Coronavirus (COVID-19) state of the epidemic 26 May 2022

Covid-19 Related Severe Illness and Death

Please note that patient testing requirements changed on 1 April 2022, which will mean a reduction in asymptomatic cases of Covid detected and a corresponding decrease in ascertained Covid-19 related occupancy and admissions. In addition, from 1 May 2022, testing changed from asymptomatic population-wide testing, to targeted testing for clinical care and surveillance. Therefore data should be interpreted with caution and over time comparison should be avoided. For more information, please see this resource from the NHS.

Please note that hospital admissions data in Scotland is dynamic and subject to daily revisions. We continue to see a large number of mostly upward revisions which is likely due to infections being identified after patients have been admitted to hospital. As the greatest revisions are likely to impact the latest two weeks of data, we have moved to reporting with a two-week lag. You can still see the latest data in Figure 7 but we advise caution in interpreting the latest trends.

Covid-19 occupancy and admissions figures presented in this section may include patients being admitted and treated in hospital or ICU for reasons other than COVID-19.

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 include reinfection cases.

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. Admissions to ICU only include PCR confirmed Covid-19 cases.

Hospital and ICU Occupancy

In the week to 22 May, daily Covid-19 hospital occupancy in Scotland appears to be on a decline; however, this is to be interpreted with caution due to recent testing changes. NHS boards reported 663 patients in hospital or in short stay ICU on 22 May with recently confirmed Covid-19, compared to 845 on 15 May. This follows a period of sharply increasing hospital occupancy numbers which peaked on 2 April with the highest figure seen throughout the pandemic at 2,406 patients (Figure 6)^[20].

NHS boards also reported 13 patients in short-stay or long-stay ICU on 22 May, compared to 17 on 15 May. Due to the changes in testing policy, any interpretations of trends need to be made with caution (Figure 6).

Hospital and ICU Admissions

In the week to 3 May, Covid-19 admissions to hospital^[33] in Scotland appear to be on a decline; however, this is to be interpreted with caution due to recent testing changes. NHS boards reported 600 admissions on 3 May, compared to 735 admissions the previous week ending 26 April. This follows a period of sharply increasing numbers of Covid-19 related hospital admissions, reaching the highest levels seen throughout the pandemic in the week to 18 March 2022 (1,677 admissions)^[34]. As noted above, we are continuing to see a large number of daily revisions, so comparisons for the latest two weeks of data have not been made^[35].

In the week to 8 May, there appears to be an increase in the number of new Covid-19 patients admitted to ICU; however, this is to be interpreted with caution due to recent testing changes. There were 21 new Covid-19 patients admitted to ICU in the week to 8 May, compared to 17 in the week to 1 May. This compares to 57 weekly ICU admissions during the most recent peak in early January 2022. As noted above we are currently seeing a large number of daily revisions, so the number of admissions to ICU for the latest two weeks are likely to change (Figure 7)^[36].

The highest number of hospital admissions in the week to 10 May were among those aged 80 and over. In the same week, approximately 68% of the hospital admissions related to patients aged 60 or older. This remains similar to 65% of admissions in the week to 26 April. According to the latest data, 61% of the hospital admissions in the week to 17 May related to patients aged 60 or older. However, the latest data does not have a lag applied to account for revisions^[39].

Average hospital admissions related to Covid-19 in children and young adults data are no longer updated in the PHS Education Dashboard^[40] due to a reduction in the quantity and quality of data available. The last update to the dashboard was on 6 May 2022 and the latest data was summarised in the State of the Epidemic report published on 13 May 2022.

In the period 27 April to 10 May 2022, 62% of Covid-19 hospital admissions stayed longer than 48 hours after being admitted. Analysis from Public Health Scotland on the same time period shows that length of stay tends to increase with age, as 58% of hospital stays for those aged 17 or younger had a length of stay of less than 24 hours, while 77% of hospital stays for those aged 80 or older had a length of stay of over 48 hours^[41]. Please note that length of stay can be influenced by a variety of factors, and that the figures above may be subject to future revisions due to the completeness of discharge summary information. For more information, please see the PHS Weekly report.

Please note that patient testing requirements in Scotland and England started changing from 1 April 2022, with further changes implemented in Scotland on 1 May 2022. Changes covering policies for testing general population and patients in Wales were set out to start the transition from the end of March. In Northern Ireland, testing changes in the general population are being phased out from 22 April, with no immediate change to public health advice. For more information see the following links for England, Wales and Northern Ireland.

Due to the testing differences across the four nations mentioned above, we have removed the four nations comparisons on hospital admissions and occupancy. From 20 May 2022, Department of Health Northern Ireland stopped reporting data on cases, deaths and testing. As a result, the four nation comparison will not be included in future reports.

Covid-19 Related Deaths and Excess Mortality

There were 52 deaths where Covid-19 was mentioned on the death certificate in the week to 22 May. Out of these, there were 29 deaths where Covid-19 was the underlying cause. The number of deaths where Covid-19 was mentioned on the death certificate decreased by 15%, or 9 deaths, compared to the previous week (61 deaths in the week to 15 May).

The 52 deaths where Covid-19 was mentioned on the death certificate in the week to 22 May 2022 is 92% lower than the peak in 2020, when the week ending 26 April 2020 saw a total of 663 deaths where Covid-19 was mentioned on the death certificate^[42]. The number of deaths is higher among those aged 45 and older but is fluctuating on a weekly basis. Covid-19 deaths among younger age groups have remained at low levels throughout the pandemic (Figure 8).National Records of Scotland publish a detailed analysis on deaths involving Covid-19 in Scotland in their weekly data releases and monthly report^[43].

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 22 May, the total number of deaths registered in Scotland was 1,191. This was 13%, or 139 deaths, above the five-year average for this week (Figure 9

Figure 9)^{[44] [45]}. In the same week, the number of deaths from Dementia and Alzheimer's disease were 9 above the previous five-year average for this week, the number of deaths from cancer diseases were 42 above the average, and deaths from circulatory diseases were 29 above the average. Deaths from respiratory disease (not including Covid-19) were 12 below the average. There were 43 excess deaths from other causes^[46].

Recent changes to reporting mean that the number of deaths where Covid-19 was mentioned on the death certificate can no longer be compared across the four nations. In addition, from 20 May 2022, Department of Health Northern Ireland stopped reporting data on cases, deaths and testing. Therefore, we have removed the four nations comparisons of death figures. For more information see the Coronavirus (COVID-19) in the UK dashboard.