Science

As Covid-19 peak seems to near, experts warn against letting guard down


In February 2021, Dr Craig Spencer wrote in a Medium post that he was as “eager as anyone to see the end of this pandemic. Thankfully, that may be in sight”.

“Covid cases and hospitalizations are dropping,” wrote Spencer, director of Global Health in Emergency Medicine at New York-Presbyterian/Columbia University Medical Center. “Vaccines are getting into arms. So, what happens next?”

Next was, of course, more Covid-19.

So – almost a year later – while Spencer is encouraged by the fact that the growth in the number of new Covid cases has slowed in parts of the country, he has been humbled by earlier waves and is not ready to celebrate the beginning of the end of the pandemic.

“It’s not like you get to the top of Everest, have a small party and then start your ascent down and take off your oxygen mask,” Spencer said. “There is still risk when you start your descent, and I think it’s important for all of us to continue to be wary and aware of that.”

While the United States has over the last month broken records for Covid hospitalizations and cases due to the highly contagious Omicron variant, the Northeast has seen a decrease in the number of daily new Covid cases or a slowing down of the rate of increase, prompting predictions that the worst of the pandemic will soon be over.

But infectious disease experts say that’s premature because of how unpredictable the virus has been and the fact that it is still surging and overwhelming hospitals in parts of the country.

“Yes, particularly in places like New York City, Omicron is peaking, but I think we have to be very careful not to confuse peaking with a low,” said Dr Celine Gounder, an infectious disease specialist and epidemiologist at New York University. “That means people who are going out and about, living their normal lives need to be careful to still make use of mitigation measures like wearing higher-quality masks and doing as much outdoors as possible.”

In the Northeast, the number of daily new cases has started to decline in the last week, according to data from the New York Times, but other places continue to experience a spike in cases. For example, 10 states saw a more than 300% increase in cases over the last two weeks.

Across the United States, there has been a 133% increase in cases and a 79% increase in Covid hospitalizations over that period.

“I think it’s very possible that we may be at a peak, and certainly that would be in line with a lot of modeling results in terms of timing, which projected peaks in mid to late January, but at the same until we see a few more days of consistent downward trends and start to see that reflected in hospitalizations as well, I would be cautious,” said Justin Lessler, an epidemiology professor at the University of North Carolina.

Despite the slowing down of the surge, when Spencer worked a shift earlier this week in the emergency room at Columbia in New York, “it was just as chaotic for me as it was for my colleagues around the city”, he said.

That’s because the emergency room was filled with patients who were very sick with Covid in addition to people coming for heart attacks, appendicitis or other ailments, as compared to the start of the pandemic when almost all the patients in emergency rooms were there because of Covid, Spencer said.

There is also a significant number of providers who are unable to work because they tested positive for Covid.

“Emergency rooms have always been adaptable, but the issue we are dealing with now is not just more patients and more Covid but also fewer providers and fewer places to put [patients],” said Spencer.

In Oklahoma, a 363% increase over the past two weeks has overwhelmed hospitals. Three hospital systems reported that they had no intensive care unit beds available, according to KFOR-TV.

At OU Health in Oklahoma City, the spike in Covid cases poses a challenge for providers treating patients with the virus but also for non-Covid patients because the hospital must take additional measures to protect them from the virus, said Dr Dale Bratzler, the hospital’s chief Covid officer.

There are also 250 staff members who are unable to work because they are isolating due to the virus, he said.

While Bratzler hopes that the state could reach its Omicron peak in the next week, he is concerned that the decline could be slower than in other states because only 54% of the population is fully vaccinated, whereas in New York the number is 73%.

“I am much more worried that we will have a substantial increase in hospitalizations over the next few weeks. We are already stretched in our systems, and since unvaccinated people are driving hospitalizations, I am very worried about that,” said Bratzler.

Still, Aaron Wendelboe, an OU epidemiologist, said that he is “a bit encouraged by what is happening in other states”.

But like other epidemiologists, Wendelboe said he is not ready to declare that we won’t see another surge like Omicron because the virus continues to mutate.

“I feel like I am a slower learner,” he said, “because I would not have predicted this big of a surge so quickly but Covid continues to surprise us.”



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