Thread by @chrischirp

🧵THREAD: a new wave has started in England (and likely about to or has in rest of UK)

TLDR: this will be 3rd wave within 6 months. Long covid an increasing issue - particularly in overexposed professions.

We don't need a UK ventilator challenge we need a ventilation one! 1/xx

5 weeks ago I said a new wave might be on its way in a 4-6 weeks.

I think it is now here and cases will go up from now. Let me show you why I think that..! 2/xx

https://twitter.com/chrischirp/status/1522644271869960200?s=20&t=b25ZP6R2x9L8cgh3mCtiwQ

After 6 months of Delta dominance, last weekend would have seen BA.2 lose its dominance - overtaken by a combination of BA.4, BA.5, BA.2.12.1 & BA.5.1 3/xx

BA.2.12.1, BA.4 and BA.5 are all at similar levels - BA.5.1 (a child of BA.5) is a new kid on the block but growing fast. It's now dominant in portugal.

Together BA.5/5.1 likely to win out...?

4/xx

This is NOT a surprise! I & others have been talking about this for weeks.

It's just that govt and others have lost any interest in doing anything about it. It's kind of frustrating to now see headlines "new wave on its way" - it's been on its way for weeks! 5/xx

Dominance doesn't necessarily mean a big new wave. But let's compare last 2 Omicron waves & ONS infection survey prevalence.

We can see that prevalence was at it lowest just at variant crossover in Feb. Looks like same thing happening now with small uptick in latest ONS. 6/xx

Good news is that prevalence is a lot lower than in Feb, so we are starting from a lower base. It is also possible that BA.2 wave will provide some protection and mean we get a smaller wave. But we will get a wave.

Esp as Jubilee weekend was just as crossover happened. 7/xx

Can we learn from other countries? Well, S.Africa had a much smaller BA.4/5 wave than its first Omicron wave.

Portugal currently has a BA.5/5.1 wave and it's as at least as big as its first Omicron wave. 8/xx

But different countries now have had very different pandemic trajectories and that means it is hard to know what will happen. We will be first big country I think to have BA.4/5 wave after big BA.2 wave. 9/xx

While vax gives similar protection against BA.4/5 than prev Omicron variants (@PeacockFlu ), almost everyone in UK is now several months out from their booster.

Over 75s should be well protected esp against severe disease from sring booster & (sadly) high BA.2 infections. 10/xx

We're not really doing any vaccinations now. 2/3 of pop have had a 3rd dose, but many remain unvaccinated - especially children. This could be an issue - esp in primary school kids - if BA4/5 get into schools this half term. 11/xx

We're also (still) going into this wave with differential protection. People in more deprived areas are much less likely to be vaccinated and boosted - and it's much starker in kids than adults. 12/xx

So infections. ONS infection survey shows that prevalence has stopped falling & might be rising across UK w/e 2 June. In England, ⬆️in teens, young adults & 35-69 yr olds.

Hosp admissions are going up in England (from lower base than Feb). The wave has (just) started. 13/xx

Deaths are still falling and it's much too early to see any signal in deaths from the latest wave. Hopefully eventual peak in deaths will be quite a bit lower than previous 2 Omicron waves, esp after spring booster in 75s+

14/xx

The new wave does mean there will be yet more people developing Long Covid. ONS data shows that Long Covid has *not* gone away in the age of Omicron, triple vax & prev infection. 15/xx

Highest long covid increases in Omicron have been in older adults. And we're seeing highest rates in social care, health care & teaching.
Just today, @TimesEducation reported that *over a third* of secondary schools struggling with long covid in teachers. 16/xx

If we are going to have waves every few months, we need to do something *sustainable* to reduce transmission. It's an airborne virus and spreads far more easily indoors and we need to address that.

Mask wearing is (unsurprisingly) dropping off - esp in younger adults. 17/xx

There has been increasing evidence coming out about how talking & singing give off more virus-containing aersols and how intense indoor exercise is also a big risk. 18/xx

But there are solutions! It's not only about masks - esp where they are impractical in restaurants/pubs/gyms... We have solutions! 19/xx

As these authors put it "A once-in-decades opportunity now exists to make sustained improvements to public and private indoor air quality" 20/xx

We spent billions on (often wasted!) PPE, on (successful) vaccines, millions on the UK ventilator challenge. We need that commitment now.

2 years later, let's have a UK Ventilation Challenge instead of the Ventilator Challenge. 21/21