The Guardian ran an article this week in which the headline was ICU is full of the unvaccinated – my patience with them is wearing thin. So are most patients in critical care unvaccinated? There has been lots of sharing of this article with many saying this is nonsense and others using it to suggest the UK needs more restrictions. I have looked at the data published by NHS England and the headline is not borne out by the facts so let me explain.
I should point out I am not working on the frontline of the NHS and writing this from the perspective of what the data shows. There may be some local variation not in line with the national picture, but remember, data influences the Government decisions, which is what I am using here.
So what does the data show?
Each week, NHS England publishes a great deal of information on hospital activity across the country. Within this compilation is the number of patients in critical care beds. Critical care units are specialist hospital wards that treat patients who are seriously ill and need constant monitoring.
The data helpfully splits out how many patients in critical care beds have Covid-19, how many don’t, and how many beds are unoccupied. I recreate this data in the chart below and it shows that currently within England, just over 1 in 5 beds has a critical care patient who has Covid-19. Just under 3 in 5 beds are patients needing care without Covid-19 and the remaining beds are unoccupied. So non-Covid-19 patients make up the bulk of patients across critical care units in the NHS at the moment. Even if every patient with Covid was unvaccinated (more below) the claim that critical care is full of unvaccinated is not supported by the data, based on NHS England’s own data. Of course, the author may refer to a specific unit in the country, but if that was the case, I do not think it should be a headline in a national newspaper.
Vaccination status of patients?
NHS England does not publish the vaccination status of patients within hospital, but the UK Health Agency gives a snapshot each week within a weekly surveillance report. The report only provides information on those admitted to hospital and does not provide information specific to those in critical care units. Table 4 on page 20 shows that for patients requiring an overnight admission to hospital within 28 days of a positive Covid-19 test, two-thirds were vaccinated and one-third unvaccinated. Remember, not all admissions are because of Covid-19 and NHS England data shows that 1 in 4 admissions are people with Covid but not because of it. If two-thirds of patients going into hospital are vaccinated, it would be remarkable if for those who then required critical care it was the majority unvaccinated. Even more so when most deaths are among vaccinated people.
Why are there so many vaccinated in hospital and dying?
Most people within the country are vaccinated, and this proportion increases for older age groups. Within England, 97% of people aged 50 and over have received two doses of a vaccine. With most of the population vaccinated, you would expect most people who end up in hospital or die to be vaccinated. The unvaccinated group is so small it would be difficult for the numbers to outweigh the vaccinated group.
One thing we can do is look at the rate of admissions and death for those who are vaccinated or not. This comes with its own issues in that understanding the size of the unvaccinated population is problematic. The Office of the Statistics Regulator has published a blog explaining more.
To overcome this, I have taken the number of cases among those vaccinated and unvaccinated in weeks 41 to 44 as published by the UKHA and taken the percentage admitted to hospital in weeks 42 to 45, assuming there is a lag for many between a positive test and an admission. In doing this, you can see the infection to hospitalisation rate is higher for unvaccinated vs vaccinated for each of the different age groups. Remember for some people there may be health reasons for not having a vaccine and these may be more vulnerable to admission to hospital.
Those who are unvaccinated are more likely to end up in hospital than someone vaccinated, but the main bulk of patients in hospital with Covid-19 are vaccinated because most of the population is in this group.
One thing that continues to be a problem is the number of excess deaths occurring in private homes. I recently looked at the data and if missing healthcare was causing unnecessary deaths. This is an area I will do more work in.
You can follow me for my daily stats updates on Twitter.
Update – 24 November
A medic on Twitter commented on a link to this blog post with some data specific to Midlands from a selection of ICU units. It shows that as of last Thursday (18 November) of the patients within ICU, 56% were unvaccinated and 43% vaccinated. While there are more patients unvaccinated it does not represent a picture that ICU units are full of unvaccinated based on the ratios. As described above, unvaccinated patients are more likely to end up in hospital and in ICU. But the situation in critical care beds is broader than the headline the Guardian article portrayed.
Update – 10 December
The Intensive Care and National Audit and research centre have issued a report where they have linked data on vaccination status to patients within ICU. Page 44 of the report cites that the percentage of patients admitted to critical care with confirmed Covid-19 that were unvaccinated in November 2021 was 48%. This is the most definitive estimate of patients in ICU by vaccine status and confirms that claims that most in critical care are unvaccinated are false.
Update – 24 December
The Intensive Care and National Audit and research centre updated their report to include data for December. This shows that 61% of admissions to ICU were unvaccinated so for this month it is fair to say most people with Covid-19 are unvaccinated.