Soaring Omicron cases threaten US hospitals, rivaling 2020 pandemic peak

Though the omicron variant tends to be milder, it is spreading so explosively across the U.S. that many hospitals expect it to rival or surpass previous records for admitting Covid patients.
 

Hospitals are bracing for a continuous rise in Covid-related bed demand for the month ahead, according to models from several facilities around the country.

At Yale New Haven Hospital in Connecticut, “Our all-time peak was 451 Covid patients in April of 2020,” said Robert Fogerty, who oversees the 1541-bed hospital’s capacity management. “I think we’re going to blow past that by next week.”

The good news, he and other hospital data experts said, is that compared with previous waves, omicron is landing far fewer people in intensive-care units, especially in regions where vaccination rates are high.

The rising demand for beds has prompted health officials to step up some protective measures, including urging people to obtain vaccine boosters and wear higher-quality masks, even though omicron infections appear to cause milder symptoms than earlier strains.

“It’s going to be a difficult winter, and the maximum period seems like it’s about to unfold over the next few weeks,” said Harvard Medical School infectious disease specialist Jacob Lemieux. “So if people can hunker down to the extent possible, that would be a service to society.”

Omicron has tended to burn out quickly in some other countries, but how steep its up-and-down trajectory will be in the U.S. remains an open question. One projection from the Institute for Health Metrics and Evaluation at the University of Washington shows the need for hospital resources peaking nationally in mid-February.

Cedars-Sinai in Los Angeles also projects the number of Covid patients in its hospitals will continue to rise into mid-February. In San Francisco, Health Director Grant Colfax said this week at a briefing that he believes “the height of the surge is upon us,” and that he expects hospitalizations to reach roughly the same level as last winter.

“For now we have enough hospital beds to manage this volume, which is good news,” Colfax said. “However, another concern is hospital staff becoming infected due to community spread and having to stay home.”

Surgeries Curtailed
 

In Texas, modeling by Houston Methodist Hospital predicts cases in Houston will peak around the end of the month and Covid patient load could rise from the current 680 to a record-breaking 850.

There, too, staff illness adds to the strain: Nearly 10% of the health system’s 28,000 staffers have tested positive during the omicron wave, according to Roberta Schwartz, the hospital’s executive vice president.

“We have curtailed many surgeries,” Schwartz said. “We have some beds closed and have been unable to accept the same numbers of transfers as we normally do.”

A significant number of those hospitalized with Covid were admitted for other reasons, according to staff at several hospitals. While less severe, omicron still strains resources as staff work to protect themselves and other patients. In hot spot Miami, for instance, Jackson Health System said Wednesday that 235 of its current 468 patients with Covid-19 were there for “primarily non-Covid reasons.”

At University of Michigan Health, Covid hospitalization numbers began shooting up last week and could ultimately increase over 50% to 150 in the coming weeks, said Vikas Parekh, who leads the system’s Covid modeling.

While some see a decoupling of case rates from hospitalization rates, he maintained rates do remain linked. though the ratio has changed: “It used to be 6.5% of cases nationally ended up in a new hospital admission,” he said, “and now it’s 3.3% — it’s not decoupled, it’s just less than delta.”

But the sheer number of cases means“that even with lower hospitalization ratios, you find places that break records,” he said.

In Boston, two major hospitals, Beth Israel Deaconess Medical Center and Massachusetts General Hospital, project that their load of Covid patients could well reach the heights of last winter’s surge in  coming weeks.

“This is challenging all of us in health care in a way that we have not seen before,” said Jennifer Stevens, who leads modeling for Beth Israel Deaconess Medical Center. 

On the plus side, high vaccination rates in greater Boston translate to less acute illness when people do fall ill, said Peter Dunn, who manages patient capacity at Mass. General and helps oversee hospital Covid capacity across the region.

In the pandemic’s first surge, Mass. General had 14 patients whose condition was so dire they needed machines to support their hearts and lungs. “We have zero right now” of such patients, Dunn said.

As of Tuesday, Mass. General had 183 Covid patients, with 32 in intensive care and only 22 of those because of Covid, Dunn said. The others happened to have Covid but were in for other reasons. At the peak of the first wave, the hospital had roughly 400 Covid patients.

“This wave is not like Wave 1 or Wave 2,” he said. “It’s completely different.”

--With assistance from Shelly Hagan and David R. Baker.