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Children Variant

Update on UK strain (and kids)…

We now know that the new variant was first found on Sept 20, 2020 in Kent and another on Sept 21, 2020 in Greater London. The new variant spread undetected until early December 2020. It’s now been identified in several countries, including several states, however spread is likely all over. The US (and rest of the world) doesn’t have nearly the variant surveillance that the UK does. (This is likely why the variant was first detected in the UK).

In the UK, the body that considers new evidence about the virus is called the New and Emerging Respiratory Virus Threats Advisory Group (NERVTAG). They virtually met on Dec 18 and Dec 22. During these meetings, there were 3 independent analyses presented regarding transmissibility (one done by University of Edinburgh; one by Imperial College London; one by London School of Hygiene and Tropical Medicine). In short, all three analyses agreed that the new variant is somewhere between 56%-71% more transmissible compared to other variants. The R(t) is estimated to be 1.2 (which is 0.38 higher than other variants). “The committee therefore has high confidence that the new variant can spread faster than other variants currently circulating in the UK”.

In one of these preliminary analyses (by Imperial College), data suggested that there may be an increase in transmission in children aged <15 years. In the meeting minutes, this is followed in bold type by: “However, these data are preliminary, and more work is required before any firm conclusions can be reached”. The primary author of this analysis, Prof Neil Ferguson, followed up this statement saying, “We haven’t established any sort of causality on that, but we can see it in the data. We will need to gather more data to see how it behaves going forward.”

This preliminary analysis was followed by a London hospital worker (Ms Laura Duffel) stated “having a ward full of children with coronavirus”. The combination of these two events have sparked quite the concern. Ms Duffel’s claim was quickly denied by clinicians. The Royal College of Paediatrics and Child Health (RCPCH) said children’s wards are not seeing any “significant pressure” from Covid-19.

In addition, members of COVID-19 Genomics UK (COG-UK) said they are not familiar with any data to suggest kids have more transmissibility than adults. COG-UK has examined the genetics of more than 160,000 cases of coronavirus in the UK and is constantly watching how the virus evolves to see whether any of the mutations are important. They said there is more data is needed to make any comments on how it affects specific groups. 

So, in short, we need more data (story of our life). Making sweeping policy changes, like closing schools, is still unfounded in the US (in my humble opinion). We will see what the UK (and other countries) decide regarding schools soon. 

Love, YLE 

Variant info: https://virological.org/t/preliminary-genomic-characterisation-of-an-emergent-sars-cov-2-lineage-in-the-uk-defined-by-a-novel-set-of-spike-mutations/563

Nervtag meeting minutes: https://khub.net/documents/135939561/338928724/SARS-CoV-2+variant+under+investigation%2C+meeting+minutes.pdf/962e866b-161f-2fd5-1030-32b6ab467896?t=1608470511452

More meeting minutes on the three analyses: https://m.box.com/shared_item/https%3A%2F%2Fapp.box.com%2Fs%2F3lkcbxepqixkg4mv640dpvvg978ixjtf/view/756964987830

SAGE meeting minutes dec 22 https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/948606/s0991-sage-meeting-74-covid-19.pdf

Categories
National changes Testing Texas update

National Update

Looks like we’ve hit our peak in the U.S.? Unfortunately not yet. We won’t start seeing the “true” holiday impact until mid- January. 

You may remember my post (back in April, I think) showing that test and case numbers are dependent on human behavior. In Texas, for example, daily case counts are much lower on days with a thunderstorm or tornado warning because testing sites close due to inclement weather. Case counts are highest on Tuesdays and lowest on Saturday/Sunday/Mondays. Reporting 7- or 14-day averages takes care of these day-to-day fluctuations. 

The same is true for the holiday season; it’s basically a really long weekend in terms of case and testing numbers. Facilities and labs have been inconsistently open, reporting is delayed, places are catching up, etc. You can see a dip in the graphs, but this is due to human behavior (rather than true reduced transmission). We won’t see the holiday impact until reporting has stabilized. It’s irresponsible to make conclusions from case, test, and death data right now. 

Right now, a much more reliable metric is hospitalizations. Hospitals are open 24/7 and, by now, have rigorous, systematic, and completely separate reporting systems than testing/case data. Because hospitalizations lag cases, we have a pretty good idea of whats been happening with cases behind closed doors. 

Unfortunately, hospitalizations are not looking good. Across the U.S., there are 123,614 COVID19 patients hospitalized right now. This is the highest it’s ever been. 

Not all places are equal though.

The Midwest continues their downward trend. Not one Midwest state reported an increase in hospitalizations since Christmas. 

The South, on the other hand, is responsible for 50% of the country’s hospitalizations. This is mainly driven by the high Texas hospitalizations. Also, the South just has more people than the Midwest or Northeast. 

Texas Hospitalizations by Trauma Service Area (TSA)

After we adjust for population, though, the West and Northeast is in worse shape than the South (but not by much) and closing in on Midwest’s peak. The West’s numbers are mainly due to Southern CA where some hospitals literally (not figuratively) have no more ICU beds.

The way we “define” hospitalizations is also changing compared to the beginning of the pandemic. The threshold for sending someone home is much lower than in the past. For example, some hospitals will send someone home with a 90% O2 level, which wouldn’t have happened prior to the pandemic or in the past few months when hospitals had beds. So, in reality, the hospitalization numbers are underestimated compared to hospitalization rates in the past. 

Nonetheless, hospitalization is the best metric we have right now. Continue to keep an eye on this number until other metrics stabilize.

Love, YLE

Data Source: Covid Tracking Project, which never ceases to amaze me with their clean, state-level data. And our dashboard at www.texaspandemic.com