Widespread vaccinations and better coronavirus treatments may have spelled less severe consequences to date as omicron cases overwhelm area hospitals, but public officials caution it’s too soon to know whether the variant ultimately will kill fewer people.
Since mid-December, when cases began to surge, through Wednesday, Black residents in Maryland made up 47 percent of new cases while making up 31 percent of the state’s overall population. White residents made up 37 percent of infections, and Asian residents 4 percent, state data show.
The disproportionate impact of virus infections on Black residents may be most stark in Maryland but also exists regionwide, according to a Washington Post data analysis. And children are being hospitalized in record numbers, most of them too young to be vaccinated. Kids under 12 made up 70 percent of infections at Children’s National Hospital in D.C. as of Tuesday afternoon, said Roberta Lynn DeBiasi, the hospital’s chief of the division of infectious diseases.
After months of pleading with the unvaccinated to get a shot, elected officials and health-care providers this week provided more evidence of the effectiveness of vaccines, and especially booster shots, at staving off severe illness for the general population, as well as nursing home residents.
Gov. Larry Hogan (R) declared a state of emergency in Maryland on Tuesday after a record 3,000-plus people were reported hospitalized with covid-19, a figure that had doubled in the past two weeks.
While the rate of infected people requiring intensive care is lower, the volume of very sick people is so large that the ICU is admitting patients in near-record numbers, said Gabe Kelen, chair of emergency medicine at Johns Hopkins University and head of the system’s coronavirus response.
“I’m almost speechless in terms of what we’re experiencing. The state is at an unimaginable level,” he said in an interview Tuesday.
The state hit about 1,200 covid-related admissions in early 2020, about half of whom were admitted to the ICU. In the last big wave, at this time last year, about a third of patients needed ICU care. About 20 percent of patients in the current wave are ending up in the ICU, which nevertheless works out to about 600 patients, Kelen said.
“All of our hospitals have exceeded the total number of covid patients they’ve admitted than in any other wave, which is pretty amazing given how mild this is supposed to be,” Kelen said of Hopkins, which operates five community hospitals in the region, including the flagship facility in Baltimore, Howard County General, Sibley Memorial and Suburban.
Deaths across D.C., Maryland and Virginia are slightly lower than they were at this time last year but are changing day-to-day. This week last year, the region’s seven-day average daily death count was 84, compared with 57 this year as of Tuesday. The difference is starkest in Virginia, with 39 deaths last year, compared with 17 this year, but the state’s increase in infections also came later than spikes in neighboring jurisdictions.
“It’s hard to know the impact on hospitalizations and deaths so early on in a really intense wave,” said Natalie Talis, population health manager at the Alexandria Health Department. “Historically, hospitalizations and deaths follow a few weeks after the surge in cases, and cases are still climbing.”
Inova, which operates five hospitals in Northern Virginia, including the 923-bed Fairfax Hospital, activated emergency status Tuesday, which means nurses in the already-strained system will care for more patients, less-urgent surgeries may be delayed and other changes are under consideration. Inova this week surpassed 400 coronavirus patients for the first time since the winter wave last year, and numbers are rising, officials said.
Inova President and CEO J. Stephen Jones said the capacity crisis means care for people who get in a car wreck or slip on the ice could be jeopardized around the country.
“We have to be honest with ourselves as a society, if this continues much further, we will have a significant number of hospitals nationwide which will go to crisis standards of care, and those won’t affect just covid patients, those will affect all patients,” he said in an interview Tuesday.
Hopkins and Inova are among the large health-care organizations that amended policies about when coronavirus-positive employees can return to work in recent weeks as infections decimated the ranks of workers and made it impossible to safely fill all empty beds.
Coronavirus-positive but asymptomatic nurses who have received a vaccine and booster are directed to return to work immediately with no period of isolation, according to Inova guidelines dated Dec. 28. Periods of isolation vary based on vaccination status and range from five days for mild symptoms to up to 20 days or longer for those with severe illness.
Kelen at Hopkins said anything less would make it impossible for hospitals to care for patients at this time. Infections rates are such that people who don’t know they have contracted the coronavirus but take proper precautions, including meticulous wearing of PPE, have been shown to not spread the disease in a health-care setting, he said.
“That is why it’s rational and reasonable under these circumstances to keep people at work who may be aware they are infected because they’re no different from the ones who are unaware they are infected,” he said.
Like other systems, Inova is relying on incentives to fill nursing shifts. Typical pandemic bonuses of $300 a shift have ballooned to $700 and even $1,000 during the holidays — a tool Jones said is not an effective long-term strategy, given how exhausted and in need of rest staff members are.
Kelen put it like this: “It’s pretty clear to me that some of us will never be the same,” he said. “I have never fought in a war. This feels very much like all the books and movies and things that you read about getting through a war. You’ll be fine, you’ll be normal, but not really.”
Staff shortages have also impacted nursing homes.
Joseph DeMattos, president of the Health Facilities Association of Maryland, said thousands of nursing home workers quit or resigned during the pandemic over health concerns or fatigue. Now, between 2,500 and 5,000 employees daily are isolating after testing positive for the virus.
“It’s resulting in a situation where you actually have empty bed capacity, but you don’t have the staff for those beds,” he said.
Of 330 coronavirus outbreaks reported in nursing homes across Maryland in the last two weeks, most have been concentrated among staff, not vulnerable residents who are vaccinated in high numbers, said Allison Ciborowski, chief executive for Leading Age Maryland, which represents 120 operators of long-term care facilities in the state.
Montgomery County Executive Marc Elrich (D) said residents in the state’s most-vaccinated jurisdiction accounted for 23 percent of the state’s coronavirus cases in the new year but only 4 percent of covid-related deaths.
“It actually matters whether you’re vaccinated or not, so please pay attention” to these numbers, he said.
Hogan said Wednesday that patients who received the booster shot make up a tiny share — 2 percent — of those hospitalized with covid-19 in the 13-hospital University of Maryland Medical System. Over the past 30 days, most hospitalizations — 74 percent — are among unvaccinated patients. He added that the omicron variant has become dominant in the state, according to lab data. Maryland Health Secretary Dennis R. Schrader said current models predict hospitalizations could soar to 5,000 patients. There are currently about 365,000 adults and 434,000 eligible kids who have not received any vaccine doses.
The District on Wednesday opened up a new PCR testing site on F Street NW between Fourth and Fifth streets and across from the National Building Museum.
The testing site, a partnership with the Centers for Disease Control and Prevention, eTrueNorth and the Federal Emergency Management Agency, will operate from 8 a.m. to 6 p.m. seven days per week.
Michael Brice-Saddler, Erin Cox, John D. Harden and Rebecca Tan contributed to this report.
