Hospital capacity concerns intensify as XBB.1.5 spreads

Hospitals nationwide are facing capacity issues amid ongoing staffing shortages and an early and severe start to the respiratory virus season. Now, the rapid spread of XBB.1.5 — a highly transmissible omicron subvariant with a high capacity for immune escape — threatens to further magnify these challenges.

Although flu and respiratory syncytial virus cases appear to be leveling off, COVID-19 hospitalizations are rising and at the highest level seen in 11 months. As of Jan. 10, a daily average of 46,677 people were hospitalized with COVID-19, up 15 percent in the last two weeks, according to data tracked by The New York Times.

Overall, COVID-19 hospitalizations are far lower than seen during the height of last winter's omicron surge, when the U.S. was reporting more than 150,000 daily hospitalizations. Still, hospitals are struggling. 

"Although there are far fewer COVID-19 patients, the hospitals are bursting at the seams, emergency department wait times are through the roof, and nurses and doctors are — simply — exhausted," Megan Ranney, MD, emergency physician and academic dean of Brown University School of Public Health in Providence, R.I., told Becker's in December. "Although quantitatively, patient loads are similar, qualitatively, it's much worse, simply because we're so understaffed and overworked."

What's more, experts are still waiting to see the full scope of how heightened travel and indoor gatherings amid the holiday season will affect COVID-19's trajectory. Virus hospitalizations tend to lag a few weeks behind case trends.

Early research suggests XBB.1.5. doesn't cause more severe disease than other omicron strains, but its ability to quickly spread is still concerning, experts say. 

"The problem isn't that it's more virulent, it's simply that being more transmissible, more people are getting sick, and there's always going to be some fraction of people who get sick who are going to need to be hospitalized," Bob Atlas, president and CEO of the Maryland Hospital Association, told CBS News

Hospitals are responding to capacity challenges by erecting surge tents outside of their facilities and hiring more temporary workers to ease staffing shortages, among other strategies. 

In December, HHS Secretary Xavier Becerra clarified that healthcare organizations can use COVID-19 flexibilities and resources to address capacity challenges stemming from a surge in patients with any respiratory virus. 

Editor's note: This article was updated Jan. 12 at 12:58 p.m. C.T.



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