Coronavirus (COVID-19): state of the epidemic - 18 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 and occupancy figures presented in this section may include patients being admitted and treated in hospital for reasons other than COVID-19.

In the week to 16 March, daily Covid-19 hospital occupancy continued to increase. NHS boards reported 1,999 patients in hospital or in short stay ICU on 16 March with recently confirmed Covid-19, compared to 1,509 on 9 March. This is an increase of 490 patients, or 32%, from a week previously, and an increase of 773 patients, or 63%, compared to two weeks previously (2 March). This compares with 2,053 patients in hospital at the peak in January 2021 (Figure 10).

Combined ICU occupancy (including short and long stay) has increased to 41 patients on 16 March, an increase of 12 patients or 41% compared to a week previously on 9 March. The number of combined ICU occupancy remains lower than the peak of 172 ICU patients recorded in January 2021.

This recent increase consists of more patients in short-stay ICU, while the number of long-stay ICU patients continues to fluctuate at low levels. There were 32 patients in short stay ICU on 16 March, compared to 19 a week previously (9 March). This is an increase of 13 patients. There were 9 patients in long stay ICU on 16 March, compared to 10 a week previously (9 March) (Figure 10)^[44].

Please note, Public Health Scotland figures on Covid-19 related hospital and ICU admissions from 16 March cover less than a 24-hour period. This is due to a reoccurrence of the technical issue from earlier in the week, meaning data has not been received since 6 P.M. on 15 March.

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 12 March there were 977 admissions to hospital for people with confirmed Covid-19, which is a decrease of 3% compared to a week previously (1,004 hospital admissions in the week to 5 March) but an increase of 26% compared to four weeks previously (773 hospital admissions in the week to 12 February). This compares to 1,237 weekly hospital admissions during the most recent peak in the week leading up to 10 January 2022 (Figure 11)^[47].

After a period of fluctuating admission numbers, the weekly number of admissions to ICU has increased in the most recent week. The latest data from PHS shows 32 new Covid-19 patients admitted to ICU in the week to 15 March, compared to 23 in the week to 8 March. This is a 39% an increase, and compares to 54 weekly ICU admissions during the most recent peak in early January 2022. This compares to 57 weekly ICU admissions during the most recent peak in early January 2022 (Figure 11)^[48].

According to data from the PHS Education Dashboard, average hospital admissions related to Covid-19 in children and young adults have continued to increase by 19% in the three-week period to 9 March (138 average weekly admissions), compared to the previous three-week period to 2 March (116 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 20 to 21, and the biggest increases were seen among those aged 2 to 4 and 5 to 11. 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^[51].

The highest number of hospital admissions in the week to 8 March were among those aged 80 and over. In the same week, approximately 57% of the hospital admissions related to patients aged 60 or older. This is a slight decrease from 61% in the week to 22 February^[52]. The proportion of patients staying 48 hours or longer was 55% in the week to 1 March, which compares to 57% in the week to 15 February (as reported on 2 March).

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 of patients with confirmed Covid-19 in Scotland per one million people was 314 patients in the week to 15 March 2022. The seven-day average hospital occupancy per one million in the same period for other UK nations were as follows^[53]:

• England: 174 per one million,
• Northern Ireland: 289 per one million,
• Wales: 201 per one million.

In Scotland, there was a daily average of 26 hospital admissions of patients with confirmed Covid-19 per one million people in the week leading up to and including 12 March 2022. Seven-day average hospital admissions per one million in the same period for other UK nations were as follows^[54]:

• England: 24 per one million,
• Northern Ireland: 19 per one million,
• Wales: 8 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 5%, or 6 deaths, to a total of 117 deaths in the week leading up to 13 March, compared to 111 in the week leading up to 6 March. This figure is 82% 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^[55].

The increase seen in the most recent week is mostly due to a high number of deaths among those older than 64. Among those aged 65 to 74, the number of deaths decreased from 21 to 17, but it increased from 34 to 36 deaths among those aged 75 to 84, and from 49 to 54 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^[56].

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 ending 13 March, the total number of deaths registered in Scotland was 1,207. This was 12 deaths fewer than the five year average for this week, or 1% below average levels^[57].

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 within 28 days of a positive Covid-19 test per one million population in the week leading up to 16 March 2022 in Scotland. In the same time period, average daily Covid-19 related deaths for the other UK nations were as follows^{[58] [59]}:

• England: 1 per one million,
• Northern Ireland: 2 per one million,
• Wales: 1 per one million.