The word “spike” has been atrociously overused during the pandemic. But in the case of the Omicron variant it is an adapt description, as dramatically demonstrated by this graph of confirmed cases in the US for the entire pandemic.
That, my friends, is a spike. And you see it in virtually every metric related to the Omicron wave.
Hospitalizations
The epi-curve for new daily hospitalizations is almost as dramatic. At its high point, new admissions were nearly double the Delta peak. However, as I have mentioned in previous posts, it is hard to compare the hospital data in this wave with previous waves because of incidental COVID admissions. Even the Biden administration has now begun to question whether we should be using a different methodology for counting COVID hospitalizations.
The good news is that hospitalizations have been rapidly falling and are now well below the previous peaks.
The Omicron wave moved through the country on a, more or less, east to west tract. So, those states on the East Coast are further down the curve. Texas, being about halfway, is a little behind the East Coast but a little ahead of most of the western states, making its numbers fairly similar to the national averages.
Notice how much lower ICUs were to general hospital beds in the Omicron wave. To some degree this is probably another indication of how widespread incidental COVID hospitalizations have been.
In the Houston area, COVID hospital numbers are rapidly declining, although not quite to the lows following the initial or the Delta waves. But at the current rate of decline, they should be back at those levels within the next week.
Fatalities
The CDC daily fatality data, which is based mostly on the report date, hit a high of 2,550 on February 1 and 2, and has since declined to under 1,900. With the dramatic decline in hospitalizations, I expect to see this number also rapidly coming down over the next couple of weeks.
After leveling out in the 50-60 range in mid-November, Texas’ report of daily fatalities (reported by date of death) currently shows they topped out at about 230 in late January. It has rapidly since come down, with the latest seven-day average at about 140. The Omicron wave peak was about half of the wave in the winter of 21-22 and about two-thirds of the Delta wave.
The number of ventilated patients has dropped by half over the last three weeks, but be still have about 800 COVID patients on ventilation in Texas. The survival rate after ventilation has not been good, so we have some more fatalities coming. But with the dramatic decline in ventilated patients, we will hopefully see that bottom out soon. The IHME model is currently predicting that COVID fatalities in Texas will fall to essentially zero by the end of March.
In about another month, we will have nearly complete fatality data for 2021. Right now, the CDC excess death analysis is showing that there were about 50,000 more fatalities in 2021 than 2020. Both years were about 20% more than recent years before the pandemic. I will be writing a more detailed analysis of the excess death calculation for 2021 in about a month.
Vaccines
Daily vaccine administrations continue to rapidly decline. The seven-day average is now below 400,000 for the first time since the vaccines were first approved. The US has stalled out at about just two-thirds of the population with two shots. The good news is that almost 90% of seniors have had two shots and over a third have received boosters.
The CDC data continues to show that the vaccines, especially when boosted, are very effective at preventing serious COVID disease and hospitalizations. But they appear to have done very little to slow down the Omicron wave, as there have likely been millions of mild and asymptomatic cases among those vaccinated.
Testing Results
The CDC’s seven-day average of new cases topped out at about 800,000 on January 9 but has since fallen to just over 100,000. The IHME model calculates that in early January nearly 5 million Americans per day were getting an Omicron infection. They are now estimating about 500,000 per day. At those rates, you pretty quickly just run out of people to get it.
Conclusion
Two interesting studies have been released recently.
One was a challenge trial conducted by the Imperial College in London in which 36 young, healthy adults were inoculated with COVID. The study found that 16 of the participants showed no indication that they ever became infected. This is the latest in a growing body of research trying to understand why some people, even though they have no immunity to the virus from a previous infection or a vaccine, nonetheless appear to be immune from to the disease. I personally know, at least, a couple of dozen married couples where one spouse got COVID but the other did not. Given the explanation we were all given about the dynamics of how COVID spreads, that should not be possible. I think the only plausible explanation is that there was a genetic component to susceptibility to the disease that we have not figured out yet. Some research, for example, suggests that Asians may have a genetic advantage in their immune system based on their ancestors exposure to an ancient coronavirus epidemic. They have certainly had much lower infection rates than other population around the world.
The second study began to explain why children were largely spared serious consequences from COVID. Normally, epidemics are especially hard on the very old and the very young. But despite the constant media drumbeat that children were at risk of serious disease from COVID, the number of fatalities has been astonishingly low. As of the end of the year, of the 66,000 childhood fatalities during the pandemic, only 678 were related to COVID. There were about a dozen causes of childhood fatality during the pandemic that outranked COVID, including car accidents, homicides, suicides, cancer, accidental suffocations, and drownings.
The Omicron wave has brought a fresh wave of pessimism among the American people about the future of COVID. A recent Monmouth University poll found that only a third of Americans thought COVID would be under control by the end of 2022 and 28% believed the US will never return to normal.
But there are a growing number of studies suggesting that immunity, and especially that from vaccination, is both longer lasting and more likely to control future strains of the virus than some have feared.1 Which actually should not be surprising and explains why no epidemic has ever lasts forever.
Cambridge professor of statistics and risk assessment, David Spiegelhalter, has suggested that the media obsession with COVID and the failure of public health officials to appropriately contextualize the risk of COVID for the average person, has created something he calls “dread risk.” He has been advocating for sometime that we must start assessing the COVID risk more realistically, suggesting that it is now at a level comparable to many other risks to which we are routinely exposed.
It will take some time for the public’s perceptions about COVID to catch up with reality, but I suspect it may happen sooner rather than later. With the polling showing that a clear majority of Americans are ready to move on, you will be hearing less and less about COVID from public officials, especially regarding any mandatory public health measures.
Note 1 – There has been extensive media coverage, with the attendant doomsday doctors’ warning about the emergence of a sub-variant of Omicron, dubbed BA2. However, a recent study found that it is not doing much to change the trajectory of the pandemic.
