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Covid-19 hospitalizations drop below 100,000 in the US, but heavy burden persists

<i>Mandi Wright/USA Today Network</i><br/>An RN tends to an intubated Covid-19 patient in the intensive care unit of St. Joseph Mercy Oakland Hospital in Pontiac
Mandi Wright/USA Today Network
An RN tends to an intubated Covid-19 patient in the intensive care unit of St. Joseph Mercy Oakland Hospital in Pontiac

By Deidre McPhillips, CNN

Covid-19 hospitalizations are dropping quickly in the United States, but a heavy burden persists, and the nation’s health care workers are exhausted under the strain.

For the first time in more than a month, there are fewer than 100,000 hospital beds in use for patients with Covid-19 nationwide, according to data from the US Department of Health and Human Services.

That’s a 38% drop from a few weeks ago, when Covid-19 hospitalizations reached a peak of more than 160,000 beds in use at one time.

No ‘magic number’

Despite the promising trends, Dr. Rochelle Walensky, director of the US Centers of Disease Control and Prevention, says it’s still too soon to change guidance and loosen Covid-19 prevention restrictions.

Hospitalizations are an important barometer, especially at the local level where decisions are made, she said at a White House Covid-19 Response Team briefing on Wednesday.

“Cases and hospitalizations are falling. This is, of course, encouraging. And that leads us, of course, to have us look at all of our guidance based on the latest data and the science and what we know about the virus,” she said.

“We’re, of course, taking a close look at this in real time, and we’re evaluating rates of transmission as well as rates of severe outcomes as we look at updating and reviewing our guidance.”

But there’s no “magic number,” Walensky said.

“Are hospitals able to, you know, take care of the car accidents, the heart attacks and strokes that routinely walk in the door because they are not at capacity taking care of patients with Covid-19? And right now across the country, our hospitals are still in crunch mode. They still have real challenges with capacity,” she said in a radio interview with WYPR’s Tom Hall on Tuesday’s edition of the show “Midday.”

Current hospitalizations have now dipped below the peak from the Delta surge and the first winter surge, but they’re still higher than they’ve been throughout the vast majority of the pandemic.

“Notwithstanding the downtick that you do see in certain areas, it’s kind of like we’re going from a crisis that was almost catastrophic in certain cases to just a serious emergency. So we’re still in a very difficult situation,” Rick Pollack, president and CEO of the American Hospital Association, told CNN.

Hospitalization rates are highest right now in West Virginia, with 61 Covid-19 hospitalizations for every 100,000 residents. That’s double the national average and four times higher than in Vermont, where there are fewer than 15 Covid-19 hospitalizations for every 100,000 residents.

It’s too soon to be too hopeful, Jim Kaufman, president and CEO of the West Virginia Hospital Association, told CNN.

“There’s a feeling of cautious optimism, but we don’t know what’s coming,” he said. “We don’t know if there’s another variant. We know there’s a lot of patients who need care that have been deferred that we need to also take care of, and we know our staff are exhausted. I think that’s the critical balance: How do you take care of your staff mentally, physically and emotionally, while still taking care of the needs of your community?”

Overall, about 1 in 7 inpatient beds is currently in use for Covid-19, and there are about 18,000 Covid-19 patients in ICUs across the country, according to HHS data.

And in the past week, more than a quarter of hospitals in the US reported a critical staffing shortage.

Although strains on the supply of personal protective equipment such as masks and gloves have lessened and vaccines have helped improve outcomes, there’s a different set of problems now than a year ago — including staff burnout and low blood supply, Pollack said.

“The work force is stretched incredibly thin, and that is taking its toll,” he said. “It’s been frustrating and exhausting and heartbreaking for those that are on the front lines.”

A growing share among children

Seniors 65 and older have consistently represented a disproportionate share of Covid-19 hospitalizations, accounting for about 17% of the US population but more than 40% of hospitalizations since the start of the pandemic.

But a growing share of Covid-19 hospitalizations are among children. Nearly 6% of all hospitalizations in the last week of January were among children, according to preliminary data from the CDC, a larger share than any other point in the pandemic.

Children younger than 5 are not eligible to be vaccinated, and vaccination rates among children lag behind those of adults. Less than a quarter (23%) of children ages 5 to 11 and 56% of those ages 12 to 17 are fully vaccinated, compared with nearly three-quarters (74%) of adults 18 and older.

And unvaccinated people are at especially high risk for hospitalization.

In December, hospitalization rates were 16 times higher among unvaccinated adults than they were among fully vaccinated adults, CDC data shows. Among seniors 65 and older, hospitalization rates were 51 times higher among the unvaccinated than among those who were fully vaccinated and boosted.

Federal Covid-19 hospitalization data has been scrutinized because it doesn’t distinguish between those patients who are being treated for Covid-19 and those who test positive after being admitted for a different reason, especially amid the spread of the highly transmissible Omicron variant.

A CDC study that involved a detailed clinical review of patient records at one hospital in Los Angeles found that about 20% of patients hospitalized with Covid-19 during a period of Omicron prevalence were admitted for other reasons.

The study did not compare the share of patients admitted for vs. with Covid-19 to other periods to know how it may have changed.

But the study’s authors note that any patient who tests positive for Covid-19 still requires the use of isolation rooms and personal protective equipment and poses transmission risk to staff, potentially exacerbating staff shortages and hospital strain.

“The pandemic health care burden is not limited to hospitalizations for symptomatic Covid-19,” they wrote.

Since the start of the pandemic, there have been about 4.4 million total Covid-19 hospital admissions, according to CDC data. In the first week of February, there were about 13,000 new Covid-19 admissions each day, about 25% less than a week earlier.

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