The Omicron Surge Rings in the New Year 2022
The constant drumbeat of warnings about this Omicron variant surging into the record books has come to pass as the world begins a third new year coping with the COVID-19 virus. The daily 7-day average of US cases is up 204% compared to two weeks ago to a staggering 405,470 cases. The good news is that hospitalizations have not kept pace as they are up a comparatively low, 35%. The even better news is that deaths are actually down 3% but we are still losing in excess of 1300 Americans a day to this virus. The majority of these deaths were preventable IF they had been vaccinated. The Hamilton County (OH) numbers mirror those nationally, as our cases have risen 123%, hospitalizations are up 19%, and deaths are up 3.6%. These trends may represent a break from the historic pattern and a “decoupling” of case counts from hospitalizations, and deaths. Are we finally seeing the benefits of the vaccines and/or the less virulent nature of the massive number of Omicron cases? Nevertheless, our committed hospital workers are exhausted as they provide the unrelenting care for COVID-19 infected Ohioans (mostly unvaccinated). Ohio Governor Mike Devine has authorized a pause in all non-essential surgical procedures and also the deployment of an additional 1,250 members of the Ohio National Guard. These measures are in an effort to relieve the stress on our state’s hospital systems. These deployed Guardsmen are not medical professionals but staff personnel since pulling Ohio’s soldier nurses, doctors, and extenders would take them away from their usual healthcare jobs. Removing them from their home hospitals would only shift the shortages in Ohio’s hospitals.
Staff shortages due to the massive number of people in quarantine after COVID-19 infection diagnosis is having a profound impact on our day to day lives. The CDC has adjusted the quarantine requirements specifying five days of quarantine after a positive test followed by five days of masking, as long as no symptoms exist. Nevertheless, thousands of flights were cancelled today (Jan. 3) due to sick flight crews. Although some school administrators are keeping schools closed after the winter break due to concerns about the huge increase in the covid-19 numbers, many schools are returning to virtual because of sick or quarantined instructors. There are schools that are able to maintain in-class instructions by using intensified rapid results testing regimens. Unfortunately, two schools in Cincinnati were closed today due to 50% of the staff being out sick.
One very timely policy issue announced by the FDA today is that children ages 12-15 years old are now approved to receive the Pfizer COVID-19 booster. This was based on real-world data from Israel where the booster was found to restore vaccine effectiveness to 75% vs the 35% residual level after the two shot mRNA series. Additionally, the FDA reduced the booster waiting period, for all age groups, down to five months instead of six months. This will help get more people boosted, but our bigger problem remains the fifty million Americans yet to receive an initial vaccination, including a 20% level of vaccination in eligible children between 5 and 12 years of age. Lastly, the FDA authorized a third Pfizer vaccination for those children between the ages of five and eleven who are immunocompromised.
One other tool in the treatment toolbox for the severely immunocompromised (ages 12 years and over) is an AstraZeneca monoclonal antibody cocktail. This has been authorized for pre-exposure prophylaxis (PrEP) or commonly known as preventative treatment, for those who do not develop adequate antibody levels after vaccinations or are unable to be vaccinated, such as those with severe allergic reactions. It should be noted that there are other severe factors which might qualify as severe immunocompromised such as treatment with high-dose steroids or the absence of certain disease fighting cells in a person’s body.
We are all tired of this virus and we are in a new year. The virus and its variants do not care. We must persist and we will triumph. Get vaccinated and boosted, wear your mask, avoid large indoor crowds, stay home if sick, and wash your hands. If we do these things, January 2022 will be less bad!
