THE NUMBER OF patients with Covid-19 in hospital but who have been admitted for other reasons is around 30%, Chief Medial Officer Dr Tony Holohan has said.
His comments come in the wake of Health Minister Stephen Donnelly saying yesterday evening that the HSE has been undertaking a “big piece of work” to analyse how many people in hospital with Covid could be classified as ‘incidental’ Covid patients.
Earlier yesterday Tánaiste Leo Varadkar had claimed that up to 30% of patients with Covid-19 are primarily being treated for other health issues.
Speaking on radio yesterday, the Fine Gael leader said, “While we have 1,000 in hospital at the moment, what the doctors are saying to us is as many as 25%-30% of those could be incidental.”
It could be somebody who has a burst appendix but also has Covid.
As recently as 30 December, Chief Medical Officer Dr Tony Holohan said in a statement that “less than 5%” of cases in hospital or intensive care have ‘incidental’ Covid. By that that definition, he explained in the December statement, he meant asymptomatic and non-infectious disease.
Speaking to reporters at a briefing today, Dr Holohan acknowledged that, using a broader definition, the figure of people in hospital who have tested positive but who are not being treated for Covid primarily could be higher.
Dr Holohan said that NPHET, at its meeting last week, identified the need to get a “much more detailed understanding” of the hospitalisation data available.
“As a result, the HSE have been, if I could use the phrase, kicking the tyres a bit more on that data,” he said.
“And yes, the HSE is of the view now that the true figure is probably much closer to a 30% figure than a 5% figure based on the work they’ve been doing over the last number of days since that NPHET meeting.”
Dr Holohan said the 30% figure would be “in accord with what is broadly bring reported internationally”.
The CMO said the HSE research into the hospitalisations arose “because we had the concern that from the data we were getting from the HSE … doesn’t really accord with what we might be hearing from other countries”.
“And for all the reasons I said, we decided we should be kicking the tyres more thoroughly on that data.”
He noted that the piece of work being conducted into hospitalisations is not concluded.
“Maybe a point to make, and that shouldn’t be lost, is that if you have a patient who is in for a completely separate purpose but happened to have Covid, they still represent a significant risk to the staff and other patients, in particular, in the hospital environment,” Dr Holohan added.
Speaking on Newstalk’s Hard Shoulder programme yesterday, Donnelly explained that there are three groups of patients in hospital with Covid at the moment.
“So you have people who are not being treated for Covid, they have no symptoms of Covid, but they have tested positive. They show up in the figures,” he said.
“There’s another group, who may be being treated for Covid, but it’s not the primary reason they’re in and the Covid isn’t particularly dangerous for them.
“And then there’s the final group who really are quite ill with Covid. They’re being actively treated for Covid. And some of them could end up in a much worse situation — could end up in critical care.”
Hospitalisation figures are regularly updated for people that have tested positive for Covid-19. However, the hospitalisation figures reported each day include all categories of patients mentioned above.
Recent reports from the HSE to government have shown that among more recent hospitalisations, the numbers admitted for the treatment of Covid alone is “way down”, as one senior health source put it, speaking to The Journal.
One example cited is a person who has broken their leg, presented to hospital, and subsequently tested positive for Covid-19.
Medics may decide to give that patient some sort of treatment or medication for their Covid symptoms, which therefore means they are included in the hospitalisation numbers.
Had they not presented to hospital with their other ailment, they would never have featured in the daily figures, the senior source pointed out.
It is understood that Donnelly has asked the HSE to provide him with as much detail as possible about the patient types included in the Covid hospitalisation numbers so as to get a better sense of what the health service may be facing.
The reason the minister wants the breakdown is it will tell the government how many people might possibly end up in critical care – which government ministers state is now the key metric it is looking at when it comes to weighing up restrictions.
A source close to the health minster has said that Donnelly is seeking “granular” detail with a view to understanding as much as possible about the impact on critical care in the weeks ahead.
It is also understood that the minister is in favour of full transparency around these hospitalisation figure breakdowns, and is very open to full transparency around each category of patient in hospital with Covid.
“It’s all about definitions,” said another senior source, who highlighted that NPHET defines ‘incidental’ cases as asymptomatic and non-infectious patients.
Severity and mortality
Data from South Africa, where Omicron rose to prominence, found fewer hospitalisations, respiratory diagnoses and a decrease in severity and mortality in the fourth wave compared to previous waves.
In the latest episode of The Explainer podcast, Mia Malan, the editor-in-chief of Bhekisisa – an award-winning health journalism centre in South Africa – told The Journal that admission rates for hospitals in the country peaked at about a quarter of the proportion that was admitted during delta.
“When people ended up in hospital, they were far less likely to fall severely ill,” Malan said.
They were less likely to require expensive resources such as ventilation, or supplemental oxygen or end up in an intensive care unit. And because of that, all in all, it put less strain on our health system.
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