Tier 3 Manchester: what are the true Covid patient figures?

Hospital patient numbers were key to whether region entered tier 3. We look at the data

The number of Covid patients in Greater Manchester’s hospitals, and how many are in intensive care, has been a key element of the argument between the mayor, Andy Burnham, and the government over the latter’s determination to put the region’s 10 boroughs into tier 3 measures.

Why does this matter?

Boris Johnson and the health secretary, Matt Hancock, have warned that the number of Covid-19 patients in intensive care units (ICUs) in Greater Manchester’s 12 hospitals is high and that the coronavirus hospitalisations are rising so fast the region could run out of ICU beds by 12 November.

However, Burnham has accused ministers of using “selective statistics”. He insisted on the BBC last Sunday that Johnson had exaggerated the number of Covid patients in hospital and therefore their impact on the local hospitals.

How many ICU beds do Greater Manchester’s hospitals have?

There are 257, according to a leaked NHS document dated 16 October, and published by the Guardian. At the time, 211 of those 257 beds were being used, an occupancy rate of 82% that included people with and without coronavirus. The document said all 29 ICU beds at Salford Royal hospital were occupied, as were all 13 at Stepping Hill hospital, in Stockport, and 17 of the 18 at the Royal Bolton hospital.

The document is known in the NHS as its “daily dashboard” and is updated every day with the latest information from the 12 hospitals. It is an internal document shared only with hospital bosses and senior doctors.

It also said there were 90 confirmed or suspected Covid patients in ICU and that another 20 people with the disease were receiving one of two forms of oxygen therapy, called Cpap and Bipap, which were less invasive than mechanical ventilation. Some of those 20 were being treated in ICU and others on specialist wards, doctors said.

Are Greater Manchester hospital ICUs usually more than 80% full in October?

Burnham’s aides said the 82% figure was not unusual for the time of year. However, doctors in the region said ICUs had never before had scores of beds filled with Covid-19 patients heading into a winter that would inevitably mean wards further filled with people with serious breathing problems, such as those who had flu or pneumonia. Hospitals can expand the number of ICU beds from 257 by triggering “surge” plans to increase capacity but staffing problems could mean care not being of the usual high quality.

How many people with Covid-19 are in hospital in the region?

As of last Friday, Greater Manchester hospitals were treating a total of 520 inpatients left seriously ill by the coronavirus, of whom 90 were in ICU and 20 were receiving Cpap or Bipap, the dashboard said. However, the Health Service Journal reported on Monday that there had been “a large increase in Covid patients since yesterday, with beds occupied by Covid-positive patients rising from just over 500 to around 650”.

Are these figures published?

The NHS does not publish the number of coronavirus cases at each hospital in Greater Manchester or anywhere else, nor a daily update on new individual hospital admissions.

Burnham has published several charts which show how many beds, including ICU beds, are being used by coronavirus patients in Greater Manchester, though this is not broken down by hospital. The numbers issued last week showed there were 415 in hospital and 55 in ICU on 13 October.

In an article headlined “The spin and secrecy surrounding Greater Manchester’s hospital figures”, the Manchester Evening News recounted how a reporter spent all day on Monday trying to obtain accurate, up-to-date figures covering Covid-related hospital and ICU bed occupancy in the region. Despite requesting information from the NHS, Burnham and Downing Street, the information was not forthcoming.

Burnham said there were “around 62” Covid patients in ICU. Is that right?

Burnham’s statement was made on The Andrew Marr Show on 18 October. The “dashboard” from last Friday, however, said the figure was between 90 and 110. The difference seems to be that while the mayor is only referring to people confirmed to have Covid-19, the NHS document includes confirmed and suspected cases as one category; hospitals do the same in order to be able to manage patients properly.


Denis Campbell Health policy editor

The GuardianTramp

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