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MSDH Addresses Omicron Wave, Hospitalizations, CDC Guidelines

Mississippi State Epidemiologist Dr. Paul Byers, seen on right at a MSDH press conference on COVID-19 with State Health Officer Dr. Thomas Dobbs speaking at a press conference
The Mississippi State Department of Health held a press conference on Wednesday, confirming that the sharp spikes in new cases were due to the omicron variant. Photo courtesy MSDH

The omicron wave is now sweeping over Mississippi with cases skyrocketing and more concerning indicators, like hospitalizations, rising behind them. The Mississippi State Department of Health announced 2,698 cases on Tuesday, and 3,594 Wednesday, a stunning rise that health officials expect to grow further as the week continues. Shortly after publication today, that number only rose, with a staggering 4,885 new cases of COVID-19.

At a Wednesday press event, State Health Officer Thomas Dobbs confirmed that the wave was the result of omicron’s arrival in the Magnolia State. “Mississippi is seeing a rapid increase in the number of cases and also a rise in the number of hospitalizations,” Dobbs said. “As of Dec. 20, 67% of specimens analyzed are omicron.”

Case counts, ultimately, may become entirely unmoored from reality as the incomparable spread of the omicron variant reaches the absolute limit of the state’s testing capacity. MSDH Director of Health Protection Jim Craig announced the doubling of testing capacity in several of the state’s key COVID-19 testing facilities, including the Trustmark Park location in Rankin. But those spots were immediately taken upon availability; currently 17 of the state’s testing locations are booked solid.

The more significant sign of omicron’s impact will be in the state’s hospitals. Evidence pointing to the variant’s milder course of disease only matters in aggregate, for many. Omicron will still result in severe disease, hospitalization and death in many older, more immunocompromised and especially unvaccinated individuals.

Hospitalizations are rising quickly, complicating hopes that the omicron variant might decouple cases from hospitalizations as it did in South Africa. Source: MSDH

Indeed, hospitalizations are already rising and in an environment that hardly needs a growing burden of disease. 

“There is a national shortage of health-care staff, and here in Mississippi we’re experiencing it just like the rest of the country,” Craig said. “Most Mississippi hospitals are experiencing staff shortages. Our COVID-related emergency department visits during the first three days of the week for over 1,700 patients per day. We’re also seeing a rapid increase in new COVID admissions, with 445 total COVID admissions in Mississippi hospitals as of yesterday.” Those hospitalizations rose again today to 514, driving the health-care system closer to a crisis akin to the delta wave.

Hospitalization numbers, which lag behind infections, have all but doubled in a matter of days. It is still too early to appraise the relationship between omicron and hospitalization, but evidence from other states presents a grimmer portrait than the remarkable decoupling between disease and hospital usage seen in South Africa.

Ohio has seen omicron driving the highest number of hospitalizations in the entire pandemic—thousands of Ohio National Guard members are now joining the effort to stem the tide of severe need in the state’s hospitals.

The Mississippi Free Press asked Dobbs what could explain the difference between Ohio and Gauteng Province in South Africa, where omicron peaked and fell without hospitalizations comparable to the earlier surges.

“Everybody’s situation is a little different, right? With South Africa, it was a younger population of folks who got it,” Dobbs explained. “They’re a younger country in general. … We certainly are going to see significantly more hospitalizations. We certainly are going to stress out our health system. To what degree is not clear, yet.”

The median age of South Africa’s population is 27 years old. In Ohio, that number is 39. Mississippi is only slightly younger than Ohio in aggregate with a median age of 37.5.

Of particular concern in the omicron wave is the state’s lack of monoclonal antibody treatment, with the main effective treatment, Sotrovimab, in short supply across the nation. “We don’t have a lot of the monoclonal treatments available right now. Most of the monoclonal treatments we have now are not effective against omicron,” Dobbs warned.

State Epidemiologist Paul Byers explained that MSDH is “working with providers that still have monoclonals to redistribute them throughout the state” to achieve equitable distribution of the few effective treatments remaining. 

Paxlovid and Molnupiravir, the newly authorized post-infection COVID pills, are also unlikely to stem the tide of omicron. MSDH acknowledged that fewer than 3,000 doses of the pills were available to Mississippi as of yesterday.

MSDH Exceeds CDC Guidelines

At Wednesday’s press event, state health leadership also grappled with the new guidelines from the Centers for Disease Control. Earlier this week, the CDC halved the isolation time for infected or exposed individuals and discarded the need for a rapid test to confirm that the infectious period of the disease had passed, a decision made due to the needs of the market.

But numerous expert observers have criticized the decision, particularly the highly suspect decision to back an early exit from isolation without a negative result on a rapid test. Rapid tests are calibrated specifically to detect infectious levels of COVID-19. Testing negative on a rapid COVID-19 test, like the kind available over the counter at pharmacies, is the best available sign that an individual is no longer capable of infecting others.

MSDH declined to pillory the CDC, as many other virologists and public-health authorities have done, but Byers acknowledged to the Mississippi Free Press that testing was a necessary component of an early end to isolation, against the CDC’s controversial guidelines.

“When in doubt, guys, if you can’t get tested, go for a longer quarantine,” Byers said. “Certainly the CDC has guidance out there, we’re going to follow the CDC guidance (to) isolate for the full five days. (But) if you can’t get tested, let’s opt for the longer quarantine period.”

MSDH leadership also stated that Gov. Tate Reeves was unlikely to issue additional pandemic orders related to masking or other public-health measures.

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