We now have the primary diagnosis (PD) update for England. Of those in hospital with COVID, there's been a continuing fall of the % for whom COVID is the PD.

In London the fall is even more marked.

I discuss why this is to be expected here.


1/
It doesn't mean we're not seeing a steep increase in hospital numbers for whom the PD is COVID though. Here's the position for England, with a 30% increase in 3 days from the 25th to 28th (since which overall occupation has risen a further 20%).

2/
And here's the equivalent regional picture, with the sharp increase in London very clear (up 42% in a week)
Again, London has risen a further 15% since the 28th, but we don't have a PD % to match the last two dates with.

3/
Note that some patients where COVID is not the PD will still be in because of it, as explained in the notes here. And the implications for care of those where COVID is an incidental condition are also described.

4/
Finally, you can't simply take a difference of two dates to calculate the primary cause of those admitted between them, as @Mailonline did recently, as I explain here.
Hopefully, its journalists won't make the same mistake with this latest data.
5/5

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More from @john_actuary

31 Dec 21
On the day the Health Sec announces that the target to offer everyone over 18 a booster (if eligible) by the year end has been met, let's take a look at progress.

321k reported today, down a third on last week.

Total is now 28.4m.

1/
There are still just under 9m who are eligible and yet to be jabbed. Even if we assumed only 90% want to come forward, that would leave around 5m still waiting, predominately U50s.

Many of course will have a recent positive test, so are unable to come forward at the moment.

2/
In total, around 76% of those eligible have been boosted - and where it really matters, over age 50, it's 91%, which is a really good performance.

3/
Read 8 tweets
31 Dec 21
An abbreviated ONS Infection Study update, shows the dramatic increase seen just before Xmas.

E is about 40% higher than the devolved administrations, which is likely to be partly due to the high prevalence in London.

Data are for week ending 23rd Dec.

1/
Note that, as usual, the figures are the average over the week. We usually have the daily time series to determine the latest date (likely to be higher during rapid growth), but they're not available this week.

It's estimated that over 2m people in E were infected.

2/
The continued rise in Omicron is charted here. Remember this is overall infections, not just new incidences, so will lag the incidence data which shows Omicron even more dominant now.

3/
Read 6 tweets
30 Dec 21
Thu🏴󠁧󠁢󠁥󠁮󠁧󠁿booster/3rd primary update:
345k reported today, the post-Xmas recovery continues, but it's still only half of a week ago.

Total is now 28.1m.

Insight from one area suggests it's demand driving the lower figures - maybe due to high infections in the younger age groups?

1/
Over the last month we can see progress here, with the Xmas break very visible. The lowest age band has now reached 40% of those with two doses (or 45% of those now eligible).

2/
The pale blue bars of those eligible but yet to be boosted now totals just over 9m, with progress since the acceleration (the middle bands), now at 8.3m.

3/
Read 5 tweets
30 Dec 21
Latest CH deaths data has nudged up, but not to an extent that contradicts the recent downward trend.

As usual we don't know vax status of these deaths, although in general CH residents have seen very high take-up. Neither do we know whether COVID was the primary cause.

1/
More generally Over 70 deaths (to 17th Dec) shows a continued but slow decline. With this population mostly boosted some weeks ago now, we wouldn't expect further sharp falls from a "booster effect", with community prevalence of the virus being the main influence now.

2/
The rapid rise of Omicron is unlikely to be influencing either graph yet to any meaningful effect, particularly as the initial surge has predominately been in younger age groups.

3/
Read 5 tweets
28 Dec 21
Tue🏴󠁧󠁢󠁥󠁮󠁧󠁿booster/3rd primary update:
209k reported yesterday, just over a quarter of the same day last week, with the Xmas break hangover continuing into the first Bank Holiday.

Total is now 27.5m, up just 400k over the last 4 days.

1/ Image
Age banded, we can see in pale blue all those unjabbed that will be eligible by the y/e, which totals just under 10m.

Progress since the acceleration started two weeks ago is shown in the middle band. and totals 7.7m.

2/ Image
And here are the proportions compared with all those who've been second dosed. Above age 50, the average is a very healthy 88%, (and c90% of those eligible), which will be making a considerable impact to dampen admissions growth.

3/ Image
Read 5 tweets
26 Dec 21
We've recently seen a fall in COVID beds occupied in London where COVID is the primary cause of occupation, from around 85% to 75%. Is this a sign of Omicron being less serious? Or is it a result of a rapidly growing variant, and the lag before "With COVID" admissions rise?

1/ Image
Here's a very simple example, which starts at Day 0 with 100 From COVID adm'ns, and 20 With COVID (so 83% primary diagnosis).

I've modelled this assuming infections double every 3 days (up 25% per day) for just 10 days, level either side.

2/ Image
Now, people admitted who just happen to test positive ("With" COVID) should increase exactly in line with this curve. (Big simplification - I've not modelled age differences here.)

So the sharp-eyed will notice this graph is exactly the same, except for axes and titles.

2/ Image
Read 12 tweets

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