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Health Care Workers Brace For The Worst As Omicron Projections Change

Though an Oregon omicron forecast has improved, the impact on hospitals still could exceed the pandemic’s worst point.
3D rendering of the omicron variant of COVID-19. | SHUTTERSTOCK
December 28, 2021

Hospitalizations have started ticking up around the state as projections continue to show the omicron variant will be bad for Oregon’s hospitals and health care workers.

The state reported 381 hospitalized patients with COVID-19 on Monday, up from 339 the previous Thursday.

Meanwhile, the latest forecast of omicron’s impact issued by Oregon Health & Science University on Dec. 23 showed an improvement over the grim projection of the previous week. But it still exceeded the real-life peak of 1,187 people with COVID-19 hospitalized statewide as of Sept. 1. 

That fall peak was accompanied by reports around the state that due to a lack of hospital beds, patients could not get needed treatment and were dying as a result, regardless of whether they’d been admitted due to COVID-19.

The newer modeling projects a peak of about 1,250 hospitalizations in mid-February if booster shots and other actions by Oregonians help blunt the surge. That’s a drop of more than a third from OHSU’s report issued on Dec. 17, which had a best-case scenario of 2,000 hospitalizations at peak.

Despite the expected hospitalizations surge, the new modeling suggests the number of deaths linked to COVID-19 will continue dropping below 10 per day, well below the state’s peak of more than 20. That reflects recent studies finding the symptoms of the new variant tend to be milder, especially for those who’ve been vaccinated.

New projections are expected from OHSU later this week. 

Dr. Steve Freer, the chief medical officer for Providence Health & Services in Oregon, said in an email that his concern is the recent increase in hospitalizations may not be related to the omicron variant; instead, it could reflect infections due to the delta variant.

“We are seeing cases rise, including hospitalizations,” he said. “What worries me is that this may yet be largely driven by delta, and we haven’t yet seen the full impact of omicron. Even if the disease is considerably less severe than previous strains, the increased infectivity will drive a large number of infections, just as it has done elsewhere in Europe and South Africa. So even if the percentage needing hospitalization is smaller than with previous variants, a small percentage of a large number will still be a lot of hospitalized patients.”

Registered nurse Matt Calzia, a nurse practice consultant with the Oregon Nurses Association, called the newer OHSU projection “a better shade of bad.” He said the crisis of the fall never really passed, in that the understaffing and workload of frontline health care workers hasn’t improved. They are still battling burnout and the moral injury of being forced to provide care that does not meet how they were trained, he said, adding that the situation “remains a crisis. And even though the projections are better, if we have another experience like the fall, it’s just going to be devastating,” Calzia said. “It’s impacting patient care.”

Dave Northfield, a spokesperson for the Oregon Association of Hospitals and Health Systems, said of the latest modeling, “These projections are not as dire as the previous numbers, but they still place the peak near the highest number of hospitalizations from the delta surge, which pushed hospitals and their staffs to the brink. The lower number also assumes that people are taking steps to reduce the spread of the virus at a time when a lot of people are gathering for the holidays. It’s definitely too soon for us to let our guard down.”

Officials are urging Oregonians to get vaccinated if they have not and to obtain a booster shot if they are eligible. 

On Dec. 17, Gov. Kate Brown announced a goal for 1 million more people in Oregon, especially the elderly or those with health conditions making them vulnerable, to get their booster against COVID-19 by the end of January to help combat the surge. 

As of Monday, the state reported that more than 145,000 people in Oregon had received a booster. The boosters are available at hospitals, pharmacies and clinics, as well as at mass-vaccination sites set up by the state.

The other measures announced by state officials on Dec. 17 include:

  • Oregon plans to open a high-volume site for monoclonal antibody therapy to treat COVID-19 patients in the Portland metro area, serving as many as 350 people a week. It will be open seven days a week, 11 hours a day. It’s intended to keep hospitalizations down. 
  • The state will register health care providers with federal agencies so they can quickly receive new antiviral drugs to treat COVID-19. 
  • The state will run an emergency management command center and coordinate available beds, ventilators and other resources stateside. 
  • The plans also include coordinating with long-term care facilities so they can provide “step-down beds” to patients who can be discharged from hospitals as a way to free up hospital beds.
  • By mid-January, state health officials plan to provide hospitals an interim crisis care tool they can use to “equitably prioritize care if doctors and nurses are forced to make heart-breaking decisions,” amid limited beds, ventilators and other resources, the state’s plan says.

You can reach Nick Budnick at [email protected] or via Twitter at @NickBudnick.