Hospitalizations up, but still low

California’s case rates may be back in summer surge territory, but its hospitalization numbers, mercifully, are not.

On the recent day when California’s daily average of new cases topped 10,000, nearly 1,400 people statewide were hospitalized with COVID-19. At previous times when the case rate has gone above 10,000, many more people have been hospitalized:

• Almost 6,400 in the summer 2020 surge.

• Almost 3,700 in the winter 2020 surge.

• About 4,000 in the summer 2021 surge.

• About 3,500 during the winter 2022 surge.

As of Wednesday, California hospitals were treating 1,967 people with COVID-19; the only times that number was lower were the past two months and about a three-month period in 2021.

It’s not all good news; the numbers of people in the hospital and in intensive care units have both doubled since their record low points last month. In Southern California:

• Los Angeles County had 429 patients hospitalized, including 55 in the ICU, up from lows of 209 and 19.

• Orange County had 126 patients hospitalized, including 17 in the ICU, up from lows of 57 and eight.

• Riverside County had 90 patients hospitalized, including 11 in the ICU, up from lows of 36 and four.

• SanBernardino County had 58 patients hospitalized, including nine in the ICU, up from lows of 28 and four.

But as Mourani, the Pomona Valley Hospital Medical Center physician, points out, not everyone in the hospital with COVID-19 is there for COVID-19. For example, someone may come in because of a fall or fracture and test positive, but their case is mild or asymptomatic. Other people may be in the hospital because the virus worsened an underlying condition such as diabetes or heart disease.

Mourani estimated that, lately in his hospital, roughly half of patients with COVID-19 are there specifically because of COVID-19.

Those patients, he said, are mostly elderly or have underlying conditions. And while the percentage of COVID-19 patients who are vaccinated is higher than it once was, Mourani said that makes sense because more of the community is vaccinated. The vaccinated patients are mostly getting mild disease, he said.

According to the latest state data, in recent weeks unvaccinated people have been 4.9 times more likely to get COVID-19 than people who are vaccinated and had a booster shot. They’re 7.4 times more likely to be hospitalized and 9.1 times more likely to die from the disease.

Accurate death data can take weeks or months to come together, so it’s hard to say what the current increase in cases will mean for mortality levels.

Mourani said he’s hopeful that with less severe disease and better treatment options, the virus will continue becoming less deadly. He also stressed that treatments are most effective when started as soon as possible after a person first feels symptoms — when patients come into the hospital with severe symptoms, it’s usually late in the disease and more difficult to treat.

But while the omicron variant may not be as deadly, it’s still killing people. Omicron was identified in Thanksgiving and state data shows that at least 12,700 people died from COVID-19 in December through February, making it California’s second-deadliest wave so far.

So, what next?

No one can predict how long the current wave will last, but UCI’s Noymer said virus levels in wastewater have started going down in Massachusetts, which may be an early sign that its surge is starting to ebb, so other parts of the country could follow suit.

State data also indicates that while case levels here are still rising, the pace of increase may be starting to slow.

When a disease becomes endemic, it will come and go in cycles. New variants will develop, and while evolution tends to favor milder strains — if a virus kills its hosts too fast or makes them too sick to go out, it can’t spread — experts say there’s no guarantee that some of those variants won’t be worse.

Noymer pointed to influenza: There was a catastrophic pandemic starting in 1918 and the disease eventually became milder, but there were fairly bad outbreaks in the 1950s and ’60s.

“And so it’s not like you can say it only ever goes down,” he said.