EMRG medium-term projections for COVID-19 hospitalisations and deaths: 9 November 2022 - ISS-G20 Laboratorium Repository

The UK Health Security Agency (UKHSA) Epidemiology Modelling Review Group (EMRG) shares these medium-term projections (MTPs) for coronavirus (COVID-19) hospitalisations and deaths with thanks to SPI-M-O, who contribute model outputs for the combined projections (not all modelling groups produce projections for both hospitalisations and deaths).

Medium-term projections

1. These medium-term projections (MTPs) for COVID-19 hospitalisations ^± and deaths ^¥ are not forecasts or predictions. They represent a scenario in which the trajectory of the epidemic continues to follow the trends that were seen in data available to 3 November 2022.

2. Several modelling groups produce their own set of projections. These individual projections are then combined to form consensus MTPs. MTPs are provided for England and Scotland, for hospital admissions (Figure 1) and England for deaths (Figure 2), as well as English regional hospital admissions (Figure 3). Due to an insufficient number of models being available, it has not been possible to produce projections for Northern Ireland hospitalisations. To note, changes in length of stay can result in differences between occupancy and admissions data, which in turn makes it more difficult for models to fit to both data streams.

3. The number of deaths are currently low in Scotland, Northern Ireland and Wales. Projecting forwards is difficult when numbers fall to very low levels, therefore projections for deaths are not provided for these nations this week. Likewise, English regional deaths are not included.

4. MTPs are provided for 4 weeks. The projections, based on continuation of current trends, become increasingly uncertain over this time-period, as current data trends are unclear. The high levels of uncertainty are seen in wide ranges of estimates between the 5th to 95th centiles (such as in Figure 1a), but these statistical extremes do not reflect the expected course of the epidemic.

5. The delay between infection, developing symptoms, the need for hospital care, and death means the MTPs cannot fully reflect the impact of policy and behavioural changes made in the 2 to 3 weeks prior to 3 November 2022 (although an assumed effect of school holidays has been included), which further increases uncertainty at present.

6. Modelling groups have used their expert judgement, estimations from NHS England, evidence from UKHSA and other published studies when making assumptions about vaccinations.

7. Projections do not include the potential effects of any novel variants. The delay between infection, developing symptoms, the need for hospital care, and death means it is unlikely that a novel variant will significantly alter the trajectories of hospitalisations and deaths in the timescales covered by these projections.

± These are new hospitalisations per day which incorporates both the number of individuals admitted with COVID-19, as well as inpatients newly diagnosed with COVID-19. Data definitions differ slightly across all 4 nations.

¥ These are the number of new deaths per day (by date of death) that are within 28 days of being identified as a COVID-19 case. Data definitions differ slightly across all 4 nations.

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