Number of patients hospitalized ‘with COVID’ vs. ‘for COVID’ is changing – Daily Democrat

While hospitals are still under pressure due to an influx of patients and staffing shortages due to the rapid spread of the omicron variant, they are now seeing a marked increase in the number of patients with COVID-19, but have been admitted for another medical condition.

This is a change from previous waves of the pandemic, when a majority of people entering hospitals with COVID-19 had difficulty breathing or low blood oxygen levels and often needed a respiratory support.

The way the current omicron variant seems to affect most people is also different, reducing the number of seriously ill people. But don’t think that means the healthcare system is in the clear or that people should dismiss the virus, medical experts say.

And whatever the reason for their hospitalization, statistics on the number of infected patients are always an important indicator of where we are in the pandemic – and what to expect from the disease when it is. considered an endemic virus that breaks out seasonally.

What changed

At the start of the pandemic, “the overwhelming majority of COVID-positive people were there (in hospital) due to respiratory need,” said Dr. Shruti Gohil, associate medical director of epidemiology and infection prevention at UC Irvine Medical. Center.

Patients seeking care suffered from chest pain, shortness of breath, high fevers and body aches, said Southern California Hospital Association CEO George Greene.

UC Irvine researcher Daniel Chow said in August 2020 that the data of more than 500 COVID-19 patients who had been treated at the university’s medical center showed that about 90% were hospitalized with coronavirus-related symptoms.

Vaccines weren’t available until the end of that year, fewer drugs were available to treat people once they were infected, and health workers were still figuring out the best ways to treat people with the virus. .

Hospitals lacked resources for critically ill COVID-19 patients. During the delta-variant wave of the virus at Providence Mission Hospital in Mission Viejo, “we were on a ventilator at one point,” said Dr. Jim Keany, associate director of the hospital’s emergency department.

At the UCI Medical Center, the ECMO (extracorporeal membrane oxygenation) machine – a last-resort treatment that works like an external heart and lungs – was used on 13 patients in the first week of January 2021. During the first week of this month, no patients needed it, according to data provided by the hospital.

Today, with omicron reducing the number of seriously ill patients, the situation is different. Orange County’s available ventilator supply — which dipped in the 30% range in January 2021 — has been between 60% and 70% for at least the past three months, according to county data.

“It’s a totally different landscape now,” because when the virus was new, no one was immune, Gohil said.

“It’s not a level playing field to compare yesterday and today, because back then the whole population was vulnerable.”

“Mixed bag”

Today with 2.1 million of nearly 3.2 million Orange County residents vaccinated and some others with some degree of immunity to previous infection, many people who get COVID-19 are less sick and can defeat the virus at home. Omicron is also thought to trigger less severe disease in many people.

Some patients presenting to hospitals have unrelated emergencies or are seeking care they delayed earlier because they were afraid of getting infected, Greene said. But then they test positive for the virus, adding to reported COVID-19 hospitalizations.

“The way we describe it is that people are hospitalized with COVID rather than COVID,” Greene said.

Gohil called the current patient population a “mixed bag” and said it also includes COVID-positive people who are not in hospital with COVID-specific symptoms, but “even if mild, in some people (this) can destabilize your underlying conditions.

For example, she said, people can have chronic conditions such as diabetes, COPD or heart failure under control until they get COVID-19 — and with their bodies trying to fight off the new infection, this long-standing health condition lands them in the hospital.

At the UCI Medical Center, Gohil and Chow estimate the split is now close to 50/50 between COVID-positive patients who are admitted with symptoms or complications of the disease and patients with another primary diagnosis.

Reflecting this shift, New York State health officials and Massachusetts said earlier this month that they would change the way COVID-19 hospitalization data is reported to separate “accidental” cases.

California does not currently make this distinction in publicly available data, nor does Orange County, but OC Health Care Agency Deputy Director of Health Dr. Regina Chinsio-Kwong said that she had spoken to hospital officials to try to get more detailed information about who is in hospitals with COVID-19.

What this means

The upshot of all this, health experts said, is that while omicron appears to make people less sick than earlier variants of the virus, that doesn’t mean this push has been any easier on hospitals.

They should always separate COVID-positive patients from those who are not infected, regardless of what brought them to the hospital, and nurses should don and change protective gear frequently. And with omicron spreading so easily, more infected people inevitably means more infected people end up in hospitals.

Gohil said rehabilitation and long-term care facilities that normally house people who no longer need hospital care but are not ready to return home are now filling up or facing outbreaks, so some patients may need to stay in hospital longer.

“What I think we should take away is that we are still in pandemic mode,” Gohil said. “We don’t want another variant to come into the picture” because it could be worse than omicron.

Health officials continue to urge everyone who is eligible to get a vaccine or booster, as it has been shown to protect people against the most serious complications of COVID-19. County statistics show that 86% of hospitalized patients with COVID-19 are unvaccinated, as are 87% of COVID-positive people in intensive care.

With the large number of people infected with the omicron, “it would have looked a lot like New York in the first round, with bodies piling up, if not for the vaccine and the natural immunity (from an infection anterior) combined,” said Keany of Providence Mission.

And while the data available for Orange County and California doesn’t fully reflect the changing patient population, the hospital association’s Green said the numbers are still a valuable indicator of where health care is headed. things.

Without tracking cases and hospitalizations, it would be unknown what percentage of people develop antibodies, and knowing how the virus behaves is key to developing protocols for “I hate to say it — COVID season,” when the virus is rampant, a he declared. .