We’re publishing another guest post by our in-house doctor, formerly a senior NHS panjandrum, this one looking at the latest hospital data. Turns out, staff absences are the reason London hospitals are under pressure, not a surge in Covid admissions due to the Omicron variant.
How quickly things change. The Daily Sceptic has asked me to provide a brief update on the unfolding situation after the Christmas weekend. Less than two weeks ago at the Downing Street press conference, Professor Chris Whitty said “by the time we get to Christmas I expect the majority of people going to hospital to be Omicron cases”. In response to a journalist’s question about Omicron, he said: “This is a really serious threat. How big we don’t know but everything we do know is bad.”
So, how bad is it?
Hospital admissions are rising, but not necessarily due to Omicron, according to Chris Hopson, the CEO of NHS providers.
Talking to chief executives this morning, the sense is that admissions are rising but not precipitately so. What’s particularly interesting is how many chief executives are talking about the number of asymptomatic patients being admitted to hospital for other reasons and then testing positive for Covid.
Trusts are not, at the moment, reporting large numbers of patients with Covid type respiratory problems needing critical care or massively increased use of oxygen, both of which we saw in January’s Delta variant peak.
Hopson is in error on one point – the peak in January was the Alpha variant. But then attention to detail is optional for NHS executives. On the other points around the reduced number of admissions and the rising proportion of incidental Covid cases, the published data support his remarks.
In this brief update on the unfolding ‘nailed on’ Omicron catastrophe, I will present a few graphics illustrating what the public are permitted to know so far.
First, the figures for the Christmas weekend. Graph One shows the admissions from the community with Covid in London hospitals in December of this year and last. It compares figures from December 2020 (the brown line) with admissions for December 2021 (the blue bars). If the confident predictions about imminent catastrophe from SAGE are to come to pass, the Omicron variant really needs to up its game. So far, it is failing to deliver. The current admission rate is less than half that associated with the Alpha variant at this time last year.
Graph Two shows the real problem in London. The blue line represents staff absences from London hospitals up to December 19th. This is the most up-to-date data we have. The NHS collects information about absenteeism on a daily basis, but will not be providing the next public update until January 13th. The brown line represents patients testing positive for Covid in London Hospitals (bear in mind, as Hopson points out, the brown line is a gross overestimate due to incidentally positive cases).
It can clearly be seen that there are far more staff off work ‘due to Covid’ than there are patients in hospital ‘with Covid’. How many have tested positive but are asymptomatic? How many have the sort of mild symptoms we’d usually associate with a cold, which in normal years would not require absence from work, nor any tests to confirm the presence of a seasonal upper respiratory tract infection? My central point is that the current pressure in London may be because we’re sending staff home for extended periods when they’re not unwell, rather than an influx of severely ill patients. Simply put, is it possible that an over reaction to a perceived threat is causing the problem rather than the Omicron variant per se.
Graph Three provides further context in relation to the overall inpatient burden in English Hospitals across the whole pandemic episode. Even taking the figures at face value and discounting the known over estimations in relation to primary diagnosis, it is clear that the 8,474 patients currently in hospital with positive Covid tests is substantially lower than the 19,783 in hospital on the same day last year – this equates to a Pritchard ratio of 0.42.
All other observable metrics such as ICU occupancy, data from the ZOE app and, of course, the now negligible death rate from Covid points to a much better situation than at this time last year. Hospital admission rates expressed as a percentage of positive tests in the community continue to fall from a peak of 9.6% in February to 2.1% now. Patients testing positive for Covid occupy 6% of NHS beds, compared to 22% this time last year. The widely predicted re-emergence of winter flu has also failed to materialise – cases of flu are still 95% below the numbers seen in 2019-20.
Despite this stable looking picture across the piece, multiple expert commentators have yet again been quoted in the mainstream media forecasting imminent catastrophe and demanding complete societal lockdown. There have been some reasonable points made around the possibility that the data over the Christmas weekend may be subject to a reporting lag, and justifiable concerns about the possibility that intergenerational mixing over Christmas could lead to more cases occurring in vulnerable older people. The SAGE meeting notes from December 23rd make reference to these possibilities. However, the general tone and content of public remarks is at variance with the available public information.
For example, Professor Danny Altmann, an immunologist based at Imperial College London, told MailOnline that Boris’s decision not to impose any further restrictions seems to show the “greatest divergence between expert clinical/scientific advice and legislation”. I fail to understand this view. His remarks are congruent with the letter published in the Lancet earlier this year by 122 self-identified experts accusing the Government of conducting a “dangerous and unethical experiment” by lifting restrictions on July 19th, which of course turned out to be nothing of the sort.
Professor Altman knows far more about immunology than I do. It would be enlightening if he could explain to the Daily Sceptic why experts like himself are so constantly antagonistic towards the Government, given that over 85% of the U.K. population have now been vaccinated against Covid – rising to 95% among the over-60s – on top of substantial natural immunity generated by infections over the last 12 months.
Other self-identified experts from Independent SAGE are promoting a subtle rebrand of societal restrictions by referring to legalised social limitations as ‘health protections’. To my mind this is an overt politicisation of science – readers should be very concerned by such Orwellian language.
When I hear expert advice that does not correlate with observational experience I lean on the motto of the Royal Society – Nullius in verba, roughly translated as ‘take no man’s word for it’. To that end and to enable non-experts like myself to assess the data for ourselves, it would be helpful if the NHS could release daily updates on Covid discharges from hospital and details about the length of stay of Covid patients. This information is available and provided to all NHS chief executives in daily email briefings, so why are taxpayers not permitted to see it? If scientists and public health doctors are pressurising the Government to restrict citizens’ right to make their own choices around freedom of movement and association, isn’t there an onus on the NHS to provide all relevant information relating to that advice?
Further data packets should be released on Thursday. I will update readers later in the week.
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