Emergency Department Admissions: Analysis of CDS Dataset (part 2)

I analyse an anonymised data dump of 1.9 million admissions records to the emergency departments of an undisclosed NHS Trust for the period June 2017 – September 2021

In part 1 of this series I ended by promising a look at the weekly counts of my ILI/COVID case indicators along with conversion of the raw daily counts into percentages for respiratory and/or infectious admissions. I’ve got a fresh cuppa to hand so let’s get stuck straight in…

ILI/COVID Weekly Counts

Here’s what we get when we flag infectious cases with a respiratory diagnosis:

The big peak here are those 26 cases for the week ending 27 December 2019, and it’s worth noting the earlier peak of 25 cases for the week ending 26 January 2018. Yes indeed, there is a modest spike marking 19 cases for the week ending 19 April 2020 which could be attributed to COVID (or something else masquerading as COVID). I don’t know about you, dear readers, but I certainly don’t get a sense of a novel and deadly pandemic.

If we combine incidence of a respiratory diagnosis, incidence of an infectious disease, and incidence of treatments typically employed for respiratory conditions we arrive at my probable ILI/COVID case indicator, weekly counts for which turn out like this:

Note just how few weekly admissions there are, the grand series mean being just 5.21 admissions per week. Also note the lack of any significant peak during the critical pandemic period despite this being the most robust indicator I can muster (according to the accepted narrative of an infectious respiratory disease, that is). Such nothingness bubbling up from the numbers from this and many previous articles of mine is why I agree wholeheartedly with PANDA’s latest summary of their current understanding.

Admission Profile As Percentage

With dwindling intake skewing the raw counts the only sure-fire way of detecting anything of interest is by deriving percentages with respect to total admissions, and this is what I now present.

Respiratory Cases

Here we have the profile for respiratory admissions adjusted for admission volume, and here we have a clear peak of 17.1% that was attained during the week ending 27 December 2019. There is a peak that pops up during the pandemic era (12.8%) that was attained during the week ending 27 March 2020. This might be exciting, novel and fresh were it not for a similar peak of 13.0% attained during the week ending 29 December 2017. Not exactly a pandemic of the novel and deadly, then, innit?

Infectious Diseases

A result in favour of the pandemic at last! Well, sort of. If we ignore earlier peaks, and especially the whopper that kicks off the series, then we get some sort of result for the week ending 10 April 2020. The question is what of the several hundred infectious diseases are we talking about here? And why is this peak limited to just a couple of weeks in April given this was supposed to be a novel pathogen taking advantage of an entire population?

Q: Is this the sort of response we get when we close down healthcare services overnight and have people turning up a few weeks later for urgent treatment that wasn’t urgent at the time? Is this bump a sign of people paying the price for poor policy?

Infectious Cases With Respiratory Conditions

This is beginning to feel like the COVID-thing of the well-spun narrative with infectious cases also exhibiting a respiratory condition. There’s a clear peak slap bang in the critical period, being a paltry 0.47% of admissions for the week ending 17 April 2020. That’s going to be 0.47% of 4030 admissions in total, which amounts to 18.9 cases. Quite. This is not a lot of folk whichever way we look at this but it did give staff plenty of time for rehearsing dance routines, thank goodness.

Respiratory Treatment

Those infectious cases exhibiting a respiratory condition didn’t result in much of a corresponding peak in treatment. There’s a bit of a peak around 10 April 2020 but this pales into insignificance when we consider the historical period back to 2017. To be honest there’s nothing that special to declare for the pandemic era.

Probable ILI/COVID

Combining the need for treatment with infection and respiratory conditions gives us our best shot at identifying cases that comply with the narrative, and here we have a magnificent peak of just 0.35% sticking right up during the week ending 17 April 2020. Strange that the very best marker for a novel and deadly disease that I can conjure from the data only lasts a week or so, but there you go; best not to question the narrative too closely lest it bite our bum! Those with hand-held calculators will already have figured that we’re looking at an ED workload of around 14.1 cases across the entire Trust during one week or so.

Q: Were the emergency departments of this NHS Trust mopping up the carnage from surrounding care homes?

The Way It is

Narrative-supporting peaks I can get using percentages, but volume; well, the volume just ain’t there, folks, and that’s as plain as the plain cake on my best china plate. If I had to shoot the muffin from the mule’s hat I’d say we ain’t lookin’ at a pandemic of any kind; no pandemic, no way, no how, no sir, and that’s about the size of it. This is an ex-pandemic; it has ceased to be. It is bereft of life. It has shuffled off its mortal coil, run down the curtain and joined the choir invisible.

Kettle On!