1.THREAD on Covid, children, failure, bafflement and anger.

TLDR: English policy has failed children, and then everyone else, I am baffled why people aren't angrier. I am angry.

23 tweet rant.

2. By the time schools broke up in July, cases in children were incredibly high, there was mass education disruption and we were going through a massive delta surge (aided by the Euros).

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3. US, Canada, France & Israel were already vaccinating 12-17 year olds to protect them from Covid *and* to protect their education in the autumn.

From June onwards, data was firming up, mainly from USA, about the v low risk of the vaccine & higher risks of Covid

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4. Over July and August, almost all European countries followed suit - and most cited the need to protect education *and* the benefits to the child given the expected wave coming in Autumn.

Germany was one of the last ones to change its mind in mid August - on clinical benefit.

5. In August, the US saw large surges in child Covid cases - particularly in states where vaccination rates were low and school mitigations were few.

By September, US had clear evidence how vaccinated teens were 10x less likely to need hospital vs their unvaccinated peers

6. From US & Israel, it was obvious that delta could rip through schools.

It was obvious that that vaccines PLUS other mitigations (e.g. masks, ventilation) could address that.

Over the summer both US & European CDCs recommended vaccines+mitigations in schools.

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7. Many people in the UK (and elsewhere) were begging govt to put mitigations in for the new term *and* vaccinate teens.

https://blogs.bmj.com/bmj/2021/08/20/christina-pagel-schools-a-gaping-hole-in-the-english-covid-strategy/


8. Meanwhile, JCVI released a series of vague statements - eventually ok-ing vax for 16/17 yr olds in mid August - *just in time* for school but did not recommend vaccination for all teens.
The CMOs did recommend vax for teens but not until 13 Sept.

9. I say "vague statements" because so far there is no detailed evidence or analysis provided for their recommendations.
Contrary to their code of conduct, there are no minutes of Covid meetings since Feb.
There is no evidence / analysis provided for the 1 dose strategy

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10. These incredibly consequential decisions, contrary to global practice, remain shrouded in secrecy.

Our peer-reviewed paper in @EditorJRSM provided a detailed risk benefit analysis of full vax course in teens & showed large benefit at current levels.
https://www.rsm.ac.uk/media-releases/2021/new-analysis-shows-benefits-of-offering-two-doses-of-covid-19-vaccine-to-children-aged-12-17-clearly-outweigh-risks/

11. We should demand no less tranparency from JCVI.

Instead, we had (and still have) high profile members of JCVI warning of vaccine risks but *not* covid risks and wrongly downplaying importance of vax in reducing transmission https://www.thetimes.co.uk/article/children-should-know-about-tiny-risk-from-covid-vaccine-insist-experts-5c5nwffxt


12. The upshot is that despite knowing full well of the risks of a large new wave in children in September, we did nothing.

Schools were promised CO2 monitors - where are they? where are the resources to *act* on poor ventilation?

13. Once vaccines were approved for teens, their roll out has been abysmal.

England is only offering vaccine through schools - Scotland also has walk in centres.

We are far behind. Neither supply nor demand are the issue - it's a failure of planning or lack of urgency or both

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14. And we are seeing the costs right now. Infections have soared in our children - 8% had Covid in the week to 9th October.

Hospitalisations in 6-17 year olds are rising steeply, despite vaccination in 16 & 17 yr olds.

15. 2 weeks ago, ~200,000 children were off school due to Covid - who knows how many now.

Long Covid cases are already increasing in young people after summer surges. Kids will suffer too - Israel seeing high demand now for its child long covid clinics after high summer cases

16. We also still don't yet know the long term impacts of Covid on health - but we know it can affect other organs.

Covid can cause heart damage, it can cause long term breathlessness and it has been linked to increased risk of developing diabetes - inc in children.

17. Unions are begging for safer schools.
https://www.fenews.co.uk/press-releases/77687-education-unions-call-for-additional-safety-measures-in-schools

The impact of vaccination in 16/17 yr olds vs 11-15 yr olds is barn door obvious from official govt data.

18. And not only are rates in 10-14yr and 5-9 yr olds rising again and higher than they've been, but all age groups are now rising.

In fact cases are rising *fastest* in the over 60s. And hospital admissions are rising a lot again.

19. And incidentally the booster programme is still going slowly - we are doing maybe 150K doses a day, compared to the 400K doses a day we were doing in Jan/Feb.
We're getting there but too slowly.
And inequalities in vax coverage persist. Of course.

20. So we are heading into winter with huge numbers of infections in children and glacial vax roll out, vulnerable over 60s where cases are already going up, increasing numbers of people living with long covid and a super stressed NHS.

What the fuck are we doing?

21. Absolutely none of this was inevitable - instead it was entirely preventable.

We needed to vax teens, put mitigations in schools and keep some mitigations for adults too.

Half term will help - let's use that opportunity!

https://www.ft.com/content/34582534-4510-4d45-bcba-2f9e04005309?shareType=nongift

22. As we head into winter with v high cases I think we need to use half term to:
accelerate vax in teens
roll out CO2 monitors everywhere & HEPA filters where necessary
resintate masks in secondary schools
tell parents what symptoms of covid in kids are (!)
start govt plan B

23. Finally - where is the accountability? where is the anger?

Our govt, the JCVI & public health officials downplaying spread in schools, have failed our children and they've failed us.

And yes, I'm fucking furious. And no, I'm not sorry for swearing. /END