The situation in our hospitals is serious and the threat to the NHS is obvious here in London, I live besides Barts hospital and the sirens of ambulances are a feature of every day. But what do the numbers tell us of what is happening? We need not just a medical expert, but one who understands statistics. Thankfully we have Dr Nicola Oliver, who is both. We also have the Covid 19 actuaries on whom we can rely for an independent view of what is happening to us. You can read their bulletins at covid-arg.com
THREAD@ICNARC have published the latest update from critical care units participating in the Case Mix Programme which covers data on patients critically ill with confirmed COVID-19, reported to ICNARC up to 23:59 on 14 January 2021.
1/— Nicola Oliver | Medical Intelligence (@NicolaMedical)
The data reported includes a comparison to the admissions during the first wave. A summary follows on behalf of @COVID19actuary. (The full report can be found here https://t.co/LfXFs1ExOH)
2/— Nicola Oliver | Medical Intelligence (@NicolaMedical) January 16, 2021
There have been increased admissions over the last 14 days compared to the previous two-week time period across all regions. In the last 14 days, the largest numbers were admitted in the London, Midlands, North West, and North East and Yorkshire regions
3/ pic.twitter.com/sTnesd4nO5— Nicola Oliver | Medical Intelligence (@NicolaMedical) January 16, 2021
All areas have now surpassed ICU admissions compared to the first wave.
4/ pic.twitter.com/mfUjZJg3vJ— Nicola Oliver | Medical Intelligence (@NicolaMedical) January 16, 2021
This next figure shows a comparison of the number of new patients critically ill with confirmed COVID-19 by date of start of critical care from 1 March 2020 to 31 August 2020 versus 1 September 2020 to date. Note the steep gradient going into the new year
5/ pic.twitter.com/U4eKFSDZMq— Nicola Oliver | Medical Intelligence (@NicolaMedical) January 16, 2021
The number of patients in critical care is shown here compared to the numbers during the first wave. Note again the steep gradient, as we moved into the new year. The pressure on ICUs is equal to or exceeding that of the first wave
6/ pic.twitter.com/GYZTMoqmQT— Nicola Oliver | Medical Intelligence (@NicolaMedical) January 16, 2021
Admissions for other causes have also been included. As you can see below, the numbers of admissions for acute MI in 2020 compared to previous years is lower.
7/ pic.twitter.com/4KsgMwakji— Nicola Oliver | Medical Intelligence (@NicolaMedical) January 16, 2021
This is not likely to be as a result of fewer MIs occurring, it has been reported that a reluctance to attend for medical care with symptoms of chest pain has a role to play.
8/— Nicola Oliver | Medical Intelligence (@NicolaMedical) January 16, 2021
Of those admitted, almost half are under the age of 60, and, as in the first wave, dominated by males. What will be the impact on a future burden of #morbidity given what we understand about post-intensive care syndrome and #longcovid?
9/ pic.twitter.com/DD1G3f2evu— Nicola Oliver | Medical Intelligence (@NicolaMedical) January 16, 2021
At this stage, there is lower prevalence of very severe comorbidities in those requiring basic respiratory support, but increased prevalence in those requiring invasive respiratory support compared to the first wave
10/ pic.twitter.com/q1BiBA8No2— Nicola Oliver | Medical Intelligence (@NicolaMedical) January 16, 2021
The pressure on ICUs is evidenced here showing that the percentage of admissions that are as a result of an inter-hospital transfer for comparable critical care has risen continuously since September.
11/ pic.twitter.com/U7qJO8X2zz— Nicola Oliver | Medical Intelligence (@NicolaMedical) January 16, 2021
In this figure the report shows us outcomes which have been received for 10,841 (of 14,710) patients. Of these, 4095 have died and 6746 have been discharged from critical care
12/ pic.twitter.com/h0c07Lq5qW— Nicola Oliver | Medical Intelligence (@NicolaMedical) January 16, 2021
Also, huge thanks to @ICNARC for their increasingly complex analysis of this situation.
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END— Nicola Oliver | Medical Intelligence (@NicolaMedical) January 16, 2021
Nicola Oliver – our thanks to her
One thing being overlooked is that only ‘lip service’ is given to ‘preventive care’ by the NHS and GP’s only seem to follow ‘minimum requirements from government’ such as ‘blood pressure and weight’ checks at prescribed intervals, especially for the elderly on pills, and little else to forward any monitoring or new or alternative techniques. Therefore at critical times such as now there is no reserve source of skills as a basis for a ‘Plan B’.
Elderly FAS/PPF Pensioner and Military Veteran.