Latest @ICNARC report was released last night. Here’s a summary on behalf of @ICS_updates and @COVID19actuary, with thanks to @NicolaMedical for holding virtual pen last week.
Update includes 449 new patients (8,699 total); 717 new outcomes (6,860 total).
Full report 👇. /1 https://t.co/pWV8voieuL
— stuart mcdonald (@ActuaryByDay) May 16, 2020
Daily admissions remain low, though it’s increasingly clear that the peak’s run off will be slower that the ascent. Indeed it will be interesting to see whether there is continued decline over the coming weeks or if we plateau. /2 pic.twitter.com/SmaHE05M7o
— stuart mcdonald (@ActuaryByDay) May 16, 2020
Little change to the geographic distribution. Reminder that three of the networks with most admissions are in London. /3 pic.twitter.com/qC6Hin0TS1
— stuart mcdonald (@ActuaryByDay) May 16, 2020
Table 1 shows demographic characteristics, compared to pneumonia caused by other viruses.
More admissions in 10 weeks that 2017-19 combined!
Groups at higher risk of needing ICU care include:
– males
– non-whites
– more deprived groups (bottom 40%)
– overweight/obese. /4 pic.twitter.com/686PdPSspF— stuart mcdonald (@ActuaryByDay) May 16, 2020
Table 2 shows medical history. Compared to viral pneumonia patients, ICU admissions for COVID-19 are far less likely to need assistance with daily living (91% don’t) or have very severe comorbidities (8% do).
It is not just people “at death’s door” who fall victim. /5 pic.twitter.com/HT5OHc2aq1
— stuart mcdonald (@ActuaryByDay) May 16, 2020
The age and sex distribution remains striking. Two thirds of the ICU patients are men aged 40-80. More men in their 40s have needed ICU care than women in their 60s! /6 pic.twitter.com/jbJutA8VZV
— stuart mcdonald (@ActuaryByDay) May 16, 2020
As in previous weeks it is clear that Asians, Blacks and Other ethnicities are over-represented.
Compared to white ethnicity, ICU admission is
– 50% more likely for Asians
– 90% more likely for blacks
– over four times as likely for other ethnicity. /7 pic.twitter.com/FOOJexvsBl— stuart mcdonald (@ActuaryByDay) May 16, 2020
BMI picture is little changed. ICU admissions are about what we’d expect for healthy weight or under. There are fewer ICU admissions than expected for the ‘overweight but not obese’ group and more for obese, especially very obese. /8 pic.twitter.com/6Kb3e1IdVu
— stuart mcdonald (@ActuaryByDay) May 16, 2020
Table 8 shows outcomes data by individual variables. It’s an interesting summary but we have multivariable analysis available now which is much more informative. /9 pic.twitter.com/G9FxVRF1Vf
— stuart mcdonald (@ActuaryByDay) May 16, 2020
Table 8 shows outcomes data by individual variables. It’s an interesting summary but we have multivariable analysis available now which is much more informative. /9 pic.twitter.com/G9FxVRF1Vf
— stuart mcdonald (@ActuaryByDay) May 16, 2020
Hazard ratios👆continued:
– only the most deprived 20% have statistically significant extra mortality risk compared to the least deprived group
– BMI is significant, chance of survival falls as BMI risesThere are other more medical breakdowns available in the report. /12
— stuart mcdonald (@ActuaryByDay) May 16, 2020
To reiterate, tweets 4-8 show relative risk of being admitted to ICU.
Tweets 9-12 show relative risk of surviving, once admitted to ICU.
Some groups are doubly at risk, e.g. Asians.
Some are more likely to need ICU but at no extra risk once admitted, e.g. Males. /13
— stuart mcdonald (@ActuaryByDay) May 16, 2020
I’ll wrap up there with thanks to @ICNARC for these informative reports and best wishes to all those working in critical care or elsewhere in the NHS who have themselves been unwell with this disease. Thanks you. /14https://t.co/hMMNXW8RDT https://t.co/dpK8NpXSbD
— stuart mcdonald (@ActuaryByDay) May 16, 2020
