LONG THREAD on UK Covid situation...

cases, hospitals, deaths, long covid, variants, global - all dealing with consistent themes.

TLDR: "living with" with high cases is bad idea. Especially while boosters and teen vax is slow and new viral treatments are on the horizon! 1/25
There was a reduction in both LFD and PCR tests over half term, so take drop in reported cases with a grain of salt over half term.

Cases were flat or dropping in each nation, but apart from NI, PCR positivity was flat or increasing. 2/25
Two weeks ago I said we should see rates in kids fall over half term & that teen vax might put a brake on it too.

So cases started dropping the week *before* half term and accelerated over half term. 3/25
While some of it will be reduced testing, we also see drops in school kids in ONS Infection survey. Cases in school aged kids have peaked (for now), but aren't (yet) dropping in adults - so won't reduce pressure on NHS yet.

Impact of back to school remains to be seen. 4/25
REACT-1 Study from Imperial reported this week comparing results from 67K people in late Oct to 100K people tested in Sept in England. People randomly sampled so not biased by who is seeking testing.

So what did they find? 5/25
Cases increased in all regions but particularly in the SW where they almost quadrupled! Doubtless accelerated by the Immensa false negative lab scandal. 6/25
Cases also increased in all age groups - and were highested by far in school age children (note slightly diff ranges to ONS).

But even in over 75s cases more than doubled. REACT authors said cases driven by school kids and moving through to vulnerable populations. 7/25
Cases are higher & rose faster, in households with children.

And for 1st time in pandemic, cases are highest in least deprived areas and cases more evenly spread. Probably because this wave driven by schools, there is little kids or parents can do to shield from exposure. 8/25
The latest ONS survey on self reported long covid came out yesterday.

I used the last 5 months of reports to look at changes in reported symptoms for >4 weeks from infections pre May to infections pre September. 9/25
Rates are generally highest in older adults, but large increases in young adults recently, reflecting super high cases in this age group over summer.

The rises in 12-16yrs prob from July high school cases. *This term* spike not yet reflected and long covid will rise :-( 10/25
So now to hospitalisations. People in hospital going up in all nations except NI, where they are high and flat.

Unfortunately, number of people needing mechanical ventilation (intensive care) also going up - this does matter.

Admissions pretty high in England. 11/25
If we look at the proportion of critical care (adult) patients who are Covid patients we can see how much it has increased since May 2021 to now.

In some regions almost a third of critically ill patients are Covid patients. @seahorse4000 12/25
This - on top everything else and 18 months of pandemic - is causing massive issues for the NHS.

We should all be shouting about this to our MPs.

This thread in particular is worth reading.
13/25
Deaths, while much lower than Jan peak, are going up and UK has recorded over 1000 deaths a week for past two weeks. 14/25
Latest UKHSA vax surveillance report showed almost 2,500 fully vaccinated people over 70 dying in four weeks in October.

This is NOT because vaccines don't work. It's because living with high case rates and vax waning means too many vulnerable older people pay the price. 15/25
For vaccination, home nations mostly in similar places except NI lagging - particularly on boosters & unvaccinated.

England still far behind Scotland and Wales on vaccinating teens. Lower than I wanted by 2nd half of term. :-(
16/25
If we look at first dose coverage by deprivation for *12-17* year olds there is a massive gap in uptake between children in most deprived areas vs least deprived. A larger gap than for adult uptake.

We need to understand and address this urgently! 17/25
Although two thirds of over 75s are boosted, almost all of them are elgibile. In general, only about 55% of those who got their 2nd dose 6+ mnths ago have been boosted. We need to match the 500K a day we were doing in winter and spring! 18/25
Delta grandchild AY.4.2 (child of AY.4) is continuing its slow spread in England (and Scot & Wales). Likely dominant by mid Jan assuming no other variant emerges.

BUT risk of new variant remains high as SAGE have repeatedly emphasised! Particulary with high school cases! 19/25
In Europe, Eastern Europe having an awful surge with high cases and much higher deaths than the UK.

They also have much lower vax rates, fuelling their high death rates. 20/25
Many countries in W Europe are now seeing surges. Fewer deaths than UK for now & similar vax rates.
They have tried to move from Vax Plus to just vax and it's hard even with high vax rates. Some are reintroducing measures like Belgium and NL. 21/25
Others - like Spain, Italy, France and Portugal, are still managing to keep a lid on it. They have higher vax rates than us, significant levels of prev infection (like us) but also have other measures 22/25
Meanwhile, the US has started vaccinating 5-11 year olds! The CDC emphasised that vaccines can prevent bad outcomes for kids and that Covid still worse for kids than other disease they vax against. 23/25
But vaccine inequalities persist across the world.

G7 promises from June are not being met. We can make more, donate more, support other countries to make more & distribute more. We must do this. 24/25
So to summarise, whether cases go up, stay high or go down gradually, we can get things under control quicker with vaccine plus. We should do this - esp as boosters and teen vax slower than needed AND effective antivirals round the corner. 25/25
PS massive thanks to Bob Hawkins who is so invaluable in pulling together many of the data sources and charts each week!!
to be clear - their drop accelerated!

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More from @chrischirp

2 Nov
Short THREAD:
In the JCVI minutes from 29 June, the committe had modelling evidence from TWO groups showing significant benefit in vaccinating teens - including preventing deaths.

They dismissed it.
Two models from Warwick and PHE showed "substantial reduction in hospitalisations of 12-17 year olds". Both models estimated vax would prevent 3 deaths per million kids vaxxed. (2/million in prev healthy children).

Warwick also showed LARGE REDUCTION in INFECTIONS.
The JCVI remained unmoved. They thought opportunity costs (affecting school vax progs) & potential harms from vax (although they earlier acknowledged vax myocarditis was q mild) outweighed benefit (but no numbers to support).

They also touted natural infection as better *again*
Read 9 tweets
29 Oct
QUICK(ISH) THREAD ON UK COVID UPDATE:

TLDR: cases dropping (partly but not wholly a half term effect), but hospital admissions & deaths rising (in England). Vax still not fast enough.

1/13
Vaccination: NI v behind on boosters *and* highest rate of unvaxxed.

England v behind still on 12-15 yrs compared to Scotland & Wales. Disappointing. 2/13
In terms of speed, boosters are getting quicker but first jabs (teens) are not (in England).

Projecting forward *current* rates, the teen and priority group booster programme won't be done till Feb.

We need to increase availability *and* demand. 3/13
Read 13 tweets
28 Oct
SHORT THREAD: about Covid testing, system strain and potential fall out from Immensa scandal on getting PCR tests...

Am highlighting stuff from @ProfColinDavis , @fascinatorfun , @cfinnecy, @samueljlovett & @Gabriel_Pogrund

TLDR: it's not just Immensa, system is straining 1/11
When you do a PCR test, the most common result is either a positive or negative. But some tests return a "void" result, which can mean a bad sample or bad testing process.
Or an "unknown" result where the test just gets lost in the system 2/11

@fascinatorfun has pointed out that voids are more common if testing capacity is under strain - rushed tests, cutting corners on equipment maintenance or procedures etc can lead to more voids.

Tests also more likely to be lost in a straining system 3/11
Read 12 tweets
26 Oct
THREAD on IMPACT OF IMMENSA SCANDAL:

Here are case rates in 10-14 yrs for the 13 most impacted English local authorities compared to all other local authorities.

The dodgy artificially low case rates are obvious as is massive increase in spread compared to rest of England 1/6
Here are primary school age children who *weren't* doing regular LFD tests and relied much more on PCR tests for symptoms.

The two dips looks as if different authorities in that list might have been impacted at different times. 2/6
The recent increase is *not* people rushing out to get tested. The last data point is 19 Oct - the scandal only broke on 15 Oct. The increases all started before then.

It wasn't just children either - here are their parents' age group 3/6
Read 6 tweets
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
23 Oct
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
Read 20 tweets

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