The latest @ICNARC intensive care weekly report has been published. A short thread to summarise, including a link to the full report. The report covers critical care admissions to 15 October and compares the second wave (1 Sep onwards) to the first. 1/10
The report now covers 1,233 patients from 1 September. Of these, 643 have outcomes reported and 590 are still receiving critical care.

Most admissions in the North of England and the Midlands. However, allowing for size of local population N. Ireland and London look bad. 2/10
Table 1 summarises patient characteristics, showing how these compare with the first wave.

As before, seven out of ten ICU admissions are males, with most aged 50-80. 3/10
The charts below show the same data as Table 1 but more visually and with a comparison to what would be expected based on the local population. Over-represented groups include:
- Asian and Black ethnicity
- More deprived groups
- those who are obese 4/10
It’s worth noting that over-representation in the ethnicity distribution looks less extreme than last week.

Looking at medical history in Table 2 we see that nine out of ten needed no assistance with daily activities. A similar number were free of severe comorbidities. 5/10
Compared to the first wave, patients are much less likely to be mechanically ventilated within the first 24hrs (26% vs 58%).

They are much less likely to need advanced respiratory or cardiovascular support, or renal support.

Indications that cases are less severe. 6/10
Regarding outcomes it is still early days but survival is much better than was seen at this stage of the first wave.

Of those no longer in critical care,
around one-in-four has died and three-in-four have been discharged from ICU. 7/10
Here is a new presentation of the 28-day mortality data, compared to the first wave. This clearly shows the fall in mortality across all demographic groups between first wave (blue) and second (orange). Most of these differences are already statistically significant. 8/10
So, in summary ICU admissions still rising, though slower than first wave. Admissions were already falling sharply at this stage last time (we’d already locked down).

Severity appears less acute on admission and survival improved. A stay in ICU is still best avoided though! 9/10
Here is a link to full report which contains lots of extra information as well as the items I’ve highlighted. In particular more medical breakdowns (I tend to focus on demographics).

The best way we can help those working in ICU is by not catching and spreading this virus. 10/10

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More from @ActuaryByDay

26 Sep
They’re back! The intensive care national audit & research centre (@ICNARC to its friends) has resumed weekly reporting in response to rapidly rising ICU admissions.

A short thread follows in which I’ll draw out key content and add some comments. 1/n
Déjà vu? Newer followers might be unaware that I used this data six months ago to challenge the myth that COVID-19 is only a risk to those who were already “at death’s door”. That thread went a bit viral, with all manner of interesting consequences! 2/n
One positive outcome was an improved relationship between actuaries and the intensive care community. A tangible example is the commitment to @ICS_updates from @COVID19actuary that we would continue to highlight the impact the COVID-19 on intensive care units. 3/14
Read 18 tweets
25 Sep
Latest COVID-19 hospital admissions and deaths data for England has been published.

Daily admissions rose rapidly this week, exceeding 300 on Wednesday for the first time since mid-June.

The increase in the moving average implies doubling time of 10-11 days. (1/4) Image
Based on recent hospital admissions data it looks like the R number was around 1.4 at the end of the first week in September. Over the next week or two we’ll see the impact of schools reopening, but also local lockdowns and other restrictions. (2/4) Image
Average daily COVID-19 hospital deaths in England has increased from under five on 31 Aug to over 25 in recent days.

For more discussion see my recent @COVID19actuary bulletin which explains how we allow for reporting delays.

👉 (3/4) Image
Read 5 tweets
24 Sep
I suspected that today’s ONS life expectancy release would not be met with the usual fanfare, but I guess I hadn’t anticipated complete media radio silence.

Still, it’s not the most “pandemic appropriate” news. UK life expectancy is at a new high!

What’s the story? 1/7 Image
UK life expectancy at birth is up by six weeks for males and seven weeks for females. Here’s the numbers direct from Ed at the ONS 👇

Crucially though, this is just updating National Life Tables to include 2019, which had record low death rates. 2/7
Life expectancy at age 65 has also increased, by around 6 weeks each for males and females.

Life expectancy at 65 is now:
83.8 years for males
86.1 years for females

Note that life expectancy at 65 is 3-4 years higher than life expectancy at birth. 3/7
Read 7 tweets
23 Sep
Latest COVID-19 hospital admissions and deaths data for England has been published.

Daily admissions rose rapidly over last two days, reaching 237 Sunday and 275 Monday, after a few days at around 200.

The increase in the moving average implies doubling time of 10-11 days. Image
For those who’ve asked, here is the same admissions data plotted on a log scale. A straight line increase implies exponential growth. Image
Average daily COVID-19 hospital deaths in England has increased from under five on 31 Aug to over 20 in recent days.

For more discussion see my recent @COVID19actuary bulletin which explains how we correct for reporting delays.

👉 Image
Read 4 tweets
22 Sep
Latest ONS deaths data (to week ending 11 September) has been released.

505 more deaths were recorded in-week compared to the 5-year average.

Year to date there have been 14% more deaths than the 5-year average (2015-19). Image
There are 99 deaths where COVID-19 was mentioned on the death certificate this week, but there were also more deaths from other causes compared to the 5-year average.

Numbers are for England and Wales only and are 11-17 days old.
Non-COVID deaths were 4% above the 5-year average.

Some of the additional deaths recorded will certainly have been catchup from last week, when we saw significantly less deaths recorded than normal as a result of Bank Holiday registry office closures.
Read 5 tweets
21 Sep
Just had a chance to catch up with today’s briefing. It struck me as a balanced assessment. They were clear on the recently observed doubling time - something I’ve been calling out for a couple of weeks - but also that it’s not inevitable it continues.…
Projecting an exponential is risky, so they were careful not to give a prediction. Still, it felt like they landed the message well about the likely picture in Oct/Nov *if* current growth continues.

A useful reminder too of just how few of us are thought to have had the virus.
I was glad to see myth that “the virus causes a milder disease now” debunked as that’s manifestly untrue - though we have got better at treating it.

Good to set expectations that vaccine availability is still some way away too.

More on recent trends 👉
Read 4 tweets

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