Coronavirus (COVID-19) state of the epidemic 25 February 2022

This report brings together the different sources of evidence and data about the Covid epidemic to summarise the current situation, why we are at that place, and what is likely to happen next.


Severe Illness: Hospitalisation, ICU and Deaths

Hospital and ICU Occupancy and Admissions

Following changes in the Covid-19 Case definition and changing testing policies since 5 January 2022, hospital and ICU occupancy figures now include patients with Covid-19 cases confirmed by either PCR or LFD. Historical figures have been updated retrospectively from 9 January 2022.

Similarly, Covid-19 admissions to hospital (including for children and young people) now include patients with Covid-19 cases confirmed either by PCR or LFD. Historical figures have been updated retrospectively from 5 January 2022. Please note that admissions to ICU only include PCR confirmed Covid-19 cases.

In the week to and including 23 February, daily Covid-19 hospital occupancy increased. NHS boards reported 1,093 patients in hospital or in short stay ICU on 23 February with recently confirmed Covid-19, compared to 912 on 16 February. This is an increase of 181 patients, or 20%, from the previous week, and compares with 2,053 patients in hospital at the peak in January 2021 (Figure 8). This corresponds with an increase in the percentage of people estimated to test positive for Covid-19 in Scotland in the week ending 20 February 2022, as seen in the ONS Covid-19 Infection Survey.

Combined ICU occupancy (including short and long stay) has remained unchanged at 25 patients on 23 February compared to 16 February. The number of combined ICU occupancy remains lower than the peak of 172 ICU patients recorded in January 2021. There were 11 patients in short stay ICU on 23 February, compared to 13 a week previously. This is a decrease of 2 patients. There were 14 patients in long stay ICU on 23 February, compared to 12 on 16 February. This is an increase of 2 patients (Figure 8)[33].

Figure 8: Patients in hospital (including short stay ICU), and patients in combined ICU with recently confirmed Covid-19, data up to 23 February 2022 [34] [35].
A line chart showing one line with the daily hospital occupancy (including short stay ICU) against the left axis and a line with ICU/HDU (including long and short stay) against the right axis, with recently confirmed Covid-19 since September 2020 until  February 2022. The number of Covid-19 patients in hospital peaked in November 2020, January 2021, July 2021, September 2021, and January 2022. The number of Covid ICU patients peaked in November 2020, January 2021 and September 2021. The chart has a note that says: “from 9 January 2022 patients include PCR and LFD confirmed cases”. Before 9 January 2022, patients include only PCR confirmed cases.

Admissions to hospital have increased over the last week, with 686 admissions to hospital for people with confirmed Covid-19 in the week to 19 February compared to 619 in the week to 12 February. This is an 11% increase over the last week, and compares to 1,171 weekly hospital admissions during the most recent peak in the week leading up to 10 January (Figure 9)[36]. Similarly to daily hospital occupancy, this corresponds with an increase in the percentage of people estimated to test positive for Covid-19 in Scotland in the week ending 20 February 2022, as seen in the ONS Covid-19 Infection Survey.

The latest data from PHS shows 19 new Covid-19 patients admitted to ICU in the week to 22 February, compared to 20 in the week to 15 February. This compares to 57 weekly ICU admissions during the most recent peak in early January 2022 (Figure 9)[37].

Figure 9: Weekly total of Covid-19 admissions to hospital and ICU with a positive Covid test in Scotland [38] [39] [40].
A line chart showing the total weekly number of hospital admissions with recently confirmed Covid-19 from March 2020 until February 2022, against the left axis, and the weekly number of ICU admissions against the right axis. Both hospital and ICU admissions peaked in March 2020, October 2020, January 2021, July 2021, September 2021 and January 2022. The chart has a note that says: “from 5 January 2022 hospital admissions include PCR and LFD confirmed cases”. Before 5 January 2022, hospital admissions include only PCR confirmed cases.

According to data from the PHS Education Dashboard, the three-week rolling average number of Covid-19 related hospital admissions for those aged under 22 peaked in the three-week period leading up to 19 January 2022 at an average of 143 admissions, which was higher than previously seen in the pandemic. While remaining at a high level, average hospital admissions related to Covid-19 in children and young adults have continued to decrease by 13% in the three-week period to 16 February (110 average weekly admissions), compared to the previous three-week period to 9 February (126 average weekly admissions) [41]. These figures refer both to young patients in hospital because of Covid-19 and with Covid-19.

In the three-week period leading up to 16 February, the rolling average of hospital admissions decreased among those aged younger than 12, and 18 to 19-year-olds. The highest rolling three-week average of Covid-19 related hospital admissions among children and young people as of 16 February, were observed amongst those aged 1 or younger, followed by those aged 5 to 11, 12 to 17, and 2 to 4. The lowest weekly case rates were seen among those aged 20 to 21 and 18 to 19[42].

While it may be helpful to compare hospital occupancy between the UK nations, any comparisons must be made with caution. Definitions are not consistent across the nations and data are not reported daily by each nation. Data from Scotland, Wales and Northern Ireland is updated retrospectively if errors come to light, while data from England is not revised retrospectively, but instead is corrected in the following day's data update. This means Covid-19 death figures are not directly comparable across the four nations. For more information see UK Government website.

The seven-day average hospital occupancy in Scotland per one million people was 181 patients in the week leading up to 22 February 2022. The seven-day average hospital occupancy per one million population in the same period for other UK nations were as follows[43]:

  • England: 165 per one million
  • Northern Ireland: 282 per one million
  • Wales: 183 per one million

In Scotland, there was a daily average of 18 hospital admissions per one million people in the week leading up to and including 19 February 2022. Seven-day average hospital admissions per one million population in the same period for other UK nations were as follows[44]:

  • England: 18 per one million
  • Northern Ireland: 18 per one million
  • Wales: 7 per one million.

Deaths

After a period of decreasing numbers of Covid-19 deaths throughout the last two months of 2021, the week to 23 January 2022 saw a peak of 146 Covid deaths. This came after three weeks of increasing numbers of deaths, largely consisting of fatalities among those aged 45 or above, as Covid-19 deaths among younger age groups have remained at similar low levels throughout the pandemic.

The overall number of Covid-19 deaths has decreased by 6%, or 5 deaths, to a total of 75 deaths in the most recent week leading up to 20 February, compared to 80 in the week prior leading up to 13 February. This figure is 89% lower than the peak in 2020, when the week ending 27 April saw a total of 663 deaths where Covid-19 was mentioned on the death certificate[45].

When it comes to Covid-19 related deaths by age groups in the week to 20 February, the number of deaths decreased in the age bands 65 to 74 and 75 to 84 compared to the previous week (the week to 13 February) (Figure 10). However, there was an increase from 33 to 39 deaths among those aged 85 and older. There were three deaths among those under age 45 in the week to 20 February, but the number of Covid-19 related deaths among the younger age groups remain low. National Records of Scotland publish a weekly detailed analysis on deaths involving Covid-19 in Scotland in their weekly report[46].

Figure 10: Weekly total number of deaths where Covid-19 was mentioned on the death certificate, by age group. Data to the week ending 20 February 2022.
A line chart showing the weekly total of deaths per age group since March 2020. Death numbers in all age groups above 44 peaked in April 2020, November 2020, January 2021, September 2021 and January 2022. Deaths in the under 44 age groups remained low throughout the whole period.

Excess deaths are the total number of deaths registered in a week minus the average number of deaths registered in the same week over the previous five years (excluding 2020). Measuring excess deaths allows us to track seasonal influenza, pandemics and other public health threats. Excess deaths include deaths caused by Covid-19 and those resulting from other causes.

In the week leading up to 20 February 2022, deaths from all causes were 9% below average levels for this time of year. This constitutes the seventh week in a row where deaths were below average[47].

Deaths data from England, Northern Ireland, Scotland and Wales use different methodologies, so they cannot be directly compared. Additionally, deaths within 28 days of positive has been updated on 1 February 2022 to include deaths following the most recent episode of infection, using the new episode-based case definition in England. For more information see UK Government website.

There were 2 average daily deaths per one million population in the week leading up to 23 February 2022 in Scotland. In the same time period, average daily deaths for the other UK nations were as follows[48] [49]:

  • England: 2 per one million
  • Northern Ireland: 2 per one million
  • Wales: 1 per one million

Contact

Email: modellingcoronavirus@gov.scot

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