - much higher levels of antibodies after 3rd dose and 96% reduction in risk of catching covid after 3rd dose compared to just 1 dose.

So we def want to them in people - & case stronger for under 50s? 3/20
But although England is progressing (almost 50% of over 80s boosted), we are falling behind keeping up with eligible people (over 6 months out) - because we did so well in Jan/Feb, we are NOT keeping up now. An issue.

NB N Ireland has barely started!! 4/20
Note that while boosters are v important, as long as they are only in over 50s, won't nec help transmission that much which is concentrated in kids & their parents' generation.

Kids vax on the other hand will make a big difference (inc 5-11 yr olds when licenced!) 5/20
Overall, cases are very high - and they've been high for a long time.
We've recorded >4 million cases since 27 June which was last time we had fewer than 20K.
That's 4 months of constant drag on health & disruption to lives. 6/20
For the home nations, Wales is highest and increasing rapidly. England going up next fastest. NI high but flat and Scotland lower and flat (but positivity there is increasing).

ONS confirms Wales & England v high but puts NI lower than Scotland - lagged to a few weeks ago? 7/20
Deaths remain relatively high (given vaccination progress) - although far lower than January peak, we've still recorded over 11,000 deaths since 27th June.

ONS death registration confirms than 86% of deaths with Covid are *directly* due to Covid. 8/20
For hospitalisations, people in hospital are going up in Wales & England but down in NI & Scotland, broadly matching case trajectories.

In England hospital admissions have gone up sharply in recent days, 25% of current ICU patients are covid patients & NHS super stretched. 9/20
Let's dig into England data a bit more...

The SW is a clear anomaly both in case rates and positivity rates. The out of step drop in early Sept *should* have been picked up much quicker.

It's not the only region affected but is the worst affected. 10/20
And the SE has seen a rapid increase in hospital admissions 3 weeks since the testing problems began (2 Sep) - ie enough time for chains of transmission to start from people wrongly believing they were negative.

This scandal will have lasting health consequences. 11/20
The other noticeable things are low London levels (some due to prev infection & cities in general being lower right now). London seeing sharp recent hosp admissions - but also has a less vaxxed population.

NE & Yorks continue to have highest burden of severe Covid cases. 12/20
Looking at local authorities in the SW you can see some local authorities have been hit harder than others - Cornwall and South Devon least affected.

More transparency from UKHSA on which areas affected would be very helpful. 13/20
You can also see that the impact on the SW is across *all ages* - highest in school age kids & their parents' generation 14/20
Bu age, cases still by far highest in school age kids - particularly 10-14 year olds. Still rising too - but hopefully half term will provide a natural break.

But all age groups now rising again... 15/20
This chart by @PaulMainwood using ONS Infection Data modelled prevalence by year of age shows beautifully how rampant infection in kids spread to parents and most recently grandparent generation. 16/20
And we are seeing this now in hospital admissions. Rising in all age groups 17/20
So that's where we are. As latest SPI-M models show future is uncertain - boosters & kids vax will have a big impact but we need to speed up. Half term will help.

But winter is coming, NHS is struggling, there's AY.4.2

18/20
That why @IndependentSage is calling for a "Vaccine Plus" approach, as are the British Medical Association, NHS confederation, the Unions and other scientists. 19/20

And we need a lot more clarity about what happened with the Immensa lab scandal and what measures are being taken to ensure it can't happen again. 20/20

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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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