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 Governments have focused on hospitalisations to determine the need
for restrictions but the data does not typically differentiate
between people admitted because of COVID-19, and those who test
positive on wards during routine checks.
"Say you're having a heart attack, come into hospital, and end up
testing positive," said Paul Hunter, a professor of medicine at
Britain's University of East Anglia.
"Is COVID-19 the cause of your heart attack? We know it could be.
But we can't know at an individual level," he said.
In Britain, the Omicron variant has driven case numbers to record
highs since it emerged at the end of November but the number of
hospital patients with COVID-19 on mechanical ventilation has barely
changed, government data shows.
The number of people with COVID-19 in hospital overall has risen,
but not proportionately with the rise in infections, while intensive
care unit (ICU) occupancy is little changed https://reut.rs/33uvTLY,
according to British Health Minister Sajid Javid.
With death rates relatively stable despite the Omicron surge, some
countries such as Spain are looking at whether to adopt new ways of
tracking the virus, though epidemiologists say shifting the goal
posts does not change the fact hospitals and their staff are still
overloaded with COVID-19 sufferers.
Data from New York https://reut.rs/3GIUSta this month showed that
42% of patients hospitalised with COVID-19 were so-called incidental
cases, people admitted for other reasons and only found to be
infected during routine testing.
British Prime Minister Boris Johnson even said last week that as
many as 30% of people in hospital with COVID-19 actually become
infected while hospitalised - something Hunter partly attributed to
Omicron's overwhelming contagiousness.
SYSTEM OVERHAUL
Hunter said intensive care occupancy was a better measure of the
real severity of an outbreak: "If you're in an ICU bed with COVID,
you're probably there because of COVID, rather than just with it."
In Italy, regional governments have argued that the nuances within
the statistics on coronavirus hospitalisation may warrant
overhauling their monitoring systems to better reflect the
relatively lower severity of Omicron.
Italy's Health Ministry said last week it was examining a draft
proposal from the regions to exclude asymptomatic people
hospitalised for other reasons from the COVID admissions data.
Critics denounced the proposal as a non-scientific bid by the
regions to avoid hitting "red zone" levels of hospitalisations that
would trigger tighter coronavirus curbs.
"The change in criteria cannot be a make-up operation that disguises
the tragic nature and scale of the pandemic," Filippo Anelli,
president of Italy's national federation of doctors, said on Friday.
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 "The numbers of infected people admitted to
non-critical areas and intensive care units,
however they are counted, are overloading
hospitals ... and exhausting the professionals
who have been managing the pandemic for two
years," he said.
The committee of scientists advising the Italian
government recommended on Saturday that the
current criteria measuring the spread of
COVID-19 be maintained. The Health Ministry
said, however, that the "preliminary" debate was
ongoing.
The question of how to classify patients in
hospital who are largely asymptomatic is set to
preoccupy European nations as they look to ease
curbs - even though it remains unclear to what
extent Omicron may have exacerbated their
medical conditions.
FROM IRELAND TO SPAIN
In Ireland, 58% of those in hospital testing
positive did not have any symptoms, according to
the Infectious Diseases Society of Ireland,
which looked at about 45% of all positive
COVID-19 cases admitted to Irish hospitals on
Jan. 11.
It found more than 70% of those hospitalised
with COVID-19 did not need oxygen therapy,
suggesting they suffered from a less severe form
of disease than previously seen.
In Denmark, about 15% of people hospitalised
people over the course of 18 months had tested
positive for coronavirus, but displayed no
symptoms and had been admitted for other
reasons, a study published this month by the
country's top infectious disease authority the
Statens Serum Institut showed.
In Spain, meanwhile, more than 18,800 people
currently in hospital have COVID-19, a 79%
increase on previous peaks.
However, 25% to 40% of those testing positive in
hospital were not being treated for COVID-19,
according to a report in newspaper El Pais this
month.
"40% of patients hospitalised in Madrid with
positive PCR tests aren't (being admitted) for
COVID," Madrid's deputy health counsellor
Antonio Zapatero said last week on Twitter.
But Simon Clarke, associate professor in
cellular microbiology at Britain's Reading
University, said even if COVID-19 levels in
hospital partly reflected the prevalence of the
virus in the population, they ought not be
dismissed.
"There's this narrative that if you come into
hospital and pick up COVID it's like a free
infection and often dismissed, whereas that's
not true: you come into hospital for a reason,
you're vulnerable, and it's likely COVID will
worsen your condition," Clarke said.
"There needs to be a recognition that regardless
of admission reason, people in hospital with
COVID is pressure on the hospitals."
(Reporting by Clara-Laeila Laudette in Madrid,
Emilio Parodi in Milan, Nikolaj Skydsgaard in
Copenhagen and Alistair Smout in London; Writing
by Clara-Laeila Laudette; Editing by Josephine
Mason and David Clarke)
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