THREAD: Where are we with Covid-19 in England now that the new tiers have started? TLDR: nowhere good and things are quite scary. 1/13

Firstly, overall cases are rising sharply. Over 40,000 people tested on 21st Dec, tested positive - just in *England*. (this is "specimen date", not "reporting date"). 2/13

Looking at it regionally, the SE is still the epicentre of new cases. London cases per 100K people now *much* higher than anywhere in the North in Oct/Nov. BUT everywhere is going up. This is *not* just a Southern problem. 3/13

Hospital admissions reflect case patterns - except that the NE & Yorks never dropped very low before plateauing. London, SE and East shooting up past the NW and Midlands. This is only to 21st Dec - probably much worse already :-( . 2nd plot shows how fast London is rising. 4/13

Overall hospital occupancy as of 24th December was only a few hundred people below the April peak. It's probably already above, or will be within a day or two. And, unlike April, we are not controlling the rise yet. 5/13

Spare a thought for NHS frontline workers - already exhausted & traumatised - facing a rapidly worsening situation. We don't have unlimited docs, nurses or other frontline staff. They need our support. Why is this not in the media? 6/13

Will the new tiers be enough? In a word - no. Especially not after Christmas. The Tier 4 areas (inc the new tier 4) are shooting up still, but tiers 2 and 3 rising substantially too. This is not under control. 7/13

Let's look at the new Tier 3 and 4 areas (mostly South and midlands) - and how they compare to the old Tier 3 areas (mostly North and midlands). Look how fast new Tier 3 places are going up. With old Tier 3 going up *and* new variant spreading - we need national tier 4. 8/13

Christmas *will* have made everything worse - how can it not have? Test turnaround times have been getting much longer again, fewer people will get tests at Xmas, reporting will be slower... for the next week at least we cannot rely on the case data. Flying pretty blind. 9/13

Hospital data when it gets updated again (last updated on 24th) might help *but* reflects infections from 10 days or so earlier. But we desperately need an answer as to whether tier 4 is enough to bring R below 1. I don't know when we'll know. 10/13

And this is especially concerning as schools & unis due to start back in a few weeks. New paper from @LSHTM & @imperialcollege warned that Tier 4 with open schools & unis very unlikely to be enough.…

We need a radical rethink of how we control the virus. The new variant is seriously bad news and, especially with Christmas, we are unlikely to have stopped it spreading across the country. Unfortunately I think the next 4-6 weeks are going to be pretty awful. 12/13

There really is no point in sugar coating it. If it weren't for the vaccine(s) I'd be seriously scared out of my wits. I still am pretty scared. The govt urgently needs a new plan - with national tier 4 being only the start. 13/13