IE 11 is not supported. For an optimal experience visit our site on another browser.

Is omicron really less severe? ICUs more slammed than ever, doctors say

People who are unvaccinated or who have underlying conditions or diseases are still most at risk for serious illness.
Image: Medical staff treat a patient who has Covid-19 in an isolation room on the Intensive Care Unit (ICU) at Western Reserve Hospital in Cuyahoga Falls, Ohio, on Jan. 5, 2022.
Medical staff members treat a patient who has Covid-19 in an isolation room in the intensive care unit at Western Reserve Hospital in Cuyahoga Falls, Ohio, on Jan. 5.Shannon Stapleton / Reuters

Intensive care units nationwide were already overwhelmed with chronically ill patients — many sick with Covid-19 and related illnesses — when omicron hit. 

Though the highly contagious variant has proven to spare most people the most severe forms of illness, the sheer number of those infected has led to a greater number of people sickened severely enough to need ICU treatment.

"If the percentage of people who get omicron who get really sick is very, very low, it is more than made up for by the fact that so many people are getting it," said Dr. Lakshman Swamy, a pulmonary and critical care physician at Cambridge Health Alliance in Boston.

"What would be rare isn't so rare, because there's just so many people with omicron," he said.

What’s more, health care systems are swamped even more by chronically ill patients who have diseases that worsened due to a dearth of care during the early days of the pandemic.

The unvaccinated are the people who are dying in the ICU from Covid. That hasn't changed throughout all of this.

 Dr. Lakshman Swamy, Cambridge Health Alliance, Boston.

An NBC News analysis of data from the U.S. Department of Health and Human Services finds that Covid-related ICU hospitalizations are up by nearly one-third over the past two weeks.

And as of this week, 1 in 5 hospitals with ICUs don't have any beds left in their critical units. More than half are at 85 percent capacity. 

Covid patients who become sick enough to need critical care, no matter which variant hit them, tend to be those who never got the vaccination.

"The unvaccinated are the people who are dying in the ICU from Covid," Swamy said. "That hasn't changed throughout all of this."

Full coverage of the Covid-19 pandemic

Patients with Covid in intensive care units across the country are mostly suffering from underlying health problems, such as diabetes, obesity or kidney disease, doctors say.

What’s more, ICUs are also caring for patients whose chronic conditions have become worse for one of two reasons: Either Covid exacerbated their underlying illness, or they were unable to receive appropriate care because of pandemic restrictions in doctors’ offices.

“Many of the patients that I see are patients whose diabetes are out of control,” said Dr. Joshua Denson, a pulmonary medicine and critical care physician at Tulane University Medical Center in New Orleans. “Now they have Covid, which is what set off their diabetes in the first place to be out of control,” he said.

In some cases, he explained, a coronavirus infection prompts an inflammatory response that makes underlying problems, such as diabetes, worse. Infections tend to disrupt the body’s immune system, undermining its ability to manage chronic illnesses.

Dr. Todd Rice, director of the intensive care unit at Vanderbilt University Medical Center in Nashville, Tennessee, said his team is also seeing chronically ill patients whose ongoing conditions were made worse simply because of a lack of care due to the pandemic.

Slight deviations in blood pressure or blood sugar control can often be corrected with a visit to a primary care physician, he said.

“Those patients couldn’t see anyone because their doctors were so overwhelmed with people with Covid,” Rice said. Conditions that “may have been averted by being able to see a doctor and get a little tweak of insulin, for example, continued to get worse.”

ICUs are inundated with an influx of omicron patients while still caring for patients who were sickened during the delta wave. Though access to lifesaving treatments has improved, the mental health of critical care physicians, nurses and other ICU staff has diminished. Morale is down. Burnout is astronomical.

"The cumulative effect of all of these surges is hitting us in a really hard way," Swamy said. "We're getting more tired and weaker with every one of these onslaughts."

Delta plus omicron

When the delta variant began circulating rapidly in the summer of 2021, hospitalized patients tended to be younger and healthier because the most vulnerable elderly adults had largely been protected through vaccination.

Many critically ill Covid patients — especially those infected during the delta surge — have stayed hospitalized for longer periods of time rather than dying as fast as many did early in 2020.

“A lot of Covid patients that come in critically ill don’t leave the ICU very quickly. They stay with us for weeks on end,” said Dr. Abhijit Duggal, a pulmonary and critical care specialist at the Cleveland Clinic.

He said that while it seems to be easier to get patients with omicron stabilized and out of the ICU more quickly, "there is a subgroup of them that, once they do get sick, they stay with us for a longer period of time." 

Physicians are also more comfortable treating Covid patients, compared to earlier in the pandemic. And ECMO equipment, which supports heart and lung function, is no longer in short supply.

Increased survivability of patients and availability of appropriate treatments are welcome, ICU staff say.

Download the NBC News app for full coverage of the Covid-19 pandemic

Even if patients are now able to get to a doctor's office for ongoing care of chronic illnesses, physicians say they are now seeing the results of the lack of or delayed care due to shutdowns in 2020.

"We're seeing people who weren't getting treated for diseases earlier in the pandemic," said Dr. Ken Lyn-Kew, a pulmonologist in the critical care department at Denver's National Jewish Health. "Their disease state has progressed, and now they're presenting with exacerbations of the disease that they wouldn't have had otherwise."

Swamy, of Cambridge Health Alliance, agreed.

"What really screams at you in the face is that these people have just not had the care they've needed," he said. Those worsening health problems are "coming back with ferocity."

Follow NBC HEALTH on Twitter & Facebook.