It's been a while since I posted anything here, but this was so important, it was vital to get it out, on the grounds that it's important to change your opinion when the data changes. For a very long time, I've said that the "with COVID/of COVID" hospitalization and death dispute was mainly a distraction, one designed to minimize the disease burden from people who didn't want to believe the pandemic was worth all the bother others invested in it. It's now fair to say that COVID-19 hospitalization data isn't as meaningful as it used to be. Researchers tried to find out how many people were really in the hospital for severe COVID, but because it is a "must-report" disease, hospitalization counts include people in the hospital for other conditions who incidentally test positive for COVID-19. The way to understand this, then, is to get a handle on just how sick people with COVID are:
Instead of meticulously looking at why a few hundred patients were admitted to a pair of hospitals, they analyzed the electronic records for nearly 50,000 COVID hospital admissions at the more than 100 VA hospitals across the country. Then they checked to see whether each patient required supplemental oxygen or had a blood oxygen level below 94 percent. (The latter criterion is based on the National Institutes of Health definition of “severe COVID.”) If either of these conditions was met, the authors classified that patient as having moderate to severe disease; otherwise, the case was considered mild or asymptomatic.The study found that from March 2020 through early January 2021—before vaccination was widespread, and before the Delta variant had arrived—the proportion of patients with mild or asymptomatic disease was 36 percent. From mid-January through the end of June 2021, however, that number rose to 48 percent. In other words, the study suggests that roughly half of all the hospitalized patients showing up on COVID-data dashboards in 2021 may have been admitted for another reason entirely, or had only a mild presentation of disease.
This increase was even bigger for vaccinated hospital patients, of whom 57 percent had mild or asymptomatic disease. But unvaccinated patients have also been showing up with less severe symptoms, on average, than earlier in the pandemic: The study found that 45 percent of their cases were mild or asymptomatic since January 21. According to Shira Doron, an infectious-disease physician and hospital epidemiologist at Tufts Medical Center, in Boston, and one of the study’s co-authors, the latter finding may be explained by the fact that unvaccinated patients in the vaccine era tend to be a younger cohort who are less vulnerable to COVID and may be more likely to have been infected in the past.
So that's mainly a good thing: it means nearly half people in the hospital aren't generally in the ICU for COVID, but that they're for some other reason. It would be interesting (but obviously much more complicated) to get similar numbers for deaths.
