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

24 Oct
Not only does Wales have a very high case rate at the moment it also has an *extremely high* positivity rate - almost a quarter of people tested are testing positive...
Also -Welsh hospital admissions with Covid are pretty much the same as their *first wave* peak and half their Jan 2021 peak.

In contrast, England is at about a quarter of Jan peak and a third of first wave peak.
You can see a vaccine effect though - severity of illness seems quite a bit less this time around and with shorter stays (so total number in hospital lower at any one time)
Read 6 tweets
19 Oct
Two things stand out to me from this chart:

1. The SW is accelerating much faster than anywhere else
2. London rates are almost half those everywhere else.

1. could be driven by the testing scandal but I have no idea what is driving the lower rates in London! and... 1/2
... it's not just testing behaviours!
Positivity rates in SW are also climbing steeply (*before the scandal came out late last week).

Meanwhile positivity rates in London are *also* lower than everywhere else, so it's not just lack of testing 2/2
PS the lower rates in London are seen across the whole age range.
Read 4 tweets
17 Oct
THREAD: Some numbers on Covid and kids since 1 Sept 2020.

For 5-14 yr old kids:
Whole of Autumn term (rise of Alpha) through to spring: 239K confirmed cases.
Summer term starts low, then Delta. April - August another 285K cases.
Since 1 Sept, 336K cases *so far*. 1/7
Case ascertainment improved in March with regular testing for school kids - but even compared to summer term, numbers this term are *far higher*.

ONS infection survey (no testing bias) reported that prevalence in 2nd-ry school kids now more than 2x higher than winter peak . 2/7
What will burden of Long Covid be in children infected since summer?
ONS estimated that in 4 weeks to 2 May, 23K children ages 2-16 had persistent symptoms from Covid caught at least 12 weeks before - ie infections before mid Feb 2021.
(June dataset: ons.gov.uk/peoplepopulati…) 3/7
Read 7 tweets
16 Oct
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
Read 23 tweets
14 Oct
VARIANTS: Everyone knows that Delta is the dominant variant in the UK (almost 100% of cases).

But Delta has continued to mutate & there are several subtypes in the UK (all start with AY).

The most common is called AY.4 - almost 80% of sequenced cases in UK are this type 1/6
So far no Delta subtype has seemed to have had much of an advantage over the others & non-Delta variants aren't getting anywhere
news.sky.com/story/covid-19…

But AY.4 has developed a new mutation (S:Y145H) & that variation (AY.4+S:Y145H) has been growing here since July 2/6
It was spotted by @CorneliusRoemer and he suggested giving it its own designation: AY.4.2 (meaning it becomes an official subsubtype of Delta subtype AY.4).

This designation has recently been accepted github.com/cov-lineages/p…… 3/6
Read 7 tweets
9 Oct
Nick Triggle did his version of the article @martinmckee & I wrote in the Guardian about how UK has much higher case rates (& death rates) than West & North Europe...

Of course there are different views, but here are some areas I see differently... 1/9

bbc.co.uk/news/health-58…
That Europe is doing "vaccine plus" - high vax coverage and some measures such as masks indoors, school mitigations, covid passports is the entire point- it works much better than "vaccine just" in keeping cases (and all their bad consequences) down

And...
2/9
not clear that contact rates are higher here than in Europe - contacts in Europe are SAFER because they've take additional precautions.

In fact SAGE says we are still not close to pre pandemic contact rates in England. Many do not feel able to "be normal" due to high cases. 3/9
Read 10 tweets

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