Up to 40% of ‘Covid hospital patients’ infected with Delta variant may have been admitted for a different illness, official figures suggest
- A total of 1,904 people in England had spent at least one night in hospital with the mutant virus by June 21
- But 739 (39%) may have went to hospital for other condition and tested positive through routine NHS testing
- Experts said findings show chunk of admissions reported by Government every day will be ‘incidental cases’
Four out of 10 patients hospitalised with the Indian Covid variant in England may have been admitted for something else, analysis of official data suggests.
Public Health England’s fortnightly report on the ‘Delta’ strain showed a total of 1,904 people had spent at least one night in hospital with the mutant virus by June 21.
But the agency admits 739 (39 per cent) of these patients may have went to hospital for a different condition or injury and tested positive through routine NHS testing.
Experts said the findings show that a significant number of the Covid admissions reported by the Government every day will be ‘incidental cases’.
Cambridge University epidemiologist Dr Raghib Ali and Dr Simon Clarke, a microbiologist at Reading University, told MailOnline that this will become more common as the outbreak grows. Officials expect there to be at least 100,000 Covid infections per day by next month.
There are still some patients who fall gravely ill with the virus and do not get tested until they arrive at hospital, Dr Raghib said, but this is happening less often now that testing is so widespread.
Less people are becoming severely ill thanks to the vaccines. Professor Paul Hunter, an expert in medicine at the University of East Anglia, said that by next winter ‘most cases admitted with a positive test will not be admitted because of Covid’.
PHE’s figures also show that of the Indian variant patients who presented at A&E by June 21, just over three in 10 spent the night in hospital, with the rest sent home on the same day.
The promising stats come amid growing anecdotal reports of hospital Covid patients having milder symptoms than in previous waves, due to vaccines and the fact younger people now make up a greater proportion of cases.
Overall, cases of the ultra-infectious Indian variant have risen by 54,000 in a week – up by a third – and the strain now makes up 99 per cent of all new cases in England. There have been 215,000 Indian variant cases in total but this is an underestimate because not every positive sample is analysed for mutations.
Since the strain was first detected in April, the most cases have been discovered in Manchester (6,818), Bolton (5,984), Leeds (5,353), Birmingham (4,777) and Blackburn (3,918).
Public Health England’s fortnightly report on the ‘Delta’ strain showed a total of 1,904 people had spent at least one night in hospital with the mutant virus by June 21. But the agency admits 739 (39 per cent) of these patients may have went to hospital for a different condition or injury and tested positive through routine NHS testing
PHE’s figures also show that of the Indian variant patients who presented at A&E by June 21, just over three in 10 spent the night in hospital, with the rest sent home on the same day
Since the strain was first detected in April, the most cases have been discovered in Manchester (6,818), Bolton (5,984), Leeds ( 5,353), Birmingham (4,777) and Blackburn (3,918)
Overall, cases of the ultra-infectious Indian variant have risen by 54,000 in a week – up by a third – and the strain now makes up 99 per cent of all new cases in England. There have been 123,000 Indian variant cases in total but this is an underestimate because not every positive sample is analysed for mutations
Professor Clarke said MailOnline’s analysis highlighted the need to be wary of using general hospital admission figures as an indicator of how much severe disease is being caused by Covid.
‘It’s detecting the proportion of Covid in society, but what it’s doing is meaning the total number of admissions is not a good indicator of the disease burden.
‘And that is reflected in the low number of people who are going into intensive care [compared to general admissions].’
There are currently about 450 Covid patients being admitted to hospital every day in the UK and the number appears now to be growing rapidly after more than doubling in a month.
England’s Covid R rate may now be as high as 1.5 — the highest it has been since the second wave spiralled out of control in October, Government scientists have announced.
SAGE estimates the R rate in England is between 1.2 and 1.5, growing three to seven per cent every day.
It came as official data today showed around one in 160 people had Covid with the outbreak growing nearly 60 per cent in England last week.
The R rate is highest in the South East, South West and North East and Yorkshire, all of which have rates as high as 1.6 according to estimates.
It is now lowest in the North West — despite spiralling cases in the region — which has an estimated rate of between 1.1 and 1.2.
And office for National Statistics (ONS) data shows around 330,000 were infected with coronavirus on any given day last week.
Cases increased in all age groups and in all regions, statisticians said, as the Indian ‘Delta’ variant continues to cause a surge in infections across the country.
The figures come despite some signs the third wave across the UK may already be slowing. Department of Health bosses posted 32,551 new infections yesterday, up 16.3 per cent on last Thursday.
But it was the sixth day in a row the rise in the seven-day average for cases — 34.92 per cent — fell, down from 42.81 per cent on Wednesday.
And experts today said the outbreak in England may begin to shrink once people stop meeting up in large crowds as regularly when Euro 2020 is finished.
But in a clear sign of the ‘vaccine effect’, admissions are far lower now than at any point previously in the outbreak when cases were this high — there are 28,000 cases on average each day.
The last time there were this many new infections and the epidemic was rising was in late December in the midst of the second wave, when there were more than 2,000 patients going into wards each day.
Dr Ali said the PHE data provided ‘some evidence that there are a higher proportion of patients now that have Covid as an incidental finding’ than in previous waves.
The fact there is far more testing now than ever before — roughly a million swabs are deployed daily now compared to 400,000 in winter — means it’s a ‘reasonable assumption’ that more incidental cases will be picked up in the NHS.
Professor Hunter said this will become more of an issue as community transmission continues to double every nine days, as it is now.
He told MailOnline: ‘There is no doubt that the overall figures on hospitalisation will include cases who just happen to be positive and are picked up by routine screening when they are admitted for something else.
‘This will become more of an issue as more people have mild or asymptomatic infections as a result of vaccination or prior infection.’
Like Dr Ali, Professor Hunter warned that disentangling the primary cause of admission among Covid hospital patients was difficult.
‘It’s difficult to know for sure, sometimes even in an individual patient. For example, take someone who has been admitted following a car crash and tests positive. Did they crash because the were driving when not well?
‘This is more likely to be an issue in younger people and children where a higher proportion of admissions with a positive test may not be admitted because of the disease. It’s also more likely in the vaccinated.
‘I suspect in a year or so most cases admitted with a positive test will not be admitted because of Covid.’
Hospitals are still required to separate any patient who tests positive, no matter what condition they were primarily admitted for, which puts extra pressure on the NHS.
Trusts in Leeds and Birmingham, where the Indian variant is spreading quickest, have already cancelled some routine operations – including non-urgent cancer care – to cope with the recent rise in Covid admissions.
Stringent infection control measures and repeated lockdowns during the pandemic have led to a record waiting list of 5.3million in England.
But there are already early signs that those presenting at A&E with Covid are experiencing a milder illness than in previous waves.
PHE’s report shows that 43 per cent of A&E attendees with the Kent variant, which began spreading before the UK’s vaccination drive picked up pace, spent a night or more on a ward compared to 35 per cent with the Indian version.
Of the 1,904 people who were admitted to hospitals in England with the Delta variant by June 21, 1,283 (67 per cent) were under the age of 50.
Among the age group, 77 per cent were unvaccinated, and further 8 per cent were less than 21 days after their first dose of vaccine. A total of 118, or 9 per cent, had had one jab and 48, or 4 per cent, had had two.
Of the 615 aged 50 or over, a third were unvaccinated, a quarter had been given one dose and 43 per cent were fully vaccinated.
Office for National Statistics (ONS) data shows around 330,000 were infected with coronavirus on any given day last week
Transport Secretary Grant Shapps urges Brits not to delete NHS Covid app which confined 350,000 to home quarantine last week
Transport Secretary Grant Shapps today warned Britons not to ignore or delete the NHS Covid app because the virus can ‘still harm people’ — amid widespread criticism of the software which is telling hundreds of thousands of people to isolate regardless of their vaccine status or a negative test.
Travel quarantine rules in England are due to be eased on July 19 when lockdown restrictions are lifted wholesale, but rules on self-isolation for the fully jabbed will remain in place until August 16, raising fears that people will abandon the app en masse rather than risk having to cancel a holiday.
People pinged by the app are not legally obliged to isolate, which means there is little stopping Britons from simply deleting the software or ignoring its alerts.
Mr Shapps told BBC Radio 4’s Today programme: ‘You shouldn’t ignore this (the app) because it is vital information. People should want to know if they have been in contact with somebody with coronavirus.
‘You don’t want to be spreading it around. It can still harm people.’
Latest NHS statistics shows the app issued more than 350,000 alerts during the last week of June, 60 per cent up on the previous week. The growing number of people being forced into quarantine has led to fears it may create a lockdown ‘by stealth’ even after the country officially ends restrictions this month.
Pubs, restaurants and shops fear they may have to close because so many staff are being left stuck at home by the warnings, and NHS hospitals in Leeds and Birmingham have even had to cancel routine operations because so many staff are isolating.
But this is not a sign that the vaccines aren’t working, according to Professor Sir David Spiegelhalter, an eminent statistician at the University of Cambridge.
He said this was simply due to the fact Britain has had extremely wide jab coverage and that no vaccine is 100 per cent effective. ‘This is exactly what we would expect with high coverage by a very effective – but not perfect – vaccine,’ he added.
PHE said that of the 1,904 Indian variant patients, it was confident 1,165 were admitted primarily for Covid. The other 739 patients tested positive for the virus for the first time on the same day they were admitted.
The agency said it separated these patients in its reporting to ‘help remove cases picked up via routine testing in healthcare settings whose primary cause of attendance is not COVID-19’.
It added: ‘Some of the cases detected on the day of admission may have attended for a diagnosis unrelated to COVID-19.’
The report also showed there were 257 deaths in England 28 days after testing positive for the Indian variant. In total 26 were under the age of 50, and 231 were aged 50 or over.
Of those aged over 50, 71 were unvaccinated and one was within 21 days of a first dose. Forty-one people died after developing immunity from their first jab and 116 had received both.
In the 26 under 50, three were at least 21 days after a first dose of vaccine, two had received both doses and 21 were unvaccinated.
Professor Spiegelhalter said: ‘The latest PHE data show that the majority of the 257 people who have died with the Delta variant are over 50 and have had at least one vaccination – nearly half have been fully vaccinated.
‘But this is exactly what we would expect with high coverage by a very effective – but not perfect – vaccine. Many more fully-vaccinated over-50s have died with the Delta variant… but this is expected due to the very strong risk-gradient with age: an unvaccinated 30 year-old has a lower risk than a fully vaccinated 60-year-old.
‘Around a quarter of the deaths are in unvaccinated over-50s, who presumably will have been offered the vaccine. Communities with lower vaccine uptake will be hit hard in current wave.’
PHE is monitoring four variants of concern — the Indian, Kent, South African and Brazilian strains — the highest classification, and nine variants under investigation.
There are several other strains which PHE is monitoring, including two new ones announced this week, known as B.1.619 and B.1.629.
Sources told MailOnline they were picked up in random sampling and published for transparency purposes but they are ‘nothing to get concerned about’ yet.
Vaccines have been proven to reduce the risk of severe illness from the dominant Indian variant by more than 90 per cent and slash transmission by at least 60 per cent — after two doses.
Dr Jenny Harries, chief executive of the UK Health Security Agency said: ‘The data continues to show that the sharp increase in cases that we are seeing is not being followed by a similar increase in hospitalisation and death.
‘This is because two doses of the available vaccines offer a high level of protection against the Delta variant.
‘Getting both jabs is the best way to ensure you and the people you love remain safe, so we once again urge everyone to come forward as soon as they are eligible.
‘As we approach the planned end of restrictions, we must remain cautious and careful. Cases are rising across the country, and whilst the vaccines offer excellent protection, they do not offer 100 per cent protection.
‘Be sensible, and follow ‘hands, face, space, fresh air’ at all times and make sure to get tested if required.’
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