Omicron surge will end as rapidly as it started, physician leaders predict

In line with national forecasts, health systems on opposite sides of the country — NewYork-Presbyterian and Phoenix-based Banner Health — both anticipate the omicron-driven COVID-19 surge to peak at some point this month. 

"We are not yet at the peak of the omicron variant," Marjorie Bessel, MD, Banner Health's chief clinical officer, said during a Jan. 11 news conference. While the fast-moving omicron strain has made the accuracy of forecasting especially difficult, the peak is expected to arrive "in the upcoming weeks in the markets where we operate," Dr. Bessel said. 

The daily average for new cases across Arizona stood at 12,403 on Jan. 10, a 266 percent increase over the last two weeks, data from The New York Times shows. The daily average for hospitalizations — 2,770 — across the state is also up 17 percent over the same time period. 

Across Banner Health, COVID-19 hospitalizations have been rising since Jan. 1. Currently, nearly a third of inpatient beds are occupied by COVID-19 or suspected COVID-19 patients, Dr. Bessel said, adding that 90 percent of those patients are unvaccinated. 

Rahul Sharma, MD, emergency physician-in-chief at NewYork-Presbyterian Weill Cornell Medical Center in New York City, echoed similar projections during a Jan. 10 news conference. 

Dr. Sharma also approached projections with caution, saying it's still early to draw reliable conclusions, but that current forecasts indicate the surge will peak across the system's service region in the next week or two before declining. 

Some good news: Current data suggests the surge will decline just as fast as it accelerated, the physicians said. 

"One of the things that we are learning about omicron from experience in other countries that have gone before us is that the descent from that peak will also be very rapid," Dr. Bessel said. "I'm sure that is something that everybody will be very excited to see, including all of us who are in healthcare." 

New York Gov. Kathy Hochul on Jan. 11 said the state's positivity rate has started to decline, a sign the omicron wave may begin to die down soon. On Jan. 5, New York's seven-day positivity rate average was 22.5 percent, making a small drop to 20.2 percent Jan. 11, state data shows. 

"It looks like we might be cresting over that peak," Ms. Hochul said during a news conference. "Cases are slowing down. The rate of increase is slowing down, but [cases] are still high. We are not at the end, but I wanted to say this is, to me, a glimmer of hope. A glimmer of hope at a time we desperately need that." 

Hospitalizations in the state are still on the rise, though the rate of increase is also slowing.

Most of the COVID-19 patients showing up across NewYork-Presbyterian's emergency rooms are being discharged, Dr. Sharma said. Emerging trends in clinical presentation of these patients align with current data. Most have milder symptoms — such as sore throat, congestion, fatigue, headache and nausea — compared to pre-omicron surges where severe respiratory issues were more common, he said. 

Among approximately 1,200 COVID-19-positive inpatients at NewYork-Presbyterian hospitals Jan. 10, about 50 percent of patients were primarily admitted for treatment of their virus symptoms, such as difficulty breathing and pneumonia. The other half include patients primarily hospitalized for heart attack, stroke, abdominal pain and other infections who incidentally test positive. 

Banner Health did not yet have statistics available differentiating patients primarily admitted for COVID-19 from those who incidentally test positive during routine screening, though Dr. Bessel offered the following perspective: 

"Individuals that do test positive for COVID — whether they are there for that as their primary reason for hospitalization, or if it is an incidental finding — do need to be in enhanced precautions for the safety of our staff," Dr. Bessel said. "That means that our staff will be wearing masks, gowns, and take specific precautions to protect themselves when caring for patients, whether it's an incidental COVID positive or a COVID positive reason for hospitalization." 

The conversation on primary versus incidental COVID-19 hospitalizations has picked up pace as breakthrough cases have become common amid the omicron surge, with 50 percent of COVID-19-positive patients at NewYork-Presbyterian vaccinated. And while some may dismiss all incidental COVID-19 hospitalizations as a mere coincidence that surfaces when patients seek care for other ailments, and thus inconsequential relative to the "real" COVID-19 hospitalization tally, health providers say that line of thinking is too simplistic. 

NewYork-Presbyterian is not challenged by COVID-19 alone, for example. Dr. Sharma said their emergency departments are seeing pre-pandemic volumes — as opposed to the surge in 2020, when volume fell nearly 50 percent — and current staffing shortages are much more pronounced than earlier surges.

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