Omicron may be more mild, but not for hospitals — here's why

As cases and hospitalizations rapidly rise nationwide, healthcare workers across 11 states told The Atlantic how and why this surge is pushing their hospitals to the brink. 

"The volume of people presenting to our emergency rooms is unlike anything I've ever seen before," Kit Delgado, MD, an emergency physician in Pennsylvania, told The Atlantic.  

Six ways this surge is distinct from the ones before, per The Atlantic: 

1. Roughly 62 percent of Americans are fully vaccinated. Omicron infections appear to be less severe than previous variants, and many people infected don't require hospitalization. 

2. Omicron is so transmissible that COVID-19 patients are still flooding hospitals, not to mention the steady flow of delta patients still requiring hospitalization. Even if a smaller proportion of omicron patients need hospital care, the absolute case numbers are still so high, it is enough to overwhelm the system. The virus may pose less of an individual threat, but it's disastrous for the healthcare system those individuals will ultimately need. 

3. Record numbers of children with COVID-19 are being hospitalized. Children tend to fare much better against the virus than adults, though experts have voiced concern about long COVID-19 and other long-term complications.   

"This is the highest number of pediatric hospitalizations we've seen throughout this pandemic," CDC Director Rochelle Walensky, MD, said during a Jan. 7 call with reporters. For the week ending Jan. 1, the hospitalization rate among children under 4 was 4.3 per 100,000, and 1.1 per 100,000 for those aged 5 to 17. For context, Dr. Walensky said the rate among those older than 65 was 14.7 per 100,000.

4. Omicron's ability to infect vaccinated people means more healthcare workers are sick.

"In the last two years, I've never known as many colleagues who have COVID as I do now,” said Amanda Bettencourt, PhD, president-elect of the American Association of Critical-Care Nurses. "The staffing crisis is the worst it has been through the pandemic."

"There are evenings where we have whole sections of beds that are closed because we don't have staff," said Megan Ranney, MD, an emergency physician in Rhode Island.

5. Public support is faltering. While most of the country is trying to return to normal, healthcare workers cannot. The pandemic has exposed the fragility of the unspoken social contract in which medical professionals are expected to sacrifice their own well-being for patients, said Vineet Arora, MD, a hospitalist in Chicago. "Society has decided to move on with their lives, and it's hard to blame healthcare workers for doing the same."

6. These problems are affecting all patients. "I don't think people will realize what's happening until we fall off that cliff," said Anand Swaminathan, MD, emergency physician in New Jersey. "Until you call 911 and no one comes, or you need that emergency surgery and we can't do it."


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