14 | New Scientist | 9 April 2022News
THE UK is currently experiencing
a surge in covid-19 cases caused by
the omicron variant, in common
with many countries. Inevitably,
the number of people in UK
hospitals with the illness is also
rising, and reached 2509 people
admitted on 28 March – just overhalf the daily admissions seen at
the highest peak of the pandemic
in the UK in January 2021, when it
reached more than 4500 per day.
In the current wave, covid-
is causing less severe illness than
in previous waves, thanks to the
lower intrinsic severity of the
omicron variant and higher
levels of population immunity.
The number of people who need
ventilation in intensive care is
currently less than a tenth of the
numbers seen in January 2021,
the deadliest phase of the
pandemic in the UK.
As a result, some people say that
just tracking the total number of
people with covid-19 in hospital
overstates the effect of the
pandemic on health services.
People can go to hospital for a
different reason, such as a broken
leg, for example, and be found to
have covid-19 only after routine
testing. According to figures
from NHS England, such cases of
“incidental covid” are now about
half the total number of people
in hospital with the virus.
But dismissing all those with
incidental covid underestimates
the virus’s impact on health
services. Firstly, even if covid-
isn’t the main reason someone
is admitted to hospital, it will still
worsen most people’s prognosis.
The coronavirus has always
taken a greater toll on thoseAnalysis CoronavirusDAN^ KITWOOD/GETTY
IMAG
ESInfections strain UK hospitals
High numbers of patients with covid-19 in wards have a serious impact on health
services, even if it they are in hospital for a different reason, reports Clare WilsonAmbulances at
St Thomas’ Hospital
in Londonwho are older or medically
vulnerable – and most hospital
patients are likely to fit one of
these categories. About two-thirds
of people in hospital in the UK are
over 65 and most of those who are
younger are medically vulnerable
just by virtue of their needing to
be in hospital. Even a relatively
minor operation, like a hernia
repair, will leave people at higher
risk from the infection.
In addition, covid-19 can
manifest with less common
symptoms in people who have
been vaccinated, such as stomach
upset or confusion in older people.
So it might be someone’s primary
reason for admission, even it isn’t
recorded as such. “It’s a slightly
artificial distinction,” says David
Oliver, a physician based in
Reading, UK.
Another impact is that hospitals
segregate patients who test
positive for covid-19, keeping
them in so-called hot wards, to
help reduce the spread of the virus
within the hospital. People with
incidental covid therefore get less
attention from the doctors and
nurses who are experts in theirprimary illness. “You get less
specialist care,” says Daniel
Goyal, a doctor at NHS Highland.
Despite efforts at segregation,
many people still catch covid-
while in hospital. About one in
10 people in UK hospitals with
the illness between February
and July 2020 caught the virus
during their stay.Services stretched
It causes disruption when
someone on a cold ward tests
positive: everyone else has to be
tested, those who are positive are
moved to hot wards, and there
needs to be deep cleaning. In the
meantime, new people cannot be
admitted to that ward, and care
home residents who are positive
cannot be discharged, meaning
a loss of available beds.
Services are already
overstretched – not least because
staff absences due to covid-19 are
up too. Some of those staff will
have caught the virus from
patients, regardless of whether
they were admitted with the
virus or because of it. “We know
outcomes are worse if staffing
is poor,” says Matt Butler at
Cambridge University Hospitals.
Butler hopes that in time
the coronavirus will come to be
seen similarly to the antibiotic-
resistant bacteria MRSA or
diarrhoea-causing Clostridium
difficile. These are rarely problems
for healthy people outside of
hospitals and care homes, but
inside such places, staff go to great
lengths to stop them spreading.
With MRSA and C. difficile,
hospital spread has been tackled by
bringing in strict policies on hand
washing and cleaning. For covid-19,
we will also need methods of
preventing airborne spread, says
Butler, such as better ventilation
and the use of HEPA air filters. ❚14,
People in English hospitals
with covid-19 on 29 March6252
People in English hospitals
on 29 March being treated
primarily for covid-11.3%
of people with covid-19 in UK
hospitals in February-July 2020
became infected after admission“ Cases of ‘incidental covid’
are now about half the
total number of people in
hospital with the virus”