As the number of patients in US hospitals with Covid-19 hits new records, doctors and public health experts question whether the overall number is still a reliable indicator of the pandemic’s trajectory given that some patients are allowed for other reasons.
Based on data from the US Department of Health and Human Services, the current seven-day rolling average of patients hospitalized with Covid-19 in the United States is 155,677, surpassing the peak of 139,279 patients in January 2021.
But Omicron infections are now so widespread that some people who go to hospital seek treatment for something else and test positive for Covid-19 on arrival. This threatens to complicate the link between serious illnesses and deaths and hospitalizations, which have so far served as a reliable early indicator of the progression of the pandemic.
“We see a lot of people coming to the hospital for other reasons who find out they have Covid,” said Jennifer Caputo-Seidler, a physician at Tampa General Hospital in Florida. “They may have a broken leg but are still testing positive.”
Caputo-Seidler said the hospitalization figures no longer give the full picture of what is happening with the virus because of these “incidental” admissions of Covid patients.
David Dowdy, an epidemiologist at the Johns Hopkins School of Public Health, said it was difficult to measure the impact of people testing positive for the virus in hospital despite being there for another reason due to a lack of uneven data and reporting.
“In real time, we are largely forced to make mental adjustments – there is no reliable method that I know of to ‘factor out’ these incidental admissions,” he added.
Another complicating factor is that Omicron infections are less severe than some other variants such as Delta, while many people now have better immune protection from vaccinations and previous infections.
While cases and hospitalizations have increased by 320% and 116% respectively in the last three weeks, the number of Covid patients in intensive care has not increased as quickly, increasing by only 51%.
Statewide incidental admission data has only recently become available in places like New York and Massachusetts, which have begun collecting the data. In New York State, 42% of New York State’s Covid hospitalizations are accidental while in Los Angeles County the figure is two-thirds. In Florida, the Jackson Health System reported that of their 508 currently Covid-positive patients, 53% were incidental admissions.
National hospitalization data does not include information on disease severity, non-Covid-related admissions or vaccination status. The CDC used Covid-Net, a network of 250 hospitals in 14 states to examine some of these trends, but this information was not released in time.
Yet the high number of infected patients flooding into hospitals places a heavy strain on the healthcare system due to the requirement for isolation rooms, personal protective equipment and the toll of hospital workers, many of whom are themselves. -even sick or isolated after contracting the virus.
According to data on the state of hospital capacity from a team of public health experts led by emergency physician Jeremy Faust, 1,038 US counties have reached or will soon reach hospital capacity, compared to 825 counties that have capacity.
Responding to strained hospitals in their states, Maryland Governor Larry Hogan declared a state of emergency on January 4 and Virginia Governor Ralph Northam issued an emergency order on January 10 to come to the rescue. to health care providers.
The highly infectious variant of Omicron is poised to further propel the growing number of hospitalizations. The University of Texas at Austin Covid-19 Modeling Consortium predicts that the massive increase in infections will lead to a 1.2- to 2.6-fold increase in hospitalization rates.
“Hospitals are already struggling. This means Covid cases will not receive the safe and effective treatment they need,” said Lauren Ancel Meyers, executive director of the Texas consortium. “And also that anyone who needs health care for whatever reason may or may not be able to access the care they need.”
At Tampa General, the number of Covid patients has risen from just under 10 the week before Christmas to 158 this week, putting pressure on staff as they enter a third year of crisis.
“Staffing is a huge issue because we have tons of people who are themselves infected and quarantined,” Caputo-Seidler said.
Eric Topol, director of the Scripps Research Translational Institute, said hospitalization rates will remain an important data point in the pandemic as they show the stress on the healthcare system. To dismiss a Covid infection as “accidental” is overly simplistic due to limited data and the serious complications the virus can cause, he added.
“The idea that 40% is incidental, well, who knows? There’s no thorough review of these cases and there are a lot of them that are probably due to Covid,” Topol said. “We have had a patient admitted to our center today with Chronic Obstructive Pulmonary Disease The patient arrived out of breath and tested positive for Covid – so the question is how is this patient classified?
Covid cases continue to rise nationwide in the US with no clear peak in sight, although there are signs of stabilization in northeastern states that were first hit by Omicron . A significant proportion of Americans are still vulnerable because only 62% of the population is fully vaccinated while only 22% have received a booster dose, according to CDC data.
Topol said low vaccination and booster rates in the United States meant hospitalization rates would continue to soar and the country may not see the kind of decoupling of cases and serious illnesses that some European countries , such as Portugal, Norway and Denmark, have experienced with Omicron.
“We are way behind on the boosters. . . and that’s the main thing that protects people from hospitalization,” Topol said.