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Omicron’s wave is at least 386% taller than delta’s—and it’s crushing hospitals

Doctor in protective gear inspects patients.
Enlarge / Medical Director of the Intensive Care Unit (ICU) checks the vital signs of a COVID-19 patien while her husband rests in a bed next to her at Providence Cedars-Sinai Tarzana Medical Center in Tarzana, California, on January 3, 2021.

Despite its widespread reputation for being mild, the ultra-transmissible omicron coronavirus variant is sending a record number of people to emergency departments and hospital rooms in the US, swamping health care systems nationwide.

As of January 15, omicron’s highest seven-day average of daily cases was nearly 799,000—a 386 percent increase from the highest average of daily cases seen during the delta wave (from July to the end of October). Similarly, omicron’s highest daily average of emergency department visits was 86 percent higher than that of delta’s, and hospital admissions were 76 percent higher.

The latest data comes from a study published by the Centers for Disease Control and Prevention on Tuesday. The study highlights that even though the omicron wave has been marked by relatively smaller proportions of severe cases and deaths, the variant’s extraordinary spread has still overwhelmed hospitals and taken a devastating toll on the nation.

Not so mild

“Although patients hospitalized during the Omicron period have shorter stays and less frequent ICU admissions, the high volume of hospitalizations resulting from high transmission rates during a short period can strain local health care systems in the United States, and the average daily number of deaths remains substantial,” the study concluded.

The study only included data up to January 15, when the highest average of daily deaths during the omicron wave was 1,854, a 4 percent decrease from the high seen during the delta wave. However, the average is now up to over 2,300 per day, surpassing the peak during the delta wave.

“‘Milder’ does not mean ‘mild,’ and we cannot look past the strain on our health systems and substantial number of deaths,” CDC Director Rochelle Walensky said Wednesday during a White House COVID-19 press briefing.

At this point, cases and hospitalizations are declining on a national level, though both are still climbing in some areas. The US is seeing an average of around 652,000 new COVID-19 cases per day, down from an all-time high of over 800,000 on January 14. The daily average of people hospitalized with COVID-19 now stands at nearly 155,000, down from an all-time high of nearly 160,000 about a week ago.

When people do end up in the hospital with omicron, they tend to fare better than those sickened with delta. The CDC study found that the percentage of hospitalized patients requiring invasive mechanical ventilation during the omicron wave was lower than that during the delta wave (3.5 percent versus 6.6 percent). And the percentage of hospitalized patients dying was also smaller (7.1 percent versus 12.3 percent). Length of hospital stays was shorter, with a mean during the omicron wave of 5.5 days, compared to delta’s 7.6 days.

And overall, the proportion of people severely ill with omicron is lower. At peak points during the omicron wave, the ratio of emergency room visits to cases was 87 visits per 1,000 cases, compared with delta’s 167 visits per 1,000 cases, according to the CDC study. Hospitalization rates amid omicron were 27 admissions per 1,000 cases, down from delta’s 78. And deaths from omicron up until January 15 had a ratio of nine deaths per 1,000 cases, down from delta’s 13 deaths.

A “PTSD-like situation”

But those numbers are cold comfort for people who do wind up in the hospital and for the thinning, exhausted medical staff caring for them. The CDC study reported that as much as 20.6 percent of staffed hospital beds were taken up by COVID-19 patients during the omicron wave, which is 7.2 percentage points higher than the peak seen during delta. The gap is even larger now, with the Department of Health and Human Services reporting 21 percent of hospital beds taken up by patients with COVID-19.

Headlines across the country describe overwhelmed hospitals—already short-staffed from previous waves—and providers themselves struck down by omicron. On Monday, health officials in Idaho instituted crisis standards of care in much of the southern area of the state, citing staff shortages.

“The highly contagious omicron variant has thrown us a curve ball,” Idaho Department of Health and Welfare Director Dave Jeppesen said in a statement. “Once again, the situation in our hospitals and health systems is dire—we don’t have enough resources to adequately treat patients.”

Also on Monday, officials in Michigan announced that a sixth hospital in the state will get needed assistance from federal medical staff to combat the latest COVID-19 surge. Meanwhile, another wave of Ohio National Guard troops arrived at the University of Cincinnati Medical Center.

“UC Health is experiencing a record number of patients seeking care for COVID-19 within our hospitals, and this is putting unprecedented strain upon our care teams,” a UC Health spokesperson told The Cincinnati Enquirer. The Enquirer went on to say that “hospital workers have described the recent pressure, coming after two years of pandemic-related exertion, as a ‘PTSD-like situation.'”

In the White House briefing Wednesday, Dr. Walensky implored Americans to do what they can to limit transmission, including wearing masks and getting vaccinated and boosted. “I know many people are tired, but many of our hospitals are still struggling beyond capacity,” she said. “Now is the time to do what we know works.”

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