THREAD: Why we should offer covid vax to 6 months - 5 year olds...

TLDR: this age group LESS likely to have protection from prev infection than other ages, MORE likely to need hospital & ICU than older children and young adults & safe vaccines exist 1/11 While serious outcomes are rare for under 6s, they are more common than for older children.

This chart shows how much higher hospital admissions with Covid for 0-5 yrs vs 6-17 yrs (adjusted for population size).

Overall, 20K admissions in <6s since 2020, over 13K in 2022! 2/11

Tonight is the 15th anniversary of my brother's death. My mum reminded me of the statement I did for the trial & I found it.

In it, I list the things I want to be able to do but can't.
It brought back the memories- those moments that are our relationships.
Here are some. 1/4

https://twitter.com/chrischirp/status/1345027300937629699

"I want him here to laugh at my love life. "
"I want to meet him for lunch at our usual place and bag the ginger beef for myself"
"I want to be his games partner at my sister’s house and laugh till I cry."
"I want to have hour long discussions about West Wing with him."
2/4

THREAD: The Covid Pandemic in England in 2022...

a look at what happened.

TLDR: One thing that didn't happen was the end of the pandemic.

Despite people telling you it's just like flu, Covid had far greater impact on illness, hospitals and deaths than flu. 1/13 Up to Dec 2021, it was very rare that more than 2% of population had Covid at any one time. 2022 blew that out of the water - for 38/52 weeks, prevalence was higher than 2%. We had 5 distinct waves and 3 waves where more than 1 in 20 were infected at peak. 2/13

NHS A&E Crisis:

December's figures were the worst yet and this really really matters.

Average response times to calls such as suspected stroke or heart attack over 1.5 hours in Dec (!) - target of 18 mins not met since early 2021 1/4 Over a third of patients are now waiting for over 4 hours from arrival to admission. This matters.

A 2021 paper found higher mortality after 5 hour wait increasing with delay.

@COVID19actuary used this to estimate extra 415 deaths/wk Sept-Nov and 500/week during Dec. 2/4

SHORT THREAD: current Covid situation in UK.

Firstly latest wave is declining in Wales & England, hopefully about to in NI & Scotland (ONS data 2 weeks behind). Hospital & prevalence data consistent.

70+ in Eng still increased to 3 Jan - xmas mixing? 1/5 Big December flu wave in English hospitals - about twice the size of pre pandemic winter seasons. Also exceeded Dec Covid peak BUT we've had 5 wave of covid in 2022 vs only one of flu. (will cover in greater detail in my 2022 thread).
2/5

THREAD: update on Covid in England.

TLDR: big spike in infections over Christmas, probably coming down now (see later tweets) but likely not for long. NHS crisis continues.

1/9 All nations saw a large spike in infections over Christmas.

In England, fact of it not a surprise from hospital admissions in Dec but higher than many were nonetheless expecting.

Driven this time almost entirely by adults. 2/9

My colleague told me how his mum suddenly deteriorated over xmas (after living independently).

After ambulance & handover delay, she then spent 28 hrs in hospital wheelchair in a corridor, confused, cold & sick. Couldn't walk to use loo. Thank god her family were with her. 1/3

https://twitter.com/minnierahman/status/1610894396416737283

She is now (thankfully) stable in a bed, but could be discharged. She can't go home (no longer safe for her). So now they are waiting for social care... and her desperately needed hospital bed is not available for the next person.

My colleague sounds totally traumatised. 2/3

THREAD: latest Long Covid Data

ONS has released its latest Long Covid stats. I'm just going to show results for those with Long Covid for *at least 12 weeks*.

Numbers are steady but high, at just under 2 million people (about 3% of population). 1/6 Essentially some people are recovering but about as many are developing new persistent symptoms - and 12 weeks (minimum in this data) is a long time to have symptoms for.

Numbers reporting a lot or little impact on their lives also staying steady - and high. 2/6

🧵on "Twindemic" of Flu, Covid & NHS crisis:

Recently there have been so many headlines relating NHS crisis to the Twindemic.

Implication is that this is unprecedented & unexpected.

It IS unprecedented. It's NOT unexpected. And likely to happen most winters now. 1/6 For last 18 months message from govt has been "Covid's now just flu", "we can live with it."

But flu is serious - NHS has been increasingly struggling every winter, along with other respiratory illnesses such as RSV.

So how is flu+covid "liveable with" for NHS? 2/6

I'm being asked whether I think the UK should start testing/quarantining travellers from China given their ongoing large wave.

My response is - when and for what purpose? Cos that determines whether it makes any sense... 1/7 If it's to reduce number of cases in UK - then testing/quarantine from China is entirely pointless. We have plenty of Covid here already, have done for ages and there is v little in place to prevent in-country transmission. 2/7

I've got a piece in @bmj_latest today about the state of the NHS - but more to the point what has led here & where next.

bmj.com/content/379/bm…

Here's a brief summary 1/10 Firstly, things are pretty bad in the NHS right now, particularly emergency care. Ambulance handovers are taking longer, people are waiting longer for an ambulance and waits in A&E are getting longer.

Targets are being missed by miles and getting worse. 2/10

Inc flu update: flu admissions still increasing alongside covid admissions. Flu was ahead last week but this week Covid has taken over.

Flu admissions now running significantly ahead of 2019/2020 and 2018/2019 peaks.

Both Covid & Flu hitting over 85s hard. Flu also in under 5s

https://twitter.com/chrischirp/status/1605874961209606144

more flu admissions in ICU but both Covid and flu ICU admissions increasing. Combined admissions highest of the year.

🧵new @UCL_CORU paper on work led by @katebrown220 to understand whether specialised hospitals who treat a lot of patients do better than those who treat fewer for children born with the most severe heart defects...

paper here:
jtcvs.org/article/S0022-…

main results are: 1/9 The most severe congenital heart defect is "functionally univentricular heart" (f-sv), where children are born with only one half of the heart working. They typically need several operations - starting v early in life - to survive.

lhm.org.uk
2/9

🧵ON PERIODS:
At @cosmicshambles #NineCarols on Sat, I talked about how we are neglecting women's pain & bleeding.

The continuing stigma and silence around periods is pathetic, wrong, devastating for women and economically nonsensical.

Some facts. 1/23

theguardian.com/society/2022/d… Women of reproductive age are a third of our population (18 million in England!) - most of these women have periods.

And periods going wrong is really common! 2/23

THREAD on latest Covid & NHS situation as we head into Christmas:

TLDR: We're hardly vaccinating now, we're def in another wave, as well as covid, flu hosp admissions increasing rapidly & NHS strain still severe.

If eligible, get yr covid & flu jabs & don't mix if yr sick! 1/9 A year ago we did almost 1 million booster doses a day. This Xmas hardly any. And it's not cos we've finished - just under half of 50-64 yr olds remain unboosted.

Far too few kids have received even 1 dose.

Most adults under 50 last received a dose almost a year ago. 2/9

THREAD summary of how Covid pandemic has highlighted (and made worse) existing inequalities.

1st - people in most deprived areas more than twice as likely not to be vaccinated vs least deprived areas - and so remain far less protected 1/8 There has been a really important study using ONS infection survey data to look at deprivation impact (and so circumventing the problem of who seeks testing).

All data from Apr 2020 to Jan 2022. I'll highlight some key results here.

ons.gov.uk/peoplepopulati… 2/8

THREAD quick update on Covid in the UK:

First, we aren't really vaxxing much any more. 30-40K a day.

This is v disappointing as only just over half of 50-64 year olds have had their autumn booster.

Meanwhile there are plenty of under 50s who'd like one! 1/5 Prevalence is creeping up - latest ONS infection survey only adds another 4 days to last week, but cases up everywhere except Scotland. Highest now in London, Yorks & going up fastest there too. 2/5

🧵So @Kit_Yates_Maths & I have written a short piece for @ConversationUK about why it makes sense to avoid infection (and reinfection) with Covid for as long as possible - and then there are things we can do to make that easier!

Main points below!

theconversation.com/covid-treatmen… 1/5 Firstly, infections are not risk free. Even after prev infection & vaccination, you can still get pretty sick or develop long covid. Risk of longer term issues also higher. Plus not everyone has had it yet and the CEV community remain at much higher risk. 2/5

THREAD: update on Covid (UK) & the NHS Crisis (England) more broadly

TLDR: could be at start (just) of a new Covid wave but don't know if it will be high. Long Covid continues to be problem

Flu & RSV causing problems

NHS in v bad state - latest data sad & frightening. 1/xx Vaccination: we're only really doing is autumn boosters which are tailing off. Uptake in 50-64 year olds is a disappointing 54%. Govt should be pushing this!

Also - most younger adults have not had a vaccine dose in almost a year. Why aren't we offering them a booster? 2/xx

Govt tech Covid report. 🤬🧵:

This seems to be a pre-emptive response to the Covid Inquiry.

Much of it is useful & fair reflection. Some seems more intended to justify policy decisions.

BUT reflections on interventions in schools is - in my opinion - totally outrageous. 1/7

https://twitter.com/CMO_England/status/1598241509891276800

In contrast to other chapters, ALL the reflections on schools are basically saying "don't bother with mitigations in schools".

gov.uk/government/pub…

2/7

UKHSA published their findings of the Immensa Scandal - reminder back in Sept 2021, the Immensa Lab wrongly reported about 40K positive tests as negative - and ongoing chains of transmission resulted in massive spikes in cases.

The timeline in the Appendix is quite damning 1/3 Local teams *repeatedly* raised suspicious negative PCR tests from 8 Sept onwards - little action taken. *3* spikes over 3 wks in daily positivity from Immensa were missed.

Not until 7 October when UKHSA epi team got their hands on it were PCR errors looked at in detail! 2/3