THREAD: State of the pandemic in the UK (esp England)

Hospital admissions are best way to compare waves right back to start - we are on wave 7 now! 4 of which happened since last July.

So cases & admissions are rising - why? does it matter? where are we 2 years in?

1/13
Vaccination: Only ~60% of UK pop is boosted, with 20% of pop still unvaccinated (mostly kids).

We're giving very few jabs now - and it matters cos even boosters are now over 10 weeks ago. And for vulnerable jabbed in autumn, over 15 weeks ago...

And boosters are waning. 2/13
This matters as vax fades even faster in more vulnerable older people.

Then, the more transmissible BA.2 Omicron subvariant is dominant everywhere now - just as vax is waning.

AND many more people going back to pre-pandemic behaviours + mandatory self-isolation scrapped
3/13
Infections are rising in all nations except NI where BA2 dominated first.

In particular, outbreaks in care homes are rising & ONS reports infections in 70+ are highest they've ever been. Admissions in 65+ are rising too.

People are worried
ft.com/content/b4bf71… 4/13
From people in hospital, looks as if NI might have peaked for now, but rising in all other nations, with Scotland starting first.

People in ICU rising in Scotland too but starting from a lower base than in Dec.

Admissions rising fast in England & in all regions. 5/13
While <50% are currently there *primarily* for Covid, that number is rising faster than those there for another reason.

Plus, Covid can play a secondary role in many admissions and *any* Covid admission requires infection control measures causing issues for the hospital. 6/13
And it causes other problems... Number of NHS staff absent is rising in England (and remains higher than 2019-2021) & particularly Scotland (where wave started earlier).

Waits in A&E are still worst ever. The NHS is still under immense strain.

7/13
Deaths within 28 days of +ve test are flat in UK as a whole, but this wave is still recent.

In Scotland, where it started earlier, deaths within 28 days *and* on death certificate are going up.

Deaths from this wave might end up higher than first Omicron wave 8/13
Finally, let's look at kids. From ONS, they had one big wave in first 18 months but 3 waves July 2021 - Jan 2022.

They've just started their 4th v big wave - and <90 days after 3rd one.

They are also least vaxxed - esp <12s.

and yes it translates to hospital. 9/13
Estimates are that ~80% of primary kids have been infected already & ~40% in most recent wave.

When are we going to stop believing that infection stops future waves? How much school disruption will we accept?

Vax protects kids & we should *actively* promote it. 10/13
There is no vaccine yet for under 5s. BUT, latest data suggests that not only does vaccination protect pregnant women, it *also* protects their babies for the first 6 months after birth.

We need to redouble efforts to protect pregnant women and their unborn babies 11/13
So. We've had pretty high burden of Covid since July. Next variant will come & cld be worse (nature.com/articles/s4157…).

If we do not *actively* reduce transmission, then we *must* increase NHS support. ()

& each accept getting ill more than we did.

12/13
I'd rather fight back.

theconversation.com/eight-changes-…

13/13
PS thanks as always to Bob Hawkins for his help in collating lots of the data and charts!

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More from @chrischirp

Mar 15
THREAD: some thoughts on current covid situation in England.

Latest hospital data just came out up to 13 March - almost 1600 admissions - still increasing & 50% higher than 2 weeks ago 1/5
Going up in all regions (fastest in SW & NE) and age groups. Going by prev Omicron (BA.1), about half might be "incidental" admissions - but are clearly showing increase in community transmission.

But boosters are waning - esp older adults who are almost 6 months out. So...2/5
it's possible that more might become "primary" covid admissions but hopefully boosters will hold. We'll see what happens to NHS diagnosis data over the next few weeks. Either way, more Covid in hospitals makes care harder and affects staff absence too. NHS still *exhausted* 3/x
Read 8 tweets
Mar 14
THREAD: @ArisKatzourakis wrote a brilliant @Nature commentary busting some popular - and unfortunately sticky - myths about the evolution of Covid and what this means for the pandemic.

I'll summarise its main points here but TLDR it's not over. 1/7
1. Endemic does NOT mean mild (e.g. TB, Malaria are endemic in some parts of the world). 2/7
2. Viruses do NOT evolve to be less virulent. They evolve to spread more efficiently - sometimes this means they end up more virulent (e.g. higher viral load), sometimes less. 3/7
Read 8 tweets
Mar 10
I wrote about 3 linked lessons from Covid that we need to learn for the future in this editorial for @ScienceMagazine

science.org/doi/10.1126/sc…

1/5
1. Massive, unwieldy, intransigent systems fundamentally changed because of the need to control Covid.

Implies that most sticky problems remain unsolved cos of "won't" *not* "can't" -> we must demand honesty from govts about which solutions are considered necessary & why 2/5
2. Some sticky problems aren't even recognised as solvable! e.g. annual deaths from flu & pneumonia. These reduced massively last 2 years .

Instead of using flu as a benchmark for Covid, question the benchmark.

Instead of return to normal, ask if normal can't be better. 3/5
Read 5 tweets
Mar 10
THREAD on new evidence showing (again!) that mask mandates in primary and secondary schools do reduce covid rates from the US Center for Disease Control (CDC)

(NB K-12 means kindergarten to yr 12 (17/18 yrs))

full report here: cdc.gov/mmwr/volumes/7…

1/4
They compared schools with full, partial & no mask mandates over autumn 2021 in the state of Arkansas and also before & after in schools that switched from no masks to masks.

Using a single state means similar contexts, background infection rates, vaccination rates 2/4
They found clear evidence that full mask mandates were better than partial ones were better than no masks. Whichever way they looked at the data, they found the same effect.

On average full masks reduced transmission by 23% - a significant amount! 3/4 ImageImageImage
Read 5 tweets
Mar 4
Quick THREAD on current Covid situation in UK

TLDR: cases, hospitalisations and deaths going down everywhere except Scotland where all are going up. BUT admissions going up last few days in England too.

1/8
Prevalence from ONS infection survey shows that it's falling everywhere *except* Scotland where it's going up quickly.

ALL nations are still much higher than at any point pre Omicron. 2/8 Image
Hospitalisations show exactly the same pattern with Scotland going up sharply.

While overall deaths within 28 days in UK are still falling, in Scotland they have started rising again.

Scottish cases increases have been in older adults H/T @PaulMainwood 3/8 ImageImageImageImage
Read 9 tweets
Mar 2
THREAD on all the reasons why I think Omicron does *not* signal the end of the pandemic

TLDR: vaccines & mitigations can hasten its end but we're not done yet & Omicron is just another milepost on the road.

So here goes: Omicron is the 4th major variant to dominate here 1/10
But variants aren't single blocks either - Delta in the UK ended up being mostly subtype AY.4 and AY.4.2 was taking over when Omicron came - and now BA.2 is taking over from BA.1.1. which took over from BA.1. 2/10
Covid evolves rapidly, but this isn't straightforward.

None of the main variants evolved *from* each other - instead so far they are all distinct, becoming gradually fitter via subvariants until replaced by an entirely new variant. 3/10

H/T
Read 10 tweets

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