The explosive growth in US coronavirus cases is raising alarm, but some experts believe the focus should be on Covid-19 hospital admissions instead. And they’re not climbing that fast.
Anthony Fauci said Sunday on ABC that while many infections cause few or no symptoms, “it is more relevant to focus on hospitalizations than total cases”. Other experts argue that the case count still has value.
As the super-infectious Omicron variant rages across the US, new Covid-19 cases per day have more than tripled in the past two weeks, reaching a record-shattering average of 480,000. Schools, hospitals and airlines are struggling as infected workers go into isolation.
Meanwhile, hospital admissions averaged 14,800 per day last week, up 63% from the week before, but down from the peak of 16,500 per day a year ago, when the vast majority of Americans were not vaccinated. Was. The average of about 1,200 deaths per day has remained steady over the past two weeks, well below the all-time high of 3,400 last January.
Public health experts suspect that those numbers, taken together, reflect the vaccine’s continued effectiveness in preventing serious disease, even against Omicron, as well as the possibility that the version may be less than the earlier versions. As does not make most people sick.
Last week, Omicron accounted for 95% of new coronavirus infections in the US, according to the Centers for Disease Control and Prevention on Tuesday gave another indication of how fast the variant has spread since it was first found in South Africa in late November.
Dr Wafa al-Sadr, director of Columbia University’s Global Health Center ICAP, said the number of cases no longer seemed to be the most significant number.
Instead, she said, the US at this stage of the pandemic “must shift its focus, especially in the era of vaccination, to really focus on preventing disease, disability and death, and therefore making them count”.
The number of daily cases and their fluctuations have been one of the most watched barometers during the outbreak and have been a reliable early warning sign of serious illness and death in past coronavirus waves.
But they have long been considered an incomplete measure, as they mainly involve laboratory-confirmed cases of Covid-19, not the actual number of infections there, which is almost certainly several times higher.
The number of daily cases is also subject to wild swings. The number of new cases reported on Monday topped an unprecedented 1 million, a figure that may reflect cases that were held up by reporting delays over the holiday weekend. The seven-day rolling average is considered more reliable.
Now, the value of the daily case count is being questioned like never before.
For one thing, the skyrocketing increase reflects, at least in part, an Omicron-inspired rampage among many Americans who are tested before holiday celebrations, and new testing at workplaces and at restaurants, theaters and other sites. Indicates requirements.
In addition, the true number of infections is probably much higher than the case count because the results of the at-home tests that Americans are rushing to use are not added to the official tally, and because long waits have put some people in line. discouraged from appearing. To be swabbed
But at the same time, the number of cases paints a less useful picture of the pandemic amid the spread of Omicron, which is causing a lot of infections but does not yet appear to be as severe in its effects.
Case counts have lost relevance, said Andrew Noymer, a public health professor at the University of California, Irvine.
“Hospitalizations happen where the rubber meets the road,” Noymer said. “This is a more objective measure,” although not perfect. He said: “If I had to choose one metric, I would choose hospitalization data.”
Tracking Covid-19 admissions can tell doctors something about the severity of the virus and the ability of hospitals to deal with the crisis. This, in turn, can help health leaders determine where to move equipment and other resources.
Still, health experts are unwilling to overstate the number of cases.
“We should not stop looking at case numbers, but it is important to acknowledge that we are seeing only a fraction of the actual number of cases,” said Dr Eric Topol, head of the Scripps Research Translational Institute.
Ali Moqdad, a professor of health metrics science at the University of Washington in Seattle, said that for each new infection detected, the US is missing two cases. But he said it was still important to keep track of the number of positive test results as Omron makes its way across the country.
Mokdad said case numbers could point to future hot spots and indicate whether the wave of infections is peaking.
Moreover, the case numbers will continue to be significant for those who are vulnerable due to age or health reasons and they need to have a sense of the virus spreading in their communities so that they can make decisions about precautions, he said. Hospitals, schools and businesses need to plan for absenteeism.
“It’s blind to know whether cases are going up or down. How can we as a country not know the epidemic curve for infections?” Mokdad said.
If testing has lost its relevance, he said, it is because the US has never developed a way to continuously and reliably monitor infections.
“Covering up failure by changing the rules is not acceptable,” he said.