Pandemic forecasters in Texas say the state’s current surge of omicron infections and hospitalizations is likely to get much worse before it gets better, with hospitalizations expected to continue climbing for at least three weeks if social behaviors don’t change and slow the trend.
Across the nation, hospitalizations are already on the verge of breaking new pandemic records. In Texas on Thursday, according to state data, about 9,200 people were hospitalized with COVID-19 — far short of the record 14,218 hospitalizations from Jan. 11, 2021.
But with current numbers climbing exponentially each week, hospitalizations of Texans with COVID are likely to follow national trends and surpass previous levels in the state before they start to decline, said Anass Bouchnita, a researcher at the University of Texas COVID-19 Modeling Consortium, which uses data and research to project the path of the pandemic nationally.
The number of Texans testing positive for the virus every day is already at an all-time high, reaching a seven-day average of almost 44,000 confirmed cases on Friday. The seven-day average of new confirmed cases during the peak of the delta surge back in September was over 15,000.
That trend is likely to continue for at least another week, Bouchnita said.
“The situation in Texas is that it probably won’t reach the peak [for cases] until the second half of January,” he said.
Experts say the extremely high case count is why so many people are showing up in the hospital even as medical evidence suggests that the omicron variant — responsible for most new and active cases in Texas — is less severe than the previously dominant delta variant.
Bouchnita talked to The Texas Tribune on Friday, the same day the UT consortium released a report with the research team’s latest calculations about omicron’s projected path nationally. The report, which looked at eight scenarios in which omicron had varying degrees of severity, infectiousness and resistance to immunity, suggests the nation could see its new cases of this more contagious but less severe strain peak by mid-January before decreasing by half in early February.
The report called the current surge the largest COVID-19 wave in the United States to date.
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Intensive care units at more than 50 hospitals are at 100% capacity, according to state reports, and some regions of the state, including El Paso, are reporting no ICU beds available in the area.
Already, the state’s children’s hospitals have more patients with COVID-19 in their beds than at any other time in the pandemic — 351 statewide on Thursday, which is higher than the last peak during the delta variant surge of 345 in early September.
“It’s pretty crazy,” said Frisco pediatrician Dr. Seth Kaplan, immediate past president of the Texas Pediatrics Society. “Our volume is way up.”
It’s mostly omicron now, very little delta in Texas, though there’s still a fair amount of delta in other parts of the US. It is true that omicron is less severe than delta, but it’s also true that it’s far more transmissible, and it’s affecting far more vaccinated people. Even with less severity, the sheer number of people being infected is driving the higher number of hospitalizations.
And while more vaccinated people are being infected by COVID, there’s still a big difference in outcomes between the vaxxed and the unvaxxed.
Omicron is sending a larger share of vaccinated people to the hospital that any previous COVID-19 variant, but unvaccinated people are still more likely to need critical care, according to Houston-area hospital officials.
Twenty-two of the 27 COVID patients in Harris Health System’s intensive care units are unvaccinated. At Houston Methodist, roughly 60 percent of the 80 COVID patients in the ICU are unvaccinated, and a high percentage of the remaining patients have underlying health conditions, said Dr. Faisal Masud, the hospital’s medical director of critical care.
It’s a similar story at St. Luke’s Health and Memorial Hermann Health System, both of which say 70 percent of ICU patients are unvaccinated.
“The vast majority of the people who are critically ill are either unvaccinated or have significant comorbidities,” said Dr. James McCarthy, chief physician executive at Memorial Hermann. “We are not seeing middle-aged, healthy, vaccinated individuals in the ICU like we did in the previous wave.”
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Statewide, the number of patients in the ICU has been steadily rising since Christmas Eve, from 1,030 to 1,711 on Wednesday, according to the Texas Department of State Health Services. That’s about half of the patients in the ICU at the peak of the delta wave, but some Houston hospitals are already seeing ICU rates double over the last week.
The number of incoming ICU patients could exceed all previous peaks, said Dr. Esmaeil Porsa, president and CEO of Harris Health System. While the vaccines may not be as effective as they were initially, the current ICU population indicates that “they are still extremely effective against severe disease,” he said.
“More and more breakthrough infections are going to happen,” Porsa said. “We’re going to get a higher percentage of people who are vaccinated, but that number is never going to be a big number. It’s always going to be minority of people.”
Overall, doctors say omicron is not damaging the lungs as much as earlier strains. Fewer COVID patients in the Harris Health ICU require mechanical ventilation compared to delta, said Porsa, but other health issues like kidney and heart failure are becoming more common.
At Methodist, Masud has observed a similar pattern. A large portion of ICU patients Masud has treated ended up in the unit because the virus exacerbated an existing disease. The risk of facing such complications is higher for unvaccinated people, he said.
“This is eliciting an immune response, which is not only limited to lungs but which makes the patients sicker, with existing disease becoming much worse,” he said.
Masud said that now is a critical time to wear a well-fitted mask in public, especially for people who are not vaccinated.
It’s the same as before, in that the things you can do to mitigate your risk haven’t changed. Get vaxxed, and get your booster. Wear an N95 or KN95 mask when out with people. Avoid large indoor events and gatherings. Stay home if you’re not feeling well. This will pass, but how bad it gets before it passes is still up in the air. For more on the national picture, see TPM, Mother Jones, and Daily Kos.