Coronavirus (COVID-19) state of the epidemic 25 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 23 February, daily Covid-19 hospital occupancy increased. NHS boards reported 1,093 patients in hospital or in short stay ICU on 23 February with recently confirmed Covid-19, compared to 912 on 16 February. This is an increase of 181 patients, or 20%, from the previous week, and compares with 2,053 patients in hospital at the peak in January 2021 (Figure 8). This corresponds with an increase in the percentage of people estimated to test positive for Covid-19 in Scotland in the week ending 20 February 2022, as seen in the ONS Covid-19 Infection Survey.

Combined ICU occupancy (including short and long stay) has remained unchanged at 25 patients on 23 February compared to 16 February. The number of combined ICU occupancy remains lower than the peak of 172 ICU patients recorded in January 2021. There were 11 patients in short stay ICU on 23 February, compared to 13 a week previously. This is a decrease of 2 patients. There were 14 patients in long stay ICU on 23 February, compared to 12 on 16 February. This is an increase of 2 patients (Figure 8)^[33].

Admissions to hospital have increased over the last week, with 686 admissions to hospital for people with confirmed Covid-19 in the week to 19 February compared to 619 in the week to 12 February. This is an 11% increase over the last week, and compares to 1,171 weekly hospital admissions during the most recent peak in the week leading up to 10 January (Figure 9)^[36]. Similarly to daily hospital occupancy, this corresponds with an increase in the percentage of people estimated to test positive for Covid-19 in Scotland in the week ending 20 February 2022, as seen in the ONS Covid-19 Infection Survey.

The latest data from PHS shows 19 new Covid-19 patients admitted to ICU in the week to 22 February, compared to 20 in the week to 15 February. This compares to 57 weekly ICU admissions during the most recent peak in early January 2022 (Figure 9)^[37].

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 143 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 continued to decrease by 13% in the three-week period to 16 February (110 average weekly admissions), compared to the previous three-week period to 9 February (126 average weekly admissions) ^[41]. These figures refer both to young patients in hospital because of Covid-19 and with Covid-19.

In the three-week period leading up to 16 February, the rolling average of hospital admissions decreased among those aged younger than 12, and 18 to 19-year-olds. The highest rolling three-week average of Covid-19 related hospital admissions among children and young people as of 16 February, were observed amongst those aged 1 or younger, followed by those aged 5 to 11, 12 to 17, and 2 to 4. The lowest weekly case rates were seen among those aged 20 to 21 and 18 to 19^[42].

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 one million people was 181 patients in the week leading up to 22 February 2022. The seven-day average hospital occupancy per one million population in the same period for other UK nations were as follows^[43]:

• England: 165 per one million
• Northern Ireland: 282 per one million
• Wales: 183 per one million

In Scotland, there was a daily average of 18 hospital admissions per one million people in the week leading up to and including 19 February 2022. Seven-day average hospital admissions per one million population in the same period for other UK nations were as follows^[44]:

• England: 18 per one million
• Northern Ireland: 18 per one million
• Wales: 7 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 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 6%, or 5 deaths, to a total of 75 deaths in the most recent week leading up to 20 February, compared to 80 in the week prior leading up to 13 February. This figure is 89% 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^[45].

When it comes to Covid-19 related deaths by age groups in the week to 20 February, the number of deaths decreased in the age bands 65 to 74 and 75 to 84 compared to the previous week (the week to 13 February) (Figure 10). However, there was an increase from 33 to 39 deaths among those aged 85 and older. There were three deaths among those under age 45 in the week to 20 February, 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^[46].

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 20 February 2022, deaths from all causes were 9% below average levels for this time of year. This constitutes the seventh week in a row where deaths were below average^[47].

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 23 February 2022 in Scotland. In the same time period, average daily deaths for the other UK nations were as follows^{[48] [49]}:

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