Omicron took 5 weeks to dominate in New York City; 6 more surge trends

The omicron COVID-19 variant accounted for nearly all genomic samples sequenced in New York City for the week ending Dec. 25, according to a Jan. 13 report from the city's health department. 

The report used data from 53 New York City hospital emergency departments and the New York State Health Electronic Response Data System to outline findings on omicron's spread, as well as disease severity and hospital capacity trends. 

Seven notes: 

1. After omicron was first detected, it took just five weeks for the strain to become dominant in New York City. In comparison, delta took about 20 weeks to take over in the city. 

2. Emergency department visits jumped following omicron's emergence. The average severity of ED visits for people with COVID-19-like illness in New York City was lower compared to earlier surges. Still, the rise in ED visits preceded an increase in hospitalizations. 

3. Because of significantly higher case numbers, the total number of hospitalizations increased during omicron's spread. Compared to a period in summer 2021 when delta was dominant, however, the overall proportion of patients currently diagnosed with COVID-19 who have been hospitalized is smaller: About 5 percent of cases resulted in hospitalization during delta's dominance, compared to about 2 percent during a period in the omicron wave. 

4. Those most likely to be hospitalized in New York City early in the omicron wave were unvaccinated (about eight times more likely than fully vaccinated people), the report found. The report also found higher proportions of hospitalizations among New Yorkers 75 and older and Black New Yorkers. 

5. A lower proportion of hospitalized patients (11 percent) have required intensive care so far amid omicron's wave compared to the peak in winter 2020-21 (20 percent). Still, "As of Dec. 30, 2021, hospitalizations exceeded last winter's surge and the number of patients in the ICU is approaching what was seen last winter," Dave Chokshi, MD, the city's health commissioner, tweeted Jan. 13. 

6. The city's healthcare system is not strained by COVID-19 patients alone, the report said. Overall, the surge has not reached levels from March 2020. Still, "Hospitals and other healthcare facilities are also strained by staff outages related to COVID-19 isolation requirements and other staffing challenges," the report said. "Total beds available is just one indicator on the healthcare system, including increased patient-to-staff ratios, which can impact the quality of patient care." 

Across NewYork-Presbyterian, for example, emergency departments are seeing pre-pandemic volumes — as opposed to the surge in 2020, when volume fell by 50 percent — and current staffing shortages are much more pronounced than earlier shortages, according to Rahul Sharma, MD, emergency physician-in-chief at NewYork-Presbyterian Weill Cornell Medical Center. 

7. During the omicron wave thus far, pediatric hospital census has remained stable or slightly lower relative to the period before the strain's emergence. However, pediatric hospitalizations "due to or with COVID-19 increased significantly," Dr. Chokshi said. Unvaccinated children were over four times more likely to be hospitalized compared to all children. 

To view the full report, click here.


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