COVID-19 hospitalizations are on track to reach a record high, as early as this week. The current 7-day average is at 109,874 as of January 8, up 34% over the prior week and far surpassing the CDC’s forecast. Pediatric hospitalizations among children with COVID-19, while still lower than any other age group, also are up, with the rise attributed to hospitalizations of children under the age of five who are not yet eligible for vaccination and driven by the increased transmissibility of Omicron. However, hospitalization data does not always provide an accurate picture of COVID-19 severity and may include incidental infections; for example, in New York, 42% of patients hospitalized with COVID-19 were hospitalized for reasons unrelated to COVID-19 and tested positive during routine testing. Even incidental COVID-19 cases place incredible strain on hospitals, as coronavirus patients need to be isolated and require a greater amount of hospital resources than non-infected patients. Around 80% of hospital and ICU beds are occupied nationwide. Hospitals continue to report that patients admitted for COVID-19 who experience poor outcomes are mostly unvaccinated. Additionally, nearly one-quarter of hospitals nationwide report critical staffing shortages. Many healthcare workers are out sick with breakthrough infections—even after changes to CDC guidelines that allow for a shortened period of isolation—and burnout is causing droves of workers to leave their positions or the healthcare profession entirely. In order to compensate for the strain, some hospitals have been forced to cancel or postpone elective procedures and hospitals in several states are implementing crisis standards of care.
There is a lot of focus now on the total number of COVID infections and the concept of “incidental” COVID hospitalizations. First, the total number of COVID infections. Nobody knows. The numbers being reported are wildly understated. Home tests are not reported. Both the antigen and the PCR tests are not perfect. A study reported by the CDC found a 20 percent false negative rate in the antigen test in symptomatic individuals and a 59 percent false negative rate in asymptomatic persons. And, a study of the Omicron variant found that 70% of infected patients were asymptomatic. So you have infected patients whose tests aren’t reported (or they can’t even find a test to take), infected patients who are tested and get a false negative result, and infected patients who don’t know they are infected and don’t get tested, and none of these are counted.
As to incidental COVID hospitalizations, it may be incidental but regardless, it is irrelevant. An incidental COVID hospitalization refers to patients who are primarily admitted for other ailments and test positive as part of routine screening. The fact is that COVID is a multisystem infection with variable presentations that can complicate care and worsen existing conditions whether it is the primary reason for hospital admission or not. COVID typically extends length of stay and because COVID patients must be isolated, they put many more demands on both hospital facilities and staff. Our current patients with the omicron variant are not as sick, but our staffing situation is at crisis levels compared to where we were with the more deadly delta variant last year.
It was 2 years ago this week that the first US death from COVID-19 was recorded, i.e., during the week of 1/11/2020. As of 1/31/2020, 158.7 million Americans had full-time jobs, 5.8 million people were jobless, and the nation’s unemployment rate was just 3.5%. As of 12/31/2021, 156.0 million Americans had full-time jobs, 6.3 million people are jobless, and the nation’s unemployment rate is only 3.9% according to the Department of Labor. At least by the measurement of jobs, we have almost come full circle.
CSSE is reporting 62,117,454 positive cases in the U.S. and 841,766 deaths. DOH reported for the week ending January 6, 4,562,954 confirmed cases in Florida with 62,688 deaths.