Dr Dan Goyal Profile picture
Jan 27 12 tweets 3 min read
Booster doses are waning.

Data from the UK’s vaccine study AND data from Israel give cause for concern.

Summary thread 🧵
Israel are well ahead of most of the world in 3rd doses of vaccines. But five months down the line the situation is concerning!
Cases, ICU patients, and deaths all rising steeply.

Hospital admissions at their highest levels since the pandemic began.
The rate of ICU admissions highest yet and still rising.
Context:
We must bear in mind the huge number of cases Israel is experiencing. It looks like it is peaking at 3 times the rate of the UK, despite still having a positivity rate > 20% (lots of undetected cases too).
And the actual individual chance of death once you get Covid continues to fall in Israel.

Although the real world risk of hospitalisation and death is higher given the increased chance of getting Covid just now.
The bottom line is that more people are dying, needing hospitalisation, and needing intensive care.

There is a massive amount of hospital resources being redirected to Covid patients.
And evidence from the UK also shows a drop in booster efficacy. Protection from admission after a Pfizer booster has fallen from 90% to 75% after 10 to 14 weeks.
What does it mean?

Risk of death once you get Omicron (assuming access to healthcare and boosted) remains relatively low (and much much lower than pre-vaccine).

But the actual individual risk with high levels of viral transmission is significant!
While Israel may weather the storm, the UK health service could not cope with another wave with higher admission rates.
We need to follow WHO guidelines and properly prepare for further waves…at least until vaccines and treatments improve further.

We need to get better (and less intrusive) at suppressing transmission. AND we need to strengthen health services, NOW!

It need not be a disaster!
Meanwhile, get vaxed!!
This is probably the best time to actually get boosted/vaccinated… maximal protection for the Omicron wave while NHS in winter mode!

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More from @danielgoyal

Jan 25
Some policy makers are using the “Flu” comparison to argue for doing less/nothing to control Covid.

Here I present an argument against such policies.

Understanding the risk of Covid is useful when deciding your own opinion about gov policy.

🧵

[FYI ⬇️ - Flu vs Covid]
Disclaimer: not a statistician. Clinical academic. This is my understanding of the current risks told plainly. Others better placed to comment further: @Kit_Yates_Maths @chrischirp @dgurdasani1 @JamesWard73 @jburnmurdoch @EricTopol @DrEricDing and others…
Risk to self: the actual risk of death from Omicron is less (vs Delta).

In crude terms, the risk of death from Flu is 0.05% (prob much less).

The current risk from Covid seems to be ~0.2% (vaccinated, confirm, ave)

This is a direct comparison. Real risk is very different.
Read 9 tweets
Jan 25
How similar is Covid to Flu in the UK?

On an individual level, the risk of severe Covid-19 in a fully boosted adult is significantly lower with Omicron than Delta.

How close is that individual risk to the risk with Flu?

Short 🧵
I will provide some data and sources at the end, but the main points are:
1. Rate of death from Covid has dropped significantly over the last year. By about ten-fold.
Read 21 tweets
Jan 22
Despite the dramatic title, Mr Snowdon raises an important point: what happens when number-crunchers neglect human factors.

I fear though, Mr Snowdon has succumbed to the very criticism he levy’s against those arguing for stronger mitigations

Thread
This is not a criticism of the many astute and invaluable statisticians. More a challenge to basic assumptions.

Indeed, often the distance and objectivity is appreciated.
But It is a pattern that seems to be emerging from economists and statisticians, that somehow the resistance of the PM to further mitigations was in some way a success.

While the economic argument seems absent, focus on healthcare numbers seems popular and problematic.
Read 19 tweets
Jan 16
Oh my, Johnson must be getting desperate. His tactic for holding onto power now seems to be “talking up” his success in managing the pandemic.

Some things to bear in mind as the battle for the narrative continues…
While we can get distracted by the ‘with’ or ‘from’ Covid argument, here is the excess death data…one of the good overall measures for how a nation responded to the pandemic.

Ireland, Germany and France had about half as many excess deaths as the UK.
We averaged between 500 to 1000 extra deaths at home per week, throughout the pandemic.

Note, only a fraction were Covid.
Read 11 tweets
Jan 14
Covid update from the UK frontline.

Things are looking different at the “front door”

Here’s how…
Context:
▪️Scotland
▪️Non-city
▪️High vax rate + high booster rate
▪️Respectful people: masks, distancing, isolating when needed.
▪️Care homes still protected
I compare this wave with the last delta wave July ‘21 to Nov ‘21 - so called, Delta baseline.

Just my experience of the patients I see.

Our rates have been about 3 X higher than our delta baseline.
Read 11 tweets
Jan 10
Back on the frontline the damage caused by 'letting it rip' is all too apparent. "Broken" seems to be the word of the day - both for staff and NHS.
As the battle for the Omicron narrative begins, hearing the word 'coping' now stings a bit too much...'success' a swell of anger...
Lots of Covid today. New outpatient treatments (someone has to administer them); loads of patients not well, but with some effort can be managed at home; the inpatients, and the odd escalation to Level 2 care..
It's a lot of work in the middle of our usual brutal winter caseloads
Being on the senior medical team is tough. Lots of compromising, and spreading too little way too thinly. Sleepless nights and little left to give for the family. I feel for the patients more...although many don't realise. I feel also for the juniors and med students...
Read 8 tweets

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