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There are more people in hospital with Covid than in late January. Why?

It’s no longer headline news and seldom causes serious illness, but it is still spreading

Antigen tests are now essential for monitoring the spread of Covid-19. Photograph: Bryan O’Brien
Antigen tests are now essential for monitoring the spread of Covid-19. Photograph: Bryan O’Brien

Covid-19. Isn't that history?
It might seem that way, but Covid-19 is still around. There are more people in hospital with the virus than there were in late January, and we've hit record levels in the admittedly short lifespan of reporting antigen test results. On Thursday, almost 12,000 positive tests – PCR and antigen – were reported.

Why is this happening?
Since the removal of restrictions, we're all moving around more, mixing more closely and most people have dispensed with masks. Spring has been slow to arrive so we're spending time in indoor environments where diseases can spread more easily.

That's pretty obvious. But why are there more people in hospital?
Not everyone in hospital with Covid-19 is there because of it. About half of hospitalisations are incidental, but that still means almost 400 people are currently in a hospital bed due to Covid-19.

But I thought the Omicron variant we have now was milder?
Omicron is less severe than previous variants, but it is super-transmissible, so more people get infected. Another factor is the waning protection provided by vaccines as time passes. A small proportion of this bigger number of cases requires treatment in hospital. Generally, the infection is confined to their upper respiratory tract, they spend less time in hospital and make better recoveries than patients in previous waves.

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The good news is that the number of patients with Covid-19 requiring admission to intensive care has continued to drop, in spite of the re-opening of society. Of the 41 Covid-19 patients in ICU on Thursday, barely half were there because of infection with the virus.

Are old people at risk? 
The average age of deaths reported last week was 83. More than 7,000 residents and staff of nursing homes and community hospitals have been infected in the current wave of the pandemic. About half the State's nursing homes have outbreaks that are still under investigation.

Mass vaccination along with milder Omicron has reduced the death toll compared to previous waves. In other countries, rising hospitalisations among older groups are being attributed to declining protection from booster shots. A fourth vaccine shot looks likely.

Should I still be worried?
Many people are still worried by the threat posed by Covid-19, and continue to wear masks and take other protective actions. Now that the State has stopped laying down national rules, it comes down to an individual assessment of the situation. Covid-19 may be no worse than flu – as the Financial Times declared this week in the UK – but individual risk levels vary hugely. So: am I at risk by dint of age or underlying conditions? Have I been vaccinated/boosted, and recently? How disruptive would it be for me to fall ill with Covid-19?

So is that it – game over?
No. Covid-19 continues to disrupt. Hospitals are among the worst affected, with over 3,000 staff off, beds closed for infection-control reasons and visiting interrupted. One Dublin principal told me 150 students and staff were out two weeks ago, and 105 last week. There is the burden of individual illness and also the legacy of long Covid after two years of pandemic. Prospects for the coming months look bright but scientists remain on high alert for new variants.

What can we do to protect ourselves in future?
We should continue to make changes that inhibit the spread of infection generally – such as better ventilation and fewer multi-bed wards in hospitals. We need better genomic sequencing so we can spot mutations earlier. We need a mechanism and a decision-making system that can react quickly should the need to protect against a new danger arise. We could also learn from the experiences of the past two years by setting up a proper investigation into the handling of the pandemic, as other countries have done.