UK COVID hospitalisations double every 9 days

This week Prime Minister Boris Johnson confirmed that the 19th July will see the country opening up - with the removal of any remaining restrictions on how we socialise, spend leisure time, or work. And despite climbing numbers of cases, policymakers have justified the easing of controls by pointing out that hospital admissions and deaths remain, thankfully, low. But when Chris Smith spoke to Loughborough University disease modeller Duncan Robertson, he pointed out that when considering the numbers of cases…

Duncan - We're seeing doubling around every nine days. The problem with that of course, is that we're still getting this link to hospitalisations. Hospitalisations are doubling at around the same rate.

Chris - How does that compare with what was going on in, say, January and last autumn, October, November, and indeed last April?

Duncan - With January, we had the alpha variant. Rates started to increase very quickly, but there was virtually no vaccination in the population then. What we're seeing now, is we're seeing most cases actually happening in the unvaccinated. And of course the unvaccinated are children and young people. But we're starting to see it creep up into the twenty-somethings, thirty-somethings, forty-somethings. And this is what has happened in the past with cases; they start in young people who are mixing and then move up the age ranges.

Chris - But is that a valid comparison? The past with the present? Because obviously the past where no one was vaccinated, we didn't have that protection, which we think is pretty good conferred by vaccination that we do now in those older people.

Duncan - Absolutely right. Vaccination has made a significant difference in terms of how much they go up those age ranges and how fast they go up those age ranges. But they're still going up those age ranges because it's not as though you reach 40 or 50 and everybody's had a vaccination. So still, if you look at the latest figures we have about 9 out of 10 people who have antibodies. Some people in their fifties, sixties, seventies, eighties, and above, haven't had a vaccination or haven't had a second vaccination. And of course with this Delta variant, more protection is after that second vaccination.

Chris - If we look though at where we are in terms of the number of people who are in hospital compared with previous outbreaks, we've got about between 1 and 2% of all of the beds in the NHS currently being used to treat people with coronavirus. Historically, we were getting up to the forties and fifties of percent. So it's hard to argue this time that we're putting the NHS under pressure.

Duncan - So this really comes down to what we think about whether the health system can cope. And I think various people have said that the health service will always cope. Essentially, you have lots of COVID cases that may come in and they will always be treated, but of course you get this difference between, should you treat a COVID patient or should you treat a non-COVID patient? And that's when you start having these trade-offs and difficult decisions have to be made. And really it's up to your definition about whether the NHS copes in those situations.

Chris - I was talking to some senior managers at one of the UK's leading hospitals today, and they told me that they're seeing quite a turnaround in terms of the type of person who they're now caring for with coronavirus compared with previously. They're seeing people who tend to be less ill and stay in hospital for less long. And so they think that actually we should be more optimistic.

Duncan - Absolutely. On average, we're seeing length of stay decrease since last waves. But the significant thing is what happens to the number of people in hospital. And even though the average stay may be being below, we still have people who are long stays, people in intensive care. So as well as looking at the rate of people coming into hospital, we have also had to look at the number of people in hospital. The numbers are really increasing on both, and if you get exponential growth or doubling of people coming into a hospital, then that poses a significant problem for the number of people in hospital.

Chris - Yeah, sure, but I think it can grow exponentially, but it doesn't mean it grows exponentially to a point where it compromises care. It certainly has done in the past, but the numbers are much lower now. We've got, say 20-30 people who are passing away compared to, in one case, 1500 people in a day earlier in the year.

Duncan - The problem is we're still seeing a link between the rate of cases increasing and the rates of hospitalisations increasing. So even though we may have very low levels, it only takes a few doublings for that to become very significant and really that link between cases and hospitalisations hasn't been broken. So if you allow more and more doublings of cases, you're going to allow more and more doublings of hospitalisations.