By Mark Jurkowitz | Outer Banks Voice on January 11, 2022
What do COVID hospitalization numbers tell us?
It was another week of unprecedented numbers in terms of the sheer volume of COVID-19 cases in Dare County — numbers driven by the very contagious Omicron variant. But the overall picture of the pandemic in this moment is more complicated than just case numbers.
The Jan. 11 update from the Dare County Department of Health and Human Services (DHHS) reported 799 cases of COVID in the week from Jan. 3-9. That’s up from what had been the record-shattering mark of 513 cases in the previous week. At the same time, the positive test rate in the county jumped to 43.68% in this past week, substantially up from the 31.05% the week of Dec. 27-Jan. 2.
The number of Dare County residents hospitalized with COVID (14) remains relatively low and increased by 1 this past week. Sadly, 1 new death was reported on Jan. 10, a woman 65 or over, who is the 27th county resident to succumb to the virus since the outset of the pandemic. She is the first resident reported to die of COVID since Dec. 7, 2021.
The DHHS also tracks the percentage of weekly cases by vaccination status. For the week of Jan. 3-9, 59% of the cases occurred among the unvaccinated with the rest of them occurring among vaccinated individuals — including the 10% of the newly infected who had also received boosters.
The Jan. 11 daily data reported by the North Carolina Department of Health and Human Services (NCDHHS) shows similar patterns when it comes to the COVID-19 case numbers. As of Jan. 11, there were 17,705 daily new cases of COVID. That is down from the astronomically high 29,069 cases reported on Jan. 8, but still well above the highest level of any other previous surge. The Jan. 11 rate of positive COVID tests was 30.5%, also reflecting a dramatic recent increase.
When it comes to hospitalizations with COVID, the numbers at the state level are exploding. As of Jan. 11, there were 3,991 hospitalizations, more than double the 1,738 people hospitalized as recently as Christmas Day. The number of residents in ICUs is also up to 722, a 55% percent increase since Dec. 25.
Thus far deaths at the state level have trailed well behind the hospitalization numbers in this current surge, something likely attributable to Omicron’s tendency to cause milder disease than other variants and because deaths are also a lagging metric that follow after hospitalizations. For the last three days reported, for example, the state lists a combined 14 COVID deaths.
In recent days, there have been reports about a significant number of people hospitalized with COVID who are not hospitalized because of COVID but became inpatients for another reason and tested positive upon an admission screening. In New York City, that latter number was reported to be as high as 50%. In Massachusetts public health officials will start differentiating from those in hospitals from COVID and those for who tested positive while admitted for something else.
In North Carolina, the NCDHHS data tracks people in the hospital with COVID, whether it was the primary reason for their admission or not. And the department stresses that regardless of why people entered the hospital, this many inpatients with COVID seriously strain health care resources. It adds that COVID infections could be causing other hospitalizations that otherwise would not have been necessary.
NCDHHS press spokesperson Catie Armstrong emailed the Voice that, “As we have seen cases increase rapidly due to the more contagious Omicron variant, we’ve seen hospitalizations increase as well and put as put a strain on our healthcare system…Typically, individuals that are admitted to the hospital are experiencing some sort of symptom severe enough to warrant hospital admission, whether that be heart trouble, severe dehydration, a severe injury, etc. If these same individuals test positive for COVID-19, they have to be placed in COVID-cohorted space which requires more use of PPE, staff, space etc. same as a person that is admitted specifically for COVID-19 related complications.”
“It’s also important to note that it is not always clear what role COVID may or may not play in someone needing hospitalization. For example, COVID can worsen other health conditions (heart conditions, breathing issues, etc.) and lead to hospitalizations that may not have been necessary without a COVID-19 diagnosis playing a role. NCDHHS is working with hospital partners on options to better understand reasons for hospitalization among those with COVID,” she added.
The Voice also asked Vidant Health, which operates eight hospitals in the region, about hospitalizations that do not involved people initially admitted for COVID.
In an email response, Vidant Communications Coordinator Ashlin Elliott stated that, “While there are some patients admitted to the hospital with COVID rather than for COVID…most COVID-positive patients who are hospitalized in the intensive care unit suffer from chronic conditions worsened by COVID or with pneumonia driven by the virus. It is difficult to provide an accurate estimate of how many patients are admitted with COVID rather than for COVID given the complicated nature of determining exactly when a patient is infected and whether or not COVID is the driving factor in a patient’s health issues in the moment care is sought.”
The email also pointed to the impact of all the COVID cases on crucial hospital resources.
“Vidant Health [is] quickly filling up with COVID patients, most of whom are unvaccinated…With the ever-increasing demand for care, and the increasing number of health care workers infected with COVID, it is straining our ability to care for those with other urgent medical needs that are not COVID-related,” the email stated. “This has already resulted in rescheduling non-emergent surgeries, longer wait times and less available team members to care for both COVID and non-COVID patients. The good news is we know that vaccinations are highly effective at preventing severe disease, hospitalizations and death…”
Both NCDHHS and Vidant officials point to the central importance of getting vaccinated to avoid severe illness.
According to NCDHHS weekly COVID summary, for the week ending on Jan. 1, a full 80% of hospitalizations were among the unvaccinated. And the unvaccinated also comprised 88% of individuals in ICUs.
For Vidant the numbers are similar: As of Jan. 10, 83% of those hospitalized with COVID are unvaccinated; 92% of those in the ICU with COVID are unvaccinated; and 95% of those on ventilators are unvaccinated.
For the purposes of categorization, unvaccinated means someone who has not received any vaccine dose or received only one Pfizer or Moderna dose.