Oregon health officials and hospitals brace for a large expected spike in COVID-19 cases after the first of the year, when modeling predicts the Omicron variant will take hold in the state and result in more hospitalizations than during the outbreak at the end of the summer, even with maximum interventions.
At a press conference Friday with Governor Kate Brown, Peter Graven, Oregon Health and Science University data specialist, presented his latest weekly update on the state’s pandemic forecast.
“I had hoped I could share better news today, but today’s forecast will anticipate another wave of serious illness in Oregon,” Graven said.
The latest models predict that Oregonians have three weeks to prepare for a peak in the Omicron variant, he said, which was first identified by South African scientists and is now spreading rapidly in Europe.
Health authorities around the world also say data on Omicron is still too limited to provide a full understanding of how the strain affects humans and spreads.
“This week we learned that there are hospitalizations that go with it,” he said. “Although the severity is less, it is not weak enough to prevent us from seeing hospitalizations.”
In Denmark and the UK, the immunity of fully vaccinated people fell by around 50%, Graven said, and the total number of people infected with Omicron in those countries was doubling every two or three days.
If Oregon follows the same pattern, based on when the first case was detected in the state, “we can expect an increase in hospitalizations in Oregon by mid-January with infections sooner than that, ”the OHSU data scientist said. “It’s different this time. The lengths of stay are shorter, the need for intensive care units or ventilators is less, but people will need the hospital, and we are preparing for that increase. “
According to OHSU modeling, which Graven said was being presented to both authorities and the public for the first time, there could be more than 3,000 hospital patients in Oregon due to the Omicron variant alone.
Transmission and boosters
Graven said the model was based on four parameters – escape of immunity, the rate at which the virus escapes antibodies from a vaccine or a previous infection; transmission rate, the number of people to whom each infected person is expected to transmit the virus; the severity, in terms of hospitalizations; and factors such as length of hospital stay, days until hospitalization, date of first case, recall rate, and behavioral response.
In Denmark, Omicron’s immune breakout was 50% and it was highly contagious – each infected person infected 8.5 more on average. The hospitalization rate was lower, 42% compared to Delta’s.
These rates were combined with Oregon’s current recall rate and the practice of behavioral interventions to predict the more than 3,000 hospitalizations, far more than what was hospitalized with COVID statewide in September, when the Delta surge peaked at around 1,200 hospital patients.
Boosters and caution could have an impact. If the rate of people receiving an extra dose of the Pfizer or Moderna vaccine were to double, Graven said, hospitalizations could be reduced from 500 at most, to 2,600.
“The other part is the behavior,” Graven said, things like reducing in-person interactions and wearing masks, which he says are currently lacking. If the public shifts from what the model calls a “moderate fear cycle” to a “full fear cycle,” maximum hospitalizations could be reduced below 2,500, according to the modeling, and the peak could also be delayed by d. ‘about a week.
Even with the combined effect of more reminders and behavioral interventions, hospitalizations are still “dramatic and higher than Delta,” exceeding 2,000, Graven said. “This is the situation we are facing. We will look at many ways to handle this. “
Following Graven’s modeling presentation, Dr Renee Edwards, OHSU’s chief medical officer, said hospital beds were already “extremely scarce in some areas of the state.”
And healthcare workers are already exhausted from nearly two years of fighting the pandemic.
“To be blunt, it sounds like another punch, especially for healthcare workers who have really pushed their limits,” Edwards said.
Edwards said the OHSU and other systems in the Portland metro area “continue to be completely full” and already have to, on occasion, refuse transfers from rural and community hospitals. Many have just resumed medical procedures they postponed during the Delta surge.
“Oregonians already have more acute illnesses from delayed care during the pandemic, and we face a huge backlog of needed delayed surgeries,” the doctor said.
Edwards said that although Omicron has proven its breakthrough potential, fully vaccinated people, and especially those who have received an extra dose, are much less likely to need hospital care.
Oregon Health Authority director Patrick Allen later said the agency estimated that 90% of the more than 2,000 COVID deaths reported since August could have been prevented by vaccination.
State response plan
The governor opened the press conference, ahead of Graven’s remarks, with a call for 1 million Oregonians to get vaccinated by January 31. for disease and expand testing.
“If you take one thing from today’s press conference, let it be this one,” Brown said. “Get your booster shot. Boosters work and are incredibly effective in maintaining your protection against this virus and hospitalization. If you haven’t yet been vaccinated, now is the time. It can be a matter of life or death.
About 28% of the state’s eligible residents had received a booster on Friday and about 65% had received a full first series. Pfizer or Moderna for the booster can be given regardless of the variety of the starting dose. Adults who received a first round of Moderna or Pfizer six months or more ago are now eligible for a booster. It’s two months for the Johnson & Johnson vaccine.
Preliminary data indicates that Pfizer’s effectiveness could be reduced to 33% against Omicron, with an increase of up to 75% with a booster. Moderna says his booster increases protection by up to 85%.
An Omicron response plan from the Oregon Health Authority notes that the state has enough doses to expand the boosters, but “the lack of staff to put out the shots is our main constraint which has led to appointments. you rare in many Oregon communities ”.
The plan says the state “will add capacity so that the health system and local public health have the capacity to double or triple their current weekly booster vaccinations.”
Brown said on Friday: “The masks, the vaccines and the incredible efforts of our health workers, public health partners and members of the National Guard got us through the delta surge. We’ll have to do the same statewide collaborative efforts to get us through Omicron. “
Oregon is one of a handful of states with indoor mask warrants still in place, although some jurisdictions have started to bring them back with the appearance of Omicron. Some health experts have advised the public to upgrade given the variant’s high transmissibility, abandoning fabric masks for surgery, combining the two, or opting for N-95 or similar masks. .
Infections in Lincoln County remained mostly stable for months, and the week to December 15 saw another modest decrease in cases for the fourth week in a row, from 70 to 64. In its update to county commissioners last week (no meeting will be held this week), Lincoln County Public Health Director Florence Pourtal also warned against Omicron, although OHSU figures were not not available at the time, and Pourtal’s remarks were worded with a little more uncertainty.
The public health director also said the department believed current cases were underreported due to lack of testing and the proliferation of home testing kits. The county has a form for those who use home antigen testing to report a positive result so public health can advise on isolation and conduct contact tracing. The underreporting was indicated by the substantial presence of viral artifacts in the sewage samples at Newport, Pourtal said.
Residents of Lincoln County are already vaccinated at a much higher rate than the state average – nearly 82% of those eligible, up from around 65%. More than half of residents over 65 have received a booster, and more than a third of those 50 to 64 have had one.
The department closed its full-scale vaccination clinic at Lincoln County Commons after last Friday’s event, and Pourtal said it would move to a mobile clinic with a set schedule in January. There is a clinic at La Juquilita in Newport on December 26, and a partial schedule of January clinics, along with a list of pharmacies with the vaccine, can be found on the county’s website at tinyurl.com/53pywzrd.