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Covid hospitalizations double since May, driven by BA.5

The highly contagious omicron subvariant now accounts for more than half of new infections in the U.S.
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Hospitals across the country are bracing for another surge in Covid-19 patients as the highly contagious omicron subvariant BA.5 sweeps the nation. 

“Statewide, we’re definitely seeing an increase,” said Dr. Jeanne Marrazzo, director of the infectious diseases division at the University of Alabama at Birmingham. 

In Utah, Dr. Brandon Webb, an infectious diseases physician at Intermountain Healthcare in Salt Lake City, said his health care system has noted a “significant uptick in hospitalizations over the last month.”

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Nationwide, hospitalizations have doubled since May, Centers for Disease Control and Prevention Director Dr. Rochelle Walensky said during a media briefing Tuesday. An NBC News analysis found that Covid-related hospitalizations are up in all but four states, with the biggest recent jumps in the South.

The increase is driven by BA.5 and another closely related subvariant, BA.4, Walenksy said. BA.5 accounted for 65% of new cases for the week ending July 9, according to the CDC. BA.4 accounted for 16.3%. 

Both subvariants are “more transmissible and more immune evading” than previous versions of omicron. That is, any immunity a person has from vaccination or previous infection may offer little to no protection against what’s currently circulating.

“Even if somebody had an infection in the massive wave of last winter,” said Dr. Jorge Salinas, an epidemiologist and infectious diseases expert at Stanford University, “they could still get sick with these new variants.” Salinas, too, has noted the increase in Covid-related hospitalizations.

There is no indication that these subvariants are more dangerous. They do not “appear to be associated with greater disease severity or hospitalizations compared to the most recent subvariants,” Dr. Anthony Fauci, the president's chief medical adviser, said during Tuesday’s briefing.

The rising hospitalizations related to Covid are likely due, in part, to the sheer number of vulnerable, newly infected people.

“Even if it’s not as severe as earlier variants,” Marrazzo said, “the number of people who are eligible to get sick is just higher.”

“This is similar to what we saw with the omicron surge in the beginning of the year,” though the rate of increase is slower than before, said Dr. Robert Atmar, a professor of infectious diseases at Baylor College of Medicine in Houston.

“It seems to be a much more gradual increase than what we’ve seen previously,” Atmar said. “That said, we haven’t peaked yet.” Wastewater samples in the Houston area, he said, continue to show a rising level of virus in the community.

The University of Arkansas for Medical Sciences in Little Rock, too, has noted the uptick in hospitalizations. As of Monday, 25 people were hospitalized with Covid there, up from about 10 in early June. 

The general standard of care for hospitalized patients is the antiviral remdesivir, plus steroids and/or oxygen support as needed. Some cases may also require anti-inflammatory drugs called baricitinib or tocilizumab. Now that physicians have better tools to treat Covid, mechanical ventilation is not as frequently used as it was earlier in the pandemic. 

“Fortunately, we haven’t seen a large influx of patients requiring intensive care unit care with this most recent surge, but I’m not holding my breath,” said Dr. Robert Hopkins, director of the Division of Internal Medicine at UAMS. 

Indeed, many intensive care units have remained relatively untouched by this latest increase. But Hopkins said there is growing concern that that may change as the virus spreads among the most vulnerable populations, namely the elderly and those with weak immune systems.

Even though the vaccines don't offer protection against infection with BA.4 and BA.5, they can reduce the risk for severe complications, Webb, of Intermountain Healthcare, said.

“About 50% of our hospital admissions are in patients who reported no vaccination,” he said.

And while the latest increases in hospitalizations are nowhere near the surge that occurred last winter, staff members are stretched thin, adding to the stress on hospital systems across the country. 

An NBC News analysis of Department of Health and Human Services data finds that hospitals in all but two states are, on average, experiencing high or extreme stress levels. The statistic is based on the number of hospital beds taken by Covid patients. 

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What’s more, absenteeism among health care workers who become infected themselves has been challenging, said Atmar. “Just like people in the community are getting infected, so are our health care personnel.”

Hopkins expressed frustration at the impact of a growing number of hospitalized Covid patients on hospitals.

“We still have an awful lot of folks in our community that did not complete full vaccination and an even larger proportion that have not been boosted,” Hopkins said. “When you have highly contagious variants, a lot of unvaccinated folks in the community and very few that are wearing masks and taking other precautions, I think it’s not terribly unexpected that we have another surge.”

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