Thread by @chrischirp

THREAD on UK Covid situation:

TLDR: not over yet. Good news is high booster coverage in over 50s & no rise in ICU. Bad news is high strain on hospitals, no plan for schools & worsening admissions & long covid for kids.

+ Indie Sage has some suggestions...

1/21

Firstly Omicron - now dominant in Scotland, Wales & England. Probably in NI but no recent data. N Ireland is about week behind other nations.

Omicron dominant in all English regions, London c. 1 week ahead.

Omicron's rise has been very rapid! 2/21

Omicron is v good at infecting vaxxed people - even being boosted only gives you about 40% protection after 10 weeks.

Booster gives *88%* protection against hospital admission - GET IT!

NB booster hosp protection for Delta was close to 100%, Omicron has made things worse. 3/21

So given boosters so important... over 50% of whole population boosted everywhere except N Ireland.

Massive booster effort before Xmas but doses have dropped now :-(

England & NI behind on teen vax (about 50% have received 1 dose). 4/21

By age (England), we have excellent booster coverage in over 60s - this is making big difference to admissions and is why e.g. N America in harder situation. BUT plenty of unboosted younger adults left and kids have v little vax protection. 5/21

Plus very large gaps in booster coverage for adults and first dose for teens by deprivation.

We *have* to address this because it will only exacerbate existing inequalities if ignored. 6/21

In terms of cases... 3 million cases in last 3 weeks - same as in the whole 12 weeks before that.

Cases & positivity rates at record highs in all nations. Testing is struggling - ONS infection survey (not affected by test capacity) shows this peak dwarfs previous ones. 7/21

Reinfections are also rising - over 140,000 in England in last two weeks - these are *not* on the daily dashboard (but will be soon). Wales & NI do include these and so will be reporting relatively higher case numbers. 8/21

Regionally, London has dropped since pre Xmas but recent days flat. all other regions rising still.

Positivity rates rising everywhere (inc London!). ONS also shows recent fall in London but age profile is interesting... 9/21

Overall in England, confirmed cases in all ages are rising. ONS shows we're likely undercounting primary school kids - extremely high rates!

Kids are returning to school & young adults to uni with highest ever prevalence. 10/21

In London, drops in school age children and young adults since just before Xmas - but flat in most recent days - *before* any new year mixing impact.

Cases in older adults are still rising (although might be flatting in over 70s). What does this mean for hospitals? 11/21

Number of people in hospital with Covid is going up sharply - not *that* far from wave 1 peak.

BUT few people are needing intensive care - pressure there is NOT rising.

Both admissions *for* & *with* covid are rising steeply, *but* percentage for is falling. 12/21

There is a lot of staff sickness - climbing steeply.

This, combined with covid pressure + high existing hospital load + social care pressure, means many hospitals are in crisis.

NHS doesn't have same resilience 2 yrs into pandemic. NW particularly stressed. 13/21

Deaths are hard to interpret right now with reporting delays over holiday period, but are likely flat or slightly increasing.

With fewer people needing intensive care and high boosters in older adults, hope that deaths will not increase too much... 14/21

If we look at the age of admissions, they might be peaking in 18-64 year olds but still going up in over 65s.

Admissions are at record highs for under 18s, *particularly* for *0-5s*.

More children have been admitted with Covid in *last 3 weeks* than *whole of 1st wave*. 15/21

If we look at long covid, children reporting symptoms longer than 4 weeks has shot up, sharply reflecting high case numbers in Sept & Oct. Adults in their parents' generation (35-49 yrs) also reporting increasing long covid. 16/21

Long covid reports in 17-24 yr old has fallen, reflecting more people recovering than being added as cases have fallen - good. But we've just seen record cases in this age group - and we have no idea about Omicron and Long Covid. Vax should help, but no omicron data. 17/21

As for kids - we know they've got more months of high (Delta) cases that will increase long covid. AND they've returned to school & likely Omicron wave. What then?

With increasing long covid & hosp admissions & little vax, we must stop pretending covid fine for kids. 18/21

Also, a new school wave will prolong the Omicron wave for everyone, and further risk school staff (already reporting more long covid alongside health care workers).

AND high school cases disrupt education for kids who fall ill and those left without teachers. 19/21

So @IndependentSage think it's too late for a circuit breaker - time for that was in Dec. Now it's about reducing the "comedown wave" as fast as possible through:
communication (symptoms, airborne)
protection (clean air, masks, vax)
support (isolation, clean air, industry) 20/21

Different ages will peak at different times. The risk of "muddling through" is that we face a slow descent, resulting in far too much illness, disruption and prolonged NHS pressure.

We didn't slow growth of Omicron, so let's now accelerate its decline. 21/21

PS incidentally, all the measures we've suggested are important for new variants, and most for new airborne diseases...

PS2 thanks to Bob Hawkins for his help as ever.

PS3 you see same patterns of long covid (but lower numbers) when looking at symptoms for longer than 12 weeks - but that still only includes people infected up to September because of lags and so misses school wave.