THREAD on Europe and whether UK is a good position for winter...

TLDR: Much of Europe in v difficult circumstances.
But UK has been in difficult circumstances since June with much more total illness and death, and still is. 1/17
Concentrating on W Europe where vax rates & context are more similar - E Europe is in its own world of pain, mainly due to population with high existing health problems and low vax, particularly in vulnerable. 2/17
Many countries in W Europe going through bad Covid surges - in both cases and deaths - each for their own combo of reasons of measures, behaviours, vax rates, waning.

They have similar vax rates to UK but are later in boosting (but also vaxxed later so waning later). 3/17
UK is *not* seeing big surges like that. BUT that is because we already surged up the infection peak back in July and have stayed high on the infection ridge ever since.

With a consequent very large burden of *avoidable* illness and death. 4/17
Compared to similarly sized neighbours (Italy 60m, Spain 47m, France 67m, Germany 83m, UK 67m), we have had far more confirmed infections - over 5m since 1 July vs 1.7m in next highest Germany. 5/17
And while some of that reflects differences in testing, it's certainly not all of it. The UK has reported almost 16K deaths since 1 July versus 8.5K in Germany and 5.7K in Italy. 6/17
*6K UK deaths were in people over 60 who died between 1 July and 30 Sept 2021*. Almost another 3K 60+ yrs died just in Oct.

*Many would have benefited from booster this autumn and still be alive.* But they didn't get the chance cos we've been tolerating such high cases. 7/17
Since 1 July we've had over 100,000 hospital admissions in England. 45,000 were in 65+'s. They could have been mostly prevented with the booster.

24,000 were in 18-64 yr olds in July & Aug - how many were in younger adults who'd not had chance yet to be double vaxxed? 8/17
What about children?

We've had nearly 3K admissions in 6-17 yrs since 1 July. Many could have been prevented with teen vax.

Admissions in 6-17 yr olds remain relatively high- how many more could be prevented if we kept cases down till they had chance for 5-11 yr old vax? 9/17
We've also seen rates of long covid inrease a lot, particularly in the young who bore brunt of infections in July & August.

That will only have got worse this autumn. 10/17
So - does UK now have quite a bit of protection from high levels of infection-induced immunity plus vaccination plus boosters? Yes we do.

But only because we've tolerated high burden of illness, hospital admissions and deaths FOR FIVE MONTHS. 11/17
Other countries are not tolerating it and so are acting to reduce measures. Meanwhile we pat ourselves on the back - and for what?

Literally thousands of people have needed hospital or died before they got the chance of a booster or (for young) 1st & 2nd vax. 12/17
The more immunity a country has, the better chance it's got.

But there's a safe way (vax) and an unsafe way (infection) to get there.

We had access to the safe way but are congratulating ourselves for choosing the unsafe way. It's madness. 13/17
And we haven't protected the NHS - if you think the NHS is coping just fine, then talk to someone who's been to A&E recently, or is waiting for their treatment or works there. Things are really really bad.
@ShaunLintern has been reporting it heroically. 14/17
Many (but not all) European countries are in a real mess too right now. We'll see what happens to them over the next few months.

Their problems in no way excuse the burden of avoidable illness and death that the UK has tolerated for the last FIVE months. 15/17
To those saying boosters are amazing & will save us this winter - they *are* amazing & will save 1000s of lives.

But 1000s died this summer before they got the chance to get them.

And at least for the next few months vaccines alone are NOT enough to get cases down. 16/17
I think it's wrong to be ok with tens of thousands new cases each day.

Our situation means we need v little to bring cases down. Work from home, masks, safer schools, child vax, booster for all adults will all have impact.

England pretty much only country doing nothing. 17/17
this graph illustrates how well the boosters work and also that many people who would have got their booster soon got sick and some died before they got that chance.

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More from @chrischirp

25 Nov
THREAD on the new variant B.1.1.529 summarising what is known from the excellent South African Ministry of Health meeting earlier today

TLDR: So much uncertain but what *is* known is extremely worrying & (in my opinion) we should revise red list immediately.

This is why: 1/16
The South African Ministry of Health had a live streamed briefing today on the new variant detected there.



The variant was identified this week and has been found in three countries so far: Botswana, South Africa and Hong Kong (returning traveller). 2/16
In South Africa it has been detected in Guateng province - positivity rates in Tshwane (part of Guateng) have increased massively in the last 3 weeks from less than 1% to over 30%.

3/16 Image
Read 17 tweets
21 Nov
Some personal thoughts:

Husband and I have just recovered (mostly) from Covid... no idea how we got it since we've been super careful and not done much. Shopping or swimming we think.

I am left grateful for masks & vaccines - here's why: 1/8
Firstly vaccines: having Covid sucked but I am sure it would have sucked much worse without being vaccinated. I am grateful that I had the chance to get that protection first.

I'm annoyed that I got sick a few weeks before my booster was due, but that's life. 2/8
Secondly masks: the first symptoms were so innocuous it was only obvious later what they were. I was 100% convinced we didn't have Covid cos we'd been so careful.

The weekend before symptoms and 1st day of, we were in *a lot* of shops.
3/8
Read 10 tweets
15 Nov
🧵The line from Boris Johnson that Europe's Covid wave might come here is *arrant nonsense* - just convenient cover if cases climb this winter.

We've been having this wave ever since end of June.

It's driven here - as elsewhere in Europe - by local context not importation 1/5
National Covid trajectory is determined by combo of:
1. public health measures (masks, ventilation, which venues are open, vax passports, testing, isolation etc) & behaviours,
2. vax rates (inc boosters)
3. levels of prev immunity

If it's spreading, combo not enough. 2/5
England relied basically on 2 since June and it's not been enough. We've now got 2 and (sadly!) 3 & it's still not bring cases down.

E Europe has nowhere near enough 2 (hence high deaths too).

Germany & Austria are lower on 2 and 3. NL, Belgium stopped 1 (esp in schools). 3/5
Read 5 tweets
15 Nov
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
Read 11 tweets
14 Nov
THREAD on child deaths from Covid:

Last week a paper came out reporting 25 deaths in 0-17 yr olds in England from Mar 2020 - Feb 2021.
nature.com/articles/s4159…

19 had an underlying health condition prompting headlines like these...

This is my view on child deaths & covid 1/10
Firstly I don't doubt the numbers.

We can compare them directly to ONS weekly death registrations with Covid on death certificate, which come in 5 yr age increments.

Drs doing death certs consider v carefully what are the contributing factors. 2/10

ons.gov.uk/peoplepopulati…
The directly comparable age ranges we have are 0-14 years from ONS and from the paper.

The authors found 16 deaths in 0-14 yr olds from 1 March 2020 - 28 Feb 2021.

For same period, ONS reported 12 deaths. Note that all ONS child deaths in that year were in England. 3/10
Read 12 tweets
8 Nov
THREAD on school learning lost during the pandemic in England:

Summarising this govt report from October - very depressing...
assets.publishing.service.gov.uk/government/upl… 1/11
The report looked at learning loss in Primary (yrs 4-6) and Secondary (yrs 7-9) school students during pandemic in Reading and Maths (Primary only) using the standardised Star Assessment method which accounts for age.

What did it find? 2/11
Firstly, they assessed loss in Oct 2020 after initial long lockdown & again in July 2021. There was a lot of lost learning initially - and some catch up since so things are better by summer 2021 than they were, but kids have *not* caught up (which would be zero lost months). 3/11
Read 12 tweets

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