As the omicron variant drives a winter spike in coronavirus cases that has now topped the summer delta wave in California, local officials and public health experts are looking eastward to New York to predict how the current surge might play out in the Golden State.
Their forecast? Cases will continue to rise, and hospitalizations are almost certain to follow, although there continues to be hope that omicron will prove less deadly than earlier variants. And data released Tuesday suggests a new surge in hospitalizations here already has begun.
California and New York have similar vaccination rates and similar pandemic restrictions in place. But while San Francisco logged the first recorded case of omicron in the U.S., cases have exploded faster in New York, giving the West Coast a bit of time to take stock and prepare. According to the latest data from the Centers for Disease Control and Prevention, the seven-day moving average case rate in New York is 171 per 100,000 residents — a number that has spiked in recent days. In California, it’s much lower at 31 but has begun to climb.
Santa Clara County Health Officer Sara Cody said Tuesday she is monitoring the situation in other cities around the country and predicted case counts in her county could rise from about 1,000 a day now to more than 2,000. Not only is that higher than the worst of delta, it is potentially higher than last winter’s surge, which preceded widespread vaccinations.
One key indicator of the omicron threat is hospitalizations, which have soared in New York in the last several weeks. New York, with a population of roughly 20 million, currently has more than 6,170 people hospitalized with the virus and a hospitalization rate of 31 COVID-19 patients per 100,000. In California, with a population about double the size of New York, about 4,750 people are hospitalized with COVID-19, making for a hospitalization rate less than half that of New York.
But the number of coronavirus patients hospitalized in California has risen 21 percent in the last two weeks, and health experts expect that to continue.
New York “is instructive,” said David Pride, an infectious disease specialist at UC San Diego Health. “My prediction is we’ll see a bump in hospitalizations” in California.
So far hospitals on both coasts have said they are not overwhelmed as many were last year before vaccines were widely available. But omicron is highly transmissible and causing more breakthrough cases in fully vaccinated people, so even if just a small percentage of those who get sick become seriously ill, hospitalizations would still climb. Vaccination remains the best way to avoid serious illness, and a booster shot offers even more protection. But only about a third of vaccinated Americans have received a booster shot, and Bay Area counties are trying to encourage more. Contra Costa and Santa Clara counties put new booster rules for essential workers in place on Tuesday.
In New York City, pediatric hospitalizations have spiked roughly five times higher than they were at the beginning of the month, with most cases involving unvaccinated children. California officials have warned the same spike is likely to happen here in the coming weeks and urged parents to get their children vaccinated.
“We’re going to have a real challenge to the health-care delivery system — namely the number of beds, the number of ICU beds and even the number of health care providers,” Anthony Fauci, the nation’s top infectious disease, expert told the Washington Post.
Hospital staffing is already becoming a challenge in the Golden State, with more health care workers calling in sick and testing positive.
“We’re already seeing it” at UCSD, Pride said. “What goes for our institution very likely goes for every institution in California.”
“We’re kind of struggling to figure out how we’re going to get enough people to do the job hospitals need to do right now,” he said.
This week, the Centers for Disease Control and Prevention halved its recommended isolation period, a move heralded by some health care providers as a way to keep staffing levels up amid a spike in hospitalizations.
Still, there are some signs of good news. New studies suggest people who get omicron experience milder symptoms and are less likely to be hospitalized than people who get the delta variant. Recent data from England suggests those infected with omicron are 15-20% less likely to visit an emergency room and 40% less likely to spend the night at a hospital. As with previous variants, people with underlying health issues and those who are unvaccinated are at increased risk of being hospitalized.
Monica Gandhi, an infectious disease doctor at UC San Francisco, said the health system is seeing some hospitalizations that are “incidental,” meaning someone showed up at a hospital for a reason other than the coronavirus but then turned up positive as part of routine testing, not because of symptoms.
But she still thinks focusing on hospitalizations at this point in the pandemic makes more sense than case counts, which can sound scary but, especially in highly vaccinated, testing-happy places like the Bay Area, can be “relatively uncoupled” from the threat of severe illness.
Locally, “hospitalizations are manageable. … It’s so different than this time last year,” Gandhi said. “Cases become sort of really unreliable at this stage of the pandemic.”
Staff reporter Gabriel Greschler contributed reporting.