Coronavirus (COVID-19): state of the epidemic - 11 March 2022

Severe Illness: Hospitalisation, ICU and Deaths

Hospital and ICU Occupancy and Admissions

Following changes in the Covid-19 Case definition and changing testing policies on 5 January 2022, hospital and ICU occupancy figures include patients with Covid-19 cases confirmed by either PCR or LFD from 9 February and onwards. Prior to this date, it only included cases confirmed by a PCR test. Hospital and ICU occupancy both include reinfection cases.

Similarly, Covid-19 admissions to hospital (including for children and young people) include patients with Covid-19 cases confirmed either by PCR or LFD from 5 January and onwards. Prior to this date, it only included cases confirmed by a PCR test. Hospital admissions include reinfection cases. Please note that admissions to ICU only include PCR confirmed Covid-19 cases.

Please note that the Covid-19 admissions figures presented in this section may include patients being admitted and treated in hospital for reasons other than COVID-19.

In the week to 9 March, daily Covid-19 hospital occupancy increased. NHS boards reported 1,509 patients in hospital or in short stay ICU on 9 March with recently confirmed Covid-19, compared to 1,226 on 2 March. This is an increase of 283 patients, or 23%, from a week previously, and an increase of 416 patients, or 38%, compared to two weeks previously (23 February). This compares with 2,053 patients in hospital at the peak in January 2021 (Figure 10).

Combined ICU occupancy (including short and long stay) remains at similar levels compared to the previous week, with 29 patients on 9 March compared to 28 patients on 2 March. The number of combined ICU occupancy remains lower than the peak of 172 ICU patients recorded in January 2021. There were 19 patients in short-term ICU (28 days or shorter) on 9 March, which is a slight increase from 16 patients on 2 March. There were 10 patients in long-term ICU (longer than 28 days) on 9 March, which is a slight decrease from 12 patients on 2 March (Figure 10)^[37].

According to data from Public Health Scotland, Covid-19 admissions to hospital have increased over the past month, but continue to fluctuate on a weekly basis. In the week to 5 March there were 852 admissions to hospital for people with confirmed Covid-19, which is a slight increase compared to four weeks previously, with 817 hospital admissions in the week to 5 February. This compares to 1,236 weekly hospital admissions during the most recent peak in the week leading up to 4 January 2022 (Figure 11)^[40].

The number of Covid-19 admissions to ICU has decreased over the past month, but also appears to be fluctuating on a weekly basis. The latest data from PHS shows 16 new Covid-19 patients admitted to ICU in the week to 8 March, compared to 25 admissions four weeks previously in the week to 8 February. This compares to 57 weekly ICU admissions during the most recent peak in early January 2022 (Figure 11)^[41].

According to data from the PHS Education Dashboard, average hospital admissions related to Covid-19 in children and young adults have increased slightly by 2% in the three-week period to 2 March (112 average weekly admissions), compared to the previous three-week period to 23 February (109 average weekly admissions). While remaining at a high level, this is lower than the previous peak in hospital admissions among children and young people in the three-week period to 19 January (155 average weekly admissions). This increase was seen among all age bands apart from among those aged 12 to 17, and 20 to 21. These figures refer both to young patients in hospital because of Covid-19 and with Covid-19, and link to both PCR and LFD test results^[44].

The highest number of hospital admissions in the week to 1 March were among those aged 80 and over. In the same week, approximately 56% of the hospital admissions related to patients aged 60 or older. This is an increase from 52% in the week to 8 February^[45].

While it may be helpful to compare hospital occupancy and admissions between the UK nations, any comparisons must be made with caution. Definitions are not consistent across the nations and data are not reported daily by each nation. Data from Scotland, Wales and Northern Ireland is updated retrospectively if errors come to light, while data from England is not revised retrospectively, but instead is corrected in the following day's data update. This means Covid-19 hospital occupancy and admissions figures are not directly comparable across the four nations. For more information see UK Government dashboard.

The seven-day average hospital occupancy in Scotland per one million people was 239 patients in the week to 8 March 2022. The seven-day average hospital occupancy per 1 million in the same period for other UK nations were as follows^[46]:

• England: 152 per one million,
• Northern Ireland: 275 per one million,
• Wales: 173 per one million.

In Scotland, there was a daily average of 22 hospital admissions per one million people in the week leading up to and including 5 March 2022. Seven-day average hospital admissions per one million in the same period for other UK nations were as follows^[47]:

• England: England: 20 per one million,
• Northern Ireland: 20 per one million,
• Wales: 6 per one million.

Deaths

After a period of decreasing numbers of Covid-19 deaths throughout the last two months of 2021, the week to 23 January 2022 saw a peak of 146 deaths where Covid-19 was mentioned on the death certificate. This came after three weeks of increasing numbers of deaths, largely consisting of fatalities among those aged 45 or above, as Covid-19 deaths among younger age groups have remained at similar low levels throughout the pandemic.

The overall number of Covid-19 deaths has increased by 38%, or 30 deaths, to a total of 110 deaths in the week leading up to 6 March, compared to 80 deaths in the week leading up to 27 February. This figure is 83% lower than the peak in 2020, when the week ending 27 April saw a total of 663 deaths where Covid-19 was mentioned on the death certificate^[48].

The increase seen in the most recent week is mostly due to a higher number of deaths among those older than 64. Among those aged 65 to 74, the number of deaths increased from 9 to 21, while it increased from 30 to 35 deaths among those aged 75 to 84, and from 34 to 47 deaths for those aged 85 and older. Age groups younger than 45 continue to experience low levels of Covid-19 related deaths while the number of deaths are fluctuating at higher levels among those aged 45 and older (Figure 12). National Records of Scotland publish a weekly detailed analysis on deaths involving Covid-19 in Scotland in their weekly report^[49].

Excess deaths are the total number of deaths registered in a week minus the average number of deaths registered in the same week over the previous five years (excluding 2020). Measuring excess deaths allows us to track seasonal influenza, pandemics and other public health threats. Excess deaths include deaths caused by Covid-19 and those resulting from other causes.

In the week leading up to 6 March, deaths from all causes were 3% above average levels for this time of year. This is the first week where deaths are above average since the week to 2 January 2022^[50].

Deaths data from England, Northern Ireland, Scotland and Wales use different methodologies, so they cannot be directly compared. The death figures below are the daily numbers of people who died within 28 days of being identified as a COVID-19 case by a positive test. The definition of a Covid-19 case aligns with the case definition used in each nation. Deaths following a possible reinfection are included from 1 February for England and Northern Ireland, and from 1 March in Scotland. For more information see UK Government website.

There were 3 average daily deaths per one million population in the week leading up to 9 March 2022 in Scotland, by the date the death was reported. In the same time period, average daily deaths for the other UK nations were as follows^{[51] [52]}:

• England: 2 per one million,
• Northern Ireland: 2 per one million,
• Wales: 2 per one million.