Omicron is lighter than Delta but still messy
The irony at Omicron, which is now responsible for an estimated 98.3% of all coronavirus cases in the United States, is that while it appears likely to yield milder outcomes than delta and earlier variants, the health system is as stressed as ever.
Public health officials warn that Omicron threatens to flood the medical infrastructure in huge numbers, and hospitals are full of critically ill patients.
“It’s going to get worse before it gets better,” said Dean Bloomberg, a pediatrician and infectious disease expert at the University of California, Davis.
Here’s what we know about why this happens:
Omicron is more contagious
The variant appears to be approximately two to five times more transmissible than delta, which previously dominated US cases.
“It is the second most infectious disease in the world right now, and it is second only to measles,” said Sarah Murray, director of the Health Information Data Science and Innovation Team and associate professor of clinical and hospital medicine at the University of California San Francisco. .
“While we are seeing early evidence that Omicron is less dangerous than Delta and that infected people are less likely to require hospitalization, it is important to note that Omicron is still more transmissible,” CDC director Rochelle Wallinsky said Wednesday.
This means that although a smaller proportion of patients with Omicron require hospitalization, the total number of COVID cases is so high that hospitals are receiving more such patients than at any time in the pandemic.
COVID-19 cases are at record levels in the United States, averaging about 1.4 million new cases reported per day, which is itself an undercount. Daily, an average of 19,800 people nationwide are now hospitalized with COVID, according to the CDC, a 33% increase from last week. Nearly a third of ICU beds across the country are now full of COVID patients, which means 1 in every 2.5 people in the country’s intensive care ward has the virus.
More Patients ‘With’ COVID Admitted
COVID is so widespread at the moment that a large percentage of patients in hospital are admitted for something else but then test positive on screening upon admission.
“We are testing a lot of asymptomatic patients in preparation for procedures or surgeries, planned hospitalizations — and even in people who are completely asymptomatic, we are seeing a positive case now of about 12%,” Murray said.
“It’s a very different scene that we’re seeing with hospital overcrowding than we’ve seen with previous waves of COVID,” said Rachel Charles, an infectious disease expert at Massachusetts General Hospital and Harvard Medical School. Nearly half of these cases are hospitalized due to illnesses unrelated to COVID.
At UCSF, Murray said about two-thirds of COVID patients have been hospitalized with the disease, while one-third have been hospitalized. with He. She. In pediatric COVID patients, about half were admitted for something other than illness.
However, even if these patients’ COVID symptoms are mild or nonexistent, their positive status places an additional burden on the hospital as they require isolation and additional safety protocols for hospital staff.
Staff shortages due to exposure and burnout
The increasing number of cases is masking doctors, nurses and other health care workers with the more contagious variant, which is causing more sudden infections among vaccinated than those previously, said Akin Demihin, director of policy for the American Hospital Association. Even with mild infections, these health care workers remain out of work for a week after their tests turned negative, according to CDC policy, just as the surge fills hospitals and increases demand for staff.
Increased Omicron will only put more pressure on doctors and nurses, who still have to take care of all those extra patients. One survey last August reported that nearly 60% of doctors feel fatigued, Demihen said, and that was two periods ago. “We hear this from hospital leaders all the time — their first, second and third priority right now is the workforce,” he said. “They know just how much health care providers have been asked over the last two years or so.”
More young children
“This time around, we’re seeing more kids under the age of 5,” Bloomberg said.
He noted that many had milder cases of bronchitis or croup, while adolescents with COVID seen in earlier periods had more severe pneumonia. Most of these young children recover well, but he cautioned that with any injury and any hospitalization, “some children will not do better.”
According to the Centers for Disease Control and Prevention (CDC), hospitalizations among young children are currently higher than at any time during the pandemic.
Vaccines still work, but boosters matter
One thing that Omicron’s rise hasn’t changed is the well-established fact that vaccines greatly improve the odds that people won’t die from COVID-19. Deaths are still on the rise, with an average of 1,600 deaths per day in the United States, a 40% increase from last week, according to the CDC. (Walinsky said in a White House briefing that she believes most of these cases are delta-types.)
“Almost everyone will end up exposed and potentially infected,” National Institute of Allergy and Infectious Diseases head, Anthony Fauci, said Wednesday, with the Omicron outbreak. “But if you are vaccinated, if you are boosted, your chances of getting the disease are very low.”
“In the hospital where I work, we have a graphic sent out daily with little icons of people, those in the ICU, those on a ventilator, and those who have been admitted because of COVID,” said Jane Marazzo, director of the division of infectious diseases at the University of Alabama College of Medicine. Medicine in Birmingham, who spoke Tuesday at a briefing for the Infectious Diseases Society of America on Omicron for reporters.
“What we learned with Omicron is that the booster makes a really big difference in terms of reducing risk,” Murray said. Her hospital is receiving both vaccinated and unvaccinated patients hospitalized due to COVID. But even patients who received only an initial series of vaccines – without a booster dose – appear to be protected from the most severe consequences.
“What we don’t see is that patients end up on ventilators if they are fully vaccinated,” she said. “I don’t have a single fully vaccinated hospital patient on a ventilator at the moment.”