As statewide COVID-19 hospitalizations near record, positive signs found elsewhere

RALEIGH, N.C. (WTVD) -- Both nationally and here in North Carolina, surging COVID-19 cases and hospitalizations are taxing healthcare systems, causing staffing shortages, and increasing concerns for an increasingly difficult stretch during the next few weeks.

"Our hospitalizations are actually the highest that we've had since January 2021," said Dr. Adia Ross, the Chief Medical Officer at Duke Regional Hospital.

Across Duke University Hospital, Duke Regional Hospital, and Duke Raleigh Hospital, there are 268 COVID-19 patients. Just three weeks ago, on Dec. 20, there were just 67 COVID-19 patients; a month before that, on Nov. 23, there were 47 COVID-19 patients.

However, the total number needs context.

"We've always had what we'll call 'incidental COVID.' People coming in with one or more other conditions, and then they're asymptomatic (for COVID) at least in the beginning of their hospitalization. Right now, our results are showing that about 1/3 of the patients are coming for something else, because we haven't changed our admission criteria. So (they're) getting hospitalized for something else, and about 1/3 of them are being found to have COVID because we are screening everybody on admission," said Ross.

Dr. David Wohl, an infectious disease specialist with UNC Health, said he believes the state needs a better tracking system to gain an understanding behind the initial reason of hospitalization to understand the overall data. He estimated it could be as high as 50% of patients first seeking care for a separate reason other than COVID.

"It's a lot more work for us now if someone comes in with a broken leg or is pregnant and has COVID-19 doesn't really have symptoms because of the infection control issues," said Wohl.

That's because even if a person did not initially seek care for COVID, they must be handled differently than other patients.

"When you have a COVID positive person, we have to put them in a special room. Our hospital is only finite. There's only so much space, there's only so much staffing. So as more and more people come in who we know have COVID-19, logistically, it creates challenges," said Wohl.

It also requires additional attention once hospitalized, as a person's symptoms can change.

"People come in and they might be there for a different reason, but they're having symptoms related to COVID-19. Maybe not enough to hospitalize them, but enough to treat them. Enough to keep them on our radar that they don't progress. Because some people come in with COVID-19 and it isn't bad, but they get worse in the hospital," said Wohl.

COVID can also exacerbate existing conditions, causing medical complications.

"It can really cause a flare-up of some of your chronic conditions. I've seen people that are maybe at risk for diabetes or pre-diabetic, and then all of a sudden come in with diabetes, and the only thing that you can say okay what tipped them over the edge was them having COVID," Ross said.

Duke University Hospital, UNC Hospital Chapel Hill campus, WakeMed Raleigh campus, and Cape Fear Valley Medical Center are reporting the highest number of ER visits for COVID-like illness since July 2020, when HHS first started tracking data.

Although hospitalizations are nearing a statewide record, ICU capacity and ventilator use is not increasing at the same rate. Similarly, hospitalizations are not rising as quickly as new cases.

While there have been breakthrough infections amongst people who are vaccinated and boosted, severe symptoms are generally rare, and the overwhelming majority of hospitalized COVID patients are unvaccinated; the disparity is even greater amongst those in the ICU.

As for the belief that Omicron is "milder" than Delta, doctors are pushing back, saying that applies to those who are vaccinated and boosted who experience a breakthrough infection, not amongst those who are unvaccinated.

"Omicron is just as deadly and life-threatening as was previous variants. We don't see anything differently with Omicron that says it's a wimpier virus," said Wohl.
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