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?

In that case it would also raise questions in all the other many civilised countries that have a similar list.

@Truelymadlydeeplysomeonesmum

In that case it would also raise questions in all the other many civilised countries that have a similar list.

But not all countries have the new variant that we do.

Some countries have a wider definition of 'frontline' though.

The very elderly have been able to shield more easily. They are still more likely to die from the illness.
The reason younger people are the ones in hospitals now, is because they are the ones getting it as they are still out and about at work or have children at school who are passing it adults asymptotically. They are still less likely to die for it than very elderly, although this obviously means longer stays in hospitals whilst they fight the illness, putting pressure on beds.
Priority is to vaccinate the people most likely to die if they get COVID.

@Truelymadlydeeplysomeonesmum

In that case it would also raise questions in all the other many civilised countries that have a similar list.

What does 'civilised' mean here? Are 'uncivilised' countries less rich, less democratic, less white? Actually, there's some similarity but also quite a bit of variation between countries and even within countries, driven by values, demographics and risk profiles.

Wow way to try and put words in my mouth.

Civilised means to me a country that will put its people and their lives before their leaders or famous.

As in Poland has behaved in a civilised way by vaccinating their politicians and famous people first!

My husband is in his 50s, a keyworker that has worked all the way through and his BMI is not great.

Despite all that we strongly believe the priority list is right. He still is less likely to end up in hospital than his mother in her 80s.

Israel are know saying early signs that the hospitalisation of over 60s is down. They have a similar priority list to us. Which means ours will work too.

@Truelymadlydeeplysomeonesmum

My husband is in his 50s, a keyworker that has worked all the way through and his BMI is not great.

Despite all that we strongly believe the priority list is right. He still is less likely to end up in hospital than his mother in her 80s.

Israel are know saying early signs that the hospitalisation of over 60s is down. They have a similar priority list to us. Which means ours will work too.

One difference I heard of in Israel (apart from the massive scale of their vaccination programme) is that they are allowing people not on the priority list to queue up at certain times for any unused vaccinations apparently (are they doing 24/7 vaccinations as well ?)

I don't understand why there isn't a system here where other keyworkers can't queue in someway, maybe digitally, for unused vaccines.
I think it's so sad that we expect key workers to keep society going and aren't giving them the protection that other countries are, particularly with this new variant. I understand the argument for doing the elderly first but not sure I agree with it.

People have been saying at their vaccination centres or GPs that if any doses left they make sure it is used.

So that tends to be on other staff in the building, companions of people with appointments or they ring around and get whoever is able to turn up last minute.

That's correct Truley my father, 76, and his wife 60 both had theirs last week.

The wife's daughter is a receptionist at a GP's surgery and rang them with half an hour to spare.

In our area last week cases were 32.9% under 30s
Over 70s was under 10%
The rest @57% was aged 31 to 69

But the death rate for the over 70s was much higher. These are the most at risk.

At the risk of sounding callous, what is the life expectancy of someone in their 80s? Surely they can't have many more years left.

Stats from mid December.

Once you vaccinate the over 75s, which should be by the end of January (plus a couple of weeks until it takes effect), then the vast majority of NHS pressure ceases.

(The middle chart is individual risk, but there are far fewer over 85's, so the death chart on the right is more of a proxy for NHS pressure)

I have been wondering the same thing. My much loved f'n'law unfort died of covid in a carehome in the first wave. The hospitals weren't accepting carehome patients so many were not taking up hospital beds. Maybe hosipitals are accepting carehome patients now.
I was wondering though as the basis of the lockdowns are to protect the nhs - how thats going to work if you have an increase in middle age people with a chance to fight the virus taking up beds. I do agree that as a society we need to protect the vunerable but I am also wondering about the working age people who are vunerable. I don't like the idea of choosing who has more right to life so I deliberately avoid forming an opinion.

I am concerned about elderly people being discharged to care homes without being vaccinated, however. Will this mean it is still not safe to visit care homes or be another way of increasing transmission?

You’re right, OP. We’re simultaneously trying to reduce deaths and hospitalisation. The groups overlap, but not as much as we’d think.

We’re trying to reduce deaths for several good reasons (for individuals, for the organisations caring for the sick elderly) and for political reasons. We’re trying to reduce hospitalisation mainly to alleviate the catastrophe unfolding in hospitals.

The decision has been taken to prioritise the elderly for mainly political reasons, but it also “feels right” to most people. To reduce hospitalisation and therefore deaths in the younger age group we’ll need to move to the clinically vulnerable and >50s as soon as we can. The current vaccination rate suggests we’re ahead of target - but the availability of vaccines could become a rate limiting step.

There’s a great Twitter thread by Christina Pagel (indie SAGE) about this:
twitter.com/chrischirp/status/1350416428025962498?s=20

At the same time we need to drive down transmission to help with all this because no vaccine is 100% effective and the more transmissions there are the more likely there are to be mutations that risk vaccine escape.

I think just carrying on expanding / scaling up the vaccination programme rather than potentially gumming it up by changing priorities at a late stage has been a better call than most tbh.

That really is a great thread, thanks for linking Janet. This is the key graph, which shows all the data clearly.
I still think it’s right to vaccinate the elderly first for a variety of reasons but the NHS won’t be safe until the over 50s are vaccinated.

@FindHungrySamurai
Thanks for posting that graph.
It shows clearly that vaccinating the over 70s should drive down deaths as well as hospital admissions quite dramatically. And obviously all the more so once we get to the over 50s which is the next target.’

Yes, vaccinating the majority of the over 75s should make a big difference to the NHS and will slash deaths, but it’ll be another month or two after that before we can really relax.

I thoughts it's because the very old normally die in the care homes rather than hospital?

The graph has a category 45 to 64, yet vaccinations are for over 50s. Why not over 45s?

Yes it’s annoying when age categories don’t match up between reports, although it seems very likely that the 45-50s make up less than their proportionate share of the 45-64 ICU admissions.
There’s definitely a case for prioritising the 40-50s when we get to stage 2 of the vaccinations rather than a free for all in ages 18-50. A lot of the people in the 40-50 age group will have undiagnosed hypertension or type 2 diabetes.

Gosh that graph shows:
How important it is to vaccinate over 75’s first
How many people in hospital are in the 45-64 category and how that age group ( not just over 50’s) need vaccinating to reduce pressure on hospitals

My relative has just had a much waited outpatient appointment cancelled ( first appointment and is really not well and being waiting for this apt) this week as all outpatient Dr’s are now involved with COVID patients in hospital at his city’s hospital apparently.

Quite worrying that people with potentially serious illnesses are now going to have to wait many more months due to the amount of people in hospital.

I am glad I am not making decisions and am hoping the 45 and overs( inc over 80’s) all get vaccinated as soon as.

Op I think you have been looking at the figures for ICU admissions where 58-60 is the average age for admission. Looking at the bar chart above The average age for total hospital admissions is probably much older.
The reason for such a low age for ICU age is down to whether the patient will survive intensive treatment not whether they will survive Covid. Strict criteria are followed.