Coronavirus (COVID-19): state of the epidemic - 18 February 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 since 5 January 2022, hospital and ICU occupancy figures now include patients with Covid-19 cases confirmed by either PCR or LFD. Historical figures have been updated retrospectively from 9 January 2022.

Similarly, Covid-19 admissions to hospital (including for children and young people) now include patients with Covid-19 cases confirmed either by PCR or LFD. Historical figures have been updated retrospectively from 5 January 2022. Please note that admissions to ICU only include PCR confirmed Covid-19 cases.

In the week to and including 16 February, daily Covid-19 hospital occupancy fluctuated. NHS boards reported 912 patients in hospital or in short stay ICU on 16 February with recently confirmed Covid-19, compared to 934 on 9 February. This is an overall 2% decrease. However, the last four days leading up to 16 February saw an increase from 868 to 912 Covid-19 patients in hospital. This compares with 2,053 patients in hospital at the peak in January 2021 (Figure 8).

Combined ICU occupancy (including short and long stay) has decreased to 25 patients on 16 February, a decrease of 9 patients or 26% compared to 9 February. The number of combined ICU occupancy remains lower than the peak of 172 ICU patients recorded in January 2021. There were 13 patients in short stay ICU on 16 February, compared to 21 a week previously. This is a decrease of 8 patients. The number of long stay ICU patients (more than 28 days) has continued to plateau in the week leading up to 16 February (Figure 8)^[33].

Admissions to hospital have continued to decrease over the last week, with 550 admissions to hospital for people with confirmed Covid-19 in the week to 12 February compared to 671 in the week to 5 February. This is a 18% decrease over the last week, and compares to 1,163 weekly hospital admissions during the most recent peak in the week leading up to 10 January (Figure 9)^[35]. The latest data from PHS shows 17 new Covid-19 patients admitted to ICU in the week to 15 February, compared to 25 in the week to 8 February. This is a 32% decrease, and compares to 57 weekly ICU admissions during the most recent peak in early January 2022 (Figure 9)^[36].

According to data from the PHS Education Dashboard, the three-week rolling average number of Covid-19 related hospital admissions for those aged under 22 peaked in the three-week period leading up to 19 January 2022 at an average of 144 admissions, which was higher than previously seen in the pandemic. While remaining at a high level, average hospital admissions related to Covid-19 in children and young adults have decreased among those aged younger than 12 in the three weeks leading up to 9 February compared to the previous three-week period leading up to 2 February. Among those aged between 12 and 21, average hospital admissions remained at similar levels compared to the previous three-week period.

The highest rolling three-week average of Covid-19 related hospital admissions among children and young people as of 9 February, were observed amongst those aged 1 or younger, followed by those aged 5 to 11, 2 to 4, and 12 to 17. The lowest weekly case rates were seen among those aged 18 to 19 and 20 to 21^[40]. These figures refer both to young patients in hospital because of Covid-19 and with Covid-19.

In the three-week period from 12 January to 1 February 2022, almost 16% of patients have a length of stay in hospital of between 24 and 48 hours each week. There has been a steady decrease of patients having a length of stay of 48 hours or longer each week over this three-week period. It is important to note that the length of stay in hospital can be influenced by a variety of factors including age, reason for admission, co-morbidities and hospital pressures^[41].

While it may be helpful to compare hospital occupancy 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 death figures are not directly comparable across the four nations. For more information see UK Government website.

The seven-day average hospital occupancy in Scotland per 100,000 population was 16 patients in the week to and including 15 February 2022. The seven-day average hospital occupancy per 100,000 in the same period for other UK nations was as follows^[42]:

• England: 18 per 100,000
• Northern Ireland: 27 per 100,000
• Wales: 21 per 100,000.

In Scotland, there was a daily average of 1 hospital admissions per 100,000 population in the week to and including 12 February 2022. Seven-day average hospital admissions per 100,000 in the same period for other UK nations were as follows^[43]:

• England: 2 per 100,000
• Northern Ireland: 2 per 100,000
• Wales: 1 per 100,000.

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 Covid deaths. 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 decreased by 33%, or 39 deaths, to a total of 79 deaths in the week leading up to 13 February, compared to 118 in the week leading up to 6 February. This figure is 88% 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^[44].

When it comes to Covid-19 related deaths across age groups in the week to 13 February, the number of deaths decreased among all age groups with people aged over 45 compared to the previous week (the week to 6 February) (Figure 10). There was one death among those under age 44 in the week to 13 February in the age group 15 to 44, but the number of Covid-19 related deaths among the younger age groups remain low. National Records of Scotland publish a weekly detailed analysis on deaths involving Covid-19 in Scotland in their weekly report^[45].

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 13 February 2022, deaths from all causes were 3% below average levels for this time of year. This constitutes the sixth week in a row where deaths were below average^[46].

Deaths data from England, Northern Ireland, Scotland and Wales use different methodologies, so they cannot be directly compared. Additionally, deaths within 28 days of positive has been updated on 1 February 2022 to include deaths following the most recent episode of infection, using the new episode-based case definition in England. For more information see UK Government website.

There were 2 average daily deaths per one million population in the week leading up to 16 February 2022 in Scotland. In the same time period, average daily deaths for the other UK nations were as follows^{[47] [48]}:

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