Cat in the Hat 🐈‍⬛ 🎩 🇬🇧 Profile picture
Dec 23 27 tweets 14 min read Read on X
COVID WASTEWATER IN EUROPE, a thread 🧵

Covid prevalence is rising fast in England.

Our Covid wave is only just beginning, but other European countries are further along the curve.

In this thread, I take you on a whistlestop tour through Europe to see what’s been happening...
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It’s important to note that Covid waves impact different countries in different ways, depending on many factors, including:

📍length of time since last big wave
📍% of population recently vaccinated
📍mitigation measures taken by government
📍population density

…and many more.
So, with that in mind, let’s take a little tour around Europe:

1. THE NETHERLANDS 🇳🇱

In the Netherlands, they’re currently seeing the highest EVER Covid wastewater signal.

And it’s not just a bit higher than the previous max - it’s a LOT higher!

coronadashboard.government.nl/landelijk/rioo…
Image
2. AUSTRIA 🇦🇹

In Austria, it’s a similar story. They’ve just seen the Covid wastewater signal rocketing to a new record high.

It’s possible that the Austrian wave has just peaked but it’s still too early to be sure - it may just be a little blip.

abwassermonitoring.at/dashboard/
Image
3. GERMANY 🇩🇪

Likewise, in Germany, they’re seeing the viral load of SARS-CoV-2 in wastewater across the country soaring to new record highs with each passing week.

corona-pandemieradar.de/en/sewage
Image
4. BELGIUM 🇧🇪

Belgium are also seeing another big spike according to their Covid wastewater surveillance, albeit not as extreme (yet) as the waves being experienced in the Netherlands, Austria and Germany.

wastewater.sciensano.be/dashboard/covi…
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5. FRANCE 🇫🇷

In France, they are also experiencing a steep & sustained rise in the Covid wastewater signal, soaring to the highest level in well over a year.

H/t @nicolasberrod
Image
6. SWITZERLAND 🇨🇭

I think perhaps you’re starting to see the trend by now.

Another huge spike in the viral load of SARS-CoV-2 in the wastewater signal (purple line) which, in some areas, is the highest it’s EVER been since the start of the pandemic.

sensors-eawag.ch/sars/overview.…
Image
7. LUXEMBOURG 🇱🇺

Since September, there has been a steady and sustained rise in the SARS-CoV-2 viral load in their wastewater surveillance, once again reaching levels that are as high, if not higher, than the previous record high.

list.lu/fileadmin/file…
Image
8. DENMARK 🇩🇰

The concentration of SARS-CoV-2 in Denmark’s wastewater is again at the highest levels they’ve seen in over a year…

en.ssi.dk/covid-19/natio…
Image
9. FINLAND 🇫🇮

Another similar story. Another massive spike in the Covid wastewater signal.

koronatilastot.fi/fi/jatevesi/
Image
10. CANADA 🇨🇦

I know I said this thread was all about Europe, but this trend is not unique to Europe.

Let’s look further afield and see what’s been happening in Ontario, Canada… 👀

Their Covid wastewater signal has been rising & rising too.

publichealthontario.ca/en/Data-and-An…
Image
11. USA 🇺🇸

The USA are also seeing signs of a big incoming wave.

biobot.io/data/
Image
11. USA 🇺🇸 (continued)

@michael_hoerger has been keeping a close eye on the data and predicts that this has the potential to be the 2nd largest COVID surge of all-time in the U.S.

His thread 🧵 below is well worth a read.
Image
12. ENGLAND 🏴󠁧󠁢󠁥󠁮󠁧󠁿

Now you might be wondering what the England wastewater surveillance data looks like…

Well, I’d love to be able to tell you, but sadly England’s wastewater surveillance was axed nearly two years ago, back in March 2022. Image
13. SCOTLAND 🏴󠁧󠁢󠁳󠁣󠁴󠁿

Meanwhile, Scotland have continued to monitor their Covid wastewater signal since 2020.

There was a fairly big double spike towards the end of the summer in August/September. The signal then dropped but has just started to rise again.

scotland.shinyapps.io/phs-respirator…
Image
14. WALES 🏴󠁧󠁢󠁷󠁬󠁳󠁿

Wales recently restarted their wastewater surveillance after a 4 month hiatus when their budget was suddenly axed back in August.

The first report since surveillance restarted has just been published. Image
15. IRELAND 🇮🇪

Ireland also keep close tabs on the Covid viral load in their wastewater.

There’s not any sign of an uplift in their signal just yet.

hpsc.ie/a-z/nationalwa…
Image
So that concludes our whistlestop tour of the Covid wastewater surveillance in Europe (& beyond).

Two key questions arise from my research:

1️⃣ Given that practically every developed nation in the world is conducting Covid wastewater surveillance, why did England stop theirs? Image
As explained in this briefing note for SAGE back in Nov 2020, “wastewater surveillance is a reliable, timely & cost-effective method” of keeping track of Covid prevalence in the community.

So why was the budget for wastewater monitoring axed in England?

assets.publishing.service.gov.uk/media/5fc8d6a2…
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A recent Freedom of Information request revealed that the cost for Wales to resume their wastewater programme was just £621k.

This is a tiny cost in the greater scheme of things, especially when compared to the £billions written off in the PPE scandal.

llyw.cymru/sites/default/…
Image
2️⃣ My second question is, given the huge surges in Covid prevalence across Europe, when are our government going to take action to reduce transmission here?

The WHO, BMA & RCN have called for improved infection control in health facilities - this would be a good place to start.
Millions of Covid vaccine doses have been stockpiled for a potential “surge” campaign this Winter.

Perhaps now would be a good time to release those vaccine doses to protect people in the coming weeks, rather than just leaving them until they expire & need to be destroyed?
Image
Perhaps the gov could also consider bringing back free Covid tests.

In the US 🇺🇸, free Covid tests can be ordered by all households and are sent out by mail:



Here in England 🏴󠁧󠁢󠁥󠁮󠁧󠁿, tests are no longer free for most people. A pack of 6 tests costs ~£10. axios.com/2023/09/20/cov…
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Another thing on my wishlist would be for some decent public health messaging, advising people in England to wear high quality masks (FFP2/3) in public indoor spaces and crowded places…

…like this recent public health campaign from New York. 👇🏻
There will be a huge amount of inter-generational mixing taking place over the next few days, so a public health message reminding people of the importance of VENTILATION could also make a huge difference right now.

Perhaps they could even re-release this video from 2 years ago?
Schools have broken up for the Christmas holidays now - but, by the time they return in a few weeks, Covid prevalence will be almost certainly be far higher.

We desperately need mitigation measures to reduce transmission - especially via improved ventilation & air filtration.

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More from @_CatintheHat

Dec 21
🧵The first official release of the ONS Winter Covid Infection Survey just dropped!

📍Covid prevalence in England & Scotland MORE THAN DOUBLED over 2 weeks, from 1.8% (on 29 Nov) to 4.2% (on 13 Dec).

📍Prevalence (as of 13 Dec) was equivalent to 2.5m people infected or 1 in 24. Image
It’s worth bearing in mind that the trend shows that rates have been rising fast in recent weeks and this latest data was from a full week ago so prevalence is almost certainly much higher right now…

…just in time for Christmas gatherings. 🎄
Estimated prevalence (🏴󠁧󠁢󠁥󠁮󠁧󠁿🏴󠁧󠁢󠁳󠁣󠁴󠁿) is highest in the young adult age-group, 18-44 years.

📍3-17 yrs: 3.2%
📍18-34 yrs: 5.8%
📍35-44 yrs: 5.7%
📍45-54 yrs: 4.6%
📍56-64 yrs: 4.0%
📍65-74 yrs: 2.6%
📍75 yrs +: 2.0% Image
Read 9 tweets
Dec 20
🚨 The WHO officially classified the variant JN.1 as a separate variant of interest (VOI) from its parent lineage BA.2.86 yesterday.

On the back of this, they also issued advice specifically recommending universal masking in all health facilities.

…epartmentofcommunications.cmail20.com/t/d-e-vkkjyud-…
Image
Maria Van Kerkhove from the WHO then followed up this announcement with a reminder that universal masking in health facilities is NOT actually a new WHO recommendation.

This has been their standard recommendation for years.

Their announcement yesterday was just a reminder.
Image
However, face masks are not required in hospitals and other health settings across the UK…

…which begs the question:

📍Why are our government not following the recommendation from the World Health Organisation to mandate universal masking in all health facilities? Image
Read 25 tweets
Dec 19
Amazing to see decent public health advice for once.

All masks are not equal, so it’s great to see Frosty the Snowman here wearing a high quality, well-fitted N95 mask.

#BeLikeFrosty ⛄️

Read on in this thread 🧵 to find out more about the wonders of N95 masks…
The study below compared the fitted filtration efficiency of surgical masks vs N95 masks:

📍Surgical mask: 38.1%
📍N95 respirator: 98.5%

As you can see, surgical masks have vastly inferior fitted filtration efficiencies compared to high quality N95s.

jamanetwork.com/journals/jamai…
Image
The physics of masks is very interesting.

N95’s filter out:

📍~100% of tiny particles (<0.1μm) through Brownian diffusion

📍~100% of the larger particles (>1.0μm) through interception

📍medium particles (~0.3μm) are trickier but an N95 mask will still filter out 95% of these. Image
Read 6 tweets
Dec 15
I just saw a neighbour who was walking past my house with her youngest daughter after dropping her eldest off at school.

She waved at me. 👋🏻

She knows how cautious we are about Covid so she immediately said:

“We’re both sick so I’ll keep my distance!”

1/
She really didn’t sound well at all and her daughter had a nasty deep chesty cough.

Thankfully she was a good distance away stood on the pavement whilst I was at my front door with the front garden & driveway between us (plus the wind was in my favour, blowing towards her).

2/
We had a brief chat (from a distance) about plans for Xmas etc.

She said she hoped both she and her daughter would be recovered in time for Christmas and explained her daughter had already had a few days off school but wasn’t showing any signs of recovery yet.

3/
Read 16 tweets
Dec 13
Is there something in the air at the moment (apart from Covid, that is!)?

Are we approaching the tipping point?

Here we have two eminent scientists - one from Germany, one from Canada - both addressing the elephant in the room in the last few days:

LONG COVID

@uksciencechief Image
Here’s the full speech from Professor Karl Lauterbach 👇🏻

@Karl_Lauterbach
And here’s the full thread from Dr Mona Nemer 👇🏻

@ChiefSciCan
Read 8 tweets
Dec 11
LONG COVID, a 🧵

Long Covid prevalence is no longer tracked in the UK so it’s useful to see data from other countries.

A new study from Canada was published this week which led with the shocking statistic that:

📍1 in 9 Canadian adults have experienced long-Covid symptoms…
Image
Of the 1 in 9 Canadian adults who have experienced Long Covid since the start of the pandemic:

📍80% experienced symptoms for at least 6 months or more;

📍58% are still continuing to experience long-term symptoms as of June 2023, ie. they have never recovered. Image
But perhaps the most interesting thing in this report is this chart which looks at the impact of cumulative infections.

The risk of developing Long Covid symptoms is:

📍15% after 1 infection

📍25% after 2 infections

📍38% after 3+ infections - that’s 1 in every 2.6 people! Image
Read 26 tweets

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