A reminder why there will be little or no benefit on infection from sacking unvaccinated carers.

89% of care workers in elderly care homes are already double vaccinated. Many of remaining 11% will have been previously infected so high level of immunity …england.nhs.uk/statistics/sta…

Even if the small % who are unvaxed & not previously infected have a higher risk of infection, they still take other control measures, e.g. isolating if symptomatic & regular testing. Any marginal additional risk reduction from sacking unvaccinated will be tiny.
But …

whether vaccinated are actually at less risk of getting infected unclear. We know there is significant waning of effectiveness against infection. Results vary, but some studies conclude VE goes to zero after as little as 4 months for AZ, 7 for Pfizer …

This is consistent with latest UK data:
% of 18-59s (the group most affected) fully vaccinated is estimated to be between 69% (using NIMS population) & 80% (using ONS).

Latest UK HSA report shows 77% of cases in that group were fully vaccinated ...

i.e. at best, overall case rates for this age group are just a little lower for the vaccinated, but quite possible that they are actually higher than in the unvaccinated ...

Whilst benefits of sacking unvaccinated carers are close to zero or worse, costs are certain & large:

staffing shortages & home closures➡️worse care for elderly & hospital bed blocking + personal hardship of those sacked & their families.

The policy truly is indefensible.

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More from @cricketwyvern

27 Oct
About this article by @whippletom on HSA surveillance data:
Using the NIMS population may underestimate unvaccinated case rates, but the data still raise serious questions about real world vaccine effectiveness which need investigating not dismissing …thetimes.co.uk/article/corona…

If we look at age 18-59 (most affected by vaccine mandates), HSA data suggest vaccinated case rate is 58% higher than unvaccinated.

Using the alternative ONS population estimates, rate amongst vaccinated is lower but only by 27%.
The true value will be somewhere in between …

On the face of it, those data are devastating for the case for vaccine mandates.

Rather than criticising @UKHSA for publishing data, far better to try to work out what is going on.

And rather than lobbying for the info to be suppressed, why not push for even more data? …
Read 5 tweets
22 Oct
The latest Public Health England Vaccine Surveillance report is very striking.

They report 80% of adult *cases* in past 4 weeks were fully vaccinated, up from 56% in 9 Sept report.

That doesn’t necessarily mean vaccinated are testing positive at a higher *rate* ...

PHE report adult rates are 40% higher amongst vaccinated overall: higher for all ages >29 & more than double for 40-79 year olds.

But PHE use NIMS population estimates which probably overestimate population meaning PHE unvaccinated case rate may be too low ...

The alternative is ONS population which has the opposite problem (i.e. unvaccinated rates using this may be too high). The true rate is probably somewhere in between.

Here are the case rates & implied vaccine effectiveness (VE) using NIMS & ONS population denominators …
Read 13 tweets
21 Oct
It’s not libertarian to think that a Govt forcing people to do something like wear masks for everyday activities under threat of criminal sanction should have strong evidence that:
a. there will be significant benefits
b. those benefits are large enough to outweigh costs

the evidence on the effectiveness of mask mandates is weak & conflicting whilst the real world experience of countries/states introducing mandates makes clear that, if there is some marginal benefit, it is not big enough to be observed in the raw data @ianmSC

On the other side, cost of mask mandates is not zero.
Masks are not free, but we can't look only at economic costs. Also:
• environmental costs of disposal
• discomfort (& for a minority, serious distress)
• barriers to communication
• impact on child development
Read 4 tweets
19 Oct
Lots of people that, as our case numbers & deaths are particularly high relative to the rest of Europe, England needs to reimpose restrictions & compulsory masks & start vaccine passports.
It’s a strange take …

Confirmed positive tests are currently relatively high in England but they are by no means the highest in Europe.

Further, high cases are partly explained by mass testing. Testing rates in England currently 9 x Spain, 8 x Germany, 2 x France or Italy.

And crucially …

deaths are actually about half the European average & just below the EU average

(note graph is from Our World in Data graph which shows the UK as a whole. Rates in England currently even lower) …
Read 7 tweets
8 Oct
The latest @UKHSA Vaccine Surveillance report now reports that the vaccinated are testing positive at a higher rate than the unvaccinated for every age group from 30-39 up ...
... The text accompanying this table says "The rate of a positive COVID-19 test is substantially lower in vaccinated individuals compared to unvaccinated individuals up to the age of 39"
I think that is just a typo & should say "up to age of 29" Perhaps @UKHSA can confirm? ...
As noted previously, there is lots of discussion about whether UK HSA are using the most appropriate population denominators & if ONS estimates are used, rates would still be higher amongst unvaccinated for most (though not all) age groups ...
Read 6 tweets
6 Oct
Lots of interesting data in the latest ONS release.
First, reinfection rates continue to be low (though a little higher in the Delta period): they find 296 out of 20,262 (1.4%) people tested positive again, a rate of 12 per 100k person days (about 4 per year). However ...
... only 137 people (0.7%) had a Ct < 30 (i.e. high viral load) when they tested positive a second time.
Further only 88 people (0.4%) reported any symptoms (see Table 1d) ...
... Second, the chance of reinfection increases somewhat over time, but remains very low even after a year.
e.g. Table 2c gives estimated reinfection rates per 100k person-days = 10.8 one year after the 1st infection ...
Read 8 tweets

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