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

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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