Who is most likely to be hospitalized or die because of COVID-19?

Look at risk factors for getting severely ill from COVID-19 and/or dying from the disease, and you might find that it doesn’t matter who you are or where you live — an infectious disease expert notes that being unvaccinated puts people in the most danger for severe outcomes.

“And that’s regardless of your age, gender, underlying comorbidity; it really is vaccination status that’s the greatest predictor of your outcome,” said Dr. Greg Schrank, an infectious disease specialist at the University of Maryland School of Medicine.

Looking at people middle aged and older, COVID-19 claims the most victims from populations that are unvaccinated, and then fully vaccinated people who haven’t gotten booster shots are more vulnerable people, such as the oldest adults and those with underlying medical conditions.

For example, unvaccinated Virginians last week were hospitalized at a rate 21.1 times than that of fully vaccinated Virginians. And, getting a booster is proven to improve outcomes.

Compare someone who’s fully vaccinated with someone who’s fully vaccinated and has received a booster, and there’s almost a sixfold difference in the rates of hospitalization among people older than 65, Schrank said.

It’s critically important for older adults and those who are vulnerable to get booster shots.

“Because with omicron, we have seen some immune evasion from the mutations within the virus, as well as the waning of antibodies over time following the initial receipt of a vaccine series,” he said. “And with the combination of those two, plus a more vulnerable person, whether it be age or comorbidity, that’s really where we’re seeing these severe outcomes play out.”

Although you’re hearing a lot lately about dropping rates of new cases, Schrank notes the drop is occurring from record-high levels.

“We reached an unprecedented, extraordinary level of community transmission earlier in January, that went well beyond anything that we’ve seen here in the pandemic,” he said. “Here in Maryland, the case incidence currently (as of Monday) is still almost as high as the peak that we reached last winter. It’s a little bit lower, but not by much.”

And, those are just the numbers that officials know about. New daily case counts are likely a vast underestimation because of the use of take-home tests with results that don’t get reported and the number of people self-diagnosing and isolating at home.

While data is still needed, the omicron variant anecdotally appears to cause less severe disease compared to previous variants. So why are so many people dying? Because of extraordinary numbers of infections.

The coronavirus that emerged from China took weeks to be tracked from city to city and state to state.

“Omicron has swept across the United States in a way that we have not yet seen with this virus and that really is fairly unprecedented, at least in the modern era, for any type of respiratory infection,” he said.

So while the breakdown of those who are hospitalized, severely ill, and die is in large part among the unvaccinated, even people who are vaccinated are getting sick. Vaccines are highly protective but not perfect at preventing severe outcomes, and there have been millions and millions of new cases each week.

“We unfortunately see and continue to see climbing rates of COVID-19 deaths as we have into February,” Schrank said.

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.

Kristi King

Kristi King is a veteran reporter who has been working in the WTOP newsroom since 1990. She covers everything from breaking news to consumer concerns and the latest medical developments.

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