Number of COVID cases may drop in importance amid omicron


The explosive increase in the number of coronavirus cases in the United States is sounding the alarm, but some experts believe the focus should instead be on COVID-19 hospital admissions. And these don’t climb that fast.

Dr Anthony Fauci, for his part, told ABC on Sunday that with many infections causing little or no symptoms, “it is much more relevant to focus on hospitalizations than on the total number of cases.” Other experts argue that the number of cases is still of value.

As the super-contagious variant of omicron rages in the United States, new cases of COVID-19 per day have more than tripled in the past two weeks, hitting a record-breaking 480,000 average. hospitals and airlines are struggling as infected workers are isolated.

Meanwhile, hospital admissions averaged 12,700 per day last week, up 46% from the previous week, but well below the peak of 16,500 per day a year ago , when the vast majority of the United States was not vaccinated. Deaths have remained stable over the past two weeks at an average of around 1,200 per day, well below the all-time high of 3,400 last January.

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Public health experts suspect that these numbers, taken together, reflect the vaccine’s continued effectiveness in preventing serious disease, even against omicron, as well as the possibility that the variant may not make most people as sick as the ones. previous versions.

Omicron accounted for 95% of new coronavirus infections in the United States last week, the Centers for Disease Control and Prevention reported on Tuesday, in another indication of how quickly the variant has spread since it was first detected in Africa. from the South at the end of November.

Dr Wafaa El-Sadr, director of ICAP, a global health center at Columbia University, said the number of cases does not appear to be the highest number right now.

Instead, she said, the United States at this point in the pandemic should “shift our focus, especially in the age of vaccination, to really focus on preventing disease, disability. and deaths, and therefore to count them ”.

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The number of daily cases and their highs and lows has been one of the most watched barometers during the outbreak and has been a reliable early warning sign of serious illness and death in previous waves of coronavirus.

But they have long been viewed as an imperfect measure, in part because they consist of lab-confirmed cases of COVID-19, and not the actual number of infections, which is almost certainly several times higher.

The number of daily cases is also subject to wild fluctuations. The number of new cases on Monday exceeded one million, a figure that may reflect a backlog delayed by reporting delays over the holiday weekend. The seven-day moving average is considered to be more reliable.

Now the value of the daily number of cases is being questioned like never before.

On the one hand, the skyrocketing increase reflects, at least in part, an omicron-induced scramble among many Americans to get tested before holiday gatherings, and new testing requirements at workplaces and across the board. restaurants, theaters and other sites.

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Also, the actual number of infections is likely much higher than the number of cases because the results of the home tests Americans rush to use are not added to the official tally, and because long waits have discouraged some people stand in line to get dabbed.

But also, the number of cases seems to paint a less useful picture of the pandemic amid the spread of omicron, which is causing many infections but so far does not appear to be so severe in its effects.

The number of cases has lost its relevance, said Andrew Noymer, professor of public health at the University of California, Irvine.

“Hospitalizations are where the rubber meets the road,” Noymer said. “It is a more objective measure”, although it is not perfect. He added, “If I had to choose just one metric, I would choose hospitalization data. “

Tracking COVID-19 admissions can educate doctors about the severity of the virus and also the ability of hospitals to cope with the crisis. This, in turn, can help health officials determine where to move equipment and other resources.

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Still, health experts are not ready to suppress the number of cases.

“We shouldn’t give up looking at the number of cases,” said Dr Eric Topol, director of the Scripps Research Translational Institute, “but it is important to recognize that we are only seeing part of the actual number of cases. “

Ali Mokdad, professor of health metrics science at the University of Washington in Seattle, said for every new infection detected, the United States missed two cases. But he said tracking the number of positive test results is still important as omicron makes its way across the country.

The number of cases may indicate future hot spots and indicate whether a wave of infection has peaked, Mokdad said.

In addition, the number of cases will continue to be important for people who are vulnerable due to their age or health reasons and who need an idea of ​​the spread of the virus in their communities so that they can make decisions. regarding precautions, he said. Hospitals, schools and businesses must plan their absences.

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“To give up on knowing if the cases go up or down is to fly blind. How can we as a country not know the epidemic curve of infection? Said Mokdad.

If testing has lost its relevance, he said, it’s because the United States has never developed a way to monitor infections consistently and reliably.

“It is not acceptable to cover up failure by changing the rules,” he said.

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