Ymx wrote: ↑Wed Apr 06, 2022 5:44 pm
Indeed. Case numbers are pretty much meaningless over this period.
With covid v For covid is significant enough to distort covid hospital admissions - unless there is an excess hospitalisations metric somewhere??
And the other key metrics being ICU admissions and excess deaths. Though as it happens there is plenty of natural variance in excess deaths. And in fact excess death rates is going to be distorted for the next few years over the previous covid peaks of eg March/Apr 2020.
Hospitalisation numbers are pretty much fixed as most hospitals are running at c98% bed occupancy so they can't really go any higher so there isn't really a metric for this! If there are no beds then hospitalisation rates can't increase unless discharges really go up and this won't happen as the care home/social care sector is under even greater pressure. Better measures are length of A&E waits, waiting times/lists for non emergency operations, cancellations of ops at short notice, diagnosis/treatment of cancer patients within the target timescales, etc. These are where the 'excess activity' shows up when beds are full.
If hospitals are filling with covid patients then the actual number of available beds goes down as you need to split hospital and patients into positive and negative areas, emergency admissions need to be isolated until tested, etc. Also when covid is high then staff absence is high and if you have no nurses then you have to close beds/wards as you cannot safely provide a service. Also staff often need to be split into separate teams for each area thus reducing flexibility for the staff who are at work. Also the infection control requirements - masking, gowning, etc - all takes time and requires more staff in covid positive areas.
Also advances in covid treatment has meant that many fewer patients are intubated and those that are are only intubated if absolutely necessary. In fact intubation caused more problems than it solved for many patients. Most covid patients are now maintained in wards due to improved medicines and oxygen therapies so comparing covid ICU numbers with those earlier in the pandemic provides a false picture.
Deaths due to covid are greatly reduced due to vaccines and better hospital treatments based on medics now knowing how best to treat covid and better therapeutics. If deaths start climbing even close to where we were before then start panicking because this will indicate either a greatly reduced vaccine protection and/or big increase in covid transmissibility, as we have seen with omicron BA2. Excess deaths will naturally flatten out over time given the high number of deaths in last two years (c160,000),many of whom were the most vulnerable, plus as you say there is natural variation in trends - for example we have seen excess deaths reduce dramatically and dip below 5 year average about this time of year for the last 2-3 years during the pandemic probably because although covid deaths have been there other deaths usually happening due to transmissible respiratory viruses ie flu, have fallen dramatically due to lock downs and other PH protections ie wearing masks, we have taken when covid waves have been high.
