The Omicron Variant

Do you know if the NSW system makes a distinction between people in hospital/ICU/dying of Covid, versus those in the same situation with Covid?
Having clarity on that helps understand the relative seriousness of Omicron.

Your local epidemiologist makes the useful point that there are actually three categories. People who are hospitalized primarily due to covid, people hospitalized for something else who are incidentally found to have have covid, and people hospitalized primarily for something else, for whom covid aggravates the problem. She also has some scattered statics about these categories, although this post focuses on pediatric cases.

Since she says, “this post is public, so feel free to share it”, i am copying the relevant part of today’s post:

“For” or “with” COVID19. There has been a lot of public interest in whether children (and adults) are hospitalized “for COVID19” or “with COVID.” While this doesn’t matter for some questions (like, hospital capacity or hospital acquired infection among vulnerable and staff), it’s important for other questions (like, severity of Omicron among kids). In the state of New York, 59% of kids admitted who have COVID 19 are hospitalized for COVID19. Without historic data, it’s hard to know what this means. But it certainly does not mean dismiss the other 41% (hospitalizations “with COVID19”). Clinicians on the ground are describing a third category: “COVID19 exacerbating medical conditions.” For example, if a child has diabetes, COVID19 infection significantly complicates the disease and the child is hospitalized. This is very different than a child with a broken bone that happens to test positive. This third category isn’t displayed widely and cannot be ignored.

Thanks for that, “it’s complicated” seems to be the general take-away there and I’m not surprised.

Figures from the UK today show official cases down 80k over the same day last week (cases are only 57% of what they were last week). That’s a very steep drop when no additional rules are in place.
Hospitalisations and numbers in hospital are level and interestingly the ICU numbers are now at their lowest level since mid-October.

This. The for profit hospitals aren’t (for the most part) traditional hospitals that take care of everyone. They’re more like surgical centers where say, all the orthopedic surgeons in town admit people to do their knee and hip replacements, the GI doctors do their colonoscopies, the ophthalmologists do their cataract surgeries, and things of that sort. They don’t have emergency rooms, and don’t admit people for illnesses that they aren’t set up to treat (like COVID).

I’m having nasty cold symptoms, very similar to the beginning of my covid infection. I also had a day of gastrointestinal symptoms. It seems so likely to be omicron. But, my daughter was sick first, and she tested negative with a rapid test. My first full day of symptoms, yesterday, I tested with a rapid test, and included swabbing my tonsils. I was also negative.

I keep hearing, though, that people test several days in a row, and wind up testing positive after 4 or 5 days of negative results. I don’t have enough rapid tests to do it daily, but I plan to do it again in a few days. It’s really disconcerting to not know if the tests are accurate or not. I could try to get a PCR test, but if it’s positive, it could just be residual because of my prior infection.

I wish we would start seeing some testing adjustments to omicron, but I know it’s too soon to expect.

I went through the same thing: runny nose, gastric issues, tiredness, cough… And tested negative.

From Katelyn jetelina, “your local epidemiologist”

(The emailed version ends: “This post is public, please feel free to share it”, so I’ve included a long excerpt here.)

31 states are reporting hospitalization rates higher than previous winter. Washington, D.C. is just hammered with hospitalizations at 308% of last winter’s hospitalizations, equating to 128 per 100,000 residents being hospitalized for COVID19. This is followed by Delaware (70 per 100K), New Jersey (70 per 100,000), New York (68 per 100K), and Pennsylvania (63 per 100K). Thankfully, though, it looks like hospitalizations in these states are slowing down and will be on the descent soon.

There are two states and 618 counties that require circuit breakers (i.e. short-term mitigation measures needed to preserve hospital functioning) at this point because their hospitals are at or above 100% capacity (assuming that the number of staffed beds has not increased in the past week). Medical military personnel have already been dispatched to a number of hospitals across the nation. Nebraska also joined a short list of states that have enacted its Crisis Standards of Care plan. But community-wide efforts to reduce spread desperately need to be taken, too. Fourteen additional states are at high risk of exceeding 100% hospital capacity in the next 1-10 days.

I thought today’s ^ provided a good summary. The basic newsletter is free and well-written.

…latest round of updates:

Jan 14th: 63,018 cases, 29 deaths (2525 in hospital, 184 in ICU)
Jan 15th: 48,768 cases, 20 deaths (2576 in hospital, 193 in ICU)
Jan 16th: 34,660 cases, 20 deaths (2650 in hospital, 191 in ICU)
Jan 17th: 29,504 cases, 17 deaths (2776 in hospital, 203 in ICU)
Jan 18th: 29,830 cases, 36 deaths (2850 in hospital, 209 in ICU)
Jan 19th: 32,297 cases, 32 deaths (2863 in hospital, 217 in ICU)

Cases are all over the place, largely due to the change in reporting, but seems to be settling at around about 30,000 per day. Hospitalizations and people in ICU have been trending up from the beginning, and sadly deaths are trending up as well. Total deaths in Australia were 77 today: the biggest number since the start of the pandemic.

In Victoria, they have declared “Code Brown.” This means a “redeployment of staff, cancelled leave, ready private hospitals, defer non-urgent cases.”

More not-so-good news about Omicron, It is probably has a longer tail of infectiousness than has been assumed (notably, 5 days of isolation probably isn’t enough).

How does Omicron spread so fast? A high viral load isn’t the answer (nature.com)

In countries around the world, Omicron has rapidly surged past other variants to become the dominant SARS-CoV-2 strain. Now, two studies show that the variant has achieved success despite causing viral levels in the body that are similar to — or lower than — those of its main competitor, the Delta variant

…in NZ we reduced our isolation period to 7 days back in November for Delta. But we recently extended it back to 10 days once bit became clear how infectious the variant was.

Well just now we’ve extended the isolation period back to 14 days. We’ve had a few cases that weren’t picked up until day 11 or 12. So even 10 days wasn’t enough.

5 days was always utter madness, driven by a need to not let essential services and the economy fall over.

We are waiting to get hit by an Omicron outbreak. It will be interesting to compare our numbers with NSW when it eventually happens. We still have significant NPI’s in place while NSW abandoned pretty much everything in December. (Bringing many of them back once it became clear that the outbreak was getting out of control) They had 46 deaths today :frowning:

My son went to school for only one day after the holiday break. He was exposed to Omicron (in all likelihood) and the 4 of us all have confirmed cases of COVID. It has been 2 weeks since I became symptomatic and I am still testing as infectious. I suspect they need to extend the isolation period past 14 days.

The problem with such long isolation periods is that they cause huge problems with staff shortages in areas where omicron is in wide circulation.
The trend has actually been to shorten the period in such countries.

Does it mean that you get more spread than if you imposed 14 days+ ? it does, but it is a balancing act. Taking millions out of the workforce for long periods has consequences.

The reduction/removal of isolation requirements is just another step on the path to the inevitability of treating of Covid as just another disease that we live with. We can’t stop it, we can only delay the spread but it’ll find everyone and expose them eventually.

Only China among major nations remains comitted to a policy of “zero covid” and that is only made possible through the most draconian measures imaginable and even those will not be successful nor ultimately sustainable.

Scientists have been working overtime to study Omicron. Many questions remain unanswered, but here’s what they’ve learned so far.

The article is behind a paywall. Can you quote or summarize what made you want to post it?

Here’s a gifted link, I believe it will work for two weeks.

Isn’t the main take-away from that chart that once symptoms clear (or actually slightly before), you’re no longer infectious? Interesting choice to present those charts in a marker-on-a-white-board freehand manner. Maybe it’s perceived as “friendlier” or easier to understand?

Interesting article. Thanks @GreenWyvern, @Ann_Hedonia.

j

IFAICT, the biggest differences between profit and non-profit hospitals are their tax status (non-profit hospitals are tax exempt) and the ability to solicit charitable tax deductible donations to fund their work.

Non-profit hospitals aren’t charity hospitals and, while they may offer a range of financial assistance programs, their patients are expected to pay. I’m going to go out on a limb and say that most hospitals in the US are non-profit. I just checked the status of three of the largest healthcare systems operating in NYC (Northwell Health, NYU Langone, and Mt Sinai) and they are all non-profits. Just because they are non-profit that doesn’t mean they can’t pay their executives and officers hefty salaries, it doesn’t mean people can’t get rich off them and it doesn’t mean they aren’t price gouging.

It is, IMHO, the reason these systems are becoming behemoths, building new specialty hospitals and medical centers at a rapid pace - as they are required to plow all “profits” from their existing operations back into the business.

As it was mentioned upthread, private hospitals tend to be smaller, specialized operations, frequently owned and operated by groups of medical professionals that are also investors. But they are the exception, not the rule - the financial incentives strongly favor non-profit hospitals, so most of them are.

Thanks!

Interesting article. A lot of questions without answers, unfortunately.

Like whether the infectious period for Omicron is really short enough to justify the new shorter isolation period. And if testing out of isolation with a rapid test makes sense when rapid tests are so much less sensitive to Omicron.