Black adult hospitalizations reached a pandemic high during the omicron wave, CDC study finds

During the peak of the omicron variant wave of the coronavirus this winter, Black adults in the United States were hospitalized at rates higher than at any moment in the pandemic, according to a report published Friday by the Centers for Disease Control and Prevention.

Black adults were four times as likely to be hospitalized compared with White adults during the height of the omicron variant surge, which started in mid-December and continued through January, the report said. In January, the CDC found, hospitalization rates for Black patients reached the highest level for any racial or ethnic group since the dawn of the pandemic.

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As the highly transmissible omicron variant usurped the delta variant's dominance, people who were unvaccinated were 12 times more likely to be hospitalized than those who were vaccinated and boosted against the coronavirus, according to the report.

And fewer Black adults had been immunized compared with White adults, said the report, which analyzed hospitalization rates in 99 counties in 14 states. The report examined the vaccination status of people older than 18 by race and ethnicity and compared hospitalization rates for the delta wave from July to Dec. 18 and for the omicron surge from Dec. 19 to Jan. 31.

According to the report, as of Jan. 26, only 39.6% of Black people older than 18 had received their primary series of two shots and just 43.9% of that group had received a booster once eligible. Meanwhile, 47.3% of White adults had been vaccinated with the initial series of shots, and 54.5% of eligible White adults had been boosted during that same time period, the report said.

Teresa Y. Smith saw evidence of the phenomenon outlined in the CDC's report as she treated patients as an emergency physician at SUNY Downstate in Brooklyn and associate dean of graduate medical education at Downstate Health Sciences University.

She has felt the crush of the pandemic's unequal impact since the pre-vaccine waves but has contended with the consequences of health disparities for much longer. Her hospital sits in a heavily Black and Latino borough, where - as in so many communities of color across the country - social, political, economic and environmental factors erode health and shorten lives.

In December, she watched as the number of cases and admissions resulting from the omicron variant "just exploded in a short, short amount of time," saying then, "there is no subtlety to it." And while the vaccinated patients she treated were less likely to be "lethally sick," many still needed to be admitted to the hospital.

"Any sort of a virus can set off people's underlying illnesses. Even a cold can make your diabetes or high blood pressure worse," she said at the beginning of the omicron surge. "So even if they're not deathly sick from covid, they still may have a jump in their glucose or not as good control of their hypertension. And so, admissions have increased because of that, but those who end up getting admitted and go to the ICU are those who are unvaccinated."

Adult hospitalization rates increased across the board - vaccinated, vaccinated and boosted, unvaccinated - in the Black community during omicron compared with delta, but not all communities of color had a similar experience, the CDC report shows. Although total hospitalization rates increased among Asian and Pacific Islander adults, rates dropped among adults in American Indian, Alaska Native and Latino communities, the report said.

In the Black community during the omicron wave, the report shows, there was a greater share of hospitalized patients who had been vaccinated compared with the delta wave. During omicron, 25.5% of Black patients had been vaccinated with the two-shot series, compared with 14.9% during delta, the report found. Unvaccinated Black people represented about 25% of all unvaccinated hospitalized patients during the delta wave, rising to 31% during the omicron phase.

Still, patients who wound up in the hospital had shorter stays during the omicron surge compared with delta, averaging four days instead of five, and fewer people needed intensive care, including being put on ventilators.

And there were fewer in-hospital deaths overall during omicron than delta, the report said.

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