Cases surge with Omicron arrival

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Cases surge with Omicron arrival

Variant causes less serious illness, but hospitals face staffing shortages

BY HOLLY KAYS STAFF WRITER

The arrival of the extremely contagious Omicron variant in conjunction with holiday travel and gatherings has caused a spike in COVID-19 cases far eclipsing anything seen in the pandemic to date — but the variant’s milder effects compared to previous COVID-19 strains could limit its impact.

“The Omicron variant is certainly leading to both an increase in cases and in hospitalizations in our community,” said William Hathaway, chief medical officer for Mission Health System. “Fortunately, all evidence to date suggests that this variant, while more contagious than prior variants, appears to cause less significant disease in those it infects.”

After reaching a post-Thanksgiving plateau, North Carolina’s daily case counts began to climb in the days preceding Christmas and then spiked to an all-time high of 19,620 Jan. 1, with counts remaining above 12,000 every day since Dec. 30. Prior to this most recent spike, the largest singleday tally for new COVID-19 cases was on Feb. 3, 2021, with 12,079 cases.

As case counts have risen, so have hospitalizations — though thus far not nearly to the extent they did during earlier surges, when case counts were lower. As of Jan. 2, 2,772 people statewide were hospitalized with COVID-19. After Christmas last year, hospitalization numbers didn’t fall below 3,000 for a month, nearly breaking 4,000.

Local hospitals are seeing the same trend. As of Jan. 4, Haywood Regional Hospital had 18 COVID-positive patients, and on Jan. 3 Harris Regional Hospital had fewer than 10. During the height of the pandemic, Harris was treating 25-30 COVID-19 patients at any one time, and HRMC had 20-25.

As of 4:30 a.m. Jan. 3, the Mission Health System had 106 COVID-positive patients, of whom 75 were at Mission Hospital in Asheville and seven at Angel Medical Center in Franklin. On Jan. 3 last year, Mission had 162 COVID-positive patients across its network.

The discrepancy could be partly due to the rapid onset of the Omicron wave. Cases have been surging for less than two weeks, with the more dramatic increase just days old — there is typically a lag between increased case counts, hospitalizations and deaths.

But Omicron seems to be causing milder illness worldwide. In both South Africa and the United Kingdom, which Omicron hit earlier than the United States, the surge in cases did not cause any corresponding surge in deaths. Recent studies indicate that Omicron does not infect the lungs like previous variants have, explaining the dearth of more serious symptoms.

It’s also possible that hospitalization numbers inflate the impact of COVID-19 as a driver for hospitalization. A Dec. 31 report from the U.K. National Health Service found that only 67% of the 8,321 COVID-positive patients occupying a hospital bed on Dec. 28 were there primarily due to COVID-19.

Despite fewer COVID-19 patients compared to this time last year, area hospitals are still struggling to meet community needs. According to Dr. Ben Guiney, an emergency room physician at Harris, that’s primarily due to staffing issues. Harris currently has 89 open positions and HRMC has 164.

“It’s because of the nursing shortage, but it’s also because nurses are now getting sick with COVID,” he said. “They’re not getting admitted to the hospital, but they can’t work for five days.”

Other hospitals are facing similar challenges — in a Jan. 3 Facebook post, the Cherokee Indian Hospital urged people to visit the emergency room only for critical illness or urgent medical care, as WNC currently faces “a critical bed shortage.”

Principal Chief Richard Sneed announced a new slate of protective measures — including masking requirements and four-day work weeks for tribal employees — that will remain in effect on the Qualla Boundary through Jan. 30.

Omicron’s onslaught is also evident in the large number of vaccinated people who are testing positive for the virus. In the week ending Jan. 3, 61.3% of new COVID-19 cases in Haywood County occurred in unvaccinated people, down from 93.2% the previous week.

At this point, said Guiney, vaccination won’t prevent infection but will prevent serious illness. Guiney, who has been vaccinated, boosted, and contracted COVID-19 in December 2020, before vaccines were available, used himself as an example. He recently caught the virus again, but this time it was just a cough — in fact, the illness was so mild that at first he didn’t even consider that he might have COVID.

“The only people that are coming in the hospital, getting admitted to the hospital, getting sick, getting on ventilators, are unvaccinated people,” he said. “Vaccinated people are not staying in the hospital. It’s just that stark.”