Ahead of Omicron, COVID hospitalizations are rising in 37 states

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U.S. COVID-19 hospitalizations are now rising in 37 of 50 states, including several with above-average vaccination rates.

Meanwhile, COVID cases are again starting to climb in nearly half of the other 13 states, signaling that hospitalizations may soon follow. Among them is Florida, where cases bottomed out after a deadly summer outbreak but have increased 29 percent over the last two weeks.

These sobering figures underscore the fact that many Americans remain vulnerable to the still-surging Delta variant as the holiday season ramps up and Delta’s heavily mutated and perhaps even faster-spreading successor, Omicron, looms on the horizon.

Nationally, the number of Americans now hospitalized for COVID — nearly 65,000 — is higher than it’s been in two months. An average of 120,000 Americans are testing positive for COVID each day; nearly 1,300 are dying. And all three metrics are heading in the wrong direction.

Medical personnel tend to patients
Medical personnel tend to patients at a hospital in Houston. (Brandon Bell/Getty Images)

The troubling trajectory of the U.S. pandemic should serve as a reminder of how far the United States, let alone the rest of the world, still has to go before reaching so-called endemicity — a state of relative normalcy in which the virus continues to circulate but widespread immunity prevents it from hospitalizing and killing thousands of Americans each day. (The H1N1 influenza virus that caused the so-called Spanish flu outbreak in 1918 killed at least 50 million people worldwide before morphing into just another seasonal flu; the four human coronaviruses that cause the common cold are also thought to have sparked pandemics.)

Heading into winter, experts hoped that naturally acquired immunity from earlier waves of infection and a full vaccination rate of 60 percent across the entire population would provide sufficient protection to prevent a repeat of the last holiday season, when cooling weather and indoor celebrations triggered America’s most devastating wave to date.

To some degree, vaccination has provided the hoped-for protection. While hospitalizations are currently rising in 14 of the 17 states (plus Washington, D.C.) with the highest full vaccination rates, most of the same states — including New York, Rhode Island, Washington, D.C., Connecticut, New Jersey, Massachusetts, Maryland, Virginia, Vermont and California — still have fewer people in the hospital, per capita, than the national average, and none are recording more deaths than they were at last winter’s peak. In September, unvaccinated Americans were 14 times more likely to die of COVID-19 than fully vaccinated Americans, according to the Centers for Disease Control and Prevention. That’s the power of vaccination.

Outside an emergency room in Coral Gables, Fla.
Outside an emergency room in Coral Gables, Fla. (Chandan Khanna/AFP via Getty Images)

The problem is that the story is different in some places with lower vaccine uptake, or with older populations whose earlier vaccine protection may be wearing off.

In Michigan, where just 55 percent of the population is fully vaccinated, the hospitalization rate (46 people per every 100,000 residents) is now higher than anywhere else in the country — and higher than at any previous point in the pandemic. Average daily deaths (121) are as high as they were last Christmas.

Several other states — Ohio, Indiana, Minnesota, New Hampshire, Maine and possibly Pennsylvania — appear to be on a similar path. For them, this winter could be worse than the last.

Going forward, the best-case scenario would be for ever-increasing natural immunity due to Delta’s continued spread — as well as rising vaccine and booster uptake — to finally produce the kind of population-wide protection required to reduce COVID-19 to a threat on par with the flu, which resulted in 12,000 to 52,000 U.S. deaths annually between 2010 and 2020. (In comparison, COVID has killed more than 500,000 Americans over the last 12 months.)

But the emergence of Omicron — which appears to spread more than twice as quickly as Delta, likely because it’s better at causing reinfections and breakthrough cases than any previous version of the coronavirus — is almost sure to further delay the end of the pandemic.

According to initial studies, people with boosters or hybrid immunity (infection plus vaccination) seem like they could be sufficiently protected from Omicron — and most people with two shots or prior infection may avoid its worst consequences.

But a variant that infects even vaccinated and recovered people as rapidly and readily as Omicron doesn't need to boast “a great degree of severity” or completely evade vaccines to inflict a great degree of damage.

It just needs to keep spreading until it reaches the vast number of people worldwide — including the U.S. — who are still susceptible to hospitalization and death.

Right now, fewer than half of Americans over 65 — the most at-risk group for hospitalization — have gotten a booster shot. Thirteen percent are still not fully vaccinated.

That’s 7 million seniors.

All told, just 19 percent of U.S. adults have been boosted. More than 41 million haven’t even gotten a single COVID vaccine shot yet. A full year after safe and effective vaccines first became available, Delta continues to hospitalize and kill far too many Americans each day. Here’s hoping that fewer remain so vulnerable if and when Omicron takes hold in the U.S.