Are hospital admissions still the best way to gauge the COVID crisis?


MADRID/LONDON (Reuters) – Using the variety of folks in hospital with COVID-19 to gauge the severity of the pandemic might not give an correct image in the Omicron period as an increasing number of sufferers with the virus are being admitted for different causes, some scientists say.

Governments have targeted on hospitalisations to decide the want for restrictions however the knowledge doesn’t usually differentiate between folks admitted due to COVID-19, and those that check optimistic on wards throughout routine checks.

“Say you are having a coronary heart assault, come into hospital, and find yourself testing optimistic,” stated Paul Hunter, a professor of drugs at Britain’s University of East Anglia.

“Is COVID-19 the reason for your coronary heart assault? We understand it could possibly be. But we won’t know at a person stage,” he stated.

In Britain, the Omicron variant has pushed case numbers to report highs because it emerged at the finish of November however the variety of hospital sufferers with COVID-19 on mechanical air flow has barely modified, authorities knowledge reveals.

The variety of folks with COVID-19 in hospital total has risen, however not proportionately with the rise in infections, whereas intensive care unit (ICU) occupancy is little modified, in accordance to British Health Minister Sajid Javid.

With loss of life charges comparatively steady regardless of the Omicron surge, some international locations corresponding to Spain are whether or not to undertake new methods of monitoring the virus, although epidemiologists say shifting the aim posts doesn’t change the reality hospitals and their workers are still overloaded with COVID-19 victims.

Data from New York this month confirmed that 42% of sufferers hospitalised with COVID-19 have been so-called incidental instances, folks admitted for different causes and solely discovered to be contaminated throughout routine testing.

British Prime Minister Boris Johnson even stated final week that as many as 30% of individuals in hospital with COVID-19 really change into contaminated whereas hospitalised – one thing Hunter partly attributed to Omicron’s overwhelming contagiousness.


Hunter stated intensive care occupancy was a greater measure of the actual severity of an outbreak: “If you are in an ICU mattress with COVID, you are most likely there due to COVID, relatively than simply with it.”

In Italy, regional governments have argued that the nuances inside the statistics on coronavirus hospitalisation might warrant overhauling their monitoring programs to higher mirror the comparatively decrease severity of Omicron.

Italy’s Health Ministry stated final week it was analyzing a draft proposal from the areas to exclude asymptomatic folks hospitalised for different causes from the COVID admissions knowledge.

Critics denounced the proposal as a non-scientific bid by the areas to keep away from hitting “crimson zone” ranges of hospitalisations that will set off tighter coronavirus curbs.

“The change in standards can’t be a make-up operation that disguises the tragic nature and scale of the pandemic,” Filippo Anelli, president of Italy’s nationwide federation of docs, stated on Friday.

“The numbers of contaminated folks admitted to non-critical areas and intensive care items, nevertheless they’re counted, are overloading hospitals … and exhausting the professionals who’ve been managing the pandemic for 2 years,” he stated.

The committee of scientists advising the Italian authorities really useful on Saturday that the present standards measuring the unfold of COVID-19 be maintained. The Health Ministry stated, nevertheless, that the “preliminary” debate was ongoing.

The query of how to classify sufferers in hospital who’re largely asymptomatic is ready to preoccupy European nations as they give the impression of being to ease curbs – though it stays unclear to what extent Omicron might have exacerbated their medical situations.


In Ireland, 58% of these in hospital testing optimistic didn’t have any signs, in accordance to the Infectious Diseases Society of Ireland, which checked out about 45% of all optimistic COVID-19 instances admitted to Irish hospitals on Jan. 11.

It discovered greater than 70% of these hospitalised with COVID-19 didn’t want oxygen remedy, suggesting they suffered from a much less extreme type of illness than beforehand seen.

In Denmark, about 15% of individuals hospitalised folks over the course of 18 months had examined optimistic for coronavirus, however displayed no signs and had been admitted for different causes, a research printed this month by the nation’s prime infectious illness authority the Statens Serum Institut confirmed.

In Spain, in the meantime, greater than 18,800 folks presently in hospital have COVID-19, a 79% enhance on earlier peaks.

However, 25% to 40% of these testing optimistic in hospital weren’t being handled for COVID-19, in accordance to a report in newspaper El Pais this month.

“40% of sufferers hospitalised in Madrid with optimistic PCR exams aren’t (being admitted) for COVID,” Madrid’s deputy well being counsellor Antonio Zapatero stated final week on Twitter.

But Simon Clarke, affiliate professor in mobile microbiology at Britain’s Reading University, stated even when COVID-19 ranges in hospital partly mirrored the prevalence of the virus in the inhabitants, they ought not be dismissed.

“There’s this narrative that when you come into hospital and decide up COVID it is like a free an infection and infrequently dismissed, whereas that is not true: you come into hospital for a purpose, you are weak, and it is seemingly COVID will worsen your situation,” Clarke stated.

“There wants to be a recognition that no matter admission purpose, folks in hospital with COVID is strain on the hospitals.”

(Reporting by Clara-Laeila Laudette in Madrid, Emilio Parodi in Milan, Nikolaj Skydsgaard in Copenhagen and Alistair Smout in London; Writing by Clara-Laeila Laudette; Editing by Josephine Mason and David Clarke)

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