Science

Omicron Is Milder Than Delta But Still Wreaking Havoc


More patients are being admitted “with” COVID

COVID is so widespread right now that a significant percentage of hospitalized patients are admitted for something else but then test positive upon screening at admittance.

“We test a lot of asymptomatic patients in preparation for procedures or surgeries, planned hospitalizations — and even in those folks who are totally asymptomatic, we’re seeing a case positivity right now of about 12%,” Murray said.

“It’s a very different landscape that we’re seeing with overcrowding in the hospital than we’ve seen with the prior waves of COVID,” said Richelle Charles, an infectious disease expert at Massachusetts General Hospital and Harvard Medical School. “Almost half of these cases are in the hospital for non-COVID-related illnesses.”

At UCSF, Murray said overall about two-thirds of their COVID patients were hospitalized for the disease, while one-third were hospitalized with it. In pediatric COVID patients, about half of them were admitted for something other than the disease.

Yet even if these patients’ COVID symptoms are mild or nonexistent, their positive status places an extra burden on the hospital because they require isolation and extra safety protocols for hospital staff.

Staffing shortages from exposure and burnout

Hidden in the increasing case numbers are doctors, nurses, and other healthcare personnel infected by the more contagious variant, which causes more breakthrough infections among the vaccinated than past ones, said Akin Demehin, the policy director at the American Hospital Association. Even with mild infections, those healthcare workers are still out of action for a week after their tests turn negative, per CDC policy, just as the surge fills up hospitals and drives up demand for staff.

The Omicron surge will only put more stress on doctors and nurses, who still have to care for all those extra patients. One survey last August reported that nearly 60% of doctors feel burned out, Demehin said, and that was two surges ago. “We hear this from hospital leaders all the time — their number one, two, and three priority right now is workforce,” he said. “They know just how much has been asked of healthcare providers over the past almost two years.”

More young children

“This time around, we’re seeing more children less than 5 years of age,” Blumberg said.

He has observed that many of them have milder cases of bronchitis or croup, whereas the teens with COVID seen in earlier surges had more severe pneumonia. Most of these young children recover well, but he cautioned that with any infection and any hospital admission, “some children aren’t going to do well.”

Hospitalizations among young children are currently higher than they’ve ever been during the pandemic, according to the CDC.

Vaccines still work, but boosters are important

One thing the Omicron surge hasn’t altered is the well-established reality that vaccines significantly improve people’s odds of not dying from COVID-19. Deaths are still on the increase, averaging 1,600 a day in the US, an increase of 40% from the past week, according to the CDC. (Walensky said at the White House briefing that she thinks most of those are Delta variant cases.)

With Omicron rampant, “virtually everybody is going to wind up getting exposed and likely get infected,” National Institute of Allergy and Infectious Diseases chief Anthony Fauci said on Wednesday. “But if you’re vaccinated, and if you’re boosted, the chances of you getting sick are very, very low.”

“At my hospital, we have a graphic that’s sent out every day that has little people icons, those in the ICU, those on a ventilator, and those admitted for COVID. And the vast majority, overwhelmingly, are unvaccinated people in all three categories,” said Jeanne Marrazzo, the director of the division of infectious diseases at the University of Alabama at Birmingham School of Medicine, who spoke Tuesday at an Infectious Diseases Society of America briefing on Omicron for reporters.

“What we’ve learned with Omicron is that the booster really makes a big difference in terms of reducing your risk,” Murray said. Her hospital is seeing both vaccinated and unvaccinated patients hospitalized for COVID. But even patients who only had an initial series of vaccines — no booster — appear to be protected from the most severe outcomes.

“What we aren’t seeing is patients ending up on ventilators if they’re fully vaccinated,” she said. “I don’t have a single fully vaccinated patient in the hospital on a ventilator right now.”



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