As the Omicron variant spreads like wildfire across the United States, it's likely just about everybody will be exposed to the strain, but vaccinated people will still fare better, the nation's leading infectious disease expert said Tuesday.
"Omicron, with its extraordinary, unprecedented degree of efficiency of transmissibility, will ultimately find just about everybody," Dr. Anthony Fauci told J. Stephen Morrison, senior vice president of the Center for Strategic and International Studies. "Those who have been vaccinated ... and boosted would get exposed. Some, maybe a lot of them, will get infected but will very likely, with some exceptions, do reasonably well in the sense of not having hospitalization and death."
In contrast, those who are not vaccinated are "going to get the brunt of the severe aspect of this," he added.
Across the United States, at least one in five eligible Americans -- roughly 65 million people-- are not vaccinated against Covid-19. More than 62% of the country has been fully vaccinated, but only 23% are fully vaccinated and boosted, according to data from the US Centers for Disease Control and Prevention.
Fauci's comments came in response to a question about whether the pandemic has entered a new phase. That will come when there's enough protection in the community and drugs to easily treat severe Covid-19, he said, adding, "We may be on the threshold of that right now."
Also Tuesday, US Food and Drug Administration acting commissioner Dr. Janet Woodcock said that while most people could catch the virus, the focus now should be on making sure hospitals and essential services function.
Woodcock was responding to a question from Sen. Mike Braun about whether it's time for the United States to change its Covid-19 strategy. Her statement was not a new assessment of Covid-19, but rather an attempt to make clear the need to prioritize essential services as the Omicron variant surges.
"I think it's hard to process what's actually happening right now, which is: Most people are going to get Covid," Woodcock said Tuesday at a Senate Health, Education, Labor and Pensions Committee hearing. "And what we need to do is make sure the hospitals can still function, transportation, you know, other essential services are not disrupted while this happens."
On Tuesday, the number of US patients hospitalized with Covid-19 hit a record high, adding strain to health care networks and pushing states toward emergency staffing and other measures as they struggle to cope.
More than 145,900 people were in US hospitals with Covid-19 as of Tuesday -- a number that surpasses the previous peak from mid-January 2021 (142,246), and is almost twice what it was two weeks ago, according to data from the Department of Health and Human Services.
The hospitalization record comes amid a surge in cases fueled by the highly transmissible Omicron variant.
The United States averaged more than 754,200 new Covid-19 cases daily over the past week, according to Johns Hopkins University data. That's about three times last winter's peak average (251,987 on January 11, 2021), and 4.5 times the peak from the Delta-driven surge (166,347 on September 1), according to JHU.
The country has averaged 1,646 Covid-19 deaths a day over the past week -- 33% higher than a week ago, according to JHU. The peak average was 3,402 daily on January 13, 2021, JHU data shows.
The Omicron variant caused 98.3% of new coronavirus cases in the United States last week, according to estimates posted Tuesday by the US Centers for Disease Control and Prevention.
Leaders activate new measures to combat surging numbers
Hospitals are increasingly juggling staffing issues -- not just because of the increased demand, but also because their employees, who are at a high risk of infection, have to isolate and recover after testing positive.
In Virginia, Gov. Ralph Northam declared a limited state of emergency Monday after the number of intensive care unit hospitalizations more than doubled since December 1. The order allows hospitals to expand bed capacity and gives more flexibility in staffing, he said, adding that it also expands the use of telehealth as well as expanding which medical professionals can give vaccines.
In Texas, at least 2,700 medical staffers are being hired, trained and deployed to assist with the surge, joining more than 1,300 personnel already sent across the state, the Texas Department of State Health Services said in a statement to CNN.
Kentucky has mobilized the National Guard to provide support, with 445 members sent to 30 health care facilities, the state announced.
"Omicron continues to burn through the commonwealth, growing at levels we have never seen before. Omicron is significantly more contagious than even the Delta variant," said Kentucky Gov. Andy Beshear, noting the earlier variant that spurred a surge of cases in the summer and fall.
"If it spreads at the rate we are seeing, it is certainly going to fill up our hospitals," he said, and Kentucky is "down to 134 adult ICU beds available."
And New Jersey reinstated a public health emergency, Gov. Phil Murphy announced, saying the state needed to "commit every resource available to beating back the wave" caused by Omicron. In the past two weeks alone, the state saw more than 10,000 people requiring hospitalization due to Covid-19, the governor said in a video announcement.
Mitigation measures such as mandatory masking are also being revived in some areas.
Delaware Gov. John Carney signed a universal indoor mask mandate Monday because of hospitalization increases, with some hospitals "over 100% inpatient bed capacity amid crippling staffing shortages," he said. Churches and places of worship are exempt, while businesses should provide masks to customers and have signage about indoor mask requirements.
"It's time for everyone to pitch in and do what works. Wear your mask indoors. Avoid gatherings or expect to get and spread Covid. Get your vaccine and, if eligible, get boosted. That's how we'll get through this surge without endangering more lives," Carney said.
Share of hospitalizations from breakthrough infections is growing, but risks for unvaccinated are higher
The HHS data on Covid-19 hospitalizations includes both those patients who are hospitalized because of Covid-19 complications and those who may have been admitted for something else but test positive for Covid-19. This has been true throughout the pandemic, though the share of patients who fall into each category may have changed over time.
Fully vaccinated people are accounting for a growing share of people hospitalized with Covid-19 -- but hospitalizations among people who received a booster shot are still rare, and the gap in risk by vaccination status has been wide.
Between April and July 2021, before the emergence of the Omicron variant, more than 90% of Covid-19 hospitalizations were among people who were either unvaccinated or partially vaccinated, according to a study published by the CDC.
But a sampling of data collected by CNN suggests that figure has dropped to somewhere between 60% and 75% in recent days and months:
• In Pennsylvania, about 75% of Covid-19 hospitalizations between September and early December 2021 were among people who were not fully vaccinated, according to data from the state health department.
• In New York, about 61% of Covid-19 hospitalizations during the week ending January 2, 2022 were among people who were not fully vaccinated, according to data from the state health department.
• Beaumont Health, the largest health care system in Michigan, reported on Thursday that 62% of Covid-19 patients in its eight hospitals were unvaccinated.
In some hospitals, up to 40% of patients with Covid-19 "are coming in not because they're sick with Covid, but because they're coming in with something else and have had Covid or the Omicron variant detected," CDC Director Dr. Rochelle Walensky told Fox News on Sunday.
But Covid-19 cases in hospitals strain resources, regardless of whether a patient was hospitalized because of Covid-19, CNN chief medical correspondent Dr. Sanjay Gupta said.
"If they get (incidentally) diagnosed with Covid in the hospital, they still need to go into infection protocol -- personal protective equipment, all of that still needs to be utilized. So it's a huge drain on the system overall," Gupta said Tuesday.
While fully vaccinated people are accounting for a larger share of Covid-19 hospitalizations, multiple accounts suggest that those who are fully vaccinated and boosted account for a small share.
In the University of Maryland Medical System, less than 5% of hospitalized patients were fully vaccinated and boosted, President and CEO Dr. Mohan Suntha said Thursday. Beaumont Health reported Thursday that only 8% of Covid-19 patients were fully vaccinated and boosted.
The CDC did not respond to CNN's multiple requests for data on the share of Covid-19 hospitalizations by vaccination status.
The agency publishes data on its website regarding the relative risk by vaccination status. Cumulatively, the risk of hospitalization has been eight times higher for unvaccinated people than for fully vaccinated people. But in the last week of November, CDC data showed that hospitalization rates were about 17 times higher for unvaccinated people than for fully vaccinated people.
Schools and industries face Omicron issues
The debate over safety in schools from Covid-19 continues to play out as only about one in six children ages 5 to 11 is fully vaccinated, according to data from the CDC.
As Los Angeles prepared to return to school on Tuesday, approximately 62,000 students and staff had tested positive for Covid-19 and will have to stay home, data from the Los Angeles Unified School District showed Monday, equating to a 14.99% positivity rate. The positivity rate of Los Angeles County at large, by comparison, has spiked to 22%.
In Chicago, educators returned to school Tuesday and students are expected to resume in-person learning Wednesday following a nearly weeklong dispute. The Chicago Teachers Union had voted to teach remotely last week, and the school district responded by canceling classes for four days.
The agreement, announced late Monday, included metrics for when a classroom would need to go remote due to Covid-19 levels.
In areas where schools have returned to in-person learning after the holiday break, the time needed for those with Covid-19 to recover has impacted some essential services.
Other sectors also are struggling due to high infection rates.
Some municipalities have seen nearly a quarter of their trash collection workforce call in sick in recent weeks due to Covid-19, leading to delays, according to the Solid Waste Association of North America.
"This coincided, unfortunately, with increased trash and recycling volumes associated with the holidays. However, we hope that as volumes decline and sanitation workers return to work, these delays will prove temporary," executive director and CEO David Biderman said in a statement Monday.
In travel, US airlines canceled thousands of additional flights over the weekend due to Covid-19 callouts and winter storms, and cruise line Royal Caribbean International announced it has canceled voyages on four ships because of "ongoing Covid-related circumstances around the world." Last week, Norwegian Cruise Line canceled the voyages of eight ships.
Public transit systems in major metropolitan areas such as New York City and Washington, DC, have had to scale back service with employees ill from Covid-19. In Detroit, 20-25% of SMART bus service is canceled or delayed, the agency said in a statement Saturday.
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