Prof. Christina Pagel Profile picture
Dec 30, 2021 19 tweets 10 min read Read on X
THREAD on England & Omicron and what is going on.

My take on it.

TLDR: things are pretty bad and I'm sad & bewildered at lack of govt action and general levels of hopium. 1/18
First off cases... reported levels in England now more than twice as high as previous peak last January and more than three times higher than at start of December.

Latest numbers reflect infections *before* Christmas mixing.

These numbers are an underestimate.

2/18
Positivity rates are also rising v steeply - testing is not keeping up with cases.

All regions rising fast, London highest and earliest. Do not take London small case drop too seriously - drop in pre xmas tests & positivity still rising. Plus xmas likely to boost again. 3/18
As I (+ many others) warned a few weeks ago, we are now at limit of how many tests we can do - and that means case numbers increasingly poor indicator of spread. Positivity is what we need to watch out for.

Lack of tests also increases transmission - esp over New Year. 4/18
Infections still highest in 20-29 year olds, but rising fast in all other age groups apart from under 10s.

Rise in 60+ esp worrying - now approaching level last seen in Jan peak. Obv vax will make a massive difference - but how much higher will cases go - esp with Xmas? 5/18
And yes - cases ARE feeding into rapid rises in hospital admissions. I said we should expect increases after Xmas and that is what we are seeing.

Admissions are rising in *all* age groups.

Again, these admissions are from infections pre-xmas & just after Omicron dominant 6/18
And to 21 Dec, 70-75% Covid admissions *for* Covid. Many of rest caught it in hospital - which is not a good thing.

data available here
england.nhs.uk/statistics/sta…

7/18
It *does* seem as if fewer admissions need intensive care (good) but needing hospital is not a good thing and massively restricts NHS ability to treat other conditions - esp with so many staff sick.

An NHS crisis based on the wards instead of ICU is still an NHS crisis. 8/18
So what next? Firstly, cases have NOT peaked yet. With Xmas and then New Year mixing, likely to peak in early(ish) Jan. Admissions will keep going up steeply.

So far, admissions higher than recent LSHTM projections and have met SAGE prediction of >2K by end of year. 9/18
Warwick (also feeding into SAGE) published their projections today over a range of scenarios. I think we are in their "Omicron 80% less severe than Delta & Plan B only" scenario.

This gives peak hospital admissions *higher* than last January (but with fewer deaths). 10/18
Putting in a short circuit break before Christmas or even on Boxing day could have greatly reduced this peak. Returning slowly to normal from mid Jan would have minimised resurgence.

But govt has missed that boat and ignored the science. 11/18
Note that admissions are already higher than Warwick peak in best case "Plan B" scenario of 90% less severe.

NHS is planning for mini Nightingales and tents in car parks. Staff shortages are causing massive problems for all care. 12/18
We've recorded 1.4m cases in England in last 2 weeks alone.

Even if Omicron less severe we know *nothing* about its long term impact. Even if less likely to cause long covid, *hundreds of thousands* more people likely to suffer long covid - affecting them *and* economy. 13/18
We've also done nothing to protect schools - which will prolong Omicron wave & put kids at risk.

New York is warning of rising admissions in young kids - they can't be vaxxed & rely on LOW community transmission to protect them. 14/18

The usual people are out there saying all will be fine soon - we just have to let people get infected and it will be done. Just as they did at previous waves.

Mass prior infection have *not* stopped the Omicron wave. Nor has mass vax. Omicron is not last variant. 15/18
We have made a tremendous progress in boosting adults - 75% eligible now boosted. Our booster programme will turn an absolute tragedy into a "mere" terrible period.

But when will we realise that (current) vaccines cannot do it all on their own?! 16/18
We *could* have prevented the NHS strain over the next weeks. We *could* have prevented the economic damage of mass sickness in businesses. We *could* have invested in ventilation like Japan. We have not.

Instead of prevention we are planning hospital tents in car parks. 17/18
Many from govt to scientists to the media to the public have decided that 100,000s cases a day are fine. We are dangerously weakening our NHS & its staff.

Too many people will end up with chronic illness & too many will die.

All I can do is keep saying it's not fine. 18/18
PS some have asked why I've not shown death data. Firstly holiday reporting backlogs have made recent data non informative and secondly any increases from Omicron wave won't show up for at least another week, likely longer.

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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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