Prof. Christina Pagel Profile picture
Jul 19 12 tweets 4 min read Read on X
Quick thread on current Covid situation in England and Long Covid.

I have Thoughts about the Inquiry Report published yesterday but am still trying to organise them.

TLDR: high Covid levels remain, Long Covid remains 1/11
This wave is not over. While the number of admissions with Covid remains lower than the autumn/winter waves, it has now remained highsh for several weeks.

This means there are a lot of people out there getting sick - and having their work, plans and holidays disrupted. 2/11 Image
Scottish wastewater data to 9 July shows a sharp decrease, suggesting that prevalence might be on its way down.

Obviously Scotland and England can have different dynamics, but it’s the best we’ve got as long as England refuses to analyse its own wastwater. 3/11 Image
A new paper on Long Covid (LC) from the US shows the ongoing risk of Long Covid.

CAVEAT 1: their data is most older men. Age/sex strongly associated with LC so can't easily extrapolate results to population. 4/11
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CAVEAT 2: they only consider *first* recorded infections - the infection with the highest risk of developing of Long Covid.

Most people have now had Covid at least once, and so again, the results are not directly comparable to the current situation. 5/11
Overall, the chance of developing new Long Covid in unvaccinated people on their first recorded infection reduced from about 10.4% to 7.8% from the original variant to the Omicron variant (that arose in December 2021 and swept the world). 6/11 Image
Being vaccinated reduced your chance of developing LC by about half (to 3.5%) - consistent with previous research on the efficacy of vaccines in preventing LC.

3.5% of vaxxed people developing LC following their 1st Omicron infection still represents a really high number.
7/11 Image
From ONS data, previous infection reduced the chance of new Long Covid by 28%. We don't know how that changes after multiple previous infections.

But even if risk of new LC is now 1-2% that is still high given ongoing waves. 8/11 Image
Covid is not seasonal, and a substantial proportion of the population are getting infected every year.

Even if for most people newly affected it resolves over several months, it still means that every wave leaves tens of thousands people with lingering symptoms. 9/11
Thousands will suffer such severe symptoms that they might be forced out of work or education and lifechanging constraints to their daily activity.

Already almost 400,000 people are severely affected, many for years. 10/11 Image
So, neither Covid nor Long Covid have gone away even if we are far from the situation we were in during the first couple of years of the pandemic. 11/11
PS you can read about this in a bit more detail in my latest post here:
christinapagel.substack.com/p/englands-ong…

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More from @chrischirp

Jul 3
THREAD: Given tomorrow's election, I've been thinking about our nation's (poor) health, the wider determinants of health and how these have worsened and what it means for policy....

TLDR: worrying only about NHS & social care is missing the point

let's dive in... 1/25
The UK has a health problem. After steady gains in life expectancy for decades, it flatlined during the austerity years and fell for the first time this century with the Covid pandemic.

The number of people out of work for long term sickness is near record levels. 2/25
There are huge inequalities between rich & poor. Boys born in the most deprived areas can expect to die almost 10 years earlier than their peers in the least deprived areas.

Even worse, they can expect to spend 18 fewer years of their life in good health (52 vs 70 years) 3/25 Image
Read 38 tweets
Jun 4
As ever, I am getting lots of pushback.
Here is a compilation of the European countries I've found with recent wastewater data. Some are going up a bit, some down a bit, some are flat, none are anywhere near previous peaks.
I can't see anything here to be panic anyone. 1/3
Image
I can't find the dashboard for Spain, but others saying it is in a wave. Perhaps it is. England has just had one - the last data we had (a couple of weeks ago from Bob Hawkins) looked as if our wave had peaked.
So, I'm not seeing reason to think things are terrible here! 2/3 Image
Yes there are new variants growing right now. They are not growing faster than JN.1 grew in December and that wave did not end up as bad as feared.
Clearly it remains true that Covid is NOT a seasonal disease (unlike Flu and RSV)
3/3
Read 5 tweets
May 8
Quick thread on the Astra Zeneca (AZ) covid vaccine since it's been in the news today.

TLDR there isn't a new "smoking gun", the AZ vax was one of first and cheapest, it saved millions of lives globally, there are better vax out there now, adapted to new variants 1/9
the AZ vaccine was one of the first approved at the end of 2020, cheaper than Pfizer, and - importantly - easier to administer in lower resource settings as it didn't require super low temperatures for storage 2/9
In most countries it was first rolled out in older adults. As it was rolled out in younger adults, a *very rare*, serious, side effect was noticed - it could cause deadly blood clots

This was spotted quickly and studied. Vax monitoring did its job. 3/9 Image
Read 11 tweets
Apr 2
A short thread on why this is not a scary chart and why all the evidence suggests that there is not much Covid around right now. 1/6 Image
the above chart is recorded covid hospital admissions / reported covid cases. It is close to 100% now *because basically only hospitals can report cases since Feb 2024*

It is to do with changes in case reporting and NOT hospital testing
2/6
In fact hospital testing has been steady since the change in testing a year ago (only symptomatic patients get tested now).

The % of people PCR tested who have Covid is 4% - there is no evidence that there are loads of symptomatic people in hospital being missed. 3/6
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Read 6 tweets
Dec 21, 2023
Beyond a shadow of a doubt that England is in its biggest Covid wave for well over a year now, with latest ONS infection survey results published.

I've written about it here
1/7 tinyurl.com/ru7h3m28
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The UKHSA have now published their modelled estimates of what percentage of English population has Covid. And as of a week ago it's high (4.3%) and rising.

Read all about it here!
2/7
It's highest in London, South East and East & in young and middle aged adults.
The main thing is it's going up and fast, so prevalence will already by significantly higher now than it was last week. 3/7
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Read 8 tweets
Nov 30, 2023
Short thread on what I said on Channel 4 news tonight.

1. Did I find Hancock a sympathetic witness?

A: I find it hard to have sympathy for someone who repeatedly claimed to have thrown protective ring around care homes, while discharging covid+ patients into them.

1/5
There were *28,000* excess deaths in care homes Apr-May 2020.

Harries thought it was "clinically reasonable" not to treat covid +ve residents in hospital. Even it was, it was NOT reasonable to return them somewhere they could infect so many other very vulnerable people. 2/5
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2. Did I think scientists bear blame for not emphasising asymptomatic transmission?

A: No, because they very clearly did advise there could be asymptomic transmission before March 2020 - sources in next tweet. 3/5
Read 5 tweets

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