THREAD: quick overview of where we are with Covid in UK - and end of a dashboard era...

TLDR: going to move to using ONS infection survey only from now on, cases still high, trend uncertain, hospitalisations and deaths falling 1/12
firstly, vaccination isn't really happening - very low numbers of 1st, 2nd or 3rd vaccinations now 2/12
PCR tests are dropping like a stone - and this is what we used to calculate to positivity rates. So they are becoming more unreliable. And then, different nations are now changing how they are reporting nations and Scotland is stopping positivity reporting. 3/12
So this is the last week I will be reporting case positivity rates for the forseeable future. From now on it's ONS infection survey only.

Positivity rates show NI increasing, Scotland flat, England and Wales decreasing.

Meanwhile case rates show everywhere decreasing. 4/12
But how reliable are case rates anyway? How many people a) doing LFDs and b) reporting positive tests? We don't know.

If we look at weekly case rates to 26 Jan and compare to weekly incidence from ONS we see significant divergence. 5/12
In fact, up to end of 2021, we see excellent correlation between ONS measured prevalence (red) and dashboard cases (blue). But in recent week this correlation has broken. I don't think we can trust reported cases any more and so I will now move to ONS infection survey only. 6/12
ONS shows increases in all countries except Wales and high prevalence.

Regional increases in South of England. By age, teens and over 50s going up.

It would be a tragedy if ONS infection survey stopped - it's a jewel and envy of the world. We blind ourselves by ending it. 7/12
Omicron subvariant BA.2 is still increasing in all UK nations. It's now 14% in England but close to 50% in N Ireland. Likely dominant there by now. Could explain continued case rises there?
Plus in England, BA.2 concentrated in South... where recent increases have been. 8/12
Hospitalisations are coming down steadily in all nations which is excellent news.

Admissions in England are falling quickly but we've had high levels since summer 2019. And this comes with consequences. 9/12
On a range of performance indicators (up to Dec 2021), things are much worse than pre 2020.
For time to diagnosis, we can see NHS catching up in summer 2020 - but they didn't get chance in summer 2021 with Delta, and now Omicron has made things worse again. 10/12
Deaths have peaked whether looking at deaths within 28 days of a positive test or ONS death certificate data. Both measures show Omicron increase.

But recent data does show dashboard deaths now overestimating "cause of death" deaths for first time. 11/12
So to summarise - am now going to use weekly and a bit lagged ONS survey only (for as long as it's available :-( ).

Transmission remains high, particularly in children. BA.2 continues to grow but UKHSA data suggests does *not* evade prev Omicron infection (good news!). 12/12

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More from @chrischirp

Oct 19
Important 🧵on our new peer-reviewed paper:

The pandemic is as bad as it ever was for babies - in year to Aug 2023, 6,300 babies under 1 were admitted to hospital wholly or partly BECAUSE of Covid.

They are ONLY age group where admissions have NOT gone down over time 1/17 Image
Our study, led by Prof @katebrown220, looked at all hospitalisations in England in children with a Covid diagnosis or positive test from Aug 2020-Aug 2023.
We then *excluded* all admissions where a Covid diagnosis was incidental (ie not why they were in hospital)
2/17 Image
Infants (babies under 1) are generally at higher risk from respiratory infections, plus they are the age group that, if infected, are overwhelmingly meeting the virus for the first time.

They are not vaccinated and have not had it before. 3/17
Read 18 tweets
Sep 26
Prof @Kevin_Fong giving the most devastating and moving testimony to the Covid Inquiry of visiting hospital intensive care units at the height of the second wave in late Dec 2020.

The unimaginable scale of death, the trauma, the loss of hope.
Please watch this 2min clip.
And here he breaks down while explaining the absolute trauma experienced by smaller hospitals in particular - the "healthier" ICU patients were transferred out, leaving them coping with so much death.

They felt so alone.
Here Prof Fong explains how every nurse he met was traumatised by watching patients die, being only able to hold up ipads to their relatives and how it went against their normal practice of trying to ensure a dignified death, with family there.
Read 5 tweets
Aug 28
THREAD: I asked what the point of Public Inquiries is for @bmj_latest

We've spent hundreds of millions of £ on Inquiries over last decades, generating deep understanding of failures & 1000s of recommendations.

But v few recommendations get implemented!
What is going on?

1/12 Image
E.g. Covid-19 Inquiry has cost £94 million so far - and is projected to cost over £200m by its end (it still has years to go).

1st report published (out of at least 9) found major flaws and proposed 10 recommendations.

Chances are low that they will be implemented :-( 2/12


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Inst for Government looked at 68 Inquiries from 1990-2017.
The Inquiries cost over £630 million and made 2,625 recommendations.

Only 6/68 Inquiries have received full scrutiny by a parliamentary select committee on implementation of recommendations. 3/12 Image
Read 12 tweets
Aug 9
🧵War causes direct civilian deaths but also indirect deaths over the following years.

Recent paper estimates eventual total direct & indirect deaths in Gaza attributable to the war - 10% of entire pop'n.

I want to explain these estimates and why deaths must be counted. 1/13 Image
Why count casualties from war anyway? For moral, legal and strategic reasons.

1 - owe it to those who have died
2 - International law says must count & identify dead as far as possible
3 - monitor progress of war & learn from tactics

2/13 Image
There are direct and indirect casualties of war. Direct deaths include those who killed by fighting or bombs.

Indirect deaths are those that die when they would otherwise have lived because of one or more of: lack of food, healthcare, housing, sanitation, income, hope. 3/13 Image
Read 14 tweets
Aug 1
THREAD: the summer Covid wave in the UK continues.
Basically, there is a LOT of Covid around and not a lot of other respiratory viruses.

If you have cold or flu symptoms, it's probably Covid.

The latest hospital data from England shows steady, quite high levels. 1/8 Image
But admissions don't tell us how much virus is circulating more generally. The best (but imperfect) measure we have is wasterwater measurements, and only in Scotland and not England.

Scotland's wastewater is showing a huge July peak - highest since Omicron's 1st yr in 2022 2/8 Image
Because different people shed different amounts of virus and variants can matter too, you can't for sure infer how many people were infected between different wasterwater peaks. BUT given the size, I'd say it's pretty likely this is the largest peak since 2022 in Scotland 3/8
Read 8 tweets
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

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