Glimmers of hope
The case counts are sky-high, but omicron is causing less severe illness than before. Hospitals are close to being overwhelmed, yet hospitalization rates are lower than earlier in the pandemic, and fewer of those admitted to hospitals are in intensive care, or need lifesaving respiratory assistance. Can it be that a less severe variant is nonetheless leading to turmoil in the health-care system?
Yes, it can, thanks largely to the sheer size of the wave. The Centers for Disease Control and Prevention reported Jan. 2 that nationwide hospital admissions of patients with confirmed covid rose to 4.45 per 100,000 people, compared with 1.53 in early November, before omicron. Of 2,224 counties in the United States that have hospital beds, an estimated 644 are projected to be at capacity and an additional 619 are at high risk of reaching their limits in the next 10 days on present trends.
The unvaccinated are driving the surge. New York state reported that in the last week of December, as omicron took hold, daily new hospital admissions of unvaccinated people soared to 58 per 100,000 residents, compared with only 4.6 for the fully vaccinated. Similar reports have come from around the country. In Louisiana, 80 percent of the hospital admissions were not fully vaccinated; in Connecticut, 71.2 percent.
The stress on hospitals is not only for beds. Health-care workers are exhausted after two years of relentless pressure. They are quitting at an unprecedented rate; 1 in 5 U.S. hospitals are reporting critical staffing shortages. In many places, the hospital crisis may have knockon effects, too, meaning that people with other health-care needs will be forced to wait, if they can.
Not everyone is being admitted for covid alone—a large portion of these patients are being admitted for other maladies that have been aggravated by covid. Both situations count as covid cases. In the day-to-day unfolding of the crisis, hospitals are seeing a marked shift to less severe illness for patients in emergency departments. One hospital official told us that while last winter 80 percent or so of those testing positive in the ER were admitted, now only about 20 percent or 25 percent are, and of those, a smaller share than before are admitted for covid alone. The big difference is vaccination: In areas with higher uptake, disease is less severe. A study from the Houston Methodist health-care system found that omicron patients’ median length of stay was 2.8 days, compared with 5.4 for the delta variant.
Vaccines, masks, testing and improved ventilation will all help ease the pressure on hospitals. It is in everyone’s interest to take advantage of the tools at hand.