Increasing metrics, fewer treatments: Hospitals facing unique challenges from Omicron

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Friday, December 31, 2021
Omicron forcing hospitals to face multiple challenges
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For the second time this week, North Carolina reported a record-high positivity rate, hitting 22% on Thursday.

RALEIGH, N.C. (WTVD) -- For the second time this week, North Carolina reported a record-high positivity rate, hitting 22% on Thursday. It comes as NCDHHS also reports a record-high number of new cases, 18,571.

Hospitalizations, which lag behind cases, have nearly doubled statewide since the beginning of the month.

"That needs to be recognized as an increase where we have yet to see all the impact of Christmas cases and we are yet to even come to New Year's Eve," said Dr. Cameron Wolfe, an infectious disease specialist with Duke Health.

Wolfe says staffers at Duke have been personally impacted by COVID.

"Yesterday alone, we had more than 150 new cases in our own staff, which has about nearly 700 employees currently sick with COVID. So because of not only more people coming in, but more of our own staff unable to deliver safe care, this is absolutely going to pinch us in the next couple of weeks," said Wolfe.

Treatment options against the omicron variant are more limited than for earlier strains, specifically when it comes to monoclonal antibodies. Two of the key options, Regen-COV and Bamlanivimab and Etesevimab are not effective against omicron. In response, the US Department of Health and Human Services has paused distributing both.

"The third (monoclonal antibody), a drug called Sotrovimab, is in national shortage," said Wolfe.

The FDA recently authorized two new oral antivirals, one from Pfizer, another by Merck; however, there is limited supply, an issue anticipated to last for months.

"They're approved, but to be frank, we have 60 doses of those also. So, people need to understand, that for most people who call up to say 'hey, I've got early COVID. 'I'm at risk, what do I do?' The answer is I can give you nothing, which is awful," said Wolfe.

"A bigger problem is our logistical ability to actually treat people. Because we have limited healthcare workers, and limited rooms to give infusions, and so on and so forth. So again, reducing the number of people who actually need to be treated has got to be the priority, " said Dr. Myron Cohen, the Director of the Institute for Global Health and Infectious Diseases at UNC's School of Medicine.

Both doctors are strongly urging people to get boosted as soon as possible, and continue to wear masks, social distance, and wash hands frequently.

"If we look at a test tube at the person who has had two doses of the vaccine, we look at the concentration of antibody available against omicron, it's 30 times less than if we boost you," said Cohen.

According to the CDC, as of Thursday morning, just 1/3 of the country has received a booster dose, though numbers are slightly higher for people over 50 years old (48.2%) and over 65 years old (58.2%).

"We're in a window of time where we're trying to build an airplane while we're flying it. And as the virus changes, we have to adapt very, very quickly," said Cohen.

"The sheer weight of omicron numbers has been such that it has really hit the front door of our emergency department, really hit the number of people who then need hospital beds, and frankly really hit our staff a way where manning those beds has been extremely difficult," said Wolfe.

Wolfe expressed worries that another surge will stress operations at health systems, and impact non-COVID patients as well.

At WakeMed thru Wednesday, 86% of patients hospitalized with COVID are unvaccinated, and 100% of COVID patients in the ICU or requiring a ventilator are not vaccinated. A hospital spokesperson told ABC 11 they have seen slight daily increases in hospitalizations - moving from 90 patients to 101 patients from Tuesday to Wednesday.