1. THREAD on latest UK Covid Numbers:

A reasonably detailed dive into the latest numbers & (some) implications.

TLDR: things going in right direction but don't think unlocking will be easy.

2. Confirmed cases are still falling & we are back at levels last seen in early December. Positivity rates (accounting for changes in numbers of tests) are also falling in all 4 nations (and in all age groups).

ONS infection survey entirely consistent with this picture.

3. Cases and positivity rates also falling across all English regions & LAs. However, E. Mids, Yorks & Humber and N.East falling slowest.

Obviously falls are GOOD, BUT the green diamonds show where we were at the end of Aug last year.

There is a LONG way to go.

4. Hospital occupancy falling steeply in all UK nations which is GOOD but everywhere still has MORE people in hospital with Covid than they did during the April peak.

ICU occupancy falling more slowly (expected) & much higher than a year ago.

The NHS is still struggling.

5. Deaths have peaked. ONS registered deaths now shows that the 4 peak weeks in April match deaths in January - and we have still to come down. Over half of all deaths have been in these two peak periods.

Reported deaths (more recent data) show that we HAVE peaked.

6. With vaccinations and the ongoing discovery of effective treatments (e.g. https://www.recoverytrial.net/news/tocilizumab-reduces-deaths-in-patients-hospitalised-with-covid-19) means we should never see that many people dying again.

The only thing that could lead to it would be catastrophic failure of policy (inc not mitigating risk of new variants).

7. Vaccinations are continuting to go really really well with about 20% of UK population having now received first dose.

We've vaccinate over 90% of over 75's and almost 75% of 70-74 year olds. This is brilliant.

8. Impact of vaccines take time to show up. At least 2 weeks to get immune response from 1st dose (maybe 3 for over 80s). Then another 2-3 weeks before you'd even start to see an impact on hospitalisations and deaths. Plus not everyone vaccinated at once.

9. Also lockdown messes with the signal... No much sign yet in the hospitalisation data but perhaps tentative sign in deaths (many who die, do not go to hospital) from @d_spiegel work.

Can't say for sure this is vaccinations, but it is consistent with a vaccination effect.

10. Enouragingly, outbreaks in care homes now falling sharply. If almost all care home residents have been vaccinated and most care home staff, these should fall further.

If there is an issue with delaying 2nd dose for older people, it will become apparent first in care homes.

11. Israel saw sharp reductions in cases and hospitalisations in people over 60 - 90% of whom are now vaccinated. Israel also doing a 3 week vaccination schedule with Pfizer. Effects really started showing 6-7 weeks in.

We should start to see clear signals by end of February.

12. But 90% of cases are in under 70s - so vaccination won't do much to prevent cases spreading if we open up.

Some thoughts about it. Firstly, there remain outbreaks in nurseries (open) and primary schools (about 20% of pupils attending). As schools open, these will go up.

13. We need to monitor cases carefully and do all we can to make schools as safe as possible for returning students and staff.
https://www.independentsage.org/the-return-to-school-a-consultation-document/

14. Lockdown exacerbates inequality - not least in exposure. Younger adults in more deprived communities more likely to get Covid - much harder for them to shelter at home. And many live in overcrowded housing which also increases exposure.

15. This should incentivise govt to do more to make workplaces safer & provide accommodation to those who cannot isolate safely at home (and proper financial support).

It also means that as restrictions ease, more people will become exposed as their leave their homes

16. The best mitigation, especially given our more transmissible strain, is to get and keep cases extremely low and do it with proper find, test, trace & SUPPORTED isolation system. Plus a slow and phased reopening to monitor for increasing transmission.

17. Internationally, the "Kent" strain is spreading to different amount across Europe. Govts are keeping strong restrictions to prevent it dominating, but B117 still becoming slowly dominant. Could lead to big March spikes there.

NB Spain had a big post Xmas surge

18. Countries where the "Kent" strain (B117) is already dominant saw massive surges as B117 took hold pre lockdowns. Harsh restrictions in all countries got it under control but - as I already said - coming safely out will be a big challenge.

19. Next week, @IndependentSage will lay out in more detail how we think we can exit lockdown safely - and, more to the point - make sure we *never* go back into one. END

Ps thanks so much to Bob Hawkins, @cfinnecy and @lukemshepherd for help in preparing charts, organising and discussing data!!