Important 🧵on our new peer-reviewed paper:

The pandemic is as bad as it ever was for babies - in year to Aug 2023, 6,300 babies under 1 were admitted to hospital wholly or partly BECAUSE of Covid.

They are ONLY age group where admissions have NOT gone down over time 1/17 Our study, led by Prof @katebrown220, looked at all hospitalisations in England in children with a Covid diagnosis or positive test from Aug 2020-Aug 2023.
We then *excluded* all admissions where a Covid diagnosis was incidental (ie not why they were in hospital)
2/17

Prof @Kevin_Fong giving the most devastating and moving testimony to the Covid Inquiry of visiting hospital intensive care units at the height of the second wave in late Dec 2020.

The unimaginable scale of death, the trauma, the loss of hope.
Please watch this 2min clip. And here he breaks down while explaining the absolute trauma experienced by smaller hospitals in particular - the "healthier" ICU patients were transferred out, leaving them coping with so much death.

They felt so alone.

THREAD: I asked what the point of Public Inquiries is for @bmj_latest

We've spent hundreds of millions of £ on Inquiries over last decades, generating deep understanding of failures & 1000s of recommendations.

But v few recommendations get implemented!
What is going on?

1/12 E.g. Covid-19 Inquiry has cost £94 million so far - and is projected to cost over £200m by its end (it still has years to go).

1st report published (out of at least 9) found major flaws and proposed 10 recommendations.

Chances are low that they will be implemented :-( 2/12

🧵War causes direct civilian deaths but also indirect deaths over the following years.

Recent paper estimates eventual total direct & indirect deaths in Gaza attributable to the war - 10% of entire pop'n.

I want to explain these estimates and why deaths must be counted. 1/13 Why count casualties from war anyway? For moral, legal and strategic reasons.

1 - owe it to those who have died
2 - International law says must count & identify dead as far as possible
3 - monitor progress of war & learn from tactics

2/13

THREAD: the summer Covid wave in the UK continues.
Basically, there is a LOT of Covid around and not a lot of other respiratory viruses.

If you have cold or flu symptoms, it's probably Covid.

The latest hospital data from England shows steady, quite high levels. 1/8 But admissions don't tell us how much virus is circulating more generally. The best (but imperfect) measure we have is wasterwater measurements, and only in Scotland and not England.

Scotland's wastewater is showing a huge July peak - highest since Omicron's 1st yr in 2022 2/8

THREAD:
I wrote about Baroness Hallett's Inquiry Module 1 report for @bmj_latest .

She found that there was *never* a plan to keep a pandemic death toll down - I discuss this and what it means going foward.

Main points below: 1/14 The headline most seen is that the UK planned for the wrong pandemic.

While it is true that was far too narrow a focus on a flu pandemic, that is not the most telling bit.

To me the most telling bit, is what the plan did NOT do 2/14

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

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

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

https://twitter.com/chrischirp/status/1797931963996889533

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

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

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 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

https://x.com/kallmemeg/status/1774362389627953570?s=20

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
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

https://x.com/kallmemeg/status/1737768682695041041?s=20

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

Hancock: "there was no way we could allow the NHS to become overwhelmed"

Except, the NHS WAS overwhelmed

Here is what NHS staff said about that time - Pls read whole 🧵
"Heartbreaking"
"Horrific"
"It broke my soul"
"We cried, we came home exhausted. We were overwhelmed"

1/16 "Overnight we were told that all “safe working rules” were gone. There was no choice, we were forced to do it"

"It felt like a death sentence. It felt out of control"

"We were put on wards with no senior support, sometimes makeshift ... with little of the right equipment"

2/16

THREAD: England Covid update

TLDR: modest August wave with flatlining hospital admissions, but expect a bigger wave later this autumn 1/12 Hospital admissions with Covid in England are still quite flat for 3rd week in a row and at a level below previous troughs.

Number of people with covid in critical care & primaril yin hospital because of Covid also flat & low.

Deaths ⬆️, from case rises few weeks ago 2/12

THREAD: Various new or expanded cancer screening programmes have been announced recently and coverage has been overwhelmingly on the pros. But there are cons too.

So let's explore some of the pros and cons...

expansion of my @guardian article


1/24 theguardian.com/commentisfree/…






First a screening recap : a relatively simple test that flags potential cause for concern. If flagged, you are offered more, gold standard, testing, often in a hospital (e.g. MRI scans, blood tests, other diagnostic procs). If those +Ve too, you are offered cancer treatment. 2/24

SHORT THREAD on current state of the NHS in England:

TLDR: Ambulance response times improving, A&E improving but still bad, diagnosis and treatment waits are not good.

First - ambulance response times higher than pre-pandemic but way down on their peak - thankfully! 1/5 % of people waiting >4 hours from arrival in A&E to either admission *or* discharge is falling but higher than pre-2020.

A *bit* better than 2022.

% waiting >12 hrs *after admit decision* falling.

BUT % who need admission waiting more than 12 hrs from *arrival* is v high 2/5

Covid update: bigger jump in England hospital admissions with Covid this week (40%⬆️). Also now seeing increase (28%⬆️) in number of patients in hospital primarily because of Covid.

Definitely in a wave but starting from much lower base than previous ones 1/6 Not sure how much it will take it off in Aug with holiday season (and biggest increases are in England holiday areas like the South West). There is a new Omicron variant around called EG.5.1 alongside XBB.1.16, and UKHSA estimate it's got about a 20% weekly growth advantage. 2/6

THREAD: what I think is happening with Covid in England right now.

TLDR: while data is sparse & comes with lots caveats, it's all pointing to pretty low Covid prevalence right now. 1/13 Firstly let's look at hospital data. Recorded Covid admissions are lower than they've been in a LONG time.

People often doubt this data because testing has changed (there is less testing in hospitals now). And that's true - but we can dig further into the data too. 2/13

THREAD: update on how the NHS is doing across ambulances, A&E, diagnostics & treatments.

TLDR: better than last winter (worst ever) but still much worse than pre pandemic. 1/10 Ambulance response times are much faster than they were this winter which is good, but still significantly slower than there were before "freedom" day in July 2021. 2/10

🧵our new definitive @bmj_latest peer-reviewed paper on kids hospitalisations in England!


More accessible & shorter version in this @ConversationUK article from me & @katebrown220
https://t.co/nNQnxiFhrR

read on for the highlights! 1/15bmj.com/content/382/bm…
theconversation.com/covid-in-kids-… The paper was led by @katebrown220 & specialist docs, with number crunching by @HarrisonDWilde using @BHFDataScience data on all admissions, tests etc.

We looked at all recorded first infections in kids 0-17 rys & any associated hospitalisations from Jul 2020 - March 2022. 2/15