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

Feb 10
THREAD: I keep being asked when we can go "back to normal" or "like it was before". My personal thoughts:

We've added a new disease to our population, more infectious and more severe than flu.

The world pre 2020 no longer exists - we may want it to, but it just doesn't. 1/13
Vaccines are amazing but do wane - esp vs sympomatic infection. Immunity from infection wanes too.

Surely Omicron has proven that high levels of antibodies in your population are no guarantee against v high levels of illness & disruption. 2/13
We *could* act as we used to & accept millions of people getting sick once or twice a year. Yearly education, business disruption. And gradually, a slightly sicker pop'n. That seems to be the current plan in UK and e.g. US.

But that's NOT the *old normal* - it's worse 3/13
Read 13 tweets
Feb 4
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
Read 19 tweets
Jan 24
So, we're back - as predicted in mid Dec (!) - in two epidemics - a growing one in children (& flat in their parents' generation) and declining in everyone else.

Unvaxxed children in schools have highest and fastest growing rates - ie 5-9 yr olds. Cases >2x higher than Dec. 1/5
And equally, while hospital admissions fall in adults, they are higher than ever and rising in children.

While most admissions are short and children recovering quickly, they are still sick enough to come to hospital.

We don't know about Omicron & PMS-TS, Long Covid etc 2/5
Most other high income countries are far ahead of us in vaccinating teens and 5-11 year olds.

We know the vaccines are safe and protect against severe illness. SAGE reported that recent teen Covid admissions to ICU were all unvaccinated. 3/5
Read 6 tweets
Jan 18
THREAD: Quick UK Covid update...

I didn't get chance to do thread after Friday @IndependentSage briefing (viewable here: )

so here is a quick update.
TLDR: cases and admissions have likely peaked, but expect schools to prolong the wave... 1/10
Reported cases have peaked and in all nations.

While many things affect case reporting, positivity rates are also falling (good). ONS always lags by a week or two, but hopefully we will see sustained drops in a week or two.

BUT prevalence is still *extraordinarily* high. 2/10
Cases are now falling in all English regions - you can see a clear pre-Xmas change in London likely driven by people cancelling plans to avoid being sick at Xmas.
NE last to peak, but it has.

Again ONS is a bit lagged, but shows London has and other regions flattening 3/10
Read 10 tweets
Jan 12
Short thread on kids, Omicron, hospitalisations:

The US is seeing record hospitalisations among children with Covid.
cbsnews.com/live/video/202…

New York has released a *very preliminary* analysis of admissions since Omicron 1/4
health.ny.gov/press/releases…
First they find that the largest *increase* in Covid admissions by age was in children, particularly under 12s and under 5s. This was both in admissions *for* and admissions *with* - about 60% were directly for Covid.

About half had no pre-existing health conditions. 2/4
They do a very preliminary comparison between Omicron and Delta (unvaccinated patients only) and find that while Omicron seems to be causing fewer hospitalisations in *adults*, the opposite is true in *children*.
Again this is preliminary but needs to be looked into further. 3/4
Read 4 tweets
Jan 9
A virus isn't endemic just cos a govt minister says it is and just cos people want it to be.

The current pattern of waning vax, new immune evasive variants, and minimal public health response seem set to doom us to massive surges once or twice a year. 1\5
If that continues we'll keep picking off the vulnerable, keep stressing a weakening NHS, create more chronic illness & mass disruption through people off sick every time. Lower quality of life for all of us.

Uncertainty in being able to plan months ahead cos of variants 2\5
And when the next pandemic comes, do we just add that disease to our repertoire after a period of mass death?

What when diseases like malaria move north through climate change?

What about rest of the world?

We're moving backwards. 3\5
Read 5 tweets

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