The U.S. has once again reached an ignoble pandemic milestone, with more than 100,000 Americans currently hospitalized with covid-19. The rise in hospitalizations follows a dramatic surge in cases fueled by the emergence of the Omicron variant. But there are several considerations that will make this peak in illness different from those in the past.
As of Monday, according to a tracker run by Newsnodes and BNO News, there are 104,737 Americans hospitalized with covid-19, including nearly 20,000 in intensive care units. It’s the first time since early September that this many people have been hospitalized and the third time overall during the pandemic. These hospitalizations aren’t just affecting adults, either. Though the raw number of children being hospitalized with covid-19 remains low, the rate of pediatric hospitalizations has surged recently in several states.
Deaths in the U.S. have been on the rise since December as well, following a lull in the fall, with nearly 2,000 reported Monday. But it’s cases that have jumped sky-high recently, with record numbers being reached in the last week. On Monday, just over a million cases were reported, though many of those were attributed to a backlog of reporting over the weekend and holidays. Even accounting for this delay, the current seven-day average of cases is now approaching a half-million.
The data is very clear by now that an individual case of Omicron is milder on average than an individual case of Delta. This mildness is partly due to the immunity that many people carry to the coronavirus—immunity that may not prevent infection but still can blunt its harm to the body. There’s also growing evidence that Omicron is inherently less likely to cause severe illness because it doesn’t infect lung cells as readily as previous strains of the virus. The exact degree to which population immunity and Omicron’s behavior accounts for its mildness is still unclear, and to someone with no immunity, Omicron may not be any less risky.
Many commentators have argued that Omicron’s mildness makes this current wave no big deal. But as the hospitalization numbers show, the country was already in a bad spot before Omicron arrived. That’s because many, if not most, of the hospitalizations this winter aren’t the result of Omicron. Early estimates from the Centers for Disease Control and Prevention originally predicted that Omicron had overtaken Delta as the dominant strain in the U.S. as early as mid-December. But these turned out to be wrong, and as late as Christmas, nearly half of all reported cases in the country were still estimated to be caused by Delta.
The average time to hospitalization after infection is around a week or so, and it can take another week or longer for people to recover. So many people now or recently in the hospital first got infected and sick weeks earlier, when Delta was still prevalent, while newly hospitalized people today may have still caught Delta. The same pattern is even more true for covid-related deaths, since it can take up to a month on average for someone to die from their infection.
This context is key because it illustrates that the U.S. healthcare system was already looking at a bad winter, and Omicron has only added to the problem. The variant is clearly able to infect people with some prior immunity created via vaccination or past infection. And it’s Omicron that’s responsible for the most recent massive surge of cases. It’s these cases that are currently flooding emergency rooms and urgent care centers in some areas, and it’s outbreaks of Omicron that are now sickening people en masse, leading to staffing shortages and other disruptions.
The experiences of South Africa, Denmark, and the UK—some of the first countries to face Omicron—do indicate that waves of Omicron leave behind less severe illness than past surges of covid-19. But the U.S. has historically done worse than many of its contemporaries during the pandemic, for various reasons. This summer, for instance, the country’s mediocre vaccination rate contributed to the higher number of deaths it faced relative to other highly vaccinated countries during their respective Delta-led peaks.
There is early U.S. data showing that Omicron cases in the hospital are less likely to require the ICU, mirroring reports from South Africa. And data continues to indicate that vaccinated people, especially those boosted, are much less likely to be hospitalized from any strain of covid-19. This means that much of the country isn’t in serious danger from Omicron.
But on a big-picture level, covid-19 is still having major negative impacts on our healthcare and other aspects of society. And the sheer increase in cases caused by Omicron this winter may cancel out, at least partly, the advantage of it being milder. There’s also the question of how many people who catch Omicron will develop chronic symptoms and whether its mildness and/or existing immunity will reduce the risk of long covid.
This pandemic wave may crash onto our shores with less impact than before, but that doesn’t mean it won’t still leave devastation in its wake.