Covid Scotland: Omicron hospital admissions lower than expected

Covid Scotland: Omicron hospital admissions lower than expected

FEWER than expected numbers of people are being admitted to hospital in Scotland after testing positive for the Omicron variant, according to new research.

Modelling by scientists at Scotland’s EAVE II project, which is tracking the pandemic, predicted that 47 Omicron patients should have been hospitalised by December 19 if infection patterns were the same as Delta. So far, however, there have been just 15 admissions.

Risk of hospital stay 40% lower with Omicron than Delta, UK data suggests

Researchers find those who test positive with new Covid variant up to 25% less likely to attend hospital at all

Ambulances outside hospital
The Imperial College outbreak modelling team analysed hospitalisations and vaccine records among all PCR-confirmed Covid cases in England between 1 and 14 December. Photograph: Tejas Sandhu/Sopa/Rex/ShutterstockThe Omicron variant of coronavirus appears to be milder, with a 20%-25% reduced chance of a hospital visit and at least a 40% lower risk of being admitted overnight, the first UK data of its kind has showed.

But as daily Covid cases topped 100,000 for the first time on Wednesday, experts warned that high transmissibility means the NHS is still at risk of being overwhelmed.

In what was described by scientists as a “qualified good news story”, two studies on Wednesday pointed to a lower risk of hospitalisation with Omicron.

An Imperial College outbreak modelling team led by Prof Neil Ferguson analysed hospitalisations and vaccine records among all PCR-confirmed Covid cases in England between 1 and 14 December. The dataset included 56,000 cases of Omicron and 269,000 cases of Delta.

Their report found that the risk of any attendance at hospital was 20% to 25% lower with Omicron versus Delta, and 40%-45% lower when the visit resulted in admission for at least one night. For the small percentage of people who had neither been previously infected with Covid nor vaccinated, the risk of hospitalisation was about 11% lower for Omicron versus Delta.

Ferguson said that while it was “good news”, the assessment did not substantially change Sage modelling pointing to 3,000 daily hospitalisations in England at the peak of the wave next month without restrictions beyond the plan B measures currently in place.

While the analysis shows evidence of “a moderate reduction” in the risk of hospitalisation associated with Omicron compared with Delta, Ferguson said, “this appears to be offset by the reduced efficacy of vaccines against infection with the Omicron variant”.

“Given the high transmissibility of the Omicron virus, there remains the potential for health services to face increasing demand if Omicron cases continue to grow at the rate that has been seen in recent weeks,” he added.

The Imperial study found that having had a previous Covid infection reduced the risk of hospitalisation from Omicron by about half compared with a first infection, the report adds.

Those hospitalised with Omicron had on average shorter stays – 0.22 days compared with 0.32 days for Delta – but more data is needed, particularly in older age groups among whom Omicron is currently less prevalent. It is too early to assess the risk of admission to intensive care and death, but the researchers say greater reductions in risk are possible.

A separate, preliminary analysis of Omicron cases in Scotland pointed to an even greater reduction in the risk of hospitalisation compared with Delta. Scientists on the Eave II study, using hospital data from 23 November to 19 December, concluded that the risk of hospitalisation may be 70% lower with Omicron than Delta.

Dr Jim McMenamin, the national Covid-19 incident director for Public Health Scotland, welcomed a “qualified good news story”, but said that it was “important we don’t get ahead of ourselves”.

The Scottish study, which has yet to be peer reviewed, is based on small numbers and most Omicron cases were in people aged 20 to 39, meaning researchers were unable to assess the severity of the disease in elderly people who are more vulnerable. The researchers logged 15 hospitalisations with Omicron, about a third of the 47 admissions that modelling suggested they should expect given the characteristics of those infected.

“The potentially serious impact of Omicron on a population cannot be underestimated. And a smaller proportion of a much greater number of cases that might ultimately require treatment can still mean a substantial number of people who may experience severe Covid infections that could lead to potential hospitalisation,” McMenamin said.

It came as the number of UK daily infections hit a record high of 106,122 despite previous signs that the wave was starting to plateau.

NHS England also said 301 Covid admissions were recorded by hospitals in London on 20 December, up 78% week on week and the highest number for a single day since 7 February.

At Westminster no decisions have yet been taken by ministers about what restrictions, if any, should be introduced after Christmas, with many Tory backbenchers and some cabinet ministers sceptical about the need for further action.

Contingency plans have been drawn up, but Downing Street sources insist these have not yet been put to ministers, and no further announcements are now expected before Christmas.

The shadow health secretary, Wes Streeting, urged the government to provide certainty. “The risk to the NHS remains. Boris Johnson needs to explain why people and businesses in England aren’t being told what the coming weeks look like, when those in Wales, Scotland and Northern Ireland have clarity,” he said.

The Liberal Democrats’ health spokesperson, Daisy Cooper, accused the prime minister of subjecting the public in England to “a Christmas of confusion and consternation”. “Once again Boris Johnson has crossed his fingers, closed his eyes and hoped for the best,” she said.

Omicron is up to 45 per cent less likely to cause hospitalisation than Delta, according to the first major real-world British study by ‘Professor Lockdown’ Neil Ferguson.

Senior SAGE scientist Neil Ferguson — who just last week warned there could be up to 5,000 daily Omicron deaths in the UK — said the country’s fourth wave will be ‘nothing like what we seen last year, with ICUs overflowing with patients’ on the back of the new findings.

His team at Imperial College London found that overall, Britons who catch Omicron are between 15 and 20 per cent less likely to be admitted than those who get Delta.

But the real-world analysis, of more than 3,000 people between December 1 and 14, found the chance of having to stay in the NHS overnight was even lower, with a reduced risk of between 40 and 45 per cent. 

The findings are believed to have been the reason Boris Johnson pumped the brakes on tougher Christmas restrictions despite case numbers rising to record levels — with 106,122 positive tests recorded today.

The latest study found that even an unvaccinated person who has never had Covid and has no immunity, there was a 10 per cent lower risk of being hospitalised with Omicron compared to Delta.

For someone how has been recently infected, the chance of hospitalisation was slashed by 69 per cent in both vaccinated and unvaccinated people.

The finding may explain why in South Africa — where up to 70 per cent of people have immunity from prior infection but only a quarter are jabbed — is seeing daily hospitalisations stall at less than 400.

Professor Ferguson said: ‘You can see in London, we are getting a lot more people hospitalised. Not for very long, probably not with very severe illness.

‘And that’s not a reflection of Omicron versus Delta — that was already true for Delta infections, that they’re less severe than they were last year because there’s a lot of immunity in the population.

‘The challenge is, if there’s enough of them it still poses quite a challenge to the NHS. We’re not talking about anything like what we saw last year with over-flowing intensive care units and ventilator beds.’

The notoriously gloomy expert confirmed he expected the Omicron wave to be milder, with patients discharged from hospitals quicker and fewer Covid deaths, but warned there could still be significant pressure on the NHS.

He also warned that if infections are 40 per cent higher than they were with Delta then that could offset any reduction in severity.

The data came just moments after a similar study conducted in Scotland found the risk of being hospitalised with Omicron was 65 per cent less with Omicron than with Delta.

University of Edinburgh researchers said Omicron was as severe as delta they would have seen around 47 people in hospital in Scotland, yet so far there are only 15. 

Meanwhile, Welsh First Minister Mark Drakeford today announced new Covid restrictions will return on Boxing Day, with large New Year’s Eve parties banned and the rule of six re-imposed on pubs and restaurants.

The two-metre social distancing will return in most public settings, while hospitality venues will be limited to table service-only and customers will have to wear face masks at all times apart from when seated.

Scotland has also announced stricter guidance for after Christmas but the Prime Minister has said there is not ‘enough evidence’ on Omicron to justify tougher curbs yet.

The PM declared last night that Christmas can definitely go ahead ‘cautiously’, but warned that the Government is tracking the spread of the mutant strain hour by hour and is ‘ready’ to act after December 25 if necessary. 

New Covid cases breach 100,000 for first time 

More than 100,000 Covid cases were recorded across the UK today for the first time as Wales announced tougher New Year curbs in two developments that could pile pressure on Boris Johnson to go further with lockdown curbs.

Government dashboard data shows there were 106,122 positive tests across the country in the past 24 hours, up by a third on the figure last week and eclipsing the previous record of 93,045 last Friday. 

While today’s cases are the most ever recorded in a single day, there are signs the week-on-week growth rate is slowing, down from 52 per cent yesterday and around 70 per cent on some days at the weekend.

The rise of Omicron is out of step with gloomy Government modelling that predicted the mutant super-strain was doubling every two days and could lead to a million infections per day by the end of the year. 

Meanwhile, latest hospital data shows there were 813 admissions across the UK on December 18, marking an increase of just five per cent in a week. Deaths dropped 15 per cent week-on-week to 140. 

Hospital admissions are rising more slowly than in previous waves and a growing body of evidence suggests Omicron is causing milder illness. 

The Imperial College London report 56,000 cases of Omicron and 269,000 cases of Delta over the first two weeks of the month. 

Professor Ferguson said: ‘Our analysis shows evidence of a moderate reduction in the risk of hospitalisation associated with the Omicron variant compared with the Delta variant. 

‘However, this appears to be offset by the reduced efficacy of vaccines against infection with the Omicron variant. 

‘Given the high transmissibility of the Omicron virus, there remains the potential for health services to face increasing demand if Omicron cases continue to grow at the rate that has been seen in recent weeks.’

Professor Azra Ghani from Imperial College London said: ‘Whilst the reduced risk of hospitalisation with the Omicron variant is reassuring, the risk of infection remains extremely high. 

‘With the addition of the booster dose, vaccines continue to offer the best protection against infection and hospitalisation.’

Experts said the Imperial study showed people who have had previous infection are significantly less likely to be hospitalised with Omicron.

Professor James Naismith, a structural biologist at the University of Oxford, said: ‘This study finds that previous infection reduces the risk of hospitalisation by around two thirds, indicating Omicron is milder if you have some immunity.

‘However, the study suggests there is no reduction in the severity of Omicron compared to Delta for the doubly vaccinated, indicating that it is not milder.

‘This finding is surprising but is grounded in data. There is no report on the benefit of boosting.

‘The study highlights the same risk as EAVE II, Omicron is not a harmless infection, it will cause serious illness and the more people it infects the more people will end up in hospital.

‘Decreasing the spread of the virus to give time to improve population coverage with the booster is the best strategy.’ 

Meanwhile, scientists in the Scotland-wide Early Pandemic Evaluation and Enhanced Surveillance of Covid said that the early data suggested that Omicron is associated with a two-thirds reduction in risk of hospitalisation when compared with the strain which used to be dominant in the country.

Dr Jim McMenamin, the national Covid incident director for Public Health Scotland, labeled the findings a ‘qualified good news story’, but said that it was ‘important we don’t get ahead of ourselves’.

He said: ‘The potentially serious impact of Omicron on a population cannot be underestimated. 

‘And a smaller proportion of a much greater number of cases that might ultimately require treatment can still mean a substantial number of people who may experience severe Covid infections that could lead to potential hospitalisation.’ 

London Covid hospitalisations rise by 50% in a week to 301 

Covid hospitalisations in London have risen 50 per cent in a week to 301, approaching the Government’s threshold of 400 for introducing lockdown restrictions across the country, official data showed today.

Ministers are said to be watching admission rates in the capital before pulling the trigger on more curbs because London is a few weeks ahead of the rest of the country in its Omicron outbreak.

Government sources say officials are considering a national two-week ‘circuit breaker’ lockdown after Christmas if London’s daily admissions breach 400 this week — which would signal ‘unsustainable’ pressure on the NHS

London recorded 301 daily admissions on December 20 — the most recent date with data — which was more than double the figure on December 5. If the current rate is to continue, it would take less than a fortnight to hit the 400 mark. 

The capital became the epicentre of the UK’s Omicron outbreak two weeks before the super mutant variant became dominant across the country and experts are treating trends in the city as a sign of what could come for England. 

Despite the recent surge in admissions in London, daily hospitalisations are still a far cry from the 850 at the peak last winter and they started from a low base this winter.

But there are fears that the sheer scale of infections that have already occurred in London may be ‘baked in’ and cause a big spike in the coming days. The NHS is considering setting up ‘field hospitals’ in existing hospital car parks in order to cope with the predicted rise in admissions.

However, the capital’s Omicron infections appear to already be plateauing just three weeks into the fresh outbreak. After doubling to 26,000 in a week, they appear to have dropped off in the last five days according to incomplete data. The rate of increase has also dropped off in the last four days.

Authors of the paper, which is yet to be peer reviewed, said if the Omicron had been like the Delta variant in Scotland they would have seen around 47 people in hospital suffering from the virus but, so far, there are only 15.

But Professor Mark Woolhouse, of the University of Edinburgh, said it was heavily caveated at the moment. The data is based on a small number of cases and didn’t have much data on those most at risk, the over 65s. 

Professor Penny Ward, visiting professor in pharmaceutical medicine at King’s College London, said: ‘On a day when the UK has registered its largest ever number of daily confirmed Covid infections, some good news has emerged from Scotland and from Imperial College. 

‘Both studies suggest that infection by the omicron variant may be less severe than infection by the delta variant, when assessed by comparing the proportion of patients needing hospital admission. 

‘At this point, both studies are based on comparisons with differing follow up periods due to the more recent appearance of the omicron variant, leaving some degree of uncertainty as to the potential for more severe outcomes among subjects affected by the omicron variant that do need hospital admission to emerge later. 

She continued: ‘However, based on this preliminary information, the decision to delay imposition of greater restrictions on social mixing than are currently advised under Plan B might be more reasonable than some have suggested. 

‘This news does not detract from the extraordinary spread of this variant across the population, and the fact that even a small proportion of people needing hospital care for Covid may become a very large number indeed if the community attack rate continues to escalate, with all that implies for overstretching the already stretched NHS. 

‘It remains important for all of us to take reasonable care, test test test, and get our boosters as soon as possible. If we all do this, then we might expect a happier new year 2022 than at the same time last year.’

It comes after official data showed there were another 302 hospital admissions in London on December 20, the latest date data is available for, which was up 79 per cent in a week — but still a fraction of the peak during the second wave, when there were 850.

Ministers are said to be watching admission rates in the capital before pulling the trigger on more curbs because London is a few weeks ahead of the rest of the country in its Omicron outbreak.

Government sources say officials are considering a national two-week ‘circuit breaker’ lockdown after Christmas if London’s daily admissions breach 400 this week — which would signal ‘unsustainable’ pressure on the NHS.      

It came as The Guardian reported that the NHS could set up ‘field hospitals’ in hospital car parks to provide ‘super surge’ capacity if Omicron causes a massive spike in hospitalisations above previous peak levels.

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