In light of the alarming numbers and news reports regarding the omicron variant, I just had to share highlights of a group conversation in my clinic this morning that I felt would be a welcome note of positivity. In short: we are winning.
While cases have spiked to as high as >10,000 per day in recent weeks, per the Minnesota Department of Health website, the peak daily number of deaths has been around 40, the average less than that. The total number of hospitalized patients has also remained under 200 throughout the state during this time. These relatively “flat” numbers, percentage wise, suggest that the virus is indeed spreading rapidly but causing less severe illness.
All current reports suggest omicron is a milder disease. Anecdotally, the patients I diagnosed in the past week had symptoms indistinguishable from the common cold; stuffy nose, congestion, cough, but no fever, intense body aches and so on. This is not to say that a subset of patients may not become seriously ill, but that is true of all respiratory viruses, including influenza. From a biological standpoint, this is what pandemics do right before they die out: a highly transmissible but less deadly form of the virus dominates, then becomes seasonal. It is more advantageous for a virus to replicate and spread than die with its host.
We are winning on the treatment front, as well. Not only do we have vaccines, which reduce severity of illness, but we now have two promising outpatient treatments. The older drug Fluvoxamine, and the new drug Paxlovid, both of which when started early prevent clinical deterioration for covid positive patients and reduce the need for hospital or emergency level care. We also have a better understanding of how to treat hospitalized patients and recognize that there are different stages or phases of this illness and therefore different treatments targeted to each.
While indeed there are bed shortages, according to the Carlson School of Business Covid-19 Tracker, as of January 3rd, 2021, only 14% of inpatient hospital beds in Hennepin County and 34% of ICU beds are occupied by covid-19 patients. The percentages vary and are higher in some rural counties, which might be related to lower rates of vaccination. Still, it would seem that the strain on hospitals is not just covid patients but also, significant staff shortages for various reasons (including quarantine for positive tests) and the sheer number of non-covid-related hospitalizations, which has been climbing since April 2021. As a primary care doctor, I have seen first hand how the pandemic had negative impacts on other aspects of my patient’s health, including weight gain, out of control diabetes, high blood pressure emergencies and so on. Combine unhealthy lifestyle choices with reduced access to care and delayed routine testing, and together there are far reaching consequences.
As long as we are on the topic of hospital beds, I would also point out the majority of both hospitalized and ICU patients (over 60%) are unvaccinated. Although the vaccines have been disappointing in terms of the numbers of boosters needed and also the ability to reduce the spread–or we wouldn’t be where we are today!–it is clear they are a source of personal protection against severe illness. I encourage everyone to consider this fact, especially in light of more reassuring safety data as we roll out more shots. And I tell all my patients to take vitamin D; low vitamin D levels are associated with worse illness should you contract the virus.
While the health care system’s response to the covid-19 pandemic definitely has areas of weakness, it is important to highlight the positive results and the gains we have been seeing. Taken all together, there is a light at the end of the tunnel; this could be the beginning of the end. Despite the news media’s tendency toward the negative, we are actually in a much better place than a year ago today, and are enjoying more freedoms, cautiously, as a result of it.
We are winning!