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Among the limitations of the study is that patients in the VA system are not representative of the U.S. population as a whole, as they include few women and no children. (Still, the new findings echo those from the two pediatric-admissions studies.) Also, like many medical centers, the VA has a policy to test every inpatient for COVID, but this is not a universal practice. Lastly, most of the data—even from the patients admitted in 2021—derive from the phase of the pandemic before Delta became widespread, and it’s possible that the ratios have changed in recent months. The study did run through June 30, however, when the Delta wave was about to break, and it did not find that the proportion of patients with moderate to severe respiratory distress was trending upward at the end of the observation period.