Why health officials say hospitalizations is metric to watch in midst of omicron surge

Coronavirus cases in the D.C. region this week have set pandemic records, prompting the return of a mask mandate in D.C. and high demand for testing in Maryland and Virginia.

Coronavirus cases are surging so much in D.C. that the city is now the top COVID-19 hot spot in the U.S., according to Johns Hopkins data that looks at new confirmed coronavirus cases per 100,000 people.

The District is seeing a daily average of more than 150 COVID-19 cases per 100,000, by far the highest rate in the country. The daily national average is 51 cases per 100,000 people.

Data from the Centers for Disease Control and Prevention shows that D.C. has the highest seven-day case rate per 100,000, with a positivity rate of 8% to 9.9%.

The spike in cases during the winter surge alone, health officials say, should be a reason for caution. Though the amount of virus in local communities is increasing, the availability of COVID-19 vaccines for everyone 5 and older that prevent severe illness and death makes hospitalizations a key metric to follow.

Dr. David Dowdy, an associate professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health, said a rise in cases is only cause for concern when it’s accompanied by an increase in hospitalized patients. The country is not seeing the “one-to-one correspondence” between cases and hospitalizations it once did, he said.

“For this region, it is the right time to be a bit more cautious,” Dowdy said. “It’s important for us not to just get concerned about a rise in cases, but to only really be worried if those rising cases are accompanied by a rise in hospitalizations, which nationally are not rising.”

Virginia on Wednesday reported 5,972 new coronavirus cases and 1,550 hospitalizations, nearly double the 843 hospitalizations posted Nov. 13. Virginia Department of Health Data indicates 76.5% of residents have received at least one vaccine dose.

Maryland added more than 4,000 new cases, with 1,465 patients hospitalized with COVID-19. During last winter’s rise in cases, as many as 1,952 people were hospitalized. Gov. Larry Hogan this week said he’s preparing hospitals for an increase in coronavirus patients, with state hospitalization expected to reach a pandemic high in January.

In Maryland, 84.5% of everyone 5 and older has received at least one COVID-19 vaccine dose.

And in D.C., which on Monday reinstituted its mask mandate and on Wednesday announced a vaccine requirement for customers at many businesses, 1,524 cases were recorded Tuesday. According to Centers for Disease Control and Prevention data, 167 new patients were hospitalized.

In D.C., 84.1% of residents are partially or fully vaccinated.

Patrick Ashley, with DC Health, said Wednesday that despite the spike in caseload, “we’re confident that our hospital system and health care system has the ability to take care of anything that we see in the community.”

Medical experts attribute the surge to the transmissibility of the omicron variant, first discovered in South Africa. It’s still unclear whether the omicron variant results in milder symptoms, because it emerged at a time of widespread vaccination. Two new British studies found that infection with the omicron variant is less likely to result in hospitalization.

Nonetheless, Dowdy said, hospitalizations are not a lagging indicator. Instead, they’re happening “in real time, along with [cases], both of them are two or three days behind what’s actually happening.”

“[The D.C. region is] a good example of you can have cases go up so high that it still has a spillover into hospitalizations,” Dowdy said. “And that’s when we need to start being more cautious and more concerned.”

Children’s National Hospital has similarly seen an increase in coronavirus cases. Last week, it recorded 398 positive cases, an increase of more than 200% compared to the prior week, said Dr. Sarah Ash Combs, an attending physician in the hospital’s emergency department.

The hospital tests every child admitted to the hospital in addition to those who arrive with coronavirus symptoms, Combs said, so some of those cases may be asymptomatic. Most of those cases are in unvaccinated children, she said.

“We’ve very luckily continued to see that children in general do well with COVID, and they seem to be doing well with this recent rise as well,” Combs said. “Some runny nose, some congestion, colds, maybe fever. We are also seeing a high number of asymptomatic patients. And that’s the really tricky part.”

The safest way to navigate the current surge, Dowdy and Combs said, is to ensure everyone eligible for a booster shot has received one. With the holidays approaching, both said vaccination, testing, wearing masks and avoiding indoor crowded settings are essential, in addition to understanding the level of risk everyone at a gathering is comfortable with.

Despite the spike in cases, which has resulted in things like Broadway show closures and sports cancellations, Combs said it’s important to recognize that “this is not the same as early 2020.”

“We both know more and we have more,” Combs said. “We have a vaccination. We know some factors about COVID. We know how it spreads. We know about efficacy numbers for things like masking. We’re no longer feeling around in the dark and trying to see what’s more effective, what’s less effective. Those things we have are very evidence-based, very scientific.”

The coronavirus, Dowdy said, will eventually be handled like the flu, because of the emergence of vaccines and therapeutics. But in the current phase of the pandemic, he said, hospitalizations are the metric to watch.

“We have new variants of the flu every year, and people don’t go crazy about that,” Dowdy said. “We can, as a society, get to a point where when we see new variants of this virus, it doesn’t become a cause for panic and alarm.”

More Coronavirus News

Looking for more information? D.C., Maryland and Virginia are each releasing more data every day. Visit their official sites here: Virginia | Maryland | D.C.

Scott Gelman

Scott Gelman is a digital editor and writer for WTOP. A South Florida native, Scott graduated from the University of Maryland in 2019. During his time in College Park, he worked for The Diamondback, the school’s student newspaper.

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