A screw in the tread rarely announces itself. It goes in, the rubber grips the shank, and the tyre holds pressure well enough that nobody notices for weeks. All that time the screw is doing damage that has nothing to do with air. The tread flexes around it on every rotation, so the shank works back and forth in its own hole and saws at the steel belt underneath, and water follows it down. Steel corrodes, and corrosion travels along a cord rather than staying where it started.
By the time the tyre gives up, the problem is no longer a hole. It is a rusted patch of belt several times the size of the screw, and a crown that has quietly lost its structure across a region rather than at a point. That does not deflate slowly. It lets go, usually on the first piece of road fast enough to load it properly. Which is why a screw is worth acting on while the tyre is still at full pressure. Taken out in the first week or two, the tread is sound and a patch closes it permanently. Left through a couple of months of deliveries and short journeys around Kingsland High Street, there is very often nothing left to repair.
A 4x4 or a big SUV makes a blowout harder rather than easier. We carry proper equipment for exactly that and stock in the larger sizes, so the wheel comes off safely, the replacement goes on and it is balanced where the car is stopped, in Stoke Newington or anywhere else you have managed to pull up. Level in De Beauvoir, sloping in Stoke Newington: we set the car straight first. Underground parking in Balls Pond or Kingsland is worth flagging.

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Kingsland High Street runs deliveries all day past the Ridley Road market, and the gutters along that stretch collect exactly the sort of hardware that ends up in a tyre: screws, staples, short nails, the leavings of unloading and small works. Most of it goes in without a sound. The permit streets around De Beauvoir are no better, because a car sits there for days between short trips and nobody ever walks around it. If you have not looked properly at your treads since the spring, it is worth two minutes with the wheels turned onto full lock.
A car parked off Dalston Lane had a screw standing proud in the crown with the tyre still at its correct pressure. It came out, the channel was clean, and a patch went in from the inside where it belongs.
Another driver had known about a screw since the spring and topped the tyre up whenever it asked. With the tyre off the rim, the belt was rust stained for the width of a hand around the entry point, and no repair would have been honest.
A crown weakened this way finally split at speed on the A10. The tyre was destroyed, which is the usual ending, and the driver was on a replacement rather than a repair.
Yes, and the fact that it is holding air is exactly what makes people leave it alone. The screw is cutting the belt underneath and letting water in whether the tyre is flat or not. Dealt with early it is a straightforward repair. Left alone it turns into a tyre you have to buy.
Because the steel belt is what holds the crown of the tyre in shape at speed. Corrosion spreads along the cords and breaks the bond between steel and rubber, so the weakened area grows well beyond the original hole. When it eventually fails it fails as a burst rather than as a leak.
Better not, unless you are ready for a tyre that empties in seconds once it is out. Leave it where it is, keep the pressure up and let us take the wheel off. The injury can then be looked at from behind, where the state of the belt actually shows itself.
There is no exact figure, but the difference between days and months is enormous. Within a week or two we almost always repair. After a season of driving on it, the belt around the hole is usually corroded far enough that a replacement is the only defensible answer.
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