It will be even milder than the other variants, it is certain that since Omicron took over, hospitalizations have started to grow steadily. Covid patients in the non-critical area are now more than 17 thousand, about half of the peak of the second wave (when vaccines did not exist). In intensive care there are instead 1,677 people against 3,848 last year.
There are undoubtedly some signs of stress in the health system. Hence the question: while Omicron generally causes less severe disease, will Omicron still be able to cause the collapse of our hospitals? Answering this question is obviously prohibitive (there are too many unknowns), but looking at the latest scientific studies and the situation in other countries, it is perhaps possible to form a less summary and more documented opinion. Let’s go in order.
There are fewer hospitalized for Covid than they seem
Let’s start by saying that with such a contagious variant the data of hospitalized patients with symptoms could be partially distorted. How? According to a study carried out by the Italian Federation of Healthcare and Hospitals, 34% of positive patients admitted are not in hospital for respiratory or pulmonary syndromes, but require health care for other pathologies. In other words, these are people who discover their positivity only at the time of hospitalization (for other reasons).
It is reasonable to assume that before Omicron the number of people who ended up in hospital “with the virus” and not “for the virus” was lower precisely because of the less sustained viral circulation. In a nutshell: if one in 30 Italians is positive for Sars-Cov-2, the chances that a hospitalized patient also has a positive swab are higher than in the past.
But even what appears to be good news has its downsides. The Italian Federation of Healthcare and Hospital Companies (Fiaso) explains that “the presence of positive patients but with other diseases” engages companies even more from an organizational point of view: they are patients who are positive and commit Covid beds. but they need interdisciplinary assistance which therefore obliges us to duplicate the organizational paths “.
Occupancy of the beds
In any case, there are starting to be more than a few alarm bells in hospitals. According to the latest data from Agenas, the National Agency for Regional Health Services, the employment of intensive care is 18% (the threshold for passing into the red zone is set at 30%) with large differences between regions. If, for example, in Puglia “only” 10% of the beds are occupied by Covid patients, in Piedmont there is a less reassuring figure of 24%, the province of Trento reaches 31%, while Calabria and Sicily stop at 20 .
Covid hospitalizations in non-critical areas also rise, reaching 27%, one percentage point more than the previous survey (the critical threshold is 40%). Hospitalizations increase in 13 regions: Valle d’Aosta breaks through the share of 50% (54%), with an increase of 8 points; but Lombardy (31%), Piedmont (33%) and Abruzzo (26%) also worry.
Covid hospitalizations increased by 32% in one week
From the monitoring of the Fiaso “sentinel” hospitals it emerged that in one week Covid hospitalizations increased by 32%. “It is the fastest acceleration recorded in two months”, underlines the Italian Federation of Health and Hospital Companies. The latest report includes 20 health and hospital facilities and 4 pediatric hospitals distributed throughout the Italian territory.
The survey was carried out on 11 January and concerns a total of 2,183 adult and 120 pediatric patients. The report highlights “an increase in hospitalizations, equal to 32%, with a marked acceleration compared to last week when the increase was 26%”. A figure “in line with the increase in incidence recorded in recent weeks and which raises an alarm on the beds reserved for the assistance of Sars-Cov-2 positive patients”.
Omicron causes milder symptoms (and you spend less time in the hospital)
Although hospitalizations are on the rise, according to several experts with Omicron a new phase of the pandemic could open in any case. All the studies conducted to date agree that the new strain generally causes milder disease. The latest field research, conducted in California, has shown that even those who are infected with Omicron will have a shorter recovery from the disease.
Epidemiologist Joseph Lewnard (University of California, Berkeley) and his team analyzed the medical records of 69,279 symptomatic patients who tested positive for coronavirus between November 30 and January 1, finding that the hospital stay of patients infected with Omicron was three days shorter (70% shorter than Delta). Furthermore, the risk of hospitalization was halved and that of being intubated reduced by 75%.
A risk that is lowered especially among vaccinated people who, according to Lewnard, would have between 64 and 73% less chance of being hospitalized than those who were not vaccinated. The study, the results of which were anticipated by the New York Times, has not yet been published in scientific journals, but has yielded similar results to other research conducted in South Africa, the United Kingdom and Denmark.
Given that the Omicron variant causes equal number of less hospitalized cases (according to a British study up to 70% less) and the shorter hospitalization time will allow to free up precious beds, the question everyone asks is whether the systems health workers will be able to withstand the brunt of an unprecedented surge in infections.
In some countries where the percentage of vaccinated is insufficient, hospitals are already in serious difficulty. This is the case, for example, in the United States where over 145,000 people are hospitalized, a figure that has no equal since the beginning of the pandemic, and practically double compared to two weeks ago. The peak in admissions reached a year ago has therefore been exceeded, when in January 2021 there were about 142 thousand hospitalizations. In the country about 62% of the population has completed the vaccination cycle, but only 23% also received the booster (in Italy 41%).
When will the infections begin to decline?
It is clear that the tightness of the system will depend on how the diagnosis curve evolves. Walter Ricciardi, consultant to the Ministry of Health, hypothesized a peak “in late January, early February”, but it is likely that before then we will break through “the wall of 300 thousand” cases per day.
In any case, it is difficult to make accurate predictions: with Omicron we travel to uncharted territories. The World Health Organization has predicted that at this rate more than half of people in Europe could be infected in the next six to eight weeks. But it is not certain that the epidemic will continue to travel at the current pace. In South Africa, after an initial flare-up, the number of infections fell just as rapidly. In the United Kingdom, the first European country to come to terms with Omicron, the curve seems to have taken the descent but more solid data will be needed to understand if it is really a trend or a flash in the pan.
When the Omicron vaccines arrive
Certainly, as also highlighted by the WHO technical group, to fight on equal terms against Omicron, updated vaccines will be needed (those in use, as is known, have a limited effect on transmission) because focusing only on boosters is not a sustainable strategy. A warning which, however, can also have a political reading, namely: this is the time to direct the stocks of pharmaceutical companies to bridge the gap with poor countries. It is certain that to have new vaccines it will take time: Pfizer announced that its vaccine will be ready in March, but the approval of the EMA (according to reports from the European medicines agency) could only arrive in April-May.
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