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COVID hospitalisations & variants

Updated: Dec 8, 2021

Hospital rates falling across Europe

Across Europe, the latest data from ECDC (link) and Gov.UK (link) shows that hospitalisation rates are falling, most likely through a combination of restrictions and increasing prevalence of vaccination. However, as Figure 1.1 and Table 1.1 illustrate this is not happening everywhere yet – hospital bed occupancy rates in France and Sweden saw slight increases last week, whilst those in Croatia have gone up by 14% over the past week.

Figure 1.1 – Trend in hospital occupancy rates for selected European countries

Source: ECDC & Gov.UK, analysis by COIOS Research

Table 1.1 – Weekly hospital occupancy rates per 100,000 pop from ECDC

Source: ECDC & Gov.UK, analysis by COIOS Research

France requires further investigation. Approximately 20% of the population has received at least 1 vaccination which should be starting to exert downward force. The peak in hospital occupancy in the UK occurred on 18 January when only 6% of the population had received their vaccination, but UK had been in lockdown since Christmas.

In addition, the prevalence of the B.1.1.7 variant in France from specimens collated by GISAID is significantly lower at 54% than other European countries (see Figure 1.2). It would suggest that there is significant scope for that variant to spread and to drive up cases and hospitalisation rates in France. All particularly worrying given concerns over the public appetite for the vaccine and the surprising declaration that current restrictions will be relaxed on 2 May (more) before evidence of an improving situation.

It is an indication of how quickly the variant can spread that four weeks ago in Crucible Week 1 (29 March) (link) we noted that the then prevalence of B.1.1.7 in the USA over the prior 4 weeks was 12.7%; the latest prevalence rate is 51.6%.

Figure 1.2 – Prevalence of variants in samples sequenced over last 4 weeks from GISAID

Source: GISAID

Surges in India and variant B.1.617

On the other side of the world, India has seen record levels of infections in recent days as a new variant B.1.617 hits the headlines. It is still too early to say what role the variant plays in the surge given reports of large gatherings, but the variant (first detected in October 2020) has been found in more than 50% of all sequenced genomes over the last 4 weeks, albeit only a very small proportion of all confirmed cases. Many countries are imposing travel restrictions to limit the spread of the variant, with the UK placing India on the “red list” of countries last Friday that requires all visitors to stay in hotel quarantine for 10 days after arrival (more).

B.1.617 has a different E484Q mutation as compared to the E484K mutations that have caused great concern in the variants first detected in Brazil (P1) and South Africa (B.1.351). B.1.617 also has mutations at positions 452 and 681 which may limit antibody effectiveness and impact spike protein processing. Multiple investigations have begun to improve our estimation of the nature of the threat posed by yet another variant.

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