One response to “Weekly Update: 1,203 patients in hospital with #COVID-19, 7.4% decrease”

1. 

   S Davidson

   April 15, 2023 at 1:08 pm

   For the ones (like myself) who continue to feel “uneasy” about the whole situation, there’s some food for thought… and some interesting links in this context.
   It always sounds good to hear about decreases… in hospital patients, in deaths and so forth. Some risks for severe disease and death for the majority of people have certainly changed over time, due to a range of factors such as vaccination, immunity, treatments and variant characteristics. The at the beginning of the pandemic in many communities demonstrated solidarity with the more vulnerable and the elderly was apparently also shortlived and the persisting risks for them are now less considered amongst the wider population.
   Health services are (currently) not in disaster mode, but still in crisis mode (at least in this country), the latter for many reasons of which some have to do with Covid, others do not.
   The risk to die from Covid if you are unlucky enough to end up in hospital is still much higher than with influenza. The commonly made comparison with the seasonal influenza therefore is not appropriate.

   Conclusions from a study in the US (https://jamanetwork.com/journals/jama/fullarticle/2803749):
   ‘This study found that, in a VA population in fall-winter 2022-2023, being hospitalized for COVID-19 vs seasonal influenza was associated with an increased risk of death. This finding should be interpreted in the context of a 2 to 3 times greater number of people being hospitalized for COVID-19 vs influenza in the US in this period. However, the difference in mortality rates between COVID-19 and influenza appears to have decreased since early in the pandemic; death rates among people hospitalized for COVID-19 were 17% to 21% in 2020 vs 6% in this study, while death rates for those hospitalized for influenza were 3.8% in 2020 vs 3.7% in this study. The decline in death rates among people hospitalized for COVID-19 may be due to changes in SARS-CoV-2 variants, increased immunity levels (from vaccination and prior infection), and improved clinical care.’

   Conclusions from a Swiss study (https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2801464):
   ‘This study shows that the COVID-19 due to the Omicron variant was associated with a higher risk of in-hospital mortality compared with patients with influenza. This indicates that the SARS-CoV-2 Omicron variant should still be taken seriously, and improved prevention and treatment strategies are still highly relevant, although overburdening of the health care system has become less likely over time.’

   It should be noted that these rates refer to deaths within a short time frame (in hospital). Deaths after the follow up period or after discharge (for example after a few months) are not included.

   I would also argue that health services should function properly, not only avoid to be overwhelmed.

   Then there is the issue of mortality rates which are difficult to interpret. When trying to put into context the Case Fatality Rate for Orkney for the first months of this year, one should probably first do some background reading, such as https://coronavirus.jhu.edu/data/mortality or the very good explanation here: https://ourworldindata.org/mortality-risk-covid
   Only then one can attempt an interpretation of Orkney’s data (extracted from gov.uk and NRS): 115 confirmed cases since the beginning of the year and 5 deaths which would result in an extraordinary CFR but we know that this cannot be true because so many cases go undetected.
   On the other hand this should give us an indication that we certainly do not test enough, we clearly lack surveillance.
   In their Policy Brief: COVID-19 surveillance from April 11th (can be downloaded here: https://www.who.int/publications/i/item/WHO-2019-nCoV-Policy_Brief-Surveillance-2023.1), the WHO states:
   ‘At this stage of the pandemic, it remains critical to sustain robust surveillance despite prevailing impressions that the pandemic is over. Several countries continue to have worrisome increases in the number of reported new COVID-19 cases and deaths due to the emergence of new Omicron subvariants, inadequate vaccination coverage, waning immunity and a lack of access to life- saving COVID-19-specific therapeutics.’

   Waning immunity is another keyword: Some will receive a booster in April, the majority will not. Seasonality will also have a dampening effect over the coming summer months. What happens in autumn? If there isn’t enough surveillance we have no idea how we should prepare for autum when virtually everybody’s immunity will have waned?

   The WHO expresses other concerns too: ‘… there is concern about the establishment of new animal reservoir(s) and potential virus evolution in novel hosts…’

   Simple logic and common sense should tell us that the more uncontrolled and unrestricted the virus can spread, the greater this risk may become. If we allow this virus to fly under the radar only because there are currently not many thousands of patients in hospital, we are gambling.

   Loading…

   Reply