‘Like a wildfire’: As Omicron surges, how much do case counts still matter?

A quarter of all local cases have come since Christmas.

Since Christmas, about 6% of all Routt County residents have tested positive for COVID-19. About a quarter of all cases locally since the start of the pandemic have come since Dec. 26.

The omicron variant-driven surge of the pandemic is rewriting records nearly every day, with case counts dwarfing those of previous waves.

“It’s like a wildfire,” said Lauren Bryan, infection preventionist at UCHealth Yampa Valley Medical Center, of the variant. “It’s going to burn through all available fuels, and clearly, it is doing that quite effectively right now.”

There have been 940 cases locally since the start of the year, but health officials say that shocking number says less about the state of the pandemic than case counts did in previous waves. Hospitalizations — always seen as a lagging indicator to case counts — and hospital capacity is now what is most important.

“This is all different. Case counts as an absolute number don’t matter as much now,” said Dr. Brian Harrington, Routt County’s chief medical officer. “Serious illness, hospitalization and death remain the important factors.”

Harrington added that case counts, as high as they have gone, are still likely being undercounted, as many take-at-home tests go unreported or people opt not to get tested at all.

Omicron is much more transmissible than other variants, and Bryan said people who have been vaccinated, boosted or infected with COVID-19 just months ago are all getting sick. For the most part, these people are experiencing less severe disease that those who are unvaccinated.

Hospitalizations and deaths are more concrete numbers, and Harrington said the latter seems to be decreasing amid omicron’s prevalence. Locally, while there are still a couple admissions with a primary COVID-19 diagnosis each week, Harrington said hospitalizations haven’t surged.

In Northwest Colorado, about 80% of hospital beds are in use. But across Colorado, hospitals are stretched further, with 93% of beds occupied.

Some patients in hospitals are there for other reasons, only testing positive for COVID-19 once they arrived. Last week, State Epidemiologist Rachel Herlihy said about 35% of hospitalizations in Colorado were like this, but, for hospital systems like UCHealth, it is higher, with as many as two-thirds of patients being deemed “incidental cases.”

But Bryan said even if COVID-19 isn’t a primary diagnosis, it still puts more stress on the hospital.

“Donning and doffing the (personal protective equipment), the staffing ratios for COVID positive people, it’s still a burden on these hospital system,” Bryan said, “even if they are asymptomatic.”

A lack of hospital capacity statewide is problematic for the Yampa Valley, because many patients end up needing a higher level of care and need to be transferred out.

“Say you fall skiing, and you get a bleed in your brain, we don’t keep that type of condition here,” Harrington said. “When those beds are full on the Front Range, we can’t move people out.”

Cases of long-COVID can’t be ignored either, Harrington said. Some patients’ lungs — even those belonging to patients who are otherwise healthy — look trashed, and some are still on oxygen and having blood clot complications long after the initial diagnosis. The elderly and those with compromised immune systems are still getting seriously sick, as well.

Last week, state health officials said cases from this wave may peak near the end of the month. Herlihy said in other places, like South Africa and the United Kingdom, a peak in hospitalizations has soon followed a peak in cases.

“We’ll probably have a two-week lag time,” Bryan said, referring to a peak in hospitalizations. “Mid- to late-February, we’ll still have high occupancy of hospital beds.”

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