Physicians are concerned about omicron's paradox for hospitals

Omicron has been referred to by some as the variant of COVID-19 you want to get if you're going to get it, due to a growing body of evidence that suggests it causes milder illness than earlier variants of COVID-19. That type of thinking has physicians and hospitals worried. 

Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, said he is concerned about complacency toward the virus variant that may cause milder illness but still has the potential to overwhelm hospitals — particularly in communities with low vaccination rates.

"When you have such a high volume of new infections, it might override a real diminution in severity so that if you have many, many, many more people with less level of severity, that might kind of neutralize the positive effect of having less severity when you have so many more people," Dr. Fauci said during a Dec. 26 appearance on ABC's "This Week."

An influx in patient volumes alone isn't responsible for the nation's strained healthcare system. Omicron's increased transmissibility means more healthcare workers are becoming infected, leaving fewer staff to care for a surge in patients. The CDC on Dec. 23 revised its isolation and quarantine guidance for healthcare workers infected with COVID-19 in an effort to alleviate the strain that staff shortages caused by COVID-19 could put on patient care. 

Under the new guidance, asymptomatic healthcare workers with COVID-19 can return to work after seven days with a negative test, which may be cut shorter if there are staffing shortages. Meanwhile, quarantine is no longer required after high-risk exposures for those who are fully vaccinated and boosted. 

"As the healthcare community prepares for an anticipated surge in patients due to omicron, CDC is updating our recommendations to reflect what we know about infection and exposure in the context of vaccination and booster doses," said Rochelle Walensky, CDC director. "Our goal is to keep healthcare personnel and patients safe, and to address and prevent undue burden on our healthcare facilities. Our priority remains prevention — and I strongly encourage all healthcare personnel to get vaccinated and boosted." 

A rise in pediatric COVID-19 hospitalizations is another differentiator from last year's winter surge. For a three-day period during the week of Christmas, about 800 children were admitted each day, The Washington Post reports. 

"We are in a difficult situation,” said Claudia Hoyen, MD, a pediatric infectious disease specialist at University Hospitals Rainbow Babies & Children’s Hospital in Cleveland. "With omicron, we are now having this new surge on top of what was left over from delta," she told the Post

Data from the American Academy of Pediatrics shows nearly 199,000 cases were reported among children for the week ending Dec. 23, a 50 percent increase over the weekly new cases since the start of the month. 

In New York, pediatric COVID-19 hospitalizations have more than doubled in the last few weeks, rising from 70 as of Dec. 11 to 184 as of Dec. 23, health officials said during a Dec. 27 update. The rise in admissions has been particularly concentrated in New York City, where hospitalizations among children increased from 22 to 109 across the same time period.  Of children with COVID-19 aged 5 to 11 — a group that is eligible for vaccination — who were admitted to New York City hospitals since Dec. 5, none were fully vaccinated, public health officials said during a Dec. 27 news conference. Statewide, about 16.4 percent of children in that age group have been fully vaccinated, while 27.3 percent have received their first dose. 

Early data and studies from other countries suggest omicron causes slightly less severe illness for an unvaccinated healthy adult without a prior infection, and significantly less severe for individuals with T-cell protection from previous infections or vaccination, according to The Atlantic's deep dive into data, studies and caveats from South Africa, Hong Kong, the U.K., Denmark and the University of Cambridge (England).

But as the author noted, "Viruses are multiplication problems." 

"A virus that's 60 percent milder yet 300 percent more infectious is going to create more severe cases, overall,” wrote The Atlantic's Derek Thompson. “With an ongoing delta wave that is already killing more than 10,000 people a week in the United States, any coincident variant — even one that is much milder — could risk overloading a healthcare system that is already worn down." 

As of Dec. 28, the number of new COVID-19 cases in the United States increased 105 percent over the past 14 days, according to the New York Times' tracker. Hospitalizations increased 6 percent in that same timeframe, while deaths fell by 5 percent. 


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