Average age of hospital admissions and vaccine priority groups

[Musicaldilemma]

Please could someone explain something to me that I have been wondering about. If the average age of hospital admissions is 58-60, but the very elderly are vaccinated first, how will this lead to less hospital admissions quickly? (if that is where the NHS being overwhelmed comes in)?
All the NHS TV clips I have watched in the last couple of days keep talking about hospital admissions being mainly 50s now so should they not be the priority then? If the aim is to stop overwhelming the NHS? Because if the NHS is less overwhelmed with Covid cases then everyone else needing treatment in hospitals will likely get it more quickly. From everything I have read a very elderly patient who catches Covid quickly usually dies quickly. It is the middle aged who are overwhelming the NHS?

You will take away the top age slice. Bad outcomes are very age dependent. Vaccination will work it's way down the age range quite quickly if / when it scales up as planned.

If we'd been able to vaccinate the 90 year olds and above from March last year, the death total would be something like 20,000 lower.

If we'd been able to vaccinate the 80 year olds and above from March last year, the death total would be something like 60,000 lower.

Those aren't the actual numbers, I can't remember them - they were on a Radio 4 More or Less programme a few weeks ago.

Suffice to say that the numbers of 80+ year olds who wouldn't have died had we had an immediate vaccine, properly made me sit up and take notice. They were huge.

80 and 90 something year olds are dying at home or in care homes.

I read your OP too quickly: obviously it can't be an instant / quick solution. Hence lockdown, which itself has a lag.

My question is why the government let stuff build up pre Christmas and said people could mix Christmas day. NHS are paying for that now.

Thank you. I understand from a moral perspective that vaccination prevents most of the deaths, if the very elderly are vaccinated. However, it seems the hospital beds being occupied for prolonged periods leading to overwhelming of hospitals is driven more by the middle aged working population (with teenagers?) and they won’t be vaccinated for ages? At least that is what the recent clips in the press suggest to me. So it is the lockdown that is meant to stop the overwhelming of hospitals not the vaccination, in the short run at least. And so many people are so focussed mentally on it all being over soon because of the vaccinations.

I also look at it that the HCPs are also getting vaccinated which should help hospitals with staffing. And the hope must be that it will reduce transmission within hospitals too.

The vaccinations are the game changer. Just not immediately.

I think over 80s are still being admitted. They are in my area
They won't get CPAP or ITU but it's hard not to give them a shot with some oxygen and IV medication abs fluids which you can't get in a care home. Remember over 80% even if over 80s do survive.

Hospitals are not refusing to admit on a purely age basis. Yet.

The average age being 60s might be due to the more scary thought that it's a mix of over 80s and under 50s leading to an average of 60s

You can't go on what's on clips on the TV either. The telly want pics of the 30yr old pregnant lady and the lad in his 20s in ITU not Maureen aged 85 rather confused trying to pull her oxygen mask off in a normal ward with lots of others like her.

Why wouldn't >80s get CPAP? I thought that was fairly non-invasive. Awkward rather than unpleasant to receive.

Most people find CPAP highly aversive. It feels like having your face sucked off I am told. I'm not saying that being over 80 would 100% exclude you but if you had dementia you likely would not manage to tolerate it.

88% of covid deaths could be avoided once 4 key groups vaccinated.

Second attachment is ICU age distribution from most recent ICNARC report.

Or to put it another way:
henrytapper.com/2020/12/08/how-logical-is-the-uks-vaccine-priority-ordering/

@CoffeeandCroissant

88% of covid deaths could be avoided once 4 key groups vaccinated.

Second attachment is ICU age distribution from most recent ICNARC report.

That bar chart pretty much confirms what the op is saying. It looks like around 13% of admissions are aged 40-49, 53% aged 50- 69, 22% aged 70-79 and 5% aged 80+

Obviously you need to know the UK profile of the population to know if certain ages are more or less likely to be admitted than other age groups but nonetheless, those percentages clearly show that lots of middle-aged people are in hospital with Covid with over ,50% of admissions being aged 50-69

I assume the deaths are disproportionately likely to come from the 70+ age group which explains the second chart but the op's point about hospitalisations still being quite high until vaccinations start including those aged 50-69.

Meant to say - OP's point holds true,

I have also been wondering this.
Also, right now many elderly are hiding at home and probably not hugely responsible for actual spread anywhere near as much as working age adults, especially hcps but also presumably teachers etc.
I feel strongly that key workers of all ages should be prioritised, partly to protect them but also surely to reduce the chances of them spreading it.

Do we prioritise vaccines for the 50 and 60 year olds and save the NHS
and the beds they occupy in intensive care or do we prioritise vaccines for the old folk and save lives. It has to be lives doesn't it?

It is just a question of priorities. Do you want the NHS back to normal or fewer deaths?

We aren't going to go back to normal life until most adults are vaccinated because people of whatever age isn't immunised will get sick. That means the old die or the middle aged fill hospitals or the young are off work ill and some get long covid.

That's why nothing much is being said about releasing lockdown.

The 50 to 60 year olds will be vaccinated around April at the latest. Going on current rates. Faster hopefully.

Plus plenty of the people in that age range taking up beds are higher up the list because they are more vulnerable.

Once all 9 groups are vaccinated we potentially protect against 94% of deaths. And from your point of view we slow the transmission of the virus. Simply because it has less people to infect. So a win win situation. Even more so if the vaccine is proven to stop transmission.

@Frazzled2207

I have also been wondering this. Also, right now many elderly are hiding at home and probably not hugely responsible for actual spread anywhere near as much as working age adults, especially hcps but also presumably teachers etc. I feel strongly that key workers of all ages should be prioritised, partly to protect them but also surely to reduce the chances of them spreading it.

But the latest figures show that cases are already starting to go down across every age group except the 80+ group.

They need it more than a 25 year old police officer. One in 4 of them will die if they get the virus.

We have started to vaccinate frontline NHS and carers. This will step up to be other keyworkers. However that won't really affect the deaths or the percentage in hospital.

Vaccinating the elderly first protects those that look after them. This age group - carers, healthcare providers, etc. - is the one ending up in hospital now.

It makes clear sense to vaccinate the elderly group once you think about it this way.

Also important to appreciate the difference between an AVERAGE and a MODE (the most common value).

Imagine you had a different disease (not COVID) that affected only the very old and very young. The AVERAGE age of patients might be 40 even though there were absolutely no patients in their 40s. None.

Also bear in mind, the low numbers of 80+ people in ITU are because doctors are avoiding sending 80+ people to ITU. As they are "not good candidates for ITU" or "unlikely to benefit from ITU".

Apart from, as pp mentioned, elderly people dying in homes and care homes, there are a lot more people aged 50-69 than there are people aged 80+. I'm sure if numbers of admissions were presented as a percentage of people in that age group rather than a percentage of total admissions, the numbers would look very different. It's also pretty certain that if you divided those 50-69 year olds up by other risk factors, relatively few would have no other risk factors and the bulk of those who didn't would be closer to 69 than 50.

@bobbiester

Also important to appreciate the difference between an AVERAGE and a MODE (the most common value).

Imagine you had a different disease (not COVID) that affected only the very old and very young. The AVERAGE age of patients might be 40 even though there were absolutely no patients in their 40s. None.

In this case, the two are quite close, as you can see from the distribution. All measures of centrality are somewhere around 60 y.o. mark.