Omicron continues to wash over Mississippi unrestrained, driving increased case counts and hospitalizations. But data from the University of Mississippi Medical Center support early hopes that the disease may have a milder course of disease in aggregate, but not for every individual.
On Monday, the Mississippi State Department of Health announced 17,525 new cases of COVID-19 over the long New Year’s weekend, a four-day count equivalent to 4,381 new cases per day. With various closures in testing sites and labs that process test results, as well as widespread unavailability of testing supplies, it is likely this report is significantly below the true spread of the virus, even more than usual.
Hospitalizations are rising with the surge—MSDH reports 695 patients with confirmed COVID-19 infections in the state’s hospitals, up significantly from lows in the mid-200s last week. Intensive-care unit usage is rising as well, up to 132 total patients from the 80s during the same time. Ventilator usage is rising slowest of all, up to 54 from roughly 40.
The enormous influx of cases has the inevitable consequence of more severe disease across the state. But UMMC Communications Director Marc Rolph told the Mississippi Free Press in a statement that the hospital was seeing a decrease in severity with omicron compared to earlier surges.
“As of this morning, the number of patients with a suspected or confirmed positive COVID-19 test result was 97 (13 of which were awaiting test results), up from 42 last Monday. The number of patients with COVID-19 in ICU care has not risen in this recent surge at the same rate as the increase in the overall patient count and, for the most part, the severity of COVID-19-related cases—including in the ICU—is less severe than in previous surges.”
Today, Rolph confirmed that hospitalizations had risen to 100, with nine awaiting test results. Growing numbers in the state’s ICU may in fact be a consequence of the rampant spread more than critical COVID-19. The communications director added that most COVID-19-positive, intubated patients had primary conditions other than COVID-19, something that was decidedly not the case when earlier surges filled the ICUs with severely ill COVID patients.
The risk from omicron is in no sense negligible. Rolph confirmed that the majority of UMMC’s COVID-19 patients were unvaccinated, a number that is almost certain to rise as the numbers of new infections continue to roll in. And more severe disease is likely to develop in some as their hospital stays continue.
With an ongoing nursing shortage, any reduction in hospital availability poses risks to Mississippians with or without COVID-19. But for now, Mississippi’s limited pool of evidence backs the broader consensus on omicron’s aggregate severity.
A lower propensity to severely hospitalize patients will not stop a rampaging virus from shutting down institutions from large outbreaks, a deep concern with both the Mississippi Legislature and the state’s schools on track to return for the new year.
From Lungs To Throat
The results of omicron’s differing severity may be visible in clinical outcomes, but what does that mean practically? Numerous studies suggest that both omicron’s rampant infectiousness and its milder average outcomes may relate to the same property: its tendency to infect the throat more intensely than the deep respiratory system.
An infection in the throat would risk infecting others more readily, but also may lead to less severe disease as the damaged, hardened lung tissue that has left so many on ventilators after the virus has departed their systems.
Other elements of omicron’s presentation may include a quicker clearance time: a shorter infection that debilitates patients less. That outcome would be particularly valuable if moderate cases continue to flood into hospitals.
Hospitals nationwide are feeling the surge, even if the most severe outcomes are emerging less. As of yesterday, hospitalizations nationwide were roughly 105,000, above the more regional delta surge. Unless transmission plateaus and declines rapidly, it is quite possible the U.S. will soon see the highest total number of hospitalizations, regardless of severity, in the entire pandemic.
Clinical reports from UMMC, Rolph said, indicate less severe disease on average, with a decreased need for additional oxygen. This tracks with theories of omicron’s severity. Distinct from the mostly unvaccinated hospitalized patients, additional research suggests that omicron, which is more likely than any previous variant to cause breakthrough infections in fully vaccinated individuals, still triggers a robust response from vaccinated T-cells.
Put simply, while fully vaccinated individuals, especially those who have not received booster doses, are susceptible to infections, the presence of a deeper immune response strongly challenges the virus’ ability to cause severe disease.