NHSUK: Non-Urgent Emergency Respiratory Admissions (%age)
So far I have placed my attention on front door emergency medicine, that is to say folk coming into the department by emergency ambulance suffering from a respiratory condition that requires emergency respiratory procedures. What we are going to consider next are those folk in the same boat who decided to make their own way to hospital. I’ve called these ‘non-urgent’ for want of a better expression; though this is a misnomer for these folk considered their plight urgent enough to get to hospital rather than see a GP. We’ve seen the A&E case load drop dramatically during lockdown, so once again I’ve calculated the percentage of these cases in relation total daily admissions so we may see where the clinical focus lies.
So here’s another extremely telling slide, in which we see the winters of 17/18 and 18/19 outgunning the winter of 19/20 for respiratory problems, and I am sure there are GPs at the coal face who will testify to this. Can anybody spot the pandemic? I sure as hell can’t, though I do see a few short-burst spikes dotted about since spring 2020. Be aware that noisy data like this will yield the occasional spike, this being the A&E equivalent to three London buses turning up at once.
Again we must note that the virus doesn’t carry a diary and strike folk on specific days on a whimsy and so we must look to prosaic explanations as to why folk decide to drive themselves to hospital one day and not the other. This could range from “I’ll see if it’s better Monday” to “my positive test has just frightened the shit out of me – I’m off to hospital”. In this we must include reactions to the many carefully crafted memes c/o the behavioural insights team - one decently scary advert and A&E gets flooded. To this we must add a bunch of everything else like pollen counts, fungal spore counts, weather and respiratory/bronchial infections of all manner.
The second slide presents the same data but smoothed out into monthly averages in order to avoid the London bus effect. September 2021 is starting to look interesting, as does the missing peak for winter 20/21. Compare this pattern with that for emergency admissions by ambulance - check out how the non-urgent peaks precede the emergency peaks. Interesting or what?!! So where are we hiding all our respiratory cases whose asthma will always plays up each winter regardless of masks and social distancing?
