Managing ICU capacity: why was that?

Until the end of April, so for more than a month, ICU admission was almost a death sentence. This was evident from the figures of the NICE Foundation. 66% of the patients died despite/from the treatment. Even when that continued, it was never substantiated why the IC was important enough to shut down the country.

De eerste reflex om ademhalingsproblemen te behandelen met intubatie is begrijpelijk. Het bleek al snel dat dat drama's opleverde. Die werden dan ook breed uitgemeten in de media: "de ziekte is verschrikkelijk". Met de behandeling werd stug doorgegaan, ondanks de bijna live-verslagen vanuit de IC over hoe weinig adequaat die behandeling was. Want daar keken we naar, niet naar een verschrikkelijke killer disease. Die situatie duurde weken voort en het land werd platgelegd zodat niemand die behandeling ontzegd hoefde te worden.

If we only look at the deceased and those who left the hospital alive, the ratio is almost 2:1.

N.B.: The orange line also has an influence but we do not know what percentage of them survived. If we put that at 50/50, the number of deaths still remains almost 2/3 of the total.

Fortunately: in retrospect, things went much better at the time!

If you look at that graph again now, you will see that mid-April looks very different. It suddenly turns out to have gone a lot better. On April 17, the blue even crosses the red line.

The disease was still the same so it is anyone's guess what happened there. Different treatment or better triage would also have been reflected in the figures at the time. Was there perhaps something wrong with the reporting?

Data changed retroactively

This positive trend is not yet visible on the graph dated April 16. When comparing the two graphs, something else is also noticeable: on the graph of April 18, the ratio was roughly two-thirds deceased, one-third having left the hospital alive. If we now look at the same graph (on July 3), we see a fifty-fifty ratio: according to this later graph, as many people had returned home on April 17 as had died after IC treatment. What happened to those figures in the meantime? Has anything been reported about this? It cannot be found.

The striking thing is that the mortality figures, shown by the red dots, have not been changed. That is not possible simply because they are anchored in other databases. On the other hand, the number of patients still in hospital as of the end of March has been significantly reduced. At the same time, the number of patients who left the hospital alive at the end of March has subsequently increased significantly.

Op 20 april (laatste bolletje rechts) werden destijds 450 "uit het ziekenhuis ontslagen patiënten" gerapporteerd. in de nu gepresenteerde data zijn dat er 650 geworden. How can you be wrong by 200 patients? 10 patients are missing, I get that, but 200 if you count 450..? The discrepancy starts to emerge at the end of March. And by the end of March no one had noticed.

Het aantal patiënten dat de IC levend had verlaten per 16 april was destijds 490. Nu zijn het er zo'n 320. Bedenk daarbij dat "overleden" en "IC verlaten" samen bepalend zijn voor het aantal vrijkomende IC-bedden. Volgens de grafiek van 3 juli waren er dus 170 bedden meer vrij dan ze destijds dachten.

In any case, the data on which the steering was done at the time were not correct. Then I assume that they are now and have therefore been corrected afterwards. The country has been shut down on the basis of incorrect data.

The figures will now be able to counter future critical questions about the substantiation of steering in the ICU a little better than the original report could have done. RIVM will be able to use that well.

[EDIT: These numbers have never been paid attention to]