NEW: our big story as trailed on Friday is a detailed analysis of the critical importance of vaccination in beating Covid

Top-line: if US had matched vaccination coverage of leading European countries, it would have *halved* its Covid hospitalisations…
This is due to the very steep age-gradient in risk of severe Covid, meaning even small gaps in coverage among the most elderly carry huge risk
Here’s vax uptake and waning among the elderly in the US and several European countries.

Note how that red "unvaxxed elderly" segment extends much further right for the US, with millions still vulnerable well into its summer Delta wave.

Far more severely waned second doses, too
And this is after the US got off to a big head-start, getting second doses into elderly arms well ahead of Europe.

(👀 second row of charts here)

But where the black line rose first, it stopped rising at a much lower level than leading European countries.
So what we’ve done in this story is combine all the data we have on age-specific exposure:
• Baseline pre-vaccine risk of severe disease by age
• Share of age group with x doses, and how much waning
• Vaccine efficacy against Delta and Omicron
• For every day of the last year
The result: population-weighted scores for exposure to hospitalisation over time
• Eng & US started rollouts earlier
• But soon overtaken by EU countries (US because rollout slowed, England because AZ)
• Boosters pushed exposure yet lower
• Omi’s immune evasion caused a bump
And that’s where we get these charts showing how one country’s hospitalisation toll might have looked if it had another country’s vax coverage.

We start with the observed data, here for the US, and then multiply it by the ratio between US and Danish exposure scores every day
We can also flip the comparison around and see, for example, how English Covid hospitalisations would have looked if we had US vaccination coverage.

The answer: much worse, coming quite close to last winter’s peak.
Another interesting counterfactual, as also calculated by @PaulMainwood last week for the Omicron period, is what would things look like without boosters?

In England, hospital occupancy would have (un)comfortably exceeded last winter’s peak.
And here’s England with Polish rates of vaccination 😬
There’s an extensive methodology box on our story, and full reproducible code on GitHub…
So, why does all of this matter?

Because of this chart.

Covid’s IFR in England has fallen steeply since last winter, but that wasn’t by chance, it was [largely] because of vaccines.

In countries with poor vax coverage, Covid will still be far more than twice as lethal as flu.
For example, here are CFRs for England, Portugal and the US (IFRs are only possible for England, thanks to the @ONS infection survey 🙏)

Just like in hospital exposure chart, poor US vax coverage means its CFR has stayed much higher until Omicron, and remains higher with Omicron
And while Omicron’s intrinsic mildness is good news for us all, invaluable data from France (via @nicolasberrod) shows that vaccines still do more to reduce Covid’s lethality than Omicron does.
This matches what we’re hearing more hospital doctors all over the world: even with Omicron, unvaccinated people remain at substantial risk of severe disease and worse
So as long as large numbers of elderly people remain unvaxxed or have waned protection, Covid will continue to be a major burden.

If we want Covid to be over, and to be able to get on with our lives, we need to get everyone vaccinated.
And as many have said, we must also remember Covid is much more transmissible than flu, so even though its lethality per-infection has fallen, the number of infections in any given year is still far, far higher.

Down to 2x lethality 👍
5x infections 😬
It’s also worth noting that Omicron’s intrinsic mildness was a lucky strike for us. If the next variant is an offshoot of Delta, that gift would be revoked, and everything will rest on vaccines (and infection-acquired immunity) again.
Finally, a very interesting randomised controlled trial into vaccines’ impact on sporting performance concluded over the weekend, with striking results...
Researchers took elite athletes, matched on age and Grand Slam titles, and assigned them to one of two conditions:

Novax ⛔️
Needal 💉

Being unvaxxed was associated with:
• Extended periods of inactivity
• Loss of shared Grand Slam record
• Deportation

Get vaxxed, folks 👍
And with that, I’m off on holiday for a week 👋

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More from @jburnmurdoch

Dec 5
NEW: last week we got the latest UK census data, on ethnicity, religion & identity.

It was met with toxic responses from the usual suspects seeking to weaponise the stats.

Almost every word of what they claimed was false.

My column:…

And a thread 🧵
First up, Nigel Farage tweeted a hastily-recorded video from a 🇬🇧 union-jack-draped car seat (you have to admire the attention to detail 😆), stating that "London, Manchester and Birmingham are now all minority white cities".
And he wasn’t alone. The same claim appeared in a national newspaper headline:
Read 23 tweets
Dec 1
Time for Thursday’s permutations, starting with group F, where 🇧🇪 Belgium are in danger of ballsing it up.
- Only a win against Croatia guarantees progress
- A draw almost certainly means elimination, unless Canada hammer Morocco
Elsewhere in group F:
- 🇭🇷 Croatia progress with a win or draw vs Belgium, but defeat could well eliminate them unless Canada do Morocco
- 🇲🇦 Morocco almost certain to progress. Only defeat to Canada and then a precise result in the other match eliminates them
- 🇨🇦 O, Canada 🙁
Then later on it’s the big one: all to play for in group E, with 🇩🇪 Germany on the brink
- Must beat Costa Rica to have any chance
- Then need either:
- Spain to beat Japan (by any scoreline)
- Spain and Japan draw, but not too high-scoring
- Japan absolutely hammer Spain
Read 4 tweets
Nov 29
Well folks, it’s the first day of the final round of group stage matches, and this can only mean one thing:

🎉 permutations 🎉

First, England 🏴󠁧󠁢󠁥󠁮󠁧󠁿
- Win -> top the group
- Draw -> probs top, but 2nd if Iran win or huge US win
- Lose -> probs 2nd, slim chance of top or 3rd
For the US 🇺🇸, it’s a simple situation:

Fail to win, and all of that orange and red means instant elimination. But beat Iran, and progress is guaranteed, either as group winner if Wales beat England, or otherwise as runners-up to England.
Wales 🏴󠁧󠁢󠁷󠁬󠁳󠁿 are in a very tight spot:
- Must win, and even then can only progress if either
a) US & Iran draw, or
b) Wales win by at least 4 goals

Iran 🇮🇷 have a little more wiggle-room:
- A win guarantees progress
- A draw also puts them through as long as Wales don’t beat England
Read 7 tweets
Nov 21
Celebrating 34 years on this planet by watching the sun come up at 6,000 feet
Update: still pretty good
On top of the world
Read 11 tweets
Oct 30
NEW: a column in the Times argues that the only way to tackle obesity is through fat shaming (yes, you read that right).

It’s an astonishing argument to make, and unsurprisingly it falls to pieces under scrutiny.

Let’s take a look, and see if we can do better:
First, the author draws a parallel with smoking, declaring that stigmatising & shaming smokers was central to reducing cigarette consumption.

This is quite the claim, and ignores the fact that *by far* the biggest factor in reducing rates of smoking was heavily taxing cigarettes
Second, there is rather glaring problem that smoking is a behaviour, while obesity is not (HT @RottenInDenmark).

This immediately means the shaming mechanism fails on its own [dubious] merits:
Read 35 tweets
Oct 28
I made the mistake of writing that the US Senate should be reformed because one-state-one-vote is undemocratic, so I now have American commenters telling me "sir, actually it was designed that way" as if that somehow wins the argument.

This week’s column:…
Why do I say one-state-one-vote is a problem?

Well, because here’s how an issue where Americans are essentially split 50/50 — whether gun control is more important than gun rights — turns into 34 states for gun rights vs 16 states for gun control, i.e ~50/50 becomes 68/32. Image
In this way, the Senate is essentially a drag on US progress, constantly pulling back on much-needed reforms on topics like guns and abortion rights, meaning that public opinion has to shift far beyond 50/50 for legislation to change.
Read 13 tweets

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