Paul Mainwood
@PaulMainwood
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Used to study physics. Now my job title has "strategy" in it. (Taking a break from this site until change of ownership, foreclosure or similar.)
Joined April 2019
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As in bio, have now mostly given up fighting through this spammy, bot-filled mess.
May return if improved (e.g., foreclosure, change of ownership) but doubt it.
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That … does not seem to be the most striking feature of the data.
Boys are now more enthusiastic than girls about school for the first time in 30 years, according to a new study in Scotland
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ICNARC have updated their analysis of COVID patients in critical care in England, Wales and NI. They now show boosted patients as well.
They are shown in green.
Yes, I've put them on the chart.
You have to squint.
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Beautiful example to reveal the nature of an LLM (a sophisticated statistical model trained on a large corpus of text).
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Trying to keep objective.
But looking at the numbers around boosters, my main concern is that the results are being absurdly undersold.
Most people are sick of COVID, sick of being told what to do, and are thinking of boosters are a nice-to-have.
They are transformative.
(1/4)
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Still blathering on about this because I can't see it being reported.
Numbers say NHS emergency response is on its knees.
If you have a stroke/heart attack and call 999, there's a good chance you'll be waiting an hour for an ambulance. In the South West, two. If unlucky, four.
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0.52: "We have broken the chain of transmission with the vaccination programme."
There are many views you could have about managing COVID in the UK. But if Maggie Throup (the vaccination minister) believes this, the government has absolutely zero grasp of the situation.
With rising Covid cases, York MP Rachael Maskell has called for free lateral flow testing to continue for another three months in England - as is being done in Wales.
Health Minister Maggie Throup rejected the idea, saying: "We have moved on and broken the chain of tranmission."
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"40% of UK hospitalisations are vaccinated" is good, in an image.
The age distribution of who we've given vaccines to suggests that if they didn't work, ~90% hospitalisations would be vaccinated.
Actual figures imply that vaccines stopped ~92% of recipients ending up in hospital.
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Sunak and government still haven't got it. They're talking about the NHS emergency care crisis as if it's just a different kind of waiting list.
It's not that. It's more like a social contract - that if you're in real trouble, someone will come.
Right now, that's not true.
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Don't really know what to say.
Category 2 ambulance calls include those for suspected heart attacks and strokes.
The mean response time in December was 1 hour 32 minutes across England; 2 hours 39 in the South West.
The target is 18 minutes.
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French bookings for vaccinations over time.
Spot the day Emmanuel Macron told the nation that if they weren't double-vaxxed, they couldn't go into a cafe.
Seuls 3,5% des rendez-vous ont été pris par des 60 ans ou plus, les deux tiers l'ont été par des moins de 35 ans. Très forte poussée des 12-17 ans.
#Passsanitaire
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Hello. Back. Short break was needed.
Thank you to everyone who said nice things. Very, very much appreciated.
Looks scary doesn't it?
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Omicron's a scary thing. It moves fast.
To avoid a lot of human suffering, you need two things that happened in South Africa to also happen everywhere else:
1) It has to give milder outcomes than Delta.
2) It has to flash up and down really fast.
Results so far in London:
(1/n)
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Was worried I might get bored of updating this chart.
Am not.
At all.
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On the needlephobic thing, a personal note.
I'm absolutely terrified.
About 50% of injections I have, I pass out unconscious for a minute or so. Crash teams called several times. Ghastly, stressful and embarrassing.
In case it helps, my approach:
(1/4)
I’ve had sooo many needlephobic people message me. It’s very serious.
Half of the fear is public embarrassment. I tell people to go to vax centre & tell staff straight away.
Most have a quiet room they can use & take the time you need.
What do you tell them
@kierank_
?
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Shout out to the person who reported bed bug infestation as a side-effect of their receiving the Pfizer vaccine.
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11% of English adults are unvaccinated.
So if vaccines did nothing, there'd be 89 / 11 = 8.1x more vaxxed than unvaxxed in hospital.
In fact, we see 45 / 55 = 0.82x
Vaccines squish the 8.1x down to 0.82x
10x squish = 90% effective
(In fact it's higher: the 11% are mostly young)
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Not that anyone needed it, but New Zealand and Hong Kong make a comparison of two Zero Covid countries exiting with and without good vaccine coverage in their oldest.
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Latest four weeks of
@UKHSA
data with ONS denominators. Omicron is fully dominant in England at this point, and this comes through in the mess of case rates; vaccine protection not that good vs Omicron cases.
Thankfully, still *very* strong against serious illness and death.
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A quick walkthrough of how one might translate a stat like this into an rough estimate of vaccine efficacy. Not to be used as a substitute for proper work done by e.g., Public Health England, but just to check a first impulse of: 40% vaxxed? Sounds like a lot. Do they work? (1/5)
Correcting a statistic I gave at the press conference today, 19 July. About 60% of hospitalisations from covid are not from double vaccinated people, rather 60% of hospitalisations from covid are currently from unvaccinated people.
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The ONS have updated the age-adjusted all-cause mortality rates by vaccination status for England to cover all of 2022.
It's nice because it's simple. No diagnosis question, just counting deaths from all causes to give age-adjusted mortality rates for each group.
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Emergency extension of the y-axis. Big clue that something important is happening.
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Absolutely love the triple-scale chart
@TravellingTabby
implemented for Scotland here: so I thought I'd show one for the whole UK.
I've offset the admissions and deaths numbers (6 and 14 days respectively) to make the main point more clearly.
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Despite all those weird numbers being thrown around, *everyone* eligible should get their booster.
To re-iterate: Pfizer trial shows 95.6% booster efficacy against sympomatic disease ... ***versus a control group with two doses***
That last bit isn't being emphasised enough.
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The control trials, and the real-world data agree. Boosters don't just restore your protection against COVID. They make it *better* than it ever was with two doses.
Result: we boost less than half of 80+s in the UK, and the observations nearly break my graph.
(2/4)
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This is a hilarious capitulation from the BBC.
However, Lineker would be wise not to rub their faces in it, as resentment of such total humiliation can give rise to a strong backlash, reminiscent of Germany in the 193...
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But will this boosted protection - however impressive - also wane eventually?
We don't have much data yet. But the first person to be boosted now 8+ months clear. And his antibody results are still topping out higher than the test can register.
(3/4)
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One of the most worrying discoveries of the past few years is that the NHS doesn't collapse. It degrades.
And politicians have discovered that - while people would notice a collapse - most don't notice a huge degradation of essential services they use only occasionally.
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Saw people saying this study was bad.
Saw opinions along the lines that anyone sharing as evidence for or against mask efficacy should specify whether they had not read it at all, or had suffered a recent head injury.
But honestly, nothing prepares you.
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The UK is doing something hard to understand, and harder to justify.
We are both importing and producing unfeasibly huge vaccine supplies and ... sitting on them.
The stockpile is currently a little under 12m doses; ~5m of them are mRNA.
Can we *please* get them into arms now?
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Heard from vaccine-hesitant people:
"There's no point starting now; Doses 1 & 2 are useless vs Omicron, and a booster would be months away. Pointless."
Not true. Recency is nearly as important as dose #.
Start now, and the vaccines protect yourself & others sooner than you think.
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PS: I have no idea what proportion of the 34m people who have been triple vaccinated have done so while facing down our recognisably-irrational-but-not-any-less-real terror, and done it three times now.
But however many it is - thank you.
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Also, even within these hospitalisations; it looks (again, taking care on lags and reporting) as though the share of patients needing mechanical ventilation is much lower.
Exactly as the Gauteng doctors said; we might reflect how and why their observations were dismissed.
(3/n)
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This is a bad idea.
ONS covid infection survey looks set to be scrapped in the next couple months - also the Vivaldi study into disease in care homes.
Govt says final decision hasn't been taken but insiders now expect survey to end.
Story
@theipaper
by
@janemerrick23
& me:
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Now, let's not jump to conclusions.
Could be anything.
Literally anything that's been recently applied to the oldest cohorts only and is incredibly effective in stopping cases vs the unvaccinated.
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Looking at December's COVID admissions to ICU as reported by
@ICNARC
, one can (roughly) match their vaccination status to those of the population with the same median age.
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France splitting hospitalisation data by variant! In the UK we are forced to infer from time series - very prone to error.
Omicron associated with shorter stays (43% less than a day!) and with less critical care.
L'AP-HP rend publiques de premières données sur les hospitalisations par variant.
Les patients infectés par
#Omicron
vont surtout en hospitalisation conventionnelle plutôt qu'en soins critiques (Omicron représente 54% des admis en HC et 19% de ceux admis en SC fin décembre).
1/
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European countries have plenty of doses; the main obstacle to a safe, healthy, open winter seems to be ... a comms issue.
I've not heard politicians or media communicating anywhere near how well boosters work.
Please get on with it. All visuals open for use if helpful.
(4/4)
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Lacking in eloquence today, so: hell.
October ambulance response times are out.
Category 2 calls include suspected heart attacks and strokes.
The England average for October was the worst ever: 1 hour 1 minute and 19 seconds.
The target is 18 minutes.
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I've run out of ways to try to say that it's possible sustained COVID pressure is triggering spikes of NHS ambulance waits, without COVID being the underlying root cause of those waits ... I'll give up and just post graphs with bumps. Mmm. Bumps.
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Booster dose cuts your chances of getting infected with Delta by at least 7x-9x vs being double-vaccinated. UK real-world data with Pfizer & AZ.
Will this be it, or will more boosters be needed?
No-one knows. But three doses gives better protection than two doses **ever** did.
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Don't have the stamina to look at this stuff much more, but the contrast between the sacrifice these people demanded from the rest of the country in 2020-21 versus how they acted themselves, is absolutely bile-inducing.
Remarkable new evidence from a 'junior official' blowing the whistle:
🍷 Wine Time Fridays
📹 Notes sent out about avoiding cameras
😷 Told 'no point' wearing masks
❌ Culture of not adhering to 'any rules'
"The leadership of No10 failed to keep it a safe space"
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Screams in second derivative.
UK food inflation falls in May, raising hopes prices may have peaked
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On Omicron: two things that happened in South Africa must happen everywhere to avoid a lot of human suffering.
1) Omicron gives milder outcomes than Delta.
2) Omicron cases rocket, but peak and fall quickly.
In UK: no certainty; data still unclear; optimistic on both.
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The boosters are amazing, and those lines are still soaring as they crush Delta.
Too early to see Omicron, so let's keep everything crossed.
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ICNARC have updated their report of COVID ICU admissions (critical care) in England, Wales and Northern Ireland - rates per 100,000 people in each category per week. 1 May to 15 Dec 2021
They've updated their graph formats this week. I like them.
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I know that given the sheer volume of misinformation, posting these is a little like pissing into a hurricane, but here are the latest UK rates (weeks 37-40) using Office of National Statistics population numbers.
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So, if vaccination doesn't work we should expect 8.9 times more vaxxed people in hospital than vaxxed. We actually see 0.67 times.
Vaccines only work on the vaxxed, so they've "squished down" that ratio by protecting the vaxxed.
"Squishing" 0.67 / 8.9 = 0.075.
= 92.4% effective.
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- If you feel faint, sit. If you feel really faint, ask to lie down somewhere private. Once you're happy, get out into fresh air, and go and get whatever treat you like. Mine tend to be chocolate-based.
- Make sure you get a sticker, and be quietly goddamn proud of it.
(4/4)
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Yes, you’re reading that right. Study sees booster dose giving 95.6% RR reduction versus a control *of 2 doses*
The Pfizer booster trial is pretty spectacular.
10k previously 2x dosed (median 11 months from dose 2).
Randomised 1:1 placebo and 30ug.
95.6% relative risk reduction in symptomatic infection in intervention arm vs control (2dose only).
5 v 109 events 7+ days from boost.
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England rates per 100k by vaccination status for cases, hospitalisations and deaths - December 13 - January 9 from UKHSA. ONS denominators.
Consistent: vaccines not very protective vs cases as Omicron becomes dominant; still very good protection vs serious illness and death.
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Have I got the consensus right?
- Everyone thinks cases are flattening/falling.
- No-one is quite certain what it is, but the absence of football is being cautiously mentioned a lot.
- No-one thinks it's permanent.
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I think we in the UK are missing another chance.
We have:
a) A nasty exponential-looking rise in cases.
b) Our main ways to avoid NPIs: a booster programme for the vulnerable & 1st doses for teens, being outpaced by glaciers.
c) Enough doses to complete both programmes right now.
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This man is a moron.
Up to the end of September 2021, the official count of deaths of people with Covid was 137,133. This FOI request would indicate that only 17,371 of those deaths occurred in people with no other underlying causes. (2/4)
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Measles, Mumps and Rubella vaccine: 1 and 2 doses, at 5 years old.
Ticking time bomb now.
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I've been projecting UK vaccine roll-out timings on the assumption that we proceed down the age-groups until all adults are offered a dose.
But this is not what we should do.
We should open booking to all 18-39s and run a dual-track system: an AZ arm and a Pfizer + Moderna arm.
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The difference a roll-out can make.
All UK nations are allocated exactly the same doses per head, but Wales is getting them to people faster.
If the rest of the UK could match the Welsh rate, there'd be 5m more doses in arms, and we'd be opening bookings to 31 year-olds today.
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Don't do this kind of shit. Even if you think it's in a good cause. It undermines your own credibility.
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The next few weeks for Londoners are now locked in as Interesting Times, with the rest of the country only a few days behind.
The yellow and blue lines are separating from the dark red; but they need to separate a *lot* more to make anyone happy.
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You can't beat front-line clinical experience to tell you the respects in which Omicron is different to previous variants.
I just have a chart.
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(You're all trying to be funny, but no-one's coming close to "We are a group of ultra-rational people dedicated to doing good but you can't expect us to think great thoughts unless provided with country estates dating back to the thirteenth century that's just science.")
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I'll say it again: the daily case counts are a *very* good guide to the actual situation.
(No, I've not touched a single damn thing in the historical ratio; it comes out like this).
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Gosh. Vaccine escape of BA.2 looks similar - and quite possibly less - than that of BA.1.
Yet despite this, BA.2 exhibiting sizable growth advantages everywhere, even in places like Denmark, where coverage is 83%.
(Table from
@UKHSA
vaccine report )
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I despise politics.
But doesn't this party/video pose a real problem?
There's a possibility the UK may genuinely need restrictions to manage Omicron.
I'm having some difficulty seeing how the current government can announce such measures.
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One of the more valuable datasets the ONS put out during the height of the pandemic was age-standarised all-cause mortality, split by vaccination status.
Simple, because there's no diagnosis issue: just an all-cause death rate for those who got jabbed and those who didn't.
(1/2)
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I had low expectations. But to weasel through with terms like "Covid-induced loneliness" ... my god ...
This is a horrific problem. To address it, can we at least acknowledge that it was not caused directly by the virus, but by our attempts to control it?
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The contrast between England and Scotland's ambulance response times is stark (comparing whole-nation metrics: Category 2's vs Ambers on 90th percentile responses).
Scotland had a problem in December 2022, England disintegrated.
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Visualising the 3rd dose offer.
Using
@UKHSA
4-week case prevalences per 100k (ONS), UK unvaccinated adults currently face an annualised risk of a Delta case of ~25%.
Applying UKHSA's recent work on real-world vaccine effectiveness against Delta, you get something like this.
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Using the new UKHSA hospitalisation effectiveness numbers for two and three doses, I've updated the estimated hospitalisation scenario for Omicron if we had skipped the booster campaign.
Note this is a conservative estimate, and does include the effects of natural immunity.
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OK. Once and only once more.
The ONS infection survey takes a nationally representative panel with a random sample, and asks this sample to take PCRs, ~180,000 people are tested every two weeks, regardless of symptoms.
Its results are not affected by national testing levels.
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I am once again confused as to how these modelling parameters can be reconciled with what’s happening in South Africa.
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I've cheered up a bit on vaccine supply. The data is consistent with a pretty-much-OK trajectory in the coming months. (It's also consistent with disaster, but let's be happy.)
Also, people asked for sources/reasoning on some stuff I've posted already. So, some notes (1/10)
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The new
@UKHSA
paper on booster effectiveness vs Delta has some nice extra time resolution.
It gives a good answer to the oft-asked "How long do boosters take to work?"
(Guess: Omicron protection will show a similar shape on a different LH axis).
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Dashboard going weekly after today.
An occasion to thank
@statsgeekclare
,
@Pouriaaa
,
@DaveJephson
,
@jbwesty
,
@RussPlunkett
,
@Musicwallaby31
and others not on twitter. A small group of people who created and pushed through one of the best pieces of public service of the pandemic.
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- It's not rational. Arguing me out of it won't help. Helping me manage it will.
- Please don't try to minimise it. You'll see how much of a "nothing" it is when full vasovagal syncope kicks in & I'm fitting on your floor.
- We'll remember kindness & consideration for years.
2/2
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On these graphs, continuing to touch wood and throw salt over whichever shoulder it is ... but so far, cautiously ... etc ... perhaps a little more white space opening up between the lines?
Linear and log versions, so everyone can get angry at whichever one they don't like.
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Just to point out the obvious: the claim that ONS data shows vaccines don't prevent death any more is a simple, straightfoward lie.
Age standardised COVID death rates in May 22 are still more than twice as high for the unvaccinated (77 / 100kpy) as the vaccinated (36 / 100kpy).
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Latest England ONS positivity rates with weekly gaps.
The forest fire in the younger teens still blazing as of a week ago, with the secondary ripple in the 40s above 2% now.
But ... anyone else seeing anything interesting on the right hand side?
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A regular reminder that the UK government refuse to release any information on vaccine stocks.
Our vaccine stocks: the ones we paid for, the ones that protect us & our families.
I remain livid about this.
Normal geeky service to back-calculate the stocks will be restored shortly.
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I see the race to the bottom amongst professional trolls is reaching new depths.
She’s visiting “Little Miracles”, a Peterborough based charity that - amongst other things, helps CEV kids with life-limiting conditions.
What's going on here? Forget what the kids are saying. Why the hell are all these adults AND kids wearing masks? Who told them to wear masks? Utter madness.
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On the "London might have peaked, rest of country probably hasn't & it looks worse in the north of England" theme, here's the North West.
Omicron doesn't seem to be behaving any differently to South Africa & London: case decoupling and lower mechanical ventilation needed. (1/2)
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The
@ICNARC
reports are invaluable, giving data on various aspects of critical care in England, Wales and NI; all calculated by week to avoid confounding.
I've talked before how uncertainty in population numbers mean that only strong signals cut through.
Like these ones.
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The WHO have released figures from their excess deaths work. Lower total than some others have got to.
In Europe, WHO implies UK reported COVID deaths very close to excess, that Germany underreported by as much as ~40%, while France significantly overreported.
Striking.
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The UK government made several announcements yesterday. One was that they expected the UK's world-leading vaccination programme would slow to a crawl.
No-one noticed.
Even the FT - usually so good at this quantitative stuff - has this headline. (1/2)
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A lot of things not to like about this latest variant driven COVID wave. One of them is the hard-to-ignore correlation to emergency response times.
COVID is only one amongst many pressures, but sustained admissions do appear to be able to push the system towards collapse.
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Run out of enthusiastic things to say.
It's going down really fast this is good.
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Feels like maybe, maybe politicans won't be able to ignore much longer?
It's been at this level 11 months now: everyone in EM seeing the whole system collapsing, every indicator veering off the scale.
2-3 month respite from COVID - chance to stop the bleeding at least?
EXCL: This is the NHS as you’ve never seen it.
19 patients crammed on trolleys in corridors unable to get into a full A&E.
92 year-old May has been stuck on hers for 3 days.
Outside, ambulances queue, delayed getting to other calls.
Patients have died waiting.
#ITVTonight
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Wytham Abbey: one of the most stunning stately homes in in Britain, situated just outside Oxford.
Past residents include Elizabeth I, Oliver Cromwell, and Joachim von Ribbentrop.
Together with the gardens, estate was on sale for £15m last year.
Three guesses who just bought it?
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@BristOliver
What you don’t realise is that there’s seven smaller Russian Generals inside him.
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The Bayesians have finally taken control.
Can’t believe they’re replacing PCRs with this rapid online test
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Do you think we should get on with it and boost the other age-groups?
I think we should get on with it and boost the other age-groups.
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One PS:
In the space of 10 hours yesterday, we went from Edward Argar on
@BBCBreakfast
justifying the extension of restrictions by promising >10m second doses in 4 weeks, to Boris Johnson promising ~3.5m UK second doses in 5 weeks.
And no-one said a thing.
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