Hospitals across the country are bracing for a post-holiday surge in Covid-19 cases, driven by the extremely contagious omicron variant of the coronavirus.
In Rhode Island, hospitals are already in a fragile position heading into the New Year, said Dr. Nadine Himelfarb, the president of the Rhode Island Chapter of the American College of Emergency Physicians.
As of Monday, the state had the third-highest share of new Covid-19 cases in the country adjusted for population, according to an NBC News tally. Rhode Island has the highest percentage in the country of hospital beds filled, at about 88 percent, and it ranks No. 2 in the percentage of hospitals statewide reporting critical staffing shortages.
With many hospitals at or near capacity, health care staffers are exhausted, Himelfarb said, and another surge in cases, potentially after the holidays, could put hospitals in a dire situation.
"We're in a really tenuous spot as far as staffing and capacity in hospitals and emergency departments right now," she said. Many health care workers have tested positive for Covid, threatening a staffing crisis on top of a patient surge.
"Anything added to that is going to cause added strain," she said.
As the omicron variant spreads and more people travel to gather with family and friends for the holidays, emergency physicians say they are preparing for a tough winter, as Covid case numbers are expected to continue to surge heading into the New Year.
Research suggests that the omicron variant appears to be the most contagious strain to date and that it has mutations that allow it to evade some of the protection provided by vaccination or natural infection.
The variant, which was discovered in South Africa, was first detected in the U.S. on Dec. 1. By last week, it had spread to every state.
Even before Christmas, Covid case numbers were already surging, particularly in the Northeast, but the holidays could aggravate the situation, leading to a sharper rise in infections, said Dr. Jeremy Faust, an emergency physician at Brigham and Women's Hospital in Boston.
While studies suggest that the omicron variant may be less likely to cause severe illness than previous variants were, a massive surge in new infections could actually override such a "diminution in severity" and put more people in hospitals, Dr. Anthony Fauci, the White House's chief medial adviser, said at a briefing last week.
"If you have a much larger number of individual cases, the fact that you have so many more cases might actually obviate the effect of it being less severe," Fauci said.
Worried that the new variant could overwhelm understaffed hospitals, the Centers for Disease Control and Prevention loosened isolation rules last week for health care workers who have tested positive for Covid, allowing them to go back to work after seven days, instead of 10, if they test negative and don’t have symptoms. And on Monday, the agency shortened the recommended time for isolation further, to five days, for all people who are infected but have no symptoms.
The Henry Ford Health System in Detroit is "bracing for a spike in infections and hospitalizations," Bob Riney, the system's chief operating officer, said on a call with reporters last week.
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Staff members there are “very worried about what January will bring after all the holiday gatherings" and what looks like "record-setting holiday travel as the omicron variant picks up speed in Michigan," Riney said.
Dr. Alison Brodginski, an infectious disease physician at Geisinger Wyoming Valley Medical Center in Pennsylvania, said she is also worried about a post-holiday surge in case numbers, especially as people grow fatigued with the virus.
"People are tired. They want this to be over," she said. But hospitals in her area have been over capacity for several weeks.
"We’re not in a good place," she said. "The majority of health care workers, they are overwhelmed. And we are understaffed. We're pushing through."
Dr. Angela Chen, an emergency medicine physician at Mount Sinai Hospital in New York City, said the recent surge of coronavirus cases in New York feels "eerily similar" to conditions in March 2020.
Both the percentage of Covid tests that come back positive and the number of hospitalizations are rising. A few staff members have even fallen ill with the virus, she said.
"There's a little bit of a sensation of déjà vu," she said.
While the situation appears bleak heading into the New Year, Chen said she still has "cautious" optimism.
That's because the patients coming in who are fully vaccinated usually "are just not as sick," she said. They may have sore throats, runny noses, muscle aches or fevers, but their vital signs are normal, and they don't require supplemental oxygen, unlike many of the unvaccinated patients.
"And that is a really big, tangible difference from March 2020," she said.