Category Archives: Hospitalizations

Covid deaths and hospitalizations are falling in the U.S.

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Even as new omicron strains take over, Covid is no longer driving a majority of patients into the hospital. Still, doctors worry the virus could re-emerge as immunity wanes.

As the flu and RSV (respiratory syncytial virus) have spread rapidly this fall — inundating and overwhelming hospitals and their staff across the country — Covid has not.

In fact, Covid-related deaths and hospitalizations have fallen in recent months, despite the emergence of new omicron subvariants that evade immunity from previous infections and vaccination.

According to NBC News data, Covid deaths have fallen consistently since Aug. 31, when the seven-day average of daily Covid deaths was at 571. A month later, on Sept. 30, the number fell to 475. By Halloween, 365 were dying per day, on average, from Covid.

As of Nov. 14, the number had fallen to 316.

This week, the Centers for Disease Control and Prevention is expected to release new data on Covid-related mortality, finding that death rates began to decline in March 2022.

The overall hopeful sign of declining deaths could indicate yet another new Covid phase, doctors suggest. Fewer people sick enough to be hospitalized with Covid means that fewer people are dying of the illness.

The average number of Covid hospitalizations per day has decreased by 27.9% since Aug. 28, according to NBC News data.

Even better, Covid, it seems, is no longer sending a majority of patients into intensive care units.

“There has not been an increase in patients admitted to the hospital specific for Covid-related disease,” said Dr. Hugh Cassiere, director of critical care services at Sandra Atlas Bass Heart Hospital at North Shore University Hospital, part of Northwell Health in New York City.

Patients in his ICU with Covid were admitted with unrelated medical issues, and were subsequently found to be Covid-positive, Cassiere said.

“Not to say that it’s gone, but Covid has become a coincidental disease,” he said.

Dr. Vin Gupta, a pulmonologist and an affiliate faculty member at the University of Washington in Seattle, attributes the decline in deaths and severe Covid cases to a level of “baked-in immunity,” including vaccination, prior infection or a combination of the two.

While Covid-related hospitalizations are not currently increasing, Gupta warns that they could during the winter as immunity, especially from previous infection, diminishes.

“If you had Covid, say six to four months ago, you’re going to have less protection against hospitalization than if you were vaccinated,” Gupta said. “The duration and the robustness of protection wanes a lot more quickly if all you rely on is natural immunity.”

With that in mind, data from the Institute for Health Metrics and Evaluation, a research center within the University of Washington, suggest that Covid hospitalizations and deaths could tick up again in “mid-January at the earliest,” said Gupta, a medical analyst for NBC News and MSNBC.

Despite the encouraging decline in Covid deaths, another school of thought suggests that Covid has simply morphed into a new kind of fatal illness.

“Before everyone was vaccinated or had been infected, 80 or 90% of Covid looked exactly same. They had terrible pneumonia. They were in the ICU on respiratory support,” said Dr. Jeremy Faust, an emergency medicine physician at Brigham and Women’s Hospital and an instructor at Harvard Medical School in Boston.

Now, he said, “Covid deaths don’t all look the same.” While “baked-in immunity” may keep the most severe cases at a minimum, it is clear that Covid can wreak havoc on the body long after the infection has cleared.

“Somebody could have Covid and have a heart attack, and the primary cause of death is listed as a heart attack because that’s what really brought them to the hospital,” Faust said.

But, he added, “we’ll never know to what degree Covid triggered that heart attack.”

US COVID-19 admissions tick up: 10 CDC findings

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COVID-19 hospitalizations increased slightly this week after nearly two months of decline, while omicron subvariants BQ.1 and BQ.1.1 — dubbed ‘escape variants’ for their immune evasiveness — continued to gain prevalence nationwide, according to the CDC’s COVID-19 data tracker weekly review published Oct. 28.

Ten findings:

Hospitalizations

1. The seven-day hospitalization average for Oct. 19-25 was 3,249, a 1 percent increase from the previous week’s average. New hospital admissions had been falling since early August, CDC data shows.

Cases

2. As of Oct. 26, the nation’s seven-day case average was 37,683, a 25.1 percent decrease from the previous week’s average. This marks the 14th week of decline and the lowest daily case rate seen since late April, CDC data shows.

Variants

3. Based on projections for the week ending Oct. 29, the CDC estimates that BQ.1 accounts for 14 percent of cases, while BQ.1.1 accounts for 13.1 percent.

4. BA. 5 remains the nation’s dominant strain, accounting for 49.6 percent of infections. BF.7, another omicron subvariant experts are closely monitoring, makes up 7.5 percent of cases. Other omicron subvariants make up the rest. 

Community levels 

5. As of Oct. 27, 2.3 percent of counties, districts or territories had high COVID-19 community levels, 21.9 percent had medium community levels and 75.8 percent had low community levels. 

Deaths

6. The current seven-day death average is 373, down 13.7 percent from the previous week’s average. Some historical deaths have been excluded from these counts, the CDC said. 

Vaccinations

7. As of Oct. 26, about 266 million people — 80.1 percent of the U.S. population — have received at least one dose of the COVID-19 vaccine, and more than 226.9 million people, or 68.4 percent of the population, have received both doses. 

8. About 111.8 million people have received a booster dose, and more than 22.9 million people have received an updated omicron booster. However, 49.3 percent of people eligible for a booster dose have not yet gotten one, the CDC said.

Wastewater surveillance 

9. About 34 percent of the U.S. is reporting moderate to high virus levels in wastewater. Of these surveillance sites, 10 percent are seeing some of the highest levels since Dec. 1, 2021. 

10. About 50 percent of sites are reporting an increase in virus levels, and 44 percent of sites are seeing a decrease.

COVID-19 hospitalizations up in 39 states 

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COVID-19 hospitalizations are up 20 percent nationwide over the last 14 days, with 39 states and Washington, D.C., reporting an increase. 

Nationwide, COVID-19 cases increased 58 percent over the past 14 days, according to HHS data collected by The New York Times. Reported case counts may be directionally helpful at this point of the pandemic, given the use of rapid, at-home COVID-19 tests that result in under-counting.

“I think that we’re dramatically undercounting cases,” former FDA commissioner Scott Gottlieb, MD, told CBS News April 11. “We’re probably only picking up one in seven or one in eight infections.”

Hospitalizations are up 20 percent nationwide over the last 14 days, with a daily average of 19,694 people hospitalized with COVID-19 as of May 12. The CDC is keeping a close eye on the acuity of hospitalizations, with Director Rochelle Walensky, MD, noting that the agency is seeing less oxygen use, fewer ICU stays and no increase in associated death compared with earlier periods of the pandemic.

Here are the 14-day changes for hospitalizations in each state and Washington, D.C., reporting an increase, along with their daily average hospitalizations: 

Hawaii: 64 percent (92 hospitalizations)  

Maine: 61 percent (222)

Montana: 58 percent (25)

Massachusetts: 55 percent (703)

Pennsylvania: 47 percent (1,104)

Alaska: 45 percent (38)

Connecticut: 42 percent (337)

Michigan: 42 percent (812)

Rhode Island: 40 percent (87) 

Wisconsin: 39 percent (314) 

Delaware: 37 percent (188)

Iowa: 36 percent (113)

New Hampshire: 35 percent (112)

New York: 31 percent (2,627)

Virginia: 31 percent (383)

Minnesota: 28 percent (404)

Florida: 28 percent (1,380)

New Jersey: 27 percent (707)

Maryland: 25 percent (458) 

West Virginia: 24 percent (120)

Illinois: 23 percent (815)

Nevada: 23 percent (161) 

Ohio: 22 percent (734) 

Oregon: 20 percent (284)

Kentucky: 19 percent (249)

Washington, D.C.: 19 percent (84) 

Colorado: 18 percent (170) 

Vermont: 17 percent (64)

Indiana: 15 percent (297)

California: 14 percent (1,463) 

South Carolina: 13 percent (127)

Louisiana: 11 percent (65)

Kansas: 7 percent (79)

Georgia: 5 percent (576)

North Carolina: 5 percent (877) 

Utah: 4 percent (72)

Idaho: 4 percent (45)

Missouri: 3 percent (384) 

Nebraska: 2 percent (76) 

Arkansas: 2 percent (97) 

The 14-day changes for cases in each state reporting an increase, along with their daily average cases, can be found through HHS data collected by The New York Times here. Seven-day changes for cases in each state can be found here.

The more contagious omicron subvariant BA.2 makes up 68.1 percent of new cases in the U.S., according to the latest estimates from the CDC. New Jersey has the highest proportion of BA.2 cases of all states, according to the latest ranking of states by the subvariant’s prevalence.

President Joe Biden signed into law March 15 a sweeping $1.5 trillion bill that funds the government through September. The legislation did not include COVID-19 funding the White House had requested from Congress because of partisan disagreement about offsetting the funding.

The current lack of funding is affecting resources for COVID-19 testing and treatment. The Health Resources and Services Administration stopped accepting providers’ claims for COVID-19 testing and treatment of the uninsured March 22 because of a lack of sufficient funds, and stopped accepting claims for the vaccination of uninsured people April 5. The federal government is also cutting back shipments of monoclonal antibody treatments to states by 30 percent, and the U.S. supply of those treatments could run out as soon as May. 

How likely is COVID-19 hospitalization for vaccinated Americans?

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CDC Charts Show Hospitalization Rates for Unvaxxed, 2 Doses, 3 Doses

Data from federal, state, and local health agencies show COVID-19 case, hospitalization, and death rates are much lower for vaccinated Americans than they are for the unvaccinated.

The first week of December 2021, when Omicron was first detected in the US, unvaccinated adults were nearly 25 times more likely to be hospitalized than vaccinated adults. While Omicron caused a big spike in COVID-19 cases, vaccinated people continued to be less likely to be hospitalized than the unvaccinated.

In King County, Wash., which includes Seattle, unvaccinated people were 13 times more likely to be hospitalized for coronavirus since December than people who were fully vaccinated.

New York City was one of the first areas in the US to get hit with Omicron. During the week ending January 15, 0.6% of all unvaccinated people were hospitalized with COVID-19 , compared with 0.02% of all vaccinated people.

These two areas have some of the most up-to-date data that illustrates the differences in susceptibility and severity of coronavirus based on vaccination status. But other state and local health agencies as well as the Centers for Disease Control and Prevention (CDC) also provide data that shows vaccine effectiveness.

As of January 26, 210 million Americans, or 64% of the population, were considered fully vaccinated after completing the initial series of COVID-19 shots. Twenty-six percent of Americans had received a booster dose.

National data isn’t as recent but shows lower hospitalization risks among the boosted.

CDC data compiled from hospitals in 12 states shows that, in the week before Christmas, unvaccinated people ages 50 to 64 were 32 times more likely to be hospitalized with COVID-19 than people in the age range who got a booster shot. They were eight times more likely to be hospitalized with COVID-19 than fully vaccinated people without a booster.

Unvaccinated people 65 and older were about 50 times more likely to be hospitalized than those who were fully vaccinated and received a booster.

More recent data from across the country suggests vaccinated people continue to experience lower hospitalization rates.

Georgia and North Dakota are two states publishing recent data on hospitalizations for people who have received a booster shot.

These comparisons do not account for age, so they don’t directly show the effectiveness of boosters. But the available data suggests vaccinated people are hospitalized at lower rates than unvaccinated people, just like before the Omicron wave.

In the first week of December, the combination of Georgia’s unvaccinated population and those receiving only one dose of the vaccine were 10 times more likely to be in a hospital with COVID-19 than the boosted population.

Georgia counts anyone in a hospital who tests positive for COVID-19 as a COVID-19 hospitalization.

Hospitalization rates in the state increased for everyone regardless of vaccination status during the Omicron wave. But the gap between the boosted population and the unvaccinated or partially vaccinated remained.

As of mid-January, the weekly hospitalization rate for Georgia’s booster group was a third of the rate for the combined unvaccinated and not fully vaccinated population. As of January 31, 48% of Georgians were not fully vaccinated, while 17% had received a booster.

During the same period in North Dakota, unvaccinated and partially vaccinated people were about twice as likely to be hospitalized with COVID-19 compared with the vaccinated. The hospitalization gap was three times greater for those with boosters.

Several other states published data on hospitalizations through mid-January. They all show vaccinated Americans at much lower risk.

COVID-19 deaths pass peak from delta surge

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Welcome to Wednesday’s Overnight Health Care, where we’re following the latest moves on policy and news affecting your health. Subscribe here: thehill.com/newsletter-signup. 

Masks come to the Super Bowl: Fans attending the big game next month will be given KN95 masks.  

Despite omicron being less severe on average, the sheer number of cases has driven deaths past the peak from last year’s delta surge.  

The average number of U.S. COVID-19 deaths this week surpassed the height of the delta surge earlier this fall and is at its highest point since last winter, when the nation was coming out of the peak winter surge. 

The seven-day average of deaths hit 2,166 on Monday, according to the latest data from the Centers for Disease Control and Prevention (CDC). Average daily deaths in mid-September before the omicron variant was discovered peaked at around 1,900. 

While increasing evidence shows omicron may be less likely to cause death or serious illness than delta, the sheer infectiousness and the speed at which it spreads has overwhelmed hospitals, primarily with people who have not been vaccinated. 

The U.S. saw the highest numbers of deaths in the pandemic just over a year ago, before vaccines were widely available, when the daily average reached 3,400. The last time the U.S. topped 2,000 deaths was last February, as the country was slowly coming down from the January peak. 

Caution urged: Infections are falling in states that were hardest hit earlier, as well as broadly across the nation. Hospitalizations are also falling, but deaths are a lagging indicator and are still increasing. CDC Director Rochelle Walsenky said deaths have increased about 21 percent over the past week. 

The fact that the omicron variant tends to cause less severe disease on average also helped avoid an even greater crisis that would have occurred if it was as severe as the delta variant.  

COVID-19 peaking in Northeast + 2 more forecasts to know

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COVID-19 Forecasts: Hospitalizations | CDC

COVID-19 hospitalizations are at record high numbers nationwide, though some parts of the country are seeing cases plateau or fall, Surgeon General Vivek Murthy, MD, said Jan. 16 on CNN‘s “State of the Union.”

In New York and other parts of the Northeast, “we are starting to see a plateau and, in some cases, an early decline in cases,” Dr. Murthy said. Daily average cases in New York have fallen 27 percent in the last 14 days, according to Jan. 18 data tracked by The New York Times. New Jersey, Maryland and Washington, D.C., have also seen cases fall in recent days. 

“The omicron wave started later in other parts of the country. So we shouldn’t expect a national peak in the next coming days,” Dr. Murthy said. “The next few weeks will be tough.”

As of Jan. 17, a record 154,335 people were hospitalized with COVID-19 nationwide, HHS data shows. Hospitalizations had previously peaked at 142,273 on Jan. 14, 2021.

Two other forecasts to know: 

1. Daily COVID-19 hospital admissions will increase over the next four weeks, with 17,900 to 48,000 new admissions likely reported on Feb. 4, according to ensemble forecasts the CDC published Jan. 12. For context, the current seven-day hospitalization average for Jan. 5-11 is 20,637, a 24.5 percent increase from the previous week’s average. 

2. CDC forecasting predicts COVID-19 deaths will increase nationwide over the next month, with 10,400 to 31,000 deaths likely reported in the week ending Feb. 5. Current forecasts should be interpreted with caution, the CDC said, as they may not fully account for omicron’s rapid spread or changes in reporting during the holidays. 

States ranked by COVID-19 hospitalization rates: Jan. 18

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New daily COVID-19 hospitalization rates in the U.S. have risen 54 percent over the last two weeks, with all 50 states and the District of Columbia seeing hospitalization rates trend upward, according to data tracked by The New York Times.

Data is taken from HHS and was last updated Jan. 18. States are listed in order of hospitalization rate percent increase over the last two weeks. 

Alabama
14-day change: 133% increase
Hospitalizations per 100,000 people: 50

Louisiana
14-day change: 120% increase
Hospitalizations per 100,000 people: 41

California
14-day change: 118% increase
Hospitalizations per 100,000 people: 35

Mississippi
14-day change: 109% increase
Hospitalizations per 100,000 people: 47

Florida
14-day change: 105% increase
Hospitalizations per 100,000 people: 53

Hawaii
14-day change: 102% increase
Hospitalizations per 100,000 people: 25

South Carolina
14-day change: 102% increase
Hospitalizations per 100,000 people: 43

Washington
14-day change: 99% increase
Hospitalizations per 100,000 people: 31

Alaska
14-day change: 89% increase
Hospitalizations per 100,000 people: 15

Texas
14-day change: 86% increase
Hospitalizations per 100,000 people: 45

Arkansas
14-day change: 81% increase
Hospitalizations per 100,000 people: 43

Nevada
14-day change: 81% increase
Hospitalizations per 100,000 people: 57

Vermont
14-day change: 77% increase
Hospitalizations per 100,000 people: 19

Massachusetts
14-day change: 76% increase
Hospitalizations per 100,000 people: 46

Georgia
14-day change: 71% increase
Hospitalizations per 100,000 people: 57

Tennessee
14-day change: 70% increase
Hospitalizations per 100,000 people: 47

North Carolina
14-day change: 65% increase
Hospitalizations per 100,000 people: 46

Oregon
14-day change: 64% increase
Hospitalizations per 100,000 people: 21

Virginia
14-day change: 58% increase
Hospitalizations per 100,000 people: 46

Rhode Island
14-day change: 57% increase
Hospitalizations per 100,000 people: 51

Utah
14-day change: 57% increase
Hospitalizations per 100,000 people: 22

Wyoming
14-day change: 57% increase
Hospitalizations per 100,000 people: 18

Montana
14-day change: 52% increase
Hospitalizations per 100,000 people: 20

Oklahoma
14-day change: 51% increase
Hospitalizations per 100,000 people: 41

Idaho
14-day change: 50% increase
Hospitalizations per 100,000 people: 22

South Dakota
14-day change: 46% increase
Hospitalizations per 100,000 people: 39

Colorado
14-day change: 45% increase
Hospitalizations per 100,000 people: 31

Connecticut
14-day change: 44% increase
Hospitalizations per 100,000 people: 57

Missouri
14-day change: 44% increase
Hospitalizations per 100,000 people: 61

New York State
14-day change: 40% increase
Hospitalizations per 100,000 people: 67

Kentucky
14-day change: 39% increase
Hospitalizations per 100,000 people: 51

New Jersey
14-day change: 39% increase
Hospitalizations per 100,000 people: 69

District of Columbia
14-day change: 37% increase
Hospitalizations per 100,000 people: 125

Kansas
14-day change: 37% increase
Hospitalizations per 100,000 people: 43

West Virginia
14-day change: 35% increase
Hospitalizations per 100,000 people: 52

Pennsylvania
14-day change: 34% increase
Hospitalizations per 100,000 people: 63

Arizona
14-day change: 33% increase
Hospitalizations per 100,000 people: 44

Maryland
14-day change: 32% increase
Hospitalizations per 100,000 people: 60

Wisconsin
14-day change: 32% increase
Hospitalizations per 100,000 people: 43

Maine
14-day change: 28% increase
Hospitalizations per 100,000 people: 34

Nebraska
14-day change: 28% increase
Hospitalizations per 100,000 people: 35

Iowa
14-day change: 24% increase
Hospitalizations per 100,000 people: 31

Illinois
14-day change: 21% increase
Hospitalizations per 100,000 people: 56

Delaware
14-day change: 20% increase
Hospitalizations per 100,000 people: 64

Minnesota
14-day change: 20% increase
Hospitalizations per 100,000 people: 31

New Mexico
14-day change: 19% increase
Hospitalizations per 100,000 people: 31

North Dakota
14-day change: 19% increase
Hospitalizations per 100,000 people: 34

Michigan
14-day change: 17% increase
Hospitalizations per 100,000 people: 48

New Hampshire
14-day change: 14% increase
Hospitalizations per 100,000 people: 33

Ohio
14-day change: 13% increase
Hospitalizations per 100,000 people: 59

Indiana
14-day change: 8% increase
Hospitalizations per 100,000 people: 49

The data is telling a consistent story: Omicron is significantly milder.

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‘Not the same’
The details of the Omicron variant are becoming clearer, and they are encouraging.
They’re not entirely encouraging, and I will get into some detail about one of the biggest problems — the stress on hospitals, which are facing huge numbers of moderately ill Covid-19 patients. But regular readers of this newsletter know that I try to avoid the bad-news bias that often infects journalism. (We journalists tend to be comfortable delivering bad news straight up but uncomfortable reporting good news without extensive caveats.)
So I want to be clear: The latest evidence about Covid is largely positive. A few weeks ago, many experts and journalists were warning that the initial evidence from South Africa — suggesting that Omicron was milder than other variants — might turn out to be a mirage. It has turned out to be real.
“In hospitals around the country, doctors are taking notice,” my colleagues Emily Anthes and Azeen Ghorayshi write. “This wave of Covid seems different from the last one.”
There are at least three main ways that Omicron looks substantially milder than other versions of the virus:
1. Less hospitalization
Somebody infected with Omicron is less likely to need hospital treatment than somebody infected with an earlier version of Covid.
An analysis of patients in Houston, for example, found that Omicron patients were only about one-third as likely to need hospitalization as Delta patients. In Britain, people with Omicron were about half as likely to require hospital care, the government reported. The pattern looks similar in Canada, Emily and Azeen note.
Hospitalizations are nonetheless rising in the U.S., because Omicron is so contagious that it has led to an explosion of cases. Many hospitals are running short of beds and staff, partly because of Covid-related absences. In Maryland, more people are hospitalized with Covid than ever.
“Thankfully the Covid patients aren’t as sick. But there’s so many of them,” Craig Spencer, an emergency room doctor in New York, tweeted on Monday, after a long shift. “The next few weeks will be really, really tough for us.”
The biggest potential problem is that overwhelmed hospitals will not be able to provide patients — whether they have Covid or other conditions — with straightforward but needed care. Some may die as a result. That possibility explains why many epidemiologists still urge people to take measures to reduce Covid’s spread during the Omicron surge. It’s likely to last at least a couple more weeks in the U.S.
2. Milder hospitalization
Omicron is not just less likely to send somebody to the hospital. Even among people who need hospital care, symptoms are milder on average than among people who were hospitalized in previous waves.
A crucial reason appears to be that Omicron does not attack the lungs as earlier versions of Covid did. Omicron instead tends to be focused in the nose and throat, causing fewer patients to have breathing problems or need a ventilator.
As Dr. Rahul Sharma of NewYork-Presbyterian/Weill Cornell told The Times, “We’re not sending as many patients to the I.C.U., we’re not intubating as many patients, and actually, most of our patients that are coming to the emergency department that do test positive are actually being discharged.”
In London, the number of patients on ventilators has remained roughly constant in recent weeks, even as the number of cases has soared, John Burn-Murdoch of The Financial Times noted.
3. And deaths?
In the U.S., mortality trends typically trail case trends by about three weeks — which means the Omicron surge, which began more than a month ago, should be visible in the death counts. It isn’t yet:
Data as of Jan. 3.Source: New York Times database
Covid deaths will still probably rise in the U.S. in coming days or weeks, many experts say. For one thing, data can be delayed around major holidays. For another, millions of adults remain unvaccinated and vulnerable.
But the increase in deaths is unlikely to be anywhere near as large as the increase last summer, during the Delta wave. Look at the data from South Africa, where the Omicron wave is already receding:
South Africa reported identification of Omicron on Nov. 24.Source: Johns Hopkins University
The bottom line
Given the combination of surging cases and milder disease, how should people respond?
Dr. Leana Wen, Baltimore’s former health commissioner, wrote a helpful Washington Post article in which she urged a middle path between reinstituting lockdowns and allowing Omicron to spread unchecked.
“It’s unreasonable to ask vaccinated people to refrain from pre-pandemic activities,” Wen said. “After all, the individual risk to them is low, and there is a steep price to keeping students out of school, shuttering restaurants and retail shops and stopping travel and commerce.”
But she urged people to get booster shots, recommended that they wear KN95 or N95 masks and encouraged governments and businesses to mandate vaccination. All of those measures can reduce the spread of Covid and, by extension, hospital crowding and death.
What about elderly or immunocompromised people, who have been at some risk of major Covid illness even if they’re vaccinated?
Different people will make different decisions, and that’s OK. Severely immunocompromised people — like those who have received organ transplants or are actively receiving cancer treatment — have reason to be extra cautious. For otherwise healthy older people, on the other hand, the latest data may be encouraging enough to affect their behavior.
Consider this: Before Omicron, a typical vaccinated 75-year-old who contracted Covid had a roughly similar risk of death — around 1 in 200 — as a typical 75-year-old who contracted the flu. (Here are the details behind that calculation, which is based on an academic study.)
Omicron has changed the calculation. Because it is milder than earlier versions of the virus, Covid now appears to present less threat to most vaccinated elderly people than the annual flu does.
The flu, of course, does present risk for the elderly. And the sheer size of the Omicron surge may argue for caution over the next few weeks. But the combination of vaccines and Omicron’s apparent mildness means that, for an individual, Covid increasingly resembles the kind of health risk that people accept every day.

Experts say COVID-19 cases don’t tell whole story

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https://thehill.com/homenews/administration/587405-experts-say-covid-19-cases-dont-tell-whole-story?userid=12325

Coronavirus Pandemic (COVID-19) - Statistics and Research - Our World in Data


For nearly two years, Americans have looked carefully at coronavirus case numbers in the country and in their local states and towns to judge the risk of the disease.

Surging case numbers signaled growing dangers, while falling case numbers were a relief and a signal to let one’s guard down in terms of gathering with friends and families and taking part in all kinds of events.

But with much of the nation’s population vaccinated and boosted and the country dealing with a new COVID-19 surge from omicron — a highly contagious variant that some studies suggest may not be as severe as previous variants — public health officials are debating whether the nation needs to shift its thinking.

Many people are going to get omicron — but those that are vaccinated and boosted are unlikely to suffer dire symptoms.

As a result, hospitalizations and deaths are the markers that government officials need to monitor carefully to ensure the safety of communities as the nation learns to live with COVID-19.

“This is the new normal,” said Leana Wen, a public health professor at George Washington University and former Baltimore health commissioner. “This is what we will have to accept as we transition from the emergency of COVID-19 to living with it as part of the new normal.”

David Dowdy, an epidemiologist at Johns Hopkins Bloomberg School of Public Health, said that Americans all need to shift to focus on hospitalizations over cases as we enter into another year of the pandemic.

“I think that we need to start training ourselves to look, first of all, at hospitalizations. I think hospitalizations are a real-time indicator of how serious things are,” he said.

Rising case numbers still say something about the disease, and the spikes from omicron are leading to real concerns.

Anthony Fauci, the government’s top infectious disease expert, noted on Sunday that even if omicron leads to less severe cases of COVID-19, if it infects tens of millions it will have the potential of straining resources in hospitals.

“If you have many, many, many more people with a less level of severity, that might kind of neutralize the positive effect of having less severity when you have so many more people,” he said during an appearance on ABC’s “This Week.”

At the same time, the nation must get used to dealing with the coronavirus as it would deal with an annual flu season. It’s a challenge for most parts of American life, from schools and businesses that have to consider worker and student safety, to professional sports leagues that must decide how long someone sits out after a positive test — even if the person is vaccinated and not symptomatic.

“Omicron in a way is the first test of what it means to live with COVID-19,” said Wen. “And by that I mean we are going to see many people getting infected but as long as our hospital systems are not overwhelmed and as long as vaccinated people are generally protected against severe outcomes, that is how we end the pandemic phase and switch into the endemic phase.”

The omicron strain is so infectious that once the current surge has faded in the United States, it’s likely a large majority of the population will either have been vaccinated against COVID-19 or have been infected, experts say. At that point, the focus should shift away from preventing infection to preventing serious illness, multiple experts said, a message already being echoed in some corners of the White House.

Many states have been seeing staggering numbers of positive tests and lines for COVID-19 testing that stretch for several blocks. Washington, D.C., and New York state have set records in recent days for the number of new cases reported as omicron barrels through the population.

But even with case totals surpassing last year’s numbers, President Biden and White House officials have been quick to point out that hospitalizations haven’t been as high as the numbers seen in the winter of 2020.

“Because we have so many vaccinated and boosted, we’re not seeing hospitalizations drive as sharply as we did in March of 2020 or even this past fall. America has made progress; things are better,” Biden said on Monday on a White House COVID-19 response team call with the National Governors Association to discuss the administration’s response to the omicron variant.

“But we do know that with rising cases, we still have tens of millions of unvaccinated people and we’re seeing hospitalizations rise,” he added, saying that some hospitals are going to get overrun both in terms of equipment and staff.

The White House pointed to Biden’s remarks last week when asked about whether the president wants Americans and health experts to take the emphasis off of case numbers and put it on hospitalizations.

“Because omicron spreads so easily, we’ll see some fully vaccinated people get COVID, potentially in large numbers. There will be positive cases in every office, even here in the White House, among the vaccinated … from omicron. But these cases are highly unlikely to lead to serious illness,” Biden said on Dec. 21.

Chief of staff Ron Klain on Monday retweeted a CNN report about how hospitalizations are about 70 percent less than what they were around the last peak in September, but that COVID-19 cases in unvaccinated Americans could end up overwhelming health systems.

Health experts have suggested the White House’s shift in messaging away from a focus on the number of cases is a sign of what’s to come as the pandemic eventually becomes endemic.

“For two years, infections always preceded hospitalizations which preceded deaths, so you could look at infections and know what was coming,” Ashish Jha, dean of the Brown University School of Public Health, said Sunday on ABC. “Omicron changes that. This is the shift we’ve been waiting for in many ways.”

Dowdy said positive tests are also up because people are getting tested before visiting relatives.

“If a lot of people are testing positive because they are asymptomatic and wanting to make sure that they can travel etc., having a lot of those kinds of cases is not a big problem,” he said.

“In fact, that’s a good thing. It means that we’re doing the right thing as a country to define those cases,” Dowdy added.

Lawrence Gostin, a professor of global health at Georgetown University, said the shift away from tracking case numbers as a way to measure the pandemic means devoting more resources toward treatment options like the Pfizer antiviral pill.

Gostin also said testing should increasingly be used to self-diagnose so individuals can get proper treatment, rather than testing for the purpose of stopping the spread of the virus.

“The White House has got a very difficult balancing act. Certainly for now it’s going to have to emphasize the idea of masking and distancing for the purpose of protecting the health system,” Gostin said.

“We can’t live our lives in a bubble to prevent us from getting a pathogen that’s so contagious that you can’t avoid it if you’re going to be circulating and living a life in this world,” he continued. “What it means to transition to a normal life or more normal life is you have to focus not so much on preventing cases, but on preventing hospitalizations and deaths.”