Adam Briggs Profile picture
Public health consultant Oxfordshire. Senior Policy Fellow @HealthFdn. Hon Assoc Prof @Warwickmed. Test & Trace. Health/PH policy, climate, other. Views own.
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6 May
Latest T&T data: wk 22-28 April

- no big shifts in numbers tested by LFDs/PCR, and ongoing fall in +ve cases

- but some interesting changes in contact tracing: fewer contacts reached and it's taking longer, and the reasons aren't straightforward🧵…
While the number of cases transferred to contact tracing fell by 12% to 10,793, the number of close contacts identified rose by 2% to 49,151.

For the first time since the start of August, avg contacts per case was >5. ImageImage
And of those contacts, the percentage reached has dropped wk on wk for the past 5 weeks, from 90% to 84%. Image
Read 15 tweets
6 May
This week's PHE surveillance report, 26th April - 2nd May

- despite easing of social restrictions & schools returning after Easter hols, case numbers still going down among all ages.
- still regional/local variation
- and ++concerns around variants.🧵… Image
Still some big differences by region - particularly looking at younger adults in Yorkshire and Humber.

Case rates in Y&H are 42/100,000, more than 3 times the rates in the SW at just 12/100,000. ImageImage
This is even more apparent when looking at data by local authority. Image
Read 14 tweets
22 Apr
Updated our T&T performance tracker, covers 8-14th April.

Key points
- lots of changes to LFD use, with differences across the country
- despite falling cases, end-to-end journey time from symptoms to reaching contacts increasing

Detail in 🧵…
After a dip over the Easter bank holiday w/e, number of people tested increased by 15% to 4.4m

although this is still some way off the peak of 6.2m four weeks earlier
The changes have been mainly due to variations in use of rapid lateral flow devices (LFDs).

These have been rolled out by the government for people without symptoms over recent months and are now available to everyone in England.
Read 18 tweets
22 Apr
PHE's surveillance report for 12th to 18th April now out. 🧵

Second week of school holidays for most, but some schools will have gone back.

- case numbers down & vaccination up
- persistent inequalities by geography, ethnicity, & deprivation…
Case rates & positivity continue to fall across the age groups with no clear sign of pre-Easter rise in school-age cases leading to more infection in older ages.

Highest in 10-19y/o (42 per 100,000) and lowest among 70-79y/o at just 7.2/100,000.

A pattern matched by ONS survey
Case rates also falling across all the regions, with slightly higher rates in Yorkshire and Humber (45 cases per 100,000 compared with just 14/100,000 in the SW).

Again not dissimilar to ONS and good to see case rates come down (next ONS update due tomorrow)
Read 18 tweets
19 Apr
Having now worked it's way through the @Telegraph system: with @louisemarsha11, our take on the plans for replacing Public Health England. 🧵

tl,dr: we need a more, not less, joined up system if we're serious about health & inequalities

No £-wall🔓…
PHE is being split into the UK Health Security Agency (UKHSA which also includes Test&Trace) - focusing on external threats like pandemics

and the Office for Health Promotion - focusing on health improvement and inequalities, such as obesity and tobacco.…
As we wrote at the time, it's a risky business reorganising public health in the middle of a pandemic.…
Read 25 tweets
8 Apr
This week's Test & Trace data - for 25th to 31st March (around the last week of school before holidays)

- LFD tests down
- big variations in LFD use across the country
- and increase contacts per case.…
The number of people tested week on week has fallen for the past two weeks, down to 4.8m from a high of 6.2m.
The fall is due to reductions in LFD use - down 23% to 5.5m.
Read 25 tweets
8 Apr
This week's @PHE_uk COVID surveillance report, 29th March to 4th April (incl. start of the school hols). 🧵

⬇️ case rates, partly from fewer 10-19y/o LFDs with no clear sign yet of schools leading to ⬆️cases in older ages

+ important variation by region…
Further drop in cases in the most recent week following a bit of a flattening off in previous weeks - with some of this due to school holidays and fewer LFD tests.

Worth noting that for March, both REACT and ONS surveys suggest that case rates are generally static.
Big drop in LFD use, which is mainly due to a drop in test use by secondary schools (see T&T data).

The drop off has accelerated with the school holidays, but the move from testing in school to at home may have contributed over the past few weeks.
Read 19 tweets
8 Apr
Latest update from REACT-1.

Looks 11-30 March (schools fully reopened on 8th March).

- Suggests infection rates fell by around 60% between Feb and March to 0.2%
- Big differences by age, region, and deprivation
- R now estimated at approx 1.…
Falls across all regions but highest rates still in NE, NW, and Yorkshire and Humber (round 9 is swabs from 4th-23rd Feb, round 10 is 11th-30th March)

Includes 12% probability R>1 for Y&H between two rounds. <1% in all other regions.

This is consistent with ONS survey data.
Highest infection rates among 5-12y/o (as does ONS), but REACT suggests lower infection rates among school age children than ONS does.
Read 4 tweets
1 Apr
PHE latest COVID surveillance report now out, as is ONS.

Covers 22nd-28th March 🧵

-cases down all ages except 10-19yrs.
-Significant geographical variation.
-Vax still motoring.
Fall in case rates in all age gps (incl 5-9y/o) *except* for 10-19y/o where they've increased by 7% to 110 cases/100,000.

Lowest cases rates are among 70-79y/o at just 11/100,000, and generally there's a step decrease in case rates for ages 60yrs+ compared to those <60yrs.
And among 10-19y/o, case rates seem to be rising mainly among 10-16y/os.
Read 27 tweets
27 Mar
If this is true, it is so disappointingly shortsighted.

I hope that @MattHancock and @Jochurchill4 will reconsider.

A quick walk through the evidence. 🧵
Nearly one in four reception age children and one in three children at year 6 are overweight or obese.

And there are stark inequalities - children in yr 6 are *more than twice* as likely to be obese if living in the most deprived areas compared to the least.
The government is aiming to halve childhood obesity by 2030 and reduce inequalities.

You can't do this with one or two policies here and there. Obesity is complex and multifaceted. To make any kind of dent, you need a multifaceted solution.…
Read 19 tweets
25 Mar
And most recent T&T data, 11/3 to 17/3. 🧵

- More testing
- Fewer cases
- And the numbers of non-household close contacts is rising again.

This week, just a short thread to pull out main points.… Image
Small increase in number of people tested but rise of 1.3m in number of LFDs used, driven by secondary schools. ImageImageImage
And case rates generally still falling, except among school age children

Read 10 tweets
25 Mar
This week's PHE surveillance report is now out, covering 15-21 March. 🧵

- increasing case rates among 5-9y/o and 10-19y/o
- important geographic variation
- hospital data still improving
- vax going strong
- and inequalities persist.…
Number of PCR and LFD tests done similar to the previous week, but positivity (percentage of tests that are positive) for PCR still trending down and is now 2.1%

For LFDs it's 0.19% compared with 0.15% the week before.
Case rates are falling less slowly, but they're still falling across all ages...

*except* 5-9y/o where they're up 59% to 63.5/100,000, and 10-19y/o where they're up 26% to 100.7/100,000.

Case rates lowest in vaccinated cohorts.
Read 23 tweets
24 Mar
Matt Hancock speaking at #LGAPublicHealth21.

The language has officially changed from health protection to health security - with the launch of the UK Health Security Agency, or UKHSA.
Will cover pandemic prevention and response, communicable disease, and external threats.

Chief Exec will be Dr Jenny Harries (Dep CMO with hugely impressive public health background)
Chair is Ian Peters, current Chair of @NHSBartsHealth
The challenge (as ever) will be maintaining interest and funding for the agency in between crises.

Stresses importance of relationships with DsPH, although no mention yet of local PHE Health Protection Teams who have also been critical in local response as well.
Read 8 tweets
18 Mar
This week's PHE surveillance report, covers 8th-14th March. 🧵

- cases falling but LFDs making it a harder to follow trends
- Still important inequalities by local authority, ethnicity, & deprivation.
- And good news on vaccines and seroprevalence…
case rates continue to drop, but increasingly difficult to interpret pillar 2 data (community testing) here as it includes both lateral flow devices (LFDs) for those without symptoms, and PCR tests for those with symptoms.
This is laid out here - LFD test use over 5m in the most recent week reported, with positivity 0.15% compared with 2.4% among PCR tests.
Read 22 tweets
17 Mar
The Test & Trace budget for 2021/22 is £15bn.

There's no specific remit letter and whilst a new strategy is awaited (see @CommonsPAC report), the most recent T&T business plan from Dec 2020 covers four key priority areas.…
Unpacking these.

For 'Team of Teams' - it's a lots of local gov led programmes: community testing, local contact tracing, support for self-isolation, and local outbreak management.
Read 11 tweets
11 Mar
This week's T&T report. Covers 25th Feb - 3rd March.

More LFDs - esp in secondary schools,
fewer cases,
more close contacts per case,
and fewer of them from the same household as the case.

Detail in 🧵…
A pretty astonishing 3.13 million people tested in the week.

This is the most since T&T launched. Until next week's data.
This is because of the large scale roll-out of LFDs.

There were 2.76m used in week ending 3rd March, compared with 2.23 the week before, with 2/3 of the increase in use coming from secondary schools.

PCR use dropped slightly over the same period.
Read 18 tweets
11 Mar
This week's PHE COVID surveillance report, covering 1-7th March (just before schools fully reopened)

Case rates, hospitalisations, deaths continue to fall.
But some really big variation by local authority.

And vaccination uptake is going great guns. 🧵…
Case numbers and percentage testing positive (positivity) still falling across community testing (pillar 2) and health care worker/those in clinical need tests (pillar 1).
The steep drop in P2 positivity is due to the massive jump in LFD use (lateral flow devices for rapid testing among people without symptoms)

2.8m done between 1st-7th March, with a positivity of 0.17% compared with 1.7m done the week before. LFD use will rise further next wk.
Read 18 tweets
10 Mar
Today, the headlines enjoyed the @CommonsPAC report on COVID19: Test, Track and Trace (part 1).

Some reflections that don't focus on the ££ detail. 🧵1/11…
The T&T budget is massive, and it's right that it has scrutiny. The vast majority (perhaps around 80%) has gone on testing and the achievements here are pretty significant.

Regularly >5% of population are tested for a disease that we didn't know existed around a yr ago. 2/
But by the same token relatively little has been spend on the contact tracing and isolation support.

We can't test our way out of the pandemic - it has to go hand in hand with tracing contacts and ensuring people have the support they need to isolate. 3/
Read 11 tweets
4 Mar
Latest T&T data out, covers 18-24th Feb.

Bit of a dive into testing and LFD use this week.

Tl,dr: Tests up (all LFDs), cases down, and performance relatively unchanged.

Summary in pic, detail in 🧵…
There were 2.8m people tested, up 9% on the week before but still down from 3m two weeks' before.

This was all pillar 2 (community testing), up 14%. People tested using pillar 1 (HCWs and those in clinical need) fell 12%.
And more specifically, this was all lateral flow devices (LFDs) - rapid tests for people aiming to find cases among those without symptoms.

The number of LFDs used increased by 470k to 2.2m, whereas the number of pillar 2 PCR tests dropped slightly.
Read 19 tweets
4 Mar
PHE COVID surveillance report out covering 22nd-28th Feb, plus also today's REACT data. 🧵

tl,dr. Things are getting better but inequalities continue to persist.…
Case rates have continued to drop in all ages.

And check out how rates in 80+y/o were tracking with those aged 20-60yrs
but over the last few weeks the rate of decline has accelerated to track more closely with those aged 60-80yrs.
After positivity went a bit wild last week (half term and therefore far fewer LFDs being done) reassuring it's back to similar trends to the week before.

Having said this, pillar 2 positivity is really hard to interpret now as includes LFDs and PCR.
Read 21 tweets
4 Mar
Latest REACT-1 study now published suggesting prevalence of COVID in England of 0.5% between 4th-23rd Feb (round 9).

Two-thirds lower than the 1.6% reported over the same period in Jan (round 8).

But big variation by region, ethnicity, and deprivation. 1/4
Higher chance of infection among Asian ethnic groups, if more deprived, bigger households, and if health/care worker. 2/4
And whilst still declining everywhere, higher prevalence in NE, London, East Mids, with some signs that falls are stalling in London, West Mids, and SE.

Finally, lowest prevalence in 65+ but big drops across the board. 3/4
Read 4 tweets