What is happening with COVID hospital admissions?

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As you know, I’ve been sharing a few articles about the COVID situation. to help us with our thinking about church life at this phase in the pandemic. Whilst pastors and leaders cannot become experts in epidemiology and whilst our primary focus is to keep people focused on Christ, it is helpful for us to have an awareness of what is going on. This helps us to make practical plans for what is going on but I also think it has another benefit.

It’s good for pastors and leaders to have a rounder interest in life and to pay attention to developing our knowledge of general revelation and common grace. This helps us to speak to people’s life situations too. When I was at Bearwood, we used to run a training course for those who wanted to be involved in pastoral care. I took part of it and looked at Biblical principles for counselling. One of our other elders was an NHS consultant and he took a session called “medical aspects of pastoral care.” It was brilliant because as he talked about how some illnesses were associated with shocking behaviour or how he’d been called with the elders to pray for someone having a crisis of faith only to spot they were severely anaemic we realised that we are whole people and how our circumstances can be having an affect on things. I am also reminded as I write of how in 1 Kings 19 when Elijah was at his lowest and ready to give in, before God dealt with the spiritual battle going on he took care of his prophet’s physical needs giving him food and rest.

The physical practical stuff matters and so I think it is helpful for pastors to stay informed about what is going on with the pandemic. It will help us as we minister to worried, frightened people. That’s why I’ve been taking time not just to follow the stats but to try and read up on the virus where possible.

Today I wanted to share a few thoughts on the specific situation with hospital admissions. If COVID-19 is to become something we are able to live with then we will need to reach a situation where even if cases go and stay high that hospitalizations remain low. This will feed in to lower mortality.

Over the past few days after a significant drop in cases and admissions we seem to have seen hospitalisations creep up a little. This could just be a blip but it is worth keeping an eye on. We also keep an eye on things when they look a little different to what we might expect. Here’s my chart showing what I would expect to happen with admissions against what is happening.

I plotted what I expected/predicted based on two assumptions. The first was that there is a ten day lag in hospital numbers coming through following diagnosis. The second was that the hospitalisation rate was around about 2.5%. I later reduced that to 2.3% and then 2% as the rate came down.

You will notice that the chart lines form a very similar pattern. There are however two differences which mean they are not in sync. First my predicted numbers over the past week or two have been higher than the actuals, secondly there is a delay so that the actual trend seems to follow a few days after when it was predicted. So, it is possible that what we have been seeing is that the lag is slightly more now than the generally assumed 10 days.

However, look now at the % rate and you will see that it dropped quickly from ~3% to ~2%. However it has bounced back again to around 2.5%.

This has caused me to consider that there may be something else happening. It is possible that we are beginning to see signs of the rate bottoming out. However, if this were due to vaccine efficacy starting to wane I don’t think the bounce back would be that rapid. So I am inclined to think that something unusual may have been going on that caused the ratio to fall to about 1.8% early last week.

Now remember back to the Euros. What we saw at that time was a steep exponential rise in cases to ~60k per day and then that seemed to just drop back suddenly rather than feeding into further growth. You may recall that a few weeks back I suggested that we had seen a spike and then a return to the real case trend.

In other words, the ~60k cases were saw after the Euros was a false peak -albeit at that time my diagram suggested we might see a return to case growth whereas the fall from the false peak seemed to coincide with cases reaching a true peak of about 45k per day.

Now think this through. If we saw a “false peak” in cases and those cases were primarily among the under 30s, then most of those people will have been at much lower risk of serious illness than the wider population. Although there was some spread of the illness into the wider population it was much slower and smaller than among the football supporting under 30s. The result of such a phenomena is that we would reasonably expect the % of admissions to cases to be significantly lower. because we were getting an extra 10-15k of cases per day amongst people incredibly unlikely to end up in hopsital. A false peak in cases among the young and fit led to a false trough in admission ratios. This doesn’t count for the entire picture, there has been a real drop in admissions and a real reduction in the ratio, just not by as much as the short term stats suggested.

This is important because one of our primary concerns at the moment is anxiety amongst people who are watching what is happening and still seeing a significant number of people going into hospital. The tabloid media doesn’t help as it sensationalises ever apparent rise and fall in data.

As Christian leaders we want to point the anxious to the sure hope they have in Christ. Even if they do end up in hospital, even if they end up on mechanical ventilation they are not on their own. Even if they or a loved one dies from COVID-19 we remain convinced that death does not have the final word.

However, I also believe that part of being a Christian and having that hope means that as we are not overwhelmed by anxiety and so we can take time to breath and to view what is happening around us. We were made and commissioned to fill and subdue (care for, steward and order) this world and understanding it rightly is part of that. Responding wisely and appropriately to a pandemic is part of our creation mandate.

When we’ve forgotten this point I think we’ve seen the unhelpful effects as Christians have found themselves aligning with the extremes of the COVID debate. That’s why we’ve seen the panic of those who fear a return to normal life unless the virus is completely eliminated and at the same time the other extreme of arguing we must ignore the pandemic and refuse to participate in measures such as social distancing, face-masking and getting the vaccine.

The truer picture is somewhere between those extremes. COVID-19 is a serious disease that results on loss of life. We do want to act wisely to love our neighbours. Yet at the same time, it is not something that should overwhelm us and paralyse us with fear. We can act wisely but at the same time get on with life, including that so important part of our life where we gather for corporate worship.