ICU

Why Are Deaths in Highly-Vaccinated Denmark Approaching a Record High?

Denmark has become a standout sceptical hero of late, having lifted all restrictions at the start of the month and reclassified Covid as no longer “an infection critical to society”. The Government has even put out a fact check to counter misinformation about its approach – the right kind of fact check, countering actual misinformation.

The Danish shift in strategy was all the more remarkable in that it came at a time when reported infections and deaths in the country were at or close to an all-time high. Infections have since plateaued, underlining that it was the right move. However, given that the near-record deaths have come two years in and despite high levels of vaccination, it is worth digging into the data to see if there’s anything more they can tell us.

U.K. and Denmark (OWID)

The first thing that stands out is how high hospital admissions are, though as the Government says, many of these will be incidental admissions or mild cases. In addition, while hospital admissions are much higher in Denmark than the U.K., the number of patients in hospital is around the same (see below, plus the admissions (above) appear to be peaking), which presumably reflects mild cases with short stays.

ICUs Empty of Covid Patients

The number of patients being admitted to ICU for Covid in the U.K. (excluding Scotland) fell to as little as two in one day last month, according to data from the Intensive Care National Audit and Research Centre (ICNARC). MailOnline has more.

Although the figures may be slightly higher after being revised for a time lag, [ICNARC]’s Head Statistician said towards the end of January, admissions would still be “in the region of 20-30 per day”.

Speaking to the Sunday Times, Sir David Spiegelhalter, said: “The Omicron wave saw a huge rise in cases, and a moderate rise in hospitalisations.

“Since more than half of ICU admissions have not been vaccinated, this suggests an intrinsically milder virus rather than just increased protection from vaccination.'”

In contrast to January last year, when more than 400 patients were admitted into ICU for Covid in one day at a peak of the new wave, recent figures seem to suggest that Omicron, in most cases, is a milder strain.

The new report from ICNARC also found that the “percentage of patients admitted to critical care with confirmed COVID-19 that were unvaccinated decreased from 75% in May 2021 to 47% in October 2021” but increased to 61% in December.

According to the latest ONS data, the risk of death involving coronavirus, when age-adjusted, is consistently lower for those who have had at least three vaccine doses compared with unvaccinated people. 

On February 3rd there were 478 patients in mechanically ventilated beds; this figure was above 4,000 in January last year.

One mystery is why Israel’s Omicron wave is proving a rougher ride in terms of ICU admissions and deaths compared to ours.

Worth reading in full.

80% of Serious Covid Cases Are Fully Vaccinated – Israel Hospital Director

Professor Yaakov Jerris, the Director of a coronavirus ward in an Israeli hospital, has said between 70% and 80% of the serious cases in his hospital are vaccinated and that the vaccine has “no significance regarding severe illness”. Israel National News has the story.

Are Israeli hospitals really overloaded with unvaccinated Covid patients? According to Professor Yaakov Jerris, Director of Ichilov Hospital’s coronavirus ward, the situation is completely opposite.

“Right now, most of our severe cases are vaccinated,” Jerris told Channel 13 News. “They had at least three injections. Between seventy and eighty percent of the serious cases are vaccinated. So, the vaccine has no significance regarding severe illness, which is why just 20% to 25% of our patients are unvaccinated.”

Why are these figures so different to the England figures, where the latest ICNARC data show that in December, 61% of ICU patients were unvaccinated? Is Professor Jerris’s experience unusual, or is he mistaken, or is there something wrong with the England figures? Or is there a real difference between the two countries for a reason not yet explained?

Israel is one of the most vaccinated countries in the world, having moved early with third doses and more recently fourth doses. Yet its current daily Covid death toll is the highest it’s been during the pandemic. Is it because many of the deaths are incidental Covid deaths from other causes, or is there some other reason? In light of what Prof. Jerris says, how many of them are vaccinated? There are many questions still to be answered.

Worth reading in full.

Israel Covid ICU Admissions Hit Record Level Despite High Vaccination Rates and Early Booster Campaign

Covid ICU admissions in Israel hit record levels this week, reaching 130.5 per million on January 26th 2022, topping a previous peak of 127.1 per million on January 19th 2021. Why is this, when Omicron is milder and most of the country is now vaccinated whereas last winter almost none of it was?

At the previous peak only 6% of the country were double-vaccinated. Now 65% are, plus 46% are triple-vaccinated and around 8% are quadruple vaccinated. Israel was also first out the block with its booster campaigns. If the purpose of the vaccination programme was to relieve pressure on the health service – and recall it was supposed to be a two-dose vaccine, not three or four doses – it’s hard to see how it has helped much.

Having said that, the number of patients in ICU is still only around two thirds of the peak level, suggesting the stays may be shorter.

Also, deaths are currently less than half the peak – though as Dr. Noah Carl points out, this is higher than you would expect from 95% effective vaccines.

Unprecedented Low Hospital Demand: NHS Data Show a Quarter of ICU Beds Unoccupied in Mid-January

There follows a guest post by our in-house doctor, who notes the NHS has revealed that almost a quarter of ICU beds in English hospitals are unoccupied in the middle of January, which is unprecedented in recent history – normal ICU bed occupancy at this time of year is well over 90%. Why then the continued narrative of fear and doom in some quarters?

On Wednesday January 19th, Boris Johnson announced in the House of Commons that the majority of ‘Plan B’ restrictions would end in England on January 26th. Any objective analysis of the U.K. data confirms the information from South Africa in early December in relation to the mild nature of Omicron was correct. Finally, the Government has been persuaded that our South African colleagues did know what they were talking about.

After a brief incursion onto the territory of Libertaria, the forces of Hysteria have been repelled and British citizens partially regain their sovereignty. Time to hang out the bunting and open the champagne? I think not.

Reaction by lockdown zealots to removal of societal restrictions has been tediously predictable. In an echo of July 2021, a range of commentators are again using compliant mainstream media outlets to predict imminent catastrophe if societal restrictions are lifted and to condemn the Government for putting public safety ‘at risk’. Before looking at warnings of doom in more detail, I will briefly examine the data which have led to the volte face by the Government. I will not dwell too long on these numbers as most readers will already be aware that the “nailed on tsunami of admissions” has simply failed to show up. Again.

Graph 1 shows the most important information this week from the Primary Diagnosis spreadsheet. Readers will recall this shows the total numbers of patients in hospital on vertical orange bars, versus the number of people in hospital with acute Covid on blue bars. The ratio between the two is depicted by the grey line. Notice the blue bars (people ill with Covid) are falling on the right-hand side of the graph, as is the ratio. So, when the BBC reports that Covid inpatient numbers are about 15,000 and static, the true picture is there are fewer than 8,000 patients and the numbers have been falling for the last 10 days.

Graph 1

Graph 2 shows the true numbers for London, which front runs the rest of the U.K. True numbers of Covid patients are 40% of the daily reported figure and numbers have been falling steadily since January 4th.

The One Thing That Might Persuade Me to Get Jabbed

In my most recent Spectator column, I describe my recent bout of Covid and why it has almost – almost – persuaded me to get vaccinated.

While I was ill I read the following sentence in an article by Ed West, which put the wind up me: “An unvaccinated man in his fifties has about a one-in-150 chance of dying if he catches Covid, and is much more likely still to be hospitalised, put in ICU and left prematurely aged.” He didn’t give a source for the one in 150 figure, but that was on the high side, surely? Concerned, I commissioned a professor of epidemiology to calculate Omicron’s infection fatality rate for my Daily Sceptic website and he came up with 0.04 per cent, or one in 2,500, a figure that includes the vaccinated. Slightly higher for men in their fifties no doubt, but not one in 150.

However, the second part of Ed’s sentence – that the unvaccinated are more likely to end up in ICU than the vaccinated – is probably right. Was that where I was headed? I know, I know. My chances of being hospitalised, let alone put on a ventilator, were low, assuming it was Omicron. But what if it wasn’t? Or what if it was and I just got unlucky? I could picture the newspaper headline: “Unvaccinated lockdown sceptic in intensive care with severe Covid.” It wouldn’t be long before the BBC’s Clive Myrie was standing at the end of my bed, microphone in hand, asking me how I felt about not being jabbed.

This, for me, is the best argument against remaining unvaccinated. Not the risk of being in ICU and left ‘prematurely aged’ or worse, but the absolute certainty that if that happened I would be ridiculed mercilessly by my enemies. Totally undeserved, of course. I’m dubious about the effectiveness and durability of the Covid vaccines and concerned about the lack of medium- and long-term safety data, but I think of myself as a ‘vaccine sceptic’ rather than an ‘anti-vaxxer’ – and even that is over-stating it, as I’ve got nothing against the MMR. Nevertheless, you can bet your bottom dollar that if I was hospitalised with the virus I would be branded a “leading anti-vaxxer” and pilloried accordingly. In the eyes of the vaccine enthusiasts, anyone who expresses the slightest smidgen of doubt is a science-denying ‘conspiracy theorist’ and if they’re laid low by COVID-19 that’s divine justice.

Worth reading in full, obviously.

Stop Press: I’ve just been interviewed by Brendan O’Neill for his podcast to mark the second anniversary of the Free Speech Union. You can listen that here.

Most Covid Patients Discharged from ICU Make a Good Recovery, Study Finds

Mounting evidence suggests that long Covid is not the great danger it was initially claimed to be. Research by the ONS indicates that, 12 weeks after infection, the percentage of people still reporting symptoms is only 2.5 points higher than the background rate.

What’s more, several studies have found little or no difference in rates of long Covid between those who were seropositive and those who were seronegative. One French study found that believing you’d had Covid was a better predictor of long Covid symptoms than actually testing positive for Covid antibodies; the only exception being anosmia.

This suggests that many, perhaps most, cases of long Covid are psychosomatic. Thanks to all the media attention on long Covid, people may have been inclined to exaggerate their symptoms; to report things they normally wouldn’t have done.

Fortunately, the vast majority of people who catch Covid get only mild symptoms; at worst, they’re bed-ridden for a few days with a nasty cold. However, a small percentage do end up in hospital, or even the ICU. And most of these individuals experience debilitating symptoms for the rest of their lives – right? 

Apparently not, finds a new Italian study. Alberto Zangrillo and colleagues identified all the Covid patients admitted to their hospital in Milan during the first wave, who’d spent at least one day on a ventilator. Of these 116 patients, 53% survived. The authors followed up 56 of the 61 survivors one year later, and asked them to complete a questionnaire.

Note: none of the survivors died during the intervening year; 5 simply refused to answer the questionnaire. Among those who did answer, the average age was 56 and 89% were male. 

So what did the researchers find? The great majority of patients reported good quality of life. 82% had no difficulty walking; 95% had no difficulty washing or dressing; and fully 84% had no difficulties with their usual activities.

Non-trivial fractions did report some pain/discomfort and feelings of anxiety/depression. However, these patients were in the minority. Overall, 61% reported no pain or discomfort; and 64% had no feelings of anxiety or depression.

And note: some of the patients who did report these things may have experienced them before they got Covid. We can’t be sure the fractions reporting no symptoms would be 100%, or even close to 100%, in the absence of a pandemic. For example, 52% of patients in the sample had at least one pre-existing health condition.

36 out of 56 patients were given a chest CT scan, to assess the extent of lung damage. Only 4 had signs of pulmonary fibrosis (severe lung damage). Though it should be noted that other studies have reported higher rates of lung damage at one year follow-up. 

Zangrillo and colleagues’ findings should be encouraging to those who’re recovering from severe Covid. One year after admission to the ICU, only a minority of patients had symptoms serious enough to affect their day to day life.

Of course, there’s much that can and should be done to prevent people landing in the ICU, such as voluntary vaccination and precision shielding. But it’s reassuring to know that many of those who do wind up there, and are subsequently discharged, can expect to make good overall recoveries.    

If Omicron is So Mild, Why Are ICU Admissions Skyrocketing in Australia?

There’s little doubt that Omicron is causing milder disease in the U.K., as well as in South Africa, Denmark, and many other places.

However, what’s going on in Australia? ICU admissions have shot up as Omicron has taken hold (see above), as have deaths (see below). Bear in mind 77% of the population are double-vaccinated and it’s the middle of summer there.

Now, it could be just that there are so many more Omicron infections in the formerly ‘Zero Covid’ country than there were of previous variants, and that despite being milder sheer numbers are causing the spike. Indeed, Delta positivity peaked at 1.3% whereas Omicron positivity is at 22.5% and still rising (see below). With an infection rate up to 20 times higher, the fact that ICU patients are still below the Delta peak (for now) suggests it is milder and there’s just a lot of it.

Covid ICU Occupancy is Less Than a Quarter of its Peak Last January and Declined Further in the Past Two Days. Time to Declare the Pandemic Over

Despite the record numbers of reported infections in the U.K. and hospital admissions rising in the past few weeks (though up to half are incidental admissions being treated for something else), Covid ICU occupancy has barely budged since the summer, and even declined in the past two days. In London, total Covid hospital patients also declined in the past two days. This time last year, with a third of the infection rate (according to the ONS) Covid ICU occupancy nationally was three and a half times higher, at around 3,000 patients, rising to a peak of 4,000 two weeks later.

Whether due to greater population immunity, a milder strain, or better treatments, this is obviously very welcome. It is also confirmation that the pandemic is well and truly over – we are basically now expending vast resources tracking the spread of a cold – and it is time for the Government to acknowledge this fact, lift all restrictions, end all emergency powers, and bring the state of emergency to an end.

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.