Quick THREAD on cases & admissions in England & schools...

Cases fell in England for about 2 weeks but started going up again last week.

Some of this increase will reflect more testing again since half term (and positivity rates have fallen a little). 1/9
Reductions were driven by steep drops in school age kids (esp 10-14 yrs), which started week before half term.

Apart from less testing, chains of transmission were broken with continued fall week after half term.

Recent uptick tho, esp 5-9 unvaxxed.

60+ fall, boosters? 2/9
Plausible that 10 days is approx the time it takes for new chains of transmission in school to take hold & drive cases up again. Despite high prev infections.

Leicestershire schools had term & half term week earlier & they are seeing sustained increases in school kids again 3/9
There are also early signs of increase in their parents' generation 30-59 yr olds (same plot below). but not in twenty-something or 60+ : hopefully boosters in latter working but also takes longer to spread from school kids to older generations. 4/9
Leicestershire only saw one big peak in late Sept. The double England peak is probably a sign of moving localised peaks and the Immensa massive spike in SW in Oct.

Scotland too had earlier start to term & earlier half term. So what is happening there? 5/9
Big single peak in Sept (but lower than England max: 1400 vs 1900/100k/wk) but then drop & plateau.

Half term decline, then flat but now under 15 cases rising again along with 15-44 yrs. Falls in 65+

Scotland has masks in 2ndry schools & much higher teen vax than England. 6/9
In terms of admissions in England, they fell but have recently increased a bit over last few days.

However, this seems mainly from 18-64 yr olds - we have seen sustained falled in 65+, hopefully booster induced! 7/9
So I think we are likely to see another peak in school aged children in England this half term - *hopefully* lower than Oct with teen vax & prev immunity. But hard for primary school kids.

Hopefully over 60s boosters will help keep admissions & deaths from rising v much BUT 8/9
I don't think it's ok to mass infect kids (see e.g. this thread from yesterday
)

and also likely their parents will get infected too as their vax immunity wanes and before they are eligible for booster (for many, 6 months is end Dec/early Jan). 9/9
PS see also this thread from @ProfColinDavis yesterday making v similar points.

PPS and also we shouldn't be ok with static admissions ~ 700-800 a day- firstly for the people so sick with Covid and secondly for the NHS which is serious trouble.

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More from @chrischirp

Oct 19
Important 🧵on our new peer-reviewed paper:

The pandemic is as bad as it ever was for babies - in year to Aug 2023, 6,300 babies under 1 were admitted to hospital wholly or partly BECAUSE of Covid.

They are ONLY age group where admissions have NOT gone down over time 1/17 Image
Our study, led by Prof @katebrown220, looked at all hospitalisations in England in children with a Covid diagnosis or positive test from Aug 2020-Aug 2023.
We then *excluded* all admissions where a Covid diagnosis was incidental (ie not why they were in hospital)
2/17 Image
Infants (babies under 1) are generally at higher risk from respiratory infections, plus they are the age group that, if infected, are overwhelmingly meeting the virus for the first time.

They are not vaccinated and have not had it before. 3/17
Read 18 tweets
Sep 26
Prof @Kevin_Fong giving the most devastating and moving testimony to the Covid Inquiry of visiting hospital intensive care units at the height of the second wave in late Dec 2020.

The unimaginable scale of death, the trauma, the loss of hope.
Please watch this 2min clip.
And here he breaks down while explaining the absolute trauma experienced by smaller hospitals in particular - the "healthier" ICU patients were transferred out, leaving them coping with so much death.

They felt so alone.
Here Prof Fong explains how every nurse he met was traumatised by watching patients die, being only able to hold up ipads to their relatives and how it went against their normal practice of trying to ensure a dignified death, with family there.
Read 5 tweets
Aug 28
THREAD: I asked what the point of Public Inquiries is for @bmj_latest

We've spent hundreds of millions of £ on Inquiries over last decades, generating deep understanding of failures & 1000s of recommendations.

But v few recommendations get implemented!
What is going on?

1/12 Image
E.g. Covid-19 Inquiry has cost £94 million so far - and is projected to cost over £200m by its end (it still has years to go).

1st report published (out of at least 9) found major flaws and proposed 10 recommendations.

Chances are low that they will be implemented :-( 2/12


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Inst for Government looked at 68 Inquiries from 1990-2017.
The Inquiries cost over £630 million and made 2,625 recommendations.

Only 6/68 Inquiries have received full scrutiny by a parliamentary select committee on implementation of recommendations. 3/12 Image
Read 12 tweets
Aug 9
🧵War causes direct civilian deaths but also indirect deaths over the following years.

Recent paper estimates eventual total direct & indirect deaths in Gaza attributable to the war - 10% of entire pop'n.

I want to explain these estimates and why deaths must be counted. 1/13 Image
Why count casualties from war anyway? For moral, legal and strategic reasons.

1 - owe it to those who have died
2 - International law says must count & identify dead as far as possible
3 - monitor progress of war & learn from tactics

2/13 Image
There are direct and indirect casualties of war. Direct deaths include those who killed by fighting or bombs.

Indirect deaths are those that die when they would otherwise have lived because of one or more of: lack of food, healthcare, housing, sanitation, income, hope. 3/13 Image
Read 14 tweets
Aug 1
THREAD: the summer Covid wave in the UK continues.
Basically, there is a LOT of Covid around and not a lot of other respiratory viruses.

If you have cold or flu symptoms, it's probably Covid.

The latest hospital data from England shows steady, quite high levels. 1/8 Image
But admissions don't tell us how much virus is circulating more generally. The best (but imperfect) measure we have is wasterwater measurements, and only in Scotland and not England.

Scotland's wastewater is showing a huge July peak - highest since Omicron's 1st yr in 2022 2/8 Image
Because different people shed different amounts of virus and variants can matter too, you can't for sure infer how many people were infected between different wasterwater peaks. BUT given the size, I'd say it's pretty likely this is the largest peak since 2022 in Scotland 3/8
Read 8 tweets
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

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