The Daily Telegraph reported on Friday 21 August ‘hospital admissions for COVID inflated‘.
This article was wrong and misleading. It is completely untrue to suggest or imply that there has been any ambiguity in how COVID admissions have been recorded in England.
Throughout the pandemic, hospitals in England have been asked to record for operational and management information purposes whether any patient has tested positive for COVID.
This is of course sensible and responsible. Hospitals need to know who in their service has tested positive. The alternative would be for hospitals not to know which of their patients could be infectious.
It is also inevitable that when dealing with a novel virus pandemic, new evidence emerges which prompts advice to be updated.
This also, is sensible and responsible. The NHS would rightly have been criticised were it not to have updated advice in line with the latest available testing capacity and scientific evidence.
Given the lack of information about the virus, and the understandable absence of a pre-mortem test for COVID-19 at the outset of the pandemic, the definition the NHS used – “a confirmed COVID-19 patient is any patient admitted to trust who has tested positive for COVID-19” – was based on advice from the chief medical officer.
Later, as PCR testing came online, England’s hospitals were able to refine the definition of ‘positive’ patients in its service management information.
This absolutely does not mean that reported data are “inflated” or untrustworthy, but rather reflects the improved understanding of the disease caused by COVID.
Data on hospital admissions, people in hospital with COVID and people on mechanical ventilation in England were published and presented daily at the Downing Street press conferences, along with clear and transparent explanations online, including for example clarification that some admissions in devolved administrations had to be reclassified and included suspected and not just confirmed cases.
Crucially, patients’ care is always determined by each individual’s circumstances; the specific definition does not affect clinicians’ decisions about their patients.
The NHS’ approach has been consistent, transparent and robust throughout, and informed always by the latest available scientific evidence.