Tue. Feb 7th, 2023

The White House is urging people over the age of 50 to get COVID boosters, even if previously infected.Healthcare providers say they are more prepared to handle increases but nonetheless are unsure of the full impact of these latest strains, which typically have milder symptoms. Severely ill patients tend to be elderly, not fully vaccinated and/or suffering from other underlying health issues.

In the Chicago area, Edward-Elmhurst Health has recorded a steady uptick in hospitalizations during the last couple of months. Its Edward Hospital is averaging 35 COVID-related admissions per week, up from about 10 admissions per week in March, said Dr. Jonathan Pinsky, its medical director of infection control and prevention.

At omicron’s peak, Edward Hospital reported an average of 168 admissions per week. This time, fewer patients require intensive-care unit beds, and the length of stay tends to be shorter, he said.

“We need to be concerned, but it’s kind of a different concern now than it was two years ago. Two years ago, we had a population that was not immune, not infected, not vaccinated,” Pinsky said.

The new strains will likely follow a similar trajectory to the others, said Dr. Sandra Kemmerly, an infectious disease specialist and system medical director of hospital quality at Baton Rouge, Louisiana-based Oschner Health. Heightened community spread results in more hospitalizations a couple of weeks later, followed by an uptick in ICU patients.

CDC data shows the seven-day moving average for COVID deaths is staying flat so far at roughly 300 deaths nationwide.

Hospital systems are staying prepared to handle any surges.

At Oschner, isolation rules and personal protective equipment requirements remain in effect. The system has not recently used designated COVID units, activated when there are at least 15 to 20 COVID patients at a hospital. The threshold shifts based on a facility’s size.

“We’ve done it at least four or five times, so we can certainly stand them up and stand them down,” Kemmerly said.

Weston said hospital executives in his area collaborate regularly on operational challenges. The Froedtert system has implemented a centralized, risk-stratification process to disburse COVID treatments.

Staffing remains the biggest challenge, Atallah said. Many workers are out due to COVID infections. Once an employee tests positive for the virus, that employee may be out for up to 10 days, unless there is a critical labor shortage, said Dr. Stuart Cohen, chief of the infectious diseases division at UC Davis Health.

Healthcare providers continue to push for vaccinations. A vaccine tailored for the newer strains is expected to roll out this fall. Combination COVID and flu vaccines may also become an option.

“I think we’re beyond the state where we think this is going to end. It’s not ending. We’re … living with it, but living with it doesn’t mean giving up and giving into the virus. It means adjusting your lifestyle to that,” Pinsky said.

Physicians increasingly view case numbers as a less reliable data point since positive results from at-home self-testing kits typically go unreported, Weston said. Some recent estimates suggest hundreds of thousands of positive cases are falling through the cracks.

Healthcare systems are instead relying on hospitalizations or positivity rates. Milwaukee County, where Froedtert is based, has an approximately 15.4% positivity rate, up from 12% or 13% in recent weeks, Weston said. The national positivity rate had a seven-day average of 17.5% for June 24-30, more than two percentage points higher than the preceding week, according to CDC data.

Cohen said positivity rates may not be accurate either, so it also helps to look at how COVID treatments, including the antiviral medication Paxlovid or monoclonal antibodies, are being disbursed. That gives physicians a general idea of how infections are trending.

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