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A characteristic of the coronavirus epidemic (and of all epidemics) is that the number of illnesses increases first, then to those hospitalized and finally to deaths. This is apparently the case in Hungary as well, as as time progresses, the number of hospital patients and deceased will increase. However, data from the epidemic in Hungary suggest that the number of hospital admissions is growing more slowly than in the first wave, even though the epidemic has also reached the elderly. This could still be explained by a simple time lag with respect to the previous course, but in the meantime the increase in the number of deaths has accelerated. We analyze the situation in Hungarian hospitals.
Suggestion
The number of active coronavirus cases (registered and unregistered) in Hungary has increased since August. In summer, the infection only spreads among the young, but in September, according to a heat map, the number of cases among the elderly is increasing, meaning the age composition of cases is changing rapidly. This is also demonstrated by the fact that the average age of those infected is also increasing rapidly: it was 26 at the beginning of September and rose to 35 at the end of the month. The number of hospital admissions is increasing, but their proportion has strangely fallen to a clearly low level in September in relation to all active infections, despite the above processes, while we could expect an increase as the elderly are more likely of being hospitalized.
Therefore, in September, the coronavirus epidemic spread especially quickly in Hungary, significantly increasing the number of new coronavirus cases per day, the number of active infections, but the increase in hospital care does not fully reflect the rate and direction of the disease, that is, the rapid spread of the virus. now it is also spreading among the elderly.
What do the official data show?
We will now examine what we can say about hospital admissions and deaths in light of official data (daily recorded cases, recorded active cases, hospitalized, daily deaths). Our graph below shows the proportion of active infections recorded in the hospital.
This shows that in recent weeks its figures have oscillated between 3-4%, and at the end of the period we can see a rate of 3.5%, while at the beginning of September the rate was still above 5%. In August, we saw even higher values. The recent data is particularly interesting in light of the fact that the epidemic has also affected older people.
When looking at an indicator that captures shorter processes, the increase in the number of hospital admissions / the number of new cases registered per day, we do not see the increasing trend that would suggest a 10-year increase in the average age of infection in a month:
The fact that there may not be enough hospitalization among patients (or only late) who would need it is indicated by the fact that all deaths per hospital patient and all deaths per ventilated person (although we know that not all deaths will be on board sooner) increased significantly in the second half of the month. This indicator has already indicated that the elderly have reached the epidemic.
This is due in part to the escalation of the epidemic; However, if health and epidemiological performance is balanced over the period, it may be surprising that there was a period in which 2% of all hospital patients per day died based on the 7-day moving average and the rate of daily mortality per ventilator reached 30%, but shortly after (when we still cannot speak of the descending branch of the epidemic) we again saw lower figures.
In the first wave, when predominantly elderly sick people were infected, these values were lower (generally around 1% and 20%, respectively). Now, however, the average age of the recorded cases is still lower than in the first wave, but this statistic does not seem too good.
Overall, therefore, based on the above, it appears that not many will be hospitalized in the second wave of the epidemic at the moment. Increasing the average age of those infected did not significantly accelerate the increase in the number of hospital admissions. However, infection among the elderly is evident in the mortality data, that is, the number of deaths is already beginning to rise relatively quickly based on derived indicators.
What do the estimates show?
Once we know that there are a number of problems with the information provided, we modify it. This affects daily recorded cases and active infections.
- Before mid-September already testing capabilities reached their limit, so we cannot detect more cases with our daily testing capacity of 10-12 thousand. That is, even if there are more cases to prove / suspect, they cannot be included in the statistics. That is why in the calculation of our model we have increased the test capabilities in the imagination and therefore we do not allow the proportion of positive tests (when the test capabilities limit is reached) to exceed 6%. (There were days when the positivity rate was 10% in the recent period.) Therefore, we calculate the number of new cases per day if there is sufficient evidence.
- A registered active cases are misleading, according to which a Hungarian case infects for more than a month (which is obviously a registry problem and not the specificity of the virus), while in reality the time of the illness is much shorter on average. That is why we start by accumulating the recorded cases from the last 14 days (this is a smaller number than the officially active infected) and then, counting on the increasing underdetection, we look at how many active cases there may actually be.
Based on the above, the following image emerges:
Using the resulting epidemic curve close to reality (latent infected and recorded), we also examined what was happening in hospitals. It can also be seen that the proportion of hospital admissions has been reduced to a low level compared to all real cases, and the number of ventilated people also shows a downward trend despite the outbreak of the epidemic and infection of the patients. seniors.
The index, which captures short-term processes more closely (the relationship between the change in the number of hospital admissions and the total estimated number of new cases per day) also shows that very few people remain hospitalized. The very slightly upward trend is due to the negative data of September 1, without them the trend is slightly downward. This is also very strange in light of the fact that the elderly are reaching out to the elderly.
When examining the data for actual active cases and estimated daily new cases relative to hospital admissions, it appears that the median age of those infected is stagnant. However, we know that this is not the case as it has risen for 10 years in a short time. The relatively rapid mortality of all hospitalized cases, despite an even more favorable age composition than in the first wave, raises the question of whether the cases were sufficiently hospitalized for coronavirus or whether they were hospitalized “soon enough.” Of course, there is a lot of uncertainty, as the number of new cases registered and the number of active cases registered are questioned, so it would be especially important for Hungary.
- test as much as possible (significantly increase testing capabilities and the number of people to be tested),
- tests are completed quickly,
- and those who present strong symptoms of those detected should receive appropriate treatment.
At the same time, it seems inevitable that the number of people hospitalized and deceased will increase significantly in the next period.
Cover image: Getty Images
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