PHILADELPHIA — The seven-day average of new coronavirus cases in Philadelphia is the highest it’s ever been as the extremely transmissible omicron variant continues to surge in the region.
The city was averaging 1,407 new cases per day as of Monday, surpassing the previous record of 1,235 set on Dec. 8, 2020. The number has shot up in recent weeks, increasing fivefold since Nov. 30.
“The concern’s high,” said Patrick Kelly, an intensive care unit nurse at Einstein Medical Center, which is already near capacity with sick patients. “More people are in contact with people who are positive. It’s the same thing with everyone you talk to.”
As hospital surges typically lag weeks behind case surges, health officials and residents are holding their collective breath to see whether hospitals here become overwhelmed.
Clarity on how many of those recently infected will need to be hospitalized should come in mid-January, said several experts. While early research out of South Africa, England, and Denmark indicates that the omicron variant may be less likely to send people to the hospital, especially if they are vaccinated and boosted, the speed with which omicron is spreading could still overwhelm providers, even if a smaller percentage of those infected get very sick.
Emergency departments are already taxed, with waits to be seen ranging from four to six hours at city hospitals. Should cases continue to rise, hospitals may need to reinstate emergency measures taken during previous surges, including canceling some non-urgent procedures and converting other wards into ICUs.
“We really don’t want to go there like before,” said Rohit Gulati, Einstein Health System’s chief medical officer. “but if it did come to that that’s what we would be forced to do.”
The latest case surge comes as omicron spreads more rapidly than previous variants — and evades some vaccine protection — and as more people get tested for the virus.
More than 39,000 Philadelphians were tested at city sites from Dec. 20 to 22, heeding the advice of health officials, including Philadelphia health commissioner Cheryl Bettigole, who urged testing before seeing family or friends for the holidays. Even more people took at-home rapid tests, which are not accounted for in official records.
Distressing records are being set in the suburbs, as well, with the seven-day average of new cases per 100,000 people reaching pandemic highs in both the Pennsylvania suburbs and South Jersey. The average in South Jersey is the highest, at 110.8 cases per capita.
Hospitalizations have increased 60% in New Jersey over the past two weeks, according to the New York Times, and remained relatively flat in Pennsylvania over the same period. However, Pennsylvania has the third highest daily average of hospitalized COVID-19 patients in the country, and are treating nearly twice as many as New Jersey hospitals.
The rise in cases comes as hospitals are still caring for people infected during a November increase in delta variant cases and for non-COVID-19 patients.
“We have cases going up. We see the return of influenza,” said John Goldman, a University of Pittsburgh Medical Center infectious disease specialist, “and we’re seeing the return of people to the hospital after delaying care and they end up being sicker than they would.”
In the central and western parts of Pennsylvania, several hospitals were at or near capacity even before Christmas, due to a surge of COVID-19 and non-COVID-19 patients and staffing shortages.
In York, one of Pennsylvania’s hardest hit counties with 152 virus cases per 100,000 people, hospitals are assuming omicron is driving the majority of new infections.
“The disease is spreading very rapidly through the population,” Goldman said.
UPMC’s Hanover hospital in York County has 42 COVID-19 patients, the New York Times reported, and its intensive care unit is at 100% capacity.
Jennifer Horney, founding director of the University of Delaware’s epidemiology program, said we likely won’t know the variant’s impact on mortality rates until the end of January.
“While we do have a lot of people in the hospital, vaccinated people are not getting severely ill for the most part with omicron,” Horney said. “If that continues to hold, hopefully our next few weeks won’t look that bad.”
Horney is optimistic based on preliminary analyses of omicron’s behavior in South Africa, where hospital admissions for adults recently diagnosed with COVID-19 appear far less severe than they were during earlier waves of the virus. One of Great Britain’s leading immunologists, John Bell, an Oxford University professor and the government’s life sciences adviser, was quoted in the Guardian Tuesday saying the indications about omicron’s severity means high death rates in that country are “now history.” He noted even those who needed hospitalization required less oxygen treatments and had shorter stays.
While most new cases in the Philadelphia region appear mild, public health experts emphasize that vaccination is still the most effective tool for keeping hospitalizations and deaths at bay.
“Just because we’re seeing a lot of mild cases with omicron doesn’t mean people should not consider getting vaccinated and boosted as soon as they’re eligible,” Horney said.
The vaccinated and boosted are especially protected against severe infection, say medical experts in the United States and abroad. That could help Philadelphia and its collar counties, which are more vaccinated than much of the rest of the state and where a higher percentage of hospital beds currently remain available than in the commonwealth overall.
Outside of Philadelphia, 59% of all Pennsylvania residents are fully vaccinated with two doses of Pfizer or Moderna or one dose of Johnson & Johnson. Locally, however, about 62% of Philadelphians are completely immunized and about 70% are in each of the collar counties.
Additionally, about 30% of fully vaccinated Pennsylvanians outside of Philadelphia have received a booster shot, according to state data, as have about 40% of New Jerseyans, Gov. Phil Murphy said last week.
But the nearly 126 million Americans who are unvaccinated are at especially high risk. It would only take severe infections in a small percentage of this population to swamp hospitals, Gulati said.
That means for people at high risk of serious COVID-19 infections, including the elderly and immune-compromised, even vaccination isn’t a guarantee of safety.
“The cases, the last couple that have come in, they actually had their boosters,” said Kelly, the Einstein nurse. “They have some co-morbidities and all that, but it’s still concerning that even with the boosters they’re coming in sick.”
