Thursday, March 23, 2023

Denmark SSI Reports A Large Increase In COVID Hospitalizations For Week 11

WHO Weekly COVID report


Based on admittedly incomplete reporting, COVID appears to be generally in decline (down 31% globally in latest WHO weekly epi report above), but some regions have reported an increase in cases over the past 30 days. 

Leading the way are the Eastern Mediterranean region (up 89%) and South-East Asia (up 70%).  Europe is only slightly up (9%), while the Americas, Western Pacific region, and Africa all report sharp drops in cases. 

The regional rise (and fall) of different variants, changing seasons, and decreasing vaccine protection over time all contribute to this global variability in activity.  

Complicating matters, many countries around the world have sharply curtailed both the frequency, and quality, of their COVID reporting to the WHO.  In their latest weekly update, the WHO reports:

Globally, during the past 28 days, 42 (18%) countries reported data to WHO on new hospitalizations at least once. 

One of the countries which still provides regular, and detailed, reporting is Denmark. And in their latest dispatch, they report a large increase in COVID hospitalizations (up 68%) in week 11 over the previous week, across all age groups, but most prominently in those over 70. 

This (translated) summary from the Statens Serum Institut (SSI). 

Spring continues with increasing covid-19 infections and new hospitalizations

The Covid-19 infection continues to increase, and there are currently quite a few more people being hospitalized. This shows this week's trend report from the Statens Serum Institut (SSI).
Last edited on March 23, 2023

The beginning of spring continues with an increasing infection with covid-19 on virtually all parameters. But the infection is still at a low level and without a critical burden on the healthcare system.

From week 10 to 11, there is an increase in the number of SARS-CoV-2 infected people as measured by the use of PCR tests, and the incidence of infection increased in week 11 to 23 cases per 100,000 inhabitants, from 15 cases per 100,000 inhabitants in week 10. At the same time the number of PCR tests has increased by 8.5% and the positive rate has increased from 11.1% to 15.5%. The highest positive percentage is seen among the 70 to 79-year-olds.

Large increase in new admissions

For many, a positive covid-19 test also means hospitalization at the moment. Especially among the elderly between 70 and 89 years.

The number of new hospital admissions of people with a positive test for SARS-CoV-2 increased to 420 new admissions in week 11 compared to 250 in week 10.

"However, although the current increase is significant, it is still less than half as many as during the last three smaller waves of infection since the summer of 2022," explains Bolette Søborg, senior physician and section leader at SSI.

The variant XBB.1.5 carries the infection

The infection is primarily carried by the virus variant XBB.1.5, which alone accounts for 43% of all sequenced cases in week 11.

It is a variant that SSI has been keeping an eye on for a long time. It was first seen in the USA, but now it has caught on in Denmark and several other European countries. XBB.1.5. is not associated with particularly serious disease compared to the previous variants.

"It is not unexpected with a new smaller wave of infection here in the early spring. But now we are moving towards warmer times, so SSI are not particularly worried at the moment," says Bolette Søborg.

Read more in this week's trend report - week 12 2023 (pdf).

From the report:

Overall assessment 

There are signs of an increasing infection rate in all surveillance systems week 11. The number of cases with SARS-CoV-2 is increasing compared to week 10, while the positive percentage has increased despite an increase in test activity is. There is an increase in COVIDmeter’s user panel, who are presumably infected with COVID-19 in week 11 and the concentration of SARS-CoV-2 in waste water samplings continue to increase. I

In week 11 the number of new hospital admissions who are diagnosed with SARS-CoV-2 has increased across age groups. The current increasing infection rate is presumably driven by the increasing spread of XBB and its subvariants and also results in an increasing number of new hospital admission. However, the number of new hospital admissions is just above half of the levels seen in the summer and autumn/winter of 2022. The overall mortality in Denmark in week 11 is at the expected level. There is an increase in the number of new cases influenza regardless of type and in week 10, influenza was the most frequent virus found in samples from the sentinel surveillance system.  

The good news here is this surge appears to be due to the XBB.1.5 variant, which has been the dominant strain in the United States for months now.  This increase in Denmark seems unlikely to be a harbinger of another significant COVID wave. 

But the SARS-CoV-2 virus continues to evolve, recombine, and find new non-human hosts to experiment on.  

So we can't afford to take its future course and trajectory for granted.