ICNARC

Latest NHS Data Suggest Omicron No Worse Than a Bad Cold

We’re publishing a guest post by our in-house doctor looking at the latest NHS data, including ICU data. Conclusion: Omicron hospital admissions in the community are declining and are unlikely to result in severe COVID-19.

Before diving into the numbers this week, I’d like to give a big shout out to Ms. Kate Josephs CBE, formerly the Director of the Cabinet Office Covid taskforce. According to the Telegraph, which broke the story of her leaving party, she “literally wrote the rules” in relation to societal restrictions.

Ms. Josephs took to twitter yesterday to apologise for attending a leaving drinks party on December 17th 2020, when she had been substantially responsible for putting the rest of the country under house arrest. She writes about being “truly sorry” for attending the event – she clearly means she’s sorry for being exposed.

The Telegraph has a helpful timeline graphic showing the dates of the many known social events in Whitehall against a backdrop of prevailing restrictions at the time. I had no idea being a civil servant was such fun! It is interesting that the parties all cluster round periods of maximum lockdown. The brief period in the summer of 2020 was a social desert for civil servants. Maybe they were all on extended holidays?

I love a good laugh, so I’d genuinely like to thank Ms. Josephs. I haven’t laughed so much since Dominic Cummings took a 20-mile drive to test his eyes. By being exposed, this formerly faceless apparatchik has performed a valuable public service. Her hypocrisy reveals the absurdity of what Lord David Frost calls “Covid Theatre” – pointless petty regulations enforced so that the Government appears to be “doing something”. If Kate Josephs really believed in December 2020 that covid was a serious threat to her health, would she have turned up to a drinking session in a cramped Whitehall office? I think not.

Latest Covid Hospital Data: Community Admissions Falling in London, Tailing Off Nationally

We’re publishing the latest update from our in-house doctor, who’s pored over the latest NHS England and ICNARC data packets so you don’t have to. Contrary to some hysterical reports in the media yesterday, it’s actually good news. Community admissions for Covid are falling in London and tailing off across England – and of those classified as being in hospital ‘due to Covid’, 40% were admitted for something else and only have Covid incidentally.

When I was a medical student, a novel called The House of God was required reading. It relates the experience of the fictional American Dr. Roy Basch in his first year as a qualified doctor. The book contained lots of good advice for surviving the junior doctor ordeal including several ‘Rules of the House’. Rule 13 states: “The delivery of good medical care is to do as much nothing as possible.”

Surprisingly often in medicine, doing nothing is the best option. One of my former mentors frequently advised me to “do as little as possible for as long as possible” – his point being that over-hasty intervention is not just unnecessary, but can be actively damaging. This transgresses a key principle of medicine Primum, non nocere – first, do no harm.

Having looked at lots of data from multiple sources over the last few weeks, I am coming to the view that the entire country would be better off in almost every way if doctors stopped ‘doing things’ for a while – particularly if they stopped testing asymptomatic people for the variant du jour.

I will discuss the available information and explain why I have arrived at that conclusion.

Firstly, the admissions from the community in London (as the leading edge of the Omicron wave).

Graph 1 shows the daily Covid admissions from the community in the blue bars vs the same time last year on the brown line. Readers will recall that Professor Sir Chris Whitty warned at the Downing St press conference on December 15th that a big increase in Covid hospital admissions after Christmas was “nailed on”.

It looks like we are waiting for Godot, because the numbers are actually falling, not rising and are currently less than a third of levels a year ago.

According to the Latest ICU Data, the Unvaccinated Are Not ‘Overwhelming the NHS’

We’re publishing a guest post by our in-house doctor today looking at the latest ICNARC data. This is the weekly audit of NHS ICUs. It only covers the period up to November 14th, but suggests that unvaccinated Covid patients in ICU are not placing an unmanageable strain on the NHS, as some health professionals have claimed. On the contrary, as of November 15th, there were only 400 unvaccinated Covid patients in ICUs across the whole of NHS England and they were outnumbered by vaccinated patients.

Today the Prime Minister will be making a decision on further measures to limit social interactions by British citizens. Information leaked from SAGE appear to indicate the ‘scientific advisers’ to the Government are pushing him to reinstitute more aggressive social controls in an effort to control the virus.

As Monday and Tuesday (the 27th and the 28th) are bank holidays, there will be no release of Covid related data on the NHS website. Therefore, the public will be able to see even less information than usual about the quantifiable evidence on which their liberty is being curtailed.

On Christmas Eve, the Intensive Care National Audit and Research Centre (ICNARC) released an updated weekly report containing useful new information. Readers may recall that until recently, ICNARC had not produced an audit of vaccination status in ICUs. We now have data up to November 15th and this week a more granular analysis has been published. The link to the report is here and the relevant pages are 44-48.

I urge readers to examine this report for themselves in tandem with my analysis as a guide to interpretation. There has been so much misinformation around vaccines and severe Covid on both sides of the argument that a high-quality ICNARC audit is invaluable in assessing quantifiable known facts about the situation.

Readers should note that all patients included in this audit were suffering from the Delta variant. The time period ends on November 15th, well before Omicron became established in the U.K. Therefore, the debate around whether Omicron is more or less severe than Delta is irrelevant for the purposes of this commentary.

Figure 27 on page 46 shows the changing proportions of vaccinated people in ICU units between May and November compared to vaccination status in the general U.K. population. Over this period vaccination uptake increased in the community from around 60% partially or double vaccinated in May to over 80% double vaccinated in November.

Majority of Covid ICU Patients in October and November Were Vaccinated

Contrary to the claims made by Dr. Rachel Clarke and Professor Stephen Powis last month and used to blame the unvaccinated for the mounting troubles of the NHS, new data out this week shows that the majority of Covid ICU admissions in October and November were among the vaccinated, not the unvaccinated.

The latest report from ICNARC shows that of Covid ICU patients in England, Wales and Northern Ireland, 50.5% in October and 50.7% in November were double vaccinated. Add to that the 2.8% in October and 1.8% in November who were single-vaccinated and you get overall vaccinated proportions of 53.3% in October and 52.5% in November. That compares to 46.7% unvaccinated in October and 47.5% in November. Note that the unvaccinated here includes people who received a vaccine less than 14 days prior to the positive Covid test, so includes some (an unknown number) who are actually single vaccinated.

This is not what the public has been led to believe by some prominent medics and newspapers.

Covid Hospital Admissions are Falling in England, as are the Total Number of Covid Patients – and Omicron Looks Unlikely to Change That

There follows a guest post by the Daily Sceptic’s in-house doctor, a former NHS consultant now in private practice. He’s looked at the latest NHS England data and points out that there are fewer than half as many Covid patients in English hospitals than there were this time last year, not 14 times as many, as was claimed recently.

On Friday November 26th, the South African Institute for Communicable Disease released a statement in relation to the Covid variant now referred to as Omicron.

The variant had been first detected on November 12th from specimens collected in Gauteng Province and the molecular structure was characterised by November 22nd. The statement from the South African Institute on November 26th considered that the Omicron variant did not meet the WHO criteria for being either a ‘variant of interest’ (VOI) or a ‘variant of concern’ (VOC). Yet less than 24 hours later, the WHO had classified the Omicron variant as a ‘variant of concern’.

The definitions of variant classification are clearly laid out by the WHO. Classification of a ‘variant’ usually proceeds stepwise, from VOI to VOC. Classification of a VOI requires data collection to verify different effects of the specific variant and upgrading it to a VOC requires evidence that the variant is definitely evading prior immunity or making humans more severely unwell than previously.

I cannot find any evidence in the open sources to date that shows infection with the Omicron variant carries any greater risk of hospitalisation or death than the currently dominant Delta variant. One obvious possible reason for this absence of evidence is that the variant was only identified very recently. Given the known time lag between infection, the development of severe disease and hospitalisation, there has not been sufficient time to assess whether this particular new strain is clinically significant or not. It might be, but we just don’t know.

Simply put, it is not yet clear whether this new variant is a bad one (more infectious and more lethal) or a good one (more infectious but less severe). Opinion is clearly divided on how this situation will develop. Dr. Angelique Coetzee, the Chair of the South African Medical Association, speaking on Marr on Sunday 28th said that so far all the known patients infected with Omicron had very mild symptoms and none of them had been admitted to hospital.

Looking at the ‘charts that matter’ this week, we see a continual reduction in Covid admissions to hospitals (graph one). It’s important to note that all of these admissions are likely to be the Delta variant rather than the Omicron variant.

Graph one