Thread by @HugoGye

Covid-19 hospital patients are less and less likely to end up in an intensive care unit since the start of the virus' 2nd wave.

The fall is particularly sharp among older patients, and in London.

My analysis of PHE data in @theipaper:
inews.co.uk/news/analysis/…

As this graph shows, among all age groups the number of ICU admissions as a proportion of all hospital admissions has been steadily falling since week 40 (ie start of Oct).

Figures for 65-74 and 75-84 groups seem to have experienced the steepest decline.
inews.co.uk/news/analysis/…

If you break the data down by NHS region, London stands out as reducing the proportion of patients sent to ICU more than anywhere else.
inews.co.uk/news/analysis/…

There are several possible explanations for these data. NHS's Stephen Powis says: "Rapid advancements in respiratory and non-critical care mean that there is a proportion of patients, including older patients, who can, and should, be successfully treated outside of ICU."

It is not clear whether advances in covid care have been rapid enough to explain the change over just a few months.

One other explanation is more patients receiving ventilation outside ICU wards: either in 'surge ICUs', or non-invasive ventilation (eg CPAP) on regular wards.

The health service is adamant that there is no 'rationing' of care - no one who would benefit from an ICU bed is being denied one. But there are multiple anecdotal reports from recent weeks of doctors having to choose between their patient to allocate scarce intensive care space.

There's a report in today's Sunday Times, both anecdotal and data-based, which supports the suggestion that the age profile of intensive care patients has been trending younger recently: thetimes.co.uk/edition/news/w…

Matt Hancock told #Marr this morning: "At the moment, even though it’s incredibly difficult, people are able to get the care that they need." Ministers are adamant that at no point in the 1st or 2nd wave of covid-19 has the NHS been "overwhelmed", despite warnings this was a risk

(major h/t to @declamare who first set me on the trail of these data - it's amazing just how much small, often anonymous Twitter accounts have led the way in our understanding of covid in the UK)

A public law silk says he has been consulted on the legality of rationing intensive care. The NHS says that such rationing has not happened anywhere up to this point.

https://twitter.com/JohnMQC/status/1348606398771433474