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January 20, 2022

Has omicron peaked? Yes—and no.

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    New data suggests the omicron surge has peaked nationwide and cases are now starting to decline. But some areas of the country are still experiencing surges, and hospitals remain overwhelmed by a record number of patients—leading one physician to worry that the current wave will "break the [health care] system."

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    Has omicron peaked in the U.S.?

    According to a New York Times database, the omicron surge in the United States seemingly peaked on Jan. 14 with a seven-day case average of 806,801, and is now in decline, although these numbers may be affected by reporting delays over the Martin Luther King, Jr. holiday weekend. Similarly, average daily cases per capita in the four U.S. regions tracked by the Times—the West, Midwest, South, and Northeast—have appeared to peak and are now in decline.

    In particular, Connecticut, Maryland, New Jersey, and New York have seen new Covid-19 cases decline more than 30% over the last week, the Times reports. And in Colorado, Florida, Georgia, Massachusetts, and Pennsylvania, the number of new cases has fallen by more than 10%.

    "We're starting to move toward better days," said David Rubin, who runs the PolicyLab at Children's Hospital of Philadelphia. "Overall, I see lots of indications that we're moving in the right direction. I think we're just starting to turn the corner."

    However, U.S. Surgeon General Vivek Murthy on Sunday warned that the omicron surge is not yet over. "The entire country is not moving at the same pace," he said. "The [o]micron wave started later in other parts of the country."

    Some areas of the country that are less vaccinated may take longer to reach a peak in the latest surge. For example, Loren Lipworth, an epidemiologist at Vanderbilt University Medical Center, said Tennessee, where only 51.8% of the population is fully vaccinated, will likely take longer to see the end of its omicron surge.

    In addition, some epidemiologists remain cautious about omicron's potential peak, saying that it is likely too soon to tell and that infections may begin rising again.

    "We have seen before a turn-down only be followed by an acceleration," said Jennifer Nuzzo, an epidemiologist at Johns Hopkins University (JHU). "There's real danger in giving people the sense they can relax their worry prematurely."

    Hospitals remain overwhelmed by heavy patient loads

    Although omicron cases may have peaked in the United States as a whole, hospitalizations remain high, and many hospitals around the country are being overwhelmed by record numbers of patients. On Sunday, HHS data recorded a seven-day average of more than 155,000 confirmed and suspected Covid-19 hospitalizations—its highest recorded level.

    "That's more than we've ever had. I expect those numbers to get substantially higher," said Ashish Jha, dean of the Brown University School of Public Health.

    "We are being absolutely crushed," said Gabor Kelen, chair of emergency medicine at the JHU School of Medicine in Maryland.

    Specifically, at least 18 states are reporting less than 15% capacity remaining in their ICU facilities, according to HHS data.

    Alok Sengupta, chair of emergency medicine for hospitals in St. Louis run by Mercy, said, "All of our emergency departments in our hospitals are really getting hit much harder this time around."

    As a result, patients who visit an ED "may be in a bed in the emergency department, not just for many hours, which was already very bad, but possibly even for several days," said Kelen. In fact, some patients who need to be transferred from one ED to another for a higher level of emergency care are forced to wait when an ED is too full to accept transfer patients, NPR's "Shots" reports.

    "They just sit there and they die, or they have long-term ill effects related to the fact that they couldn't get the care that they needed when they needed it," said Ruth Franks Snedecor, a hospitalist in Phoenix. "And we all know with a lot of these conditions—stroke, heart attack—time is of the essence."

    "What we are dealing with in the first month of 2022 is unsustainable," Snedecor added.

    Casey Clements, an ED doctor at the Mayo Clinic in Rochester, Minn., said despite omicron's lower overall severity, the large patient loads are worse now than in previous waves. "I think it's the most dangerous and most likely to break the system in upcoming weeks," he said. (Stone, "Shots," NPR, 1/13; Day et al., Wall Street Journal, 1/16; DePasquale et al., New York Times, 1/18; Beals, The Hill, 1/13; Imbler, New York Times, 1/16; Leonhardt, New York Times, 1/13; Leonhardt, New York Times, 1/19; Stein, "Shots," NPR, 1/14; Kopsky, News Channel 5, 1/18)

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