Corona pandemic: why the hospitalization rate is unsuitable


As of: November 19, 2021 9:18 pm

It has now been decided: The hospitalization incidence is now the most important indicator of the corona pandemic. There is great criticism of this key figure – experts consider it unsuitable. Why?

What exactly is the incidence of hospitalization anyway?

To hospitalize means to be admitted to the hospital. Hospitalization therefore means the following: The number of Covid-19 cases transmitted to the Robert Koch Institute that have to be hospitalized. So that these values ​​are also comparable between regions with different populations and thus also the number of cases, the hospital admissions are converted as a rate.

This means that these are always added up for the period of the past seven days and converted to 100,000 inhabitants. This is how the hospitalization rate – or in other words, the hospitalization incidence – is made up.

How is the hospitalization rate calculated?

The basis is the absolute number of Covid-19 cases that have to be hospitalized. However, since this number differs depending on the region and population and the numbers are therefore not comparable, they are converted as incidence. To do this, the hospital admissions of the Covid 19 cases are added up for the period of the previous seven days and converted to 100,000 residents. The calculation of the hospitalization incidence is therefore the same as the incidence of new corona infections.

Is this key figure then at all suitable for evaluation?

Many experts say: No. In its current form, this corona figure is unsuitable as an indicator for assessing the pandemic. The main reason for this is the incomplete data basis and the significant delay in reporting. This would distort the values ​​and thus underestimate the pandemic and the situation in the hospitals, it is said. This delay in reporting is also evident in the seven-day incidence of new corona infections – however, it is not as pronounced there as in the incidence of hospitalization.

Because while with the incidence of new infections it only takes about three to five days for all data to arrive, with the incidence of hospitalization it sometimes takes up to two weeks or longer for all hospitalized Covid-19 cases to be reported to the RKI.

Why is there such a long delay in reporting?

There are different reasons for this. But one of the main reasons for the delay in reporting is likely to be the reporting chains in the hospitals. Because these are not so well established and therefore not as efficient. This is probably due to the fact that so far hardly any diseases are notifiable in Germany. The hospitals are therefore not used to reporting certain illnesses to the relevant health department as quickly as possible.

Hospitals can do this faster or less quickly due to different staffing capacities. In addition, sometimes after hospitalization it must be determined whether there is a Covid 19 disease at all. Because not all hospitalized Covid-19 cases are clear at the time of hospital admission that it is a Corona case.

In any case, one thing should be clear: the care of acute emergencies has top priority. A corona test can therefore be delayed, as can the official laboratory result. In addition, the reporting programs of the hospitals and the respective health authorities differ from one another regionally – delays can also occur here.

What are the consequences of the delay in reporting?

How quickly or slowly a federal state reports has direct political consequences. Because if a federal state reports more slowly, the new, statutory threshold values ​​for hospitalization incidences of 3.6 and 9 respectively will be reached later. Measures intended to contain the pandemic will therefore take effect later than necessary.

If, on the other hand, a federal state reports its hospitalized Covid-19 cases promptly, stricter measures may take effect more quickly if the incidence of hospitalization increases. An analysis by the Science Media Center currently shows that Hamburg, for example, reports the slowest of all federal states. This is probably one of the reasons why the hospitalization incidence is lower in the Hanseatic city.

Is there a way to improve the informative value?

Yes, there are several options. For example, there are statistical methods such as nowcasting. The attempt is made to compensate for the resulting delay in reporting by estimating more realistic values. The RKI uses this method in part and offers a correspondingly adjusted estimate.

However, not in his daily reporting of the hospitalization incidence, which can be called up Monday to Friday in the situation report and online under Covid-19 trends, but this adjusted estimate using the nowcasting method only appears once a week in the respective RKI report.

Daily fluctuations play a subordinate role. But it is precisely these up-to-date values ​​that are likely to be decisive for the federal states in favor of stricter or more relaxed corona measures. The political measures are thus decided on the basis of indicators that are imprecise and underestimate the pandemic and the real situation in the hospitals.

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