Has the age of patients in ICU changed?

[DuchessOfHastings123]

Over the last few months I have seen many comments on MN on how patients in this wave are much younger (under 50) compared to last year. Does anyone have any information on this?
I looked at the ICNARC reports for March 2020 and Feb 2021 and the age range of patients look very similar to me. First graph is feb 21 and second is march 20.
Just curious what other people's understanding/experience of this is

@cantmakealifeofit

I assume it’s just because the elderly are isolating more whereas people in their 20s-60s are potentially still having to go to work etc and also may not be being as careful.

Whereas in the first wave it suddenly blew up and caught everybody off guard, and naturally it sweeper through the elderly causing more deaths in that age group.

This is what I was thinking. But we were previously told that 99% of covid deaths were from over 50s. Which was the rationale for vaccinating all of them first. I wonder if that is still true. Personally I see a very strong case for vaccination of key workers as presumably these make up the majority of working age adults in ICU?

As things stand unfortunately the case for easing of restrictions does not look good as even though we have protected to some extent the 70+ It would appear hospitals are still full of younger people.

OP is seeking sources of data: posts on this thread are all anecdotal.

@RafaIsTheKingOfClay

That’s not January, it’s from September to January.

Is to January up to 1st January, or up to 31st January?

It's a massive difference for 2nd wave figures, especially in the South East. An unbelievable amount of people here were sick and hospitalised with covid in December. Most of the resulting deaths have been during January so won't show up in the up to January figures.

We need to know what percentage of cases in each age group end up in ICU / die to undestand the situation.
If cases are high in a particular age group but the same percentage end up in ICU we know the virus isn't getting more dangerous to younger people.

sources?

@Gobbolino7825

We need to know what percentage of cases in each age group end up in ICU / die to undestand the situation. If cases are high in a particular age group but the same percentage end up in ICU we know the virus isn't getting more dangerous to younger people.

Yes this is the kind of info I would like but don't know where to find it, if it is even there to be found

When you say 'end up in ICU' do you mean sedated/ventilated where a machine does all or most of the work required to breathe ? Because in a lot of Trusts patients requiring CPAP are in ICU/HDU beds ?

There have certainly been a few news articles recently suggesting patients are getting younger. See...

news.sky.com/story/covid-19-patients-are-younger-and-sicker-than-in-the-first-wave-12189178

www.itv.com/news/2021-01-18/covid-intensive-care-matron-tells-of-soul-destroying-moment-of-seeing-families-being-wiped-out

I can only say what I see in my hospital (icu nurse) but the main ages are 55-70. We have had a few cases younger than 45 but they did well (cpap for a few days and back to a ward.) The youngest I have seen die in this wave was 48 but had pre-existing cardiac issues. The youngest with no medical history was 56. There have been quite a few cases of getting more than one member from the same household (husband and wife, father and son etc.) The ages of icu patients is difficult though, because not all patients are suitable for icu care, or have the physical reserve for a prolonged stay. This is discussed with the patient- and many will refuse ventilation etc as it is either unlikely to make a difference to the end goal (leaving hospital.)
Different areas seem to have been hit differently and I wonder if this is due to different variants? We have gotten off quite lightly compared to other areas although we have been busy, 1 nurse to 2 ventilators as opposed to 1-4 in London.
I’m sure someone much cleverer than me will be researching the disease spread etc and hopefully they will have the answers soon!

My brother is a nurse on a Covid ward. All his patients are over 75.

AluckyEllie Interesting, thanks. Are you including obesity in pre-existing conditions?

In my trust the ages of the patients have definitely gone down this time.
Lots of 30 -50 year olds ventilated.

I would say the largest group are 60s but it is noticeably different this time, there are people my age. That terrifies me.

@Carrotcakeforbreakfast

In my trust the ages of the patients have definitely gone down this time. Lots of 30 -50 year olds ventilated.

I would say the largest group are 60s but it is noticeably different this time, there are people my age. That terrifies me.

Why? Why now? Young people have always died of this, it’s indiscriminate.

My OH works in ICU and says there are far more younger people coming through, he said it was manic today . With regard to London he wonders if it may be now there’s a shortage of beds that they’re prioritising those who are more likely to survive the experience, those with younger generally more fit bodies.

@AluckyEllie do you have the same number of critical care beds/ICU beds as you did before the pandemic or have the numbers been increased ?

@Fembot123 because while I can't speak for the whole UK. This time in my trust we have a significant increase of people who are my age with no underlying conditions.
More so than the first time around. We had younger patients before but not to this extent.

[quote Carrotcakeforbreakfast]@Fembot123 because while I can't speak for the whole UK. This time in my trust we have a significant increase of people who are my age with no underlying conditions.
More so than the first time around. We had younger patients before but not to this extent.[/quote]
You’re right, you can’t. You can’t actually even say anything of any veracity on a anonymous forum. You can serve what you like but swallowing it is a choice.

If there was a massive groundswell of young deaths we’d fecking well know about it, we’d have our noses ground in to it so we’d never leave the house and never question a thing.

We are seeing more patients 30-50, but we have seen more than double the patients we saw in first wave, over a longer period. It's not easily comparable. We have seen more deaths, but I suspect it will be at a similar rate if not lower.

To answer a pp, we have had various escalation areas and are using double our normal capacity. Have not been hit as hard as neighbouring trusts.

There is no more reason now than ever before to be ‘terrified’, if that is your position now it should have been your position since the start.

@FiveFootTwoEyesOfBlue I’m not sure if it would be classed as a contributor on a death certificate. For example the patient might be a bit large and pass away. I don’t know if they put that on the death certificate and I assume that is where they are auditing the deaths/pre existing conditions from? Normally it’s only mentioned in medical notes if it’s very overweight- so bmi 40 etc, rather than an extra stone or so.

@frumpety Definitely more beds than pre pandemic. We had 31 (icu and hdu) pre pandemic across 2 units. It’s now 23 green beds and 43 red beds -5 units now. Not all those beds have been occupied at one time- green patients can’t go into red and vice versa. I think 40 red beds occupied was the worst, mid jan. We were very close to expanding into next area.

It’s also hard to compare first and second wave as we now have more treatments- so the recovery trial showed a steroid had a significant affect on mortality in severe covid. So, if we are busier this time and we are giving all patients dexamethasone routinely it must mean either the transmission or variance is more severe?

@AluckyEllie thank you for everything you do x (teacher here).

And @StrugglingICUnurse too

Sources is the new arsehole phrase. I know two ICU Dr’s who are a little upset over how many younger people are in ICU. Children in my family are about to be orphaned because both parents are in ICU (Tier 4 area). My own children could lose their Dad and another person I know is at deaths door and they are in their 50’s. Anecdata enough for you?

There are up to date data available in an icnarc case mix programme report dated 5th Feb (freely available online). Have to say I was slightly surprised by the ages it’s reporting in first and second waves (older than I was expecting in the second wave, based on my recent experiences). They are nationalised (England, Wales, NI) figures though and so individual units may have periods with different experiences without skewing the numbers too far. Hospitals contributing to the data of course are able to access more comprehensive breakdowns of the numbers but this online report gives national trends. The report does consider the likely influence of new variants of covid briefly and on a quick flick through it this evening it suggests that ages on icu admission have fallen slightly since the beginning of December and I wonder if the next update may demonstrate this more clearly. The report also contains information re. comorbidity (including obesity) and functional status. It’s just over 100 pages long but worth the read if you’re interested. Also worth noting is that the report is only looking at mortality and the long term morbidity related to covid induced critical illness may well be significant and if the survivors are the younger folk then this may have a significant impact further down the line (both in economic terms and increased burden of disease later in life for these survivors).