Prof. Christina Pagel Profile picture
Dec 17, 2021 18 tweets 9 min read Read on X
THREAD: on omicron, UK cases, London & what to do next...

Last post-briefing tweet thread of the year! 1/18
First Omicron... as of 11 December, Omicron was most common in Scotland and England but starting its growth in Wales & N Ireland. With its growth speed, shares of cases will now be much higher in all regions. 2/18
In England, UKHSA "S gene dropout" data shows it was 40% of cases by 13 DEcember. It will be dominant in England by now.

WHO first designated it a variant of concern & named it Omicron 3 weeks ago today. Crazy. 3/18
In England, it's growing fast in all regions (less than 2 day doubling time in many!) but is highest in London which is maybe 5 days ahead of other regions. 4/18
Imperial college released a report today showing high immune escape, rapid growth and no evidence that omicron was milder than delta.

imperial.ac.uk/media/imperial… 5/18
Nationally, cases have reached record highs. Another record reported today.

Growth might slow over next few days because:
- school holidays
- delta might decline cos of boosters
- weekend
- testing backlogs 6/18
In fact on testing, we can see that we are doing tons of LFDs and the most PCR tests ever. Testing times are getting longer.

We might reach testing capacity next week, artifically flattening reported cases. 7/18
Back to cases... unsurprisingly (given where Omicron is most prevalent), Scotland and England are rising rapidly while Wales and NI still flat... Expect that to change over the next week.

Note that cases in under 11's sky high. Schools will be big issue next term. Again. 8/18
People in hospital are falling or flat everywhere except England where admissions are also going up. These are still mostly Delta!! Omicron admissions will start to be felt from next week on I think. And will (at least at first) be on top of these Delta ones :-(

9/18
Meanwhile we are seeing more Covid outbreaks in hospitals. We need to watch this because Omicron seems ridiculously catchable. Hospital workers need to be provided with upgraded masks asap.

bbc.co.uk/news/uk-wales-…
10/18
Deaths are flat - do not expect recent case rises to be reflected in deaths for several weeks yet.

We are accelerating booster jabs - almost 800K in one day recently. We need to keep at that level and go even higher to reach people as soon as possible. 11/18
Soooo, let's talk about London where Omicron is now the large majority of cases.

It's the fastest growing region by far in terms of cases, positivity rates and hospital admissions. Many boroughs are showing insane recent growth. 12/18
Hosp admissions by primary diagnosis show increase in *both* admissions for Covid and more incidental admissions (e.g. trauma or caught covid while in hospital for something else).

This is consistent with no evidence that Omicron milder.

Critical care already v busy. 13/18
Cases are going up fastest in 20-29 year olds but all age groups in London are going up - even school age kids where cases *had* been dropping towards the end of term. 14/18
London is the least vaccinated, least boosted region of England with large difference by deprivation, espeically in the over 50s. This means vulnerable populations will be massively exposed to, and at risk from, Omicron. What are we doing to address this? 15/18
So overall things are not looking great.

Indie SAGE suggests having a mini circuit break until Christmas eve to stop as many people as possible getting infected next week - this will save lives, protect NHS and allow limited mixing over Xmas.
16/18
And this *must* come with govt support for affected businesses - they are already suffering greatly from voluntary cancellations (and I think need support regardless).

17/18
And finally, we *must* vaccinate the world. @UNHumanright reported over 100 companies able to produce vax that are not allowed to.

It's not a zero sum game. UK must support vax waivers and tech transfer to enable much higher vax production globally. 18/18

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More from @chrischirp

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
Jul 19
Quick thread on current Covid situation in England and Long Covid.

I have Thoughts about the Inquiry Report published yesterday but am still trying to organise them.

TLDR: high Covid levels remain, Long Covid remains 1/11
This wave is not over. While the number of admissions with Covid remains lower than the autumn/winter waves, it has now remained highsh for several weeks.

This means there are a lot of people out there getting sick - and having their work, plans and holidays disrupted. 2/11 Image
Scottish wastewater data to 9 July shows a sharp decrease, suggesting that prevalence might be on its way down.

Obviously Scotland and England can have different dynamics, but it’s the best we’ve got as long as England refuses to analyse its own wastwater. 3/11 Image
Read 12 tweets
Jul 3
THREAD: Given tomorrow's election, I've been thinking about our nation's (poor) health, the wider determinants of health and how these have worsened and what it means for policy....

TLDR: worrying only about NHS & social care is missing the point

let's dive in... 1/25
The UK has a health problem. After steady gains in life expectancy for decades, it flatlined during the austerity years and fell for the first time this century with the Covid pandemic.

The number of people out of work for long term sickness is near record levels. 2/25
There are huge inequalities between rich & poor. Boys born in the most deprived areas can expect to die almost 10 years earlier than their peers in the least deprived areas.

Even worse, they can expect to spend 18 fewer years of their life in good health (52 vs 70 years) 3/25 Image
Read 38 tweets
Jun 4
As ever, I am getting lots of pushback.
Here is a compilation of the European countries I've found with recent wastewater data. Some are going up a bit, some down a bit, some are flat, none are anywhere near previous peaks.
I can't see anything here to be panic anyone. 1/3
Image
I can't find the dashboard for Spain, but others saying it is in a wave. Perhaps it is. England has just had one - the last data we had (a couple of weeks ago from Bob Hawkins) looked as if our wave had peaked.
So, I'm not seeing reason to think things are terrible here! 2/3 Image
Yes there are new variants growing right now. They are not growing faster than JN.1 grew in December and that wave did not end up as bad as feared.
Clearly it remains true that Covid is NOT a seasonal disease (unlike Flu and RSV)
3/3
Read 5 tweets
May 8
Quick thread on the Astra Zeneca (AZ) covid vaccine since it's been in the news today.

TLDR there isn't a new "smoking gun", the AZ vax was one of first and cheapest, it saved millions of lives globally, there are better vax out there now, adapted to new variants 1/9
the AZ vaccine was one of the first approved at the end of 2020, cheaper than Pfizer, and - importantly - easier to administer in lower resource settings as it didn't require super low temperatures for storage 2/9
In most countries it was first rolled out in older adults. As it was rolled out in younger adults, a *very rare*, serious, side effect was noticed - it could cause deadly blood clots

This was spotted quickly and studied. Vax monitoring did its job. 3/9 Image
Read 11 tweets
Apr 2
A short thread on why this is not a scary chart and why all the evidence suggests that there is not much Covid around right now. 1/6 Image
the above chart is recorded covid hospital admissions / reported covid cases. It is close to 100% now *because basically only hospitals can report cases since Feb 2024*

It is to do with changes in case reporting and NOT hospital testing
2/6
In fact hospital testing has been steady since the change in testing a year ago (only symptomatic patients get tested now).

The % of people PCR tested who have Covid is 4% - there is no evidence that there are loads of symptomatic people in hospital being missed. 3/6
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Read 6 tweets

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