Evidence Service to support the COVID-19 response
June 24, 2020
Mahon J, Oke J, Heneghan C.
The UK government publishes the following data:
The number of people dying with COVID-19 in hospitals in England each day has fallen from a peak of 899 on the 8th April to 50 on the 15 June.
The number of people In hospital with COVID has fallen from a peak of 15,702 on the 10th of April to 2,891 on the 19th of June.
The figure shows that the number of people with COVID-19 in hospital has fallen at a slower rate than the number of people dying.
This lead to declining death rates in hospitals, which can be seen by looking at the peak Hospital Fatality Rate (HFR) on the 2nd if April and comparing to the current HFR:
On the 2nd April, there were 644 deaths in 10,737 people in the hospital with COVID-19 HFR* peaked at 6.0%.
By the 15th of June, there were 50 deaths and 3,270 people in hospital with COVID: an HFR of 1.5%.
*HFR (hospitalized) defines a case as someone who is infected and hospitalized.
The reasons for this steep and continual decline in the deaths per day in the hospital of patients with COVID-19 are unknown and should be explored. Potential reasons could include:
The reasons for the declining death rate in hospitals may be a combination of one or all of these factors or due to some other reason, we have not considered. In either case, further research is warranted to understand why the hospital death rate has declined so markedly over the past 8 weeks.
SEE BMJ News for coverage of this article:
Covid-19: Continued outbreaks in care homes risk extending pandemic, say experts
BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m2530 (Published 24 June 2020)
Correction: this page has been corrected on the 25th of June
AUTHORS
James Mahon is an economist who holds an honorary post at the Liverpool Reviews and Implementation Group (LRiG) in the Department of Health Services Research at Liverpool University and works alongside the York Health Economics Consortium (YHEC) at the University of York.
Jason Oke is a Senior Statistician at the Nuffield Department of Primary Care Health Sciences and Module Coordinator for Statistical Computing with R and Stata (EBHC Med Stats), and Introduction to Statistics for Health Care Research (EBHC), as part of the Evidence-Based Health Care Programme.
Carl Heneghan is Professor of Evidence-Based Medicine and Director of Studies for the Evidence-Based Health Care Programmes (Full bio and disclosure statement here)
Disclaimer: the article has not been peer-reviewed; it should not replace individual clinical judgement, and the sources cited should be checked. The views expressed in this commentary represent the views of the authors and not necessarily those of the host institution, the NHS, the NIHR, or the Department of Health and Social Care. The views are not a substitute