Omicron surge drives hospitalizations to record-breaking levels in D.C. region

Across the region, more people are hospitalized with COVID-19 than at any other point in the pandemic — underscoring the magnitude of omicron's surge in the final weeks of the year.

Both D.C. and Maryland are reporting their highest numbers of patients sick with COVID-19 this week. According to the Washington Post's local coronavirus tracker, more than 600 people in D.C. are currently hospitalized with the virus, the most ever recorded in the pandemic. Out of all COVID-19-related hospital admissions over the month of December, half occurred between Dec. 22 and Dec. 28, DC Health officials said on Wednesday. Residents between the ages of 24-35 and 55-64 make up the majority of recent COVID-related admissions, per the city.

Maryland likewise set a record this week, with more than 2,000 people currently hospitalized with the virus, higher than the patient load during the January 2021 surge, before vaccines were widely available.

"Because of the sheer volume of cases, we are seeing more patients in the hospital," senior deputy with DC Health Patrick Ashley said during a press conference Wednesday.

Public health experts had been waiting to see omicron's impact on healthcare systems. In past waves of the virus, an increase in hospitalizations has lagged a few weeks behind a surge in cases. Before the holiday, public health professor at University of Maryland Neil J. Sehgal told DCist/WAMU that omicron's impact would manifest in hospitalization numbers during the week between Christmas and New Year's. Now, as cases continue to surge, he expects to see the number of patients sick the virus climb and sustain through at least February.

"Based on the latest projections that I've reviewed cases are expected to reach their high in January, which means our hospitals are going to continue to fill until mid-February," Sehgal says. "But comparing where we are to other phases of the pandemic, certainly we're in a much better place, per case, during this winter surge."

Unlike other phases of the pandemic, the omicron variant does not appear to be causing as severe illness as previous surges. In South Africa, where the variant was first detected, health department officials announced this week that the omicron surge has waned without a severe increase in deaths. In the D.C. region, deaths have not increased as dramatically as cases, but just as hospitalizations lag a week or two behind case spikes, a rise in deaths similarly lags a week or two behind a surge in hospitalizations.

Officials say there are reasons to be cautiously hopeful. In D.C., while the number of total patients sick with COVID-19 is at an all-time high, the number of patients requiring ventilators or intensive care remains below the levels reported during previous surges. And vaccines, especially, boosers, remain effective in preventing serious illness and death from omicron. According to Ashley, unvaccinated individuals are ten times more likely to contract COVID-19 than boosted individuals, and 20 times more likely to die from COVID. Roughly 2 out of every 10 fully vaccinated residents has received a booster, according to the city's data.

"We've become much better at treating COVID," Ashley said Wednesday. "We're seeing far fewer patients that are on ventilators."

That's good news on an individual level — but even if omicron is leading to less severe illness and death, the sheer number of people going into the hospital is straining health system resources across the region. On Thursday, the Virginia Health Department and the Virgina Hopsital and Healthcare Association urged residents with mild COVID-19 cases or other non-serious injuries to avoid visiting "already burdened hospital emergency departments." The number of Virginians hospitalized with the virus is lower than it was during previous waves (roughly 2,200 as of Dec. 31,) but VDH and VHHA officials expecting those numbers to worsen into the new year.

"The peak of this latest surge may not arrive until several weeks after the holiday season concludes, making it likely that its true impact on public health and the health care delivery system is yet to be fully felt," the agencies said in a joint statement on Thursday,

When Maryland surpassed 2,000 hospitalizations on Wednesday, Gov. Larry Hogan restated his earlier pledge of $100 million to help short-staffed hospitals weather the omicron wave. Hospitals have been directed since mid-December to suspend elective surgeries and maximize bed capacity, and the state has set up a surge operations center to accomdate the influx of patients.

In D.C., officials maintain that despite the surge in COVID-19 patients, hospital capacity — meaning the total number of patients in the hospital — has remained relatively stable over December, with about 26% of beds available for use currently. But as the surge in cases continues, the city announced a $15 million grant for hospitals to fund staffing needs. According to Ashley, about one out of every four hospital staff members is out due to COVID-19 isolation or quarantine.

"Hypothetically, if the risk of hospitalization is half is great for omicron as compared to delta, but twice as many people end up infected, the impact on the health care system would be exactly the same," Sehgal says. "What's concerning me both in our region and nationally, is that we we may face a healthcare worker shortage and what's going to make this wave different than previous waves is the impact that it has on to the basic necessary services that keeps society functioning."

The influx of hospitalizations comes as the D.C. area experiences one of the worst COVID-19 surges in the U.S. D.C. is recording the highest number of cases per capita out of any state in the country, outpacing New York City, the one-time epicenter of the virus. Officials haven't yet been able to answer why the region, which due to myriad factors (mask wearing policies, vaccination rates, and public behavior) escaped the worst of previous surges, became a hotspot during the omicron wave. Sehgal theorizes it's likely due to several overlapping factors, but adds that a definite conclusion can't be reached until researchers dig into more data in January.

"We're seeing diminishing vaccine effectiveness against omicron, but there were also policy decisions in the District that prompted this return to normal, that sense that we were all feeling at the beginning of November," he says. "It was certainly was spurred on by the mayor's decision to rescind the mask mandate, which was a push back in the direction of normalcy, ill-timed, clearly, but capacity limits dropped much earlier than that. Restaurants and bars were filling again, people were returning to their their normalized lives."

Shortly after vaccines became widely available to the general public in the late spring and summer, the emergence of the delta variant in July interrupted many locals' plans for "Hot Vax Summer." As that surge subsided in the fall (an autumn that Sehgal notes had particulary mild weather), he suggests more people felt comfortable going out, protected by a mask policy that was still in place (but later dropped before Thanksgiving) and a relatively high vaccination rate in the region. He also notes that D.C. has many young residents — ages 20-49 — who are more likely to encounter the virus either through young children attending school, or in social settings.

"One of the reasons that in the previous national waves you didn't see that effect in D.C. and [D.C.] felt really safe, is because we had that wall of vaccination," Sehgal says. "Unfortunately, under omicron, that wall doesn't hold. Also during those previous waves, we continued the layers of protection like the mask mandate."

On Thursday, D.C. recorded 2,241 new cases, bringing the city's weekly case rate per 100,000 residents to 1,904, a 70% increase from one month ago. If hospitalizations right now reflect cases identified between one and two weeks ago — when the city recorded 800 infections a day, he expects the numbers to only worsen as health systems feel the impact of 2,000-plus daily infections.

"What I said then and what I stand by now, is that between Christmas and New Year's we would see what the impact of those cases would be on hospitalizations in the District. We're between Christmas and New Year's and hospitalizations are up about 200%," he says. "If that 200% increase in hospitalization is attributable to 800 case days and 500 case days, a week from now, think about where our hospitals might be."

This story is from DCist.com, the local news site of WAMU.