Thread by @chrischirp

THREAD - STATE OF COVID IN UK

Quite long but hopefully comprehensive thread on where we are...

TLDR: cases increasingly hard to interpret, hosp & deaths declining, schools big issue, new (but not more severe) subvariant growing 1/18

Vax - vaccinations have dropped off a cliff in 2022. 80K a day vs almost 1 million before Xmas.

And it's not cos we've finished! Esp NI has only 50% of pop boosted.

We need to keep trying to increase uptake - messaging that pandemic is over and omicron mild doesn't help. 2/18

PCR tests have dropped off massively too since we've stopped requiring confirmatory tests for LFDs. *Reported* use of LFDs is also dropping.

Some is less infection, but not all. Will make both reported cases & positivity rate (based on PCR) hard to interpret. 3/18

NI calcs +ve rate differently now so is on separate plot.

Positivity and cases are now flat for all nations except NI.

Since 31st NI & England reporting reinfections >90 days after 1st, Wales >42 days after 1st and Scotland not yet... 4/18

Can see (approx) impact of adding known reinfections in England here - the increase in reinfections with Omicron is clear -> ~10% of cases each day.

It's great that UKHSA have added them now, but with Omicron it's possible 90 days is too long an interval... 5/18

Reported cases suggests Scotland & Wales back to Nov levels, but ONS infection survey says nowhere near & that scot & wales going up.

Meanwhile, Zoe symptom tracker app says cases back to peak levels. Each measuring diff thing over diff timescale but usually consistent. 6/18

So cases are still *v high* but trend hard to interpret. Hospitalisaitons are going steadily down which is good.

That said, NHS staff absences are still much higher than last 2 yrs so still a lot of pressure in terms of staffing as well as higher occupancy than autumn. 7/18

In terms of death, deaths by day reported went over 500 this week which caused lots of misleading reporting. Need to look at 7-day avgs *and* numbers by date of death (a bit lagged).

Deaths seem to have peaked ~300 a day - still high! but nowhere near 500. 8/18

So what is on horizon? Well, Omicron has 3 main types: BA.1 (main one in UK), BA.1.1 (daughter of BA.1) & BA.2 (sibling of BA.1).

BA.1.1 seems to outcompete BA.1 and BA.2 outcompetes both. 9/18

Denmark has higher vax rates than us & BA.2 now dominant - v high cases (equiv to >600K a day here!).

But while deaths & admissions are rising, they are in line with less severity (given case numbers!). ICU cases are falling still. So BA.2 prob no more severe than BA.1 10/18

In England, BA.1.1 has been taking over from BA.1, but now BA.2 seems to be outcompeting both.

BA.2 most prevalent in N Ireland (which has high case growth now!) & London & SE in England. 11/18

While on variants, ONS released analysis of chance of symptoms (on day of test only - symptoms could be over or still to come).

Both Delta & Omicron more likely to cause symptoms than Alpha *and* 2nd infections just as likely to have symptoms as 1st Delta infections. 12/18

And then... children & schools. Dashboard says cases in kids & parents' generation flat or declining. Zoe app says they are going up.
ONS infection survey shows cases 2x higher in primary than secondary and high.
Next week's ONS will show whether case trend up or down. 13/18

And these high infections have consequences. Admissions in children stay stubbornly (relatively) high with Omicron - and data suggests Omicron is *not* milder for kids.

Plus Long Covid has been going up in kids & school staff. 14/18

ONS also released vaccination updates this week.

Firstly, vaccinations in teens is still much lower than in adults - esp second doses.

Secondly, rates are much lower in schools in more deprived areas. 15/18

For teenagers who had been vaccinated, most common reason was to protect others and then themselves.

So, although JCVI do not consider benefits to others in their decisions on child vax, it's worth noting that teens do consider it.

Also, most parents would vax 5-11 yrs. 16/18

And finally - ventilation! almost third of schools said that good ventilation was hard to implement.

Half said not enough CO2 monitors, and 10% of CO2 monitored rooms had poor readings and no way of improving. 17/18

Accepting that the virus is airborne is vital to learning to adapt to Covid - that means we need to understand mask use & how we make air cleaner.

So please do watch this discussion in Indie SAGE today with @trishgreenhalgh & @adsquires! 18/18

PS thanks to Bob Hawkins as ever for his help with getting some of the data & plots!