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10 January 2022 ⚡️ Brace yourself.
Hospitalizations in NYC and Chicago are well on their way to doubling; US cases, tripling. For the week ending 02 January 2022, 6% of COVID19 cases in England were possible reinfections.
On Thanksgiving, South African officials announced a new COVID19 variant; the World Health Organization designated it a variant of concern the next day, 26 November. Six weeks later, Omicron is the dominant variant in Europe and the US. It is extremely contagious but not as fatal due to vaccinations (particularly boosted), prior infection and, researchers hypothesize, less damage to the lower respiratory system.
The good news for individuals is that patients with Omicron are less likely to wind up in the hospital (especially when vaxxed and boosted). Should they need to go to the hospital, they less likely to land in ICU, and hospital stays are also shorter, on average.
The bad news for the medical system is one of sheer numbers.
Oregon hospitals may activate crisis standards of care if their critical care resources are severely limited, the number of patients presenting for critical care exceeds capacity, and there is no option to transfer patients to other critical care facilities. ~ 07 January 2022
The bad news for society is potentially widespread labor disruption (not unlike that airlines reported over the holiday) will hit every sector. “Essential workers” will get sick and stay home; hopefully, they will also stay out of the hospital.
In addition, people will die, not of Covid-19, but because they cannot get timely treatment due to resources being tied up with Covid patients, most who have chosen not to get vaccinated or boosted.
Massachusetts hospitals: worst surge that we have had
About 1-in-4 of the 5,000 US hospitals that report data to USHHH have a “critical staffing shortage”
States are mobilizing National Guard troops to help with medical care
Apple, Macy’s and Walmart are among retailers that have reduced hours or temporarily closed locations due to staff shortages.
Supermarkets in the Northwest struggled to keep shelves stocked with perishables during December record cold and snow. There are national reports of shortages due to Omicron. And Australia has scraped isolation rules for food workers.
Anecdotes: a friend’s son’s school bus is running 30-40 minutes late due to lack of drivers. The Starbucks at Alderwood Mall in Lynnwood, WA has been closed repeatedly since Christmas due to insufficient healthy staff. The Apple store closed two hours before the mall on Saturday. The University of Washington has extended online classes from only the first week of January through the end of the month.
The CDC has changed guidance on isolation from 10 days to five, and companies are following suit. For example, Amazon has told workers they now only have to isolate for a week after testing positive. One challenge to that reduced isolation block: we still don’t know the number of days that Omicron is infectious, on average. We’re guessing that five is sufficient.
In California, asymptomatic health care workers who test positive “will no longer have to isolate or test negative and can return to work immediately.” A pragmatic hospital response to reduced staff increases risk for everyone. Triage.
In cities hit early with the Omicron variant (above chart), the number of Covid-19 patients who need intensive care or mechanical ventilation is approaching or exceeding last winter’s two-year peak. Deaths are rising. Again.
For example, in Illinois you can see that deaths began rising in November, following the rise in cases in October. The Omicron rate should not mirror the Delta rate, but people are dying of Omicron infections.
The US per capita death rate is greater than that of the UK, the EU and South Africa. And it began rising on 05 January 2022. That’s Omicron, not Delta.
The official US case rate is now almost three times the peak in early 2021. The actual case rate is under-reported due to asymptomatic cases and at-home testing.
The sheer number of patients is overwhelming. And the virility of Omicron means that doctors, nurses and staff will get sick and need to stay home, further exacerbating stress on the system.
US hospitals have been recruiting nurses internationally since before Omicron. In September, more than 5,000 international nurses were awaiting final visa approval.
Last week, the Washington State Hospital Association asked the state to declare a “crisis with overrun emergency departments and hospitals.” Washington ranks 35th among the 50 states in per capita cases nationally (154 average new cases per 100K; US is 215) and 42th in per capita deaths.
These hospitalization data are from Washington state. Hospitalization from Covid-19 is more likely if you’re unvaccinated, regardless of age or which state you live in.
More than one-in-three (37%) Americans have not been vaccinated. There is no vaccine for children younger than five years old (about 6% of the population). It is unlikely that there is anything a stranger can say to an anti-vaxxer today that will change their mind.
If you are vaccinated and boosted, your risk of hospitalization and death is reduced.
About half of us who are vaccinated have gotten a booster. If you’re not boosted, please do so. Reduce your risk! Reject GOP naysayers. And WSJ opinion columnists like Luc Montagnier (an anti-vaxxer with the Nobel disease) and Jed Rubenfeld (“disgraced” Yale law professor).
Then there’s the issue of reinfection, minor in the scheme of things if you are vaccinated.
The Financial Times reported Sunday that for the week ending 02 January 2022, the UK health ministry identified 59,783 possible reinfections (🎁), defined as a positive Covid-19 test at least 90 days after a prior positive test. That’s 6% of the 1M reported cases that week, a significant increase from the 2.4% reinfection rate for the total 11.1M official cases for the pandemic’s almost two years.
Although reinfections are usually less severe than first infections, they can still be fatal, especially for unvaccinated people. The first reported Omicron death in the US was of a man in his fifties previously infected with Covid-19 but not vaccinated.
Look at those UK data again: for the week ending 02 January 2022, the UK recorded 9% of its official total Covid-19 cases over an almost two-year period.
We know official case numbers are under-reported. For example, from January 4-5, 2022, about 3-in-5 patients in NYC were admitted for Covid-19 infections. About 40% were admitted for something else and subsequently tested positive for Covid-19. Asymptomatic.
Buckle in. Vax, mask, distance. It’s all we can do.
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