The latest REACT-1 study shows what many experts and health professionals feared would happen in the UK without mitigations: a higher number of infections in households with children is driving the rise of infection in the 65+ age group. Analysis of the REACT-1 study results by Dr Deepti Gurdasani.

First published in November 2021.

REACT-1 is a study by Imperial College London scientists that monitors coronavirus infection levels over time.

REACT-1 results from today:

  • highest SARS-CoV-2 prevalence since the study started in May 2020;
  • very high prevalence in primary and secondary school kids;
  • higher infection in households with children;
  • increase in AY.4.2 variant to 11% end October;
  • 4x increase in the South West of England – due to Immensa scandal.

REACT-1 shows the overall prevalence of SARS-CoV-2 was higher than in any previous round of REACT-1 since May 2020. It estimates that ~1.2 million people were infected on any day towards the end of October. Swab positivity declines towards the end of October coinciding with half-term.

The study finds the highest prevalence of infection ~5.7% among primary and secondary school age children, with increased risk for those living with children. They say this is driving the rise of infection in the 65+ age group where prevalence has doubled between September and October.

There is a 4x increase in positivity in the South-West that is very likely linked to the Immensa scandal.

This figure says everything:

It is clear:

  1. that schools are driving transmission substantially;
  2. this is driving up infections in more vulnerable groups ultimately translating to more hospitalisations and deaths.

Much of this is down to the lack of mitigations and vaccination in children.

We see declines in infection in children, but also reflected in other age groups around half-term. Shows a clear picture of impact of school holidays on transmission among children and in the community.

Unfortunately these are likely to be short-lived as school re-open.

REACT-1 concludes that there is risk to vulnerable children and household contacts. It says that accelerated vaccination of children is likely to make a difference. So far children’s vaccination has been very slow, and delaying offering this appears to have had huge negative impact.

The harm done by multiple government policies, and lack of oversight of contract provision is very clear in this study. Despite vaccines, it is shameful that we have the highest infection rates we have ever had.

A lot of this is down to very high rates of infection in children (due to lack of mitigations and vaccination) spilling over into other age groups, which has also resulted in higher hospitalisation and death rates than this time last year (when we didn’t have vaccines!)

The huge surge in the South West appears to be down to the Immensa scandal, which the government is still denying had any impact. This almost certainly led to loss of life, as have our exceptional policies of almost no mitigations and huge delays in vaccination in schools.

Who is accountable? The JCVI’s minimisation of COVID-19 in children, with clear repeated narratives of infection being ‘advantageous’ for children and important for the UK COVID-19 pandemic has almost certainly been fatal for many.

There is so much the government could be doing to avoid over 1,100 deaths per week and unsustainable pressure on the NHS: simple measures that don’t disrupt people’s lives, but ensure they can get healthcare, and children can go into schools protected without disruption.

But will it?

Also worth adding about the AY.4.2 variant: we don’t know much about it but the consistent growth (even if not very fast) is worrying. The last UKHSA report showed a significantly higher household secondary attack rate compared to Delta (more likely to transmit to contacts).

At this point, anything outcompeting Delta, and showing a higher proportion of contacts infected worries me, given how transmissible and able to escape Delta is.

PMP Magazine


Dr Deepti Gurdasani, Senior Lecturer in Epidemiology, Statistical Genetics, Machine Learning, Queen Mary University of London.

Going Further:

  • REACT-1 round 15 interim report: Exponential rise in prevalence of SARS-CoV-2 infection in England from end September 2021 followed by dip during October 2021 [PDF] | Imperial College London

  • Text: This piece was first published as a Twitter thread and turned into the above article on 4 November 2021 with the purpose of reaching a larger audience. It has been minorly edited and corrected, and published with the author’s consent. | The author of the tweets writes in a personal capacity.
  • Cover: Adobe Stock/freshidea.

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