New Virus Cases Begin to Slow in U.S. Cities Where Omicron Hit First

At another bleak moment of the pandemic in the United States — with nearly 800,000 new cases a day, deaths rising and federal medical teams deploying to overwhelmed hospitals — glints of progress have finally started to emerge. In a handful of places that were among the first to see a surge of the Omicron variant last month, reports of new coronavirus infections have started to level off or decline.

Daily case reports have been falling rapidly around Cleveland, Newark and Washington, D.C., each of which sustained record-shattering spikes over the past month. There were also early signs in Chicago, New York, Puerto Rico and hard-hit ski resort towns in Colorado that cases were hitting a plateau or starting to drop.

The slowing of the spread in those places was welcome news, raising the prospect that a national peak in the Omicron wave may be approaching. But most of the country continued to see explosive growth in virus cases, with some Western and Southern states reporting 400 percent increases over the past two weeks. Officials also warned that hospitalizations and deaths lag actual infections, meaning that even in places where new cases have begun declining, it would still be weeks before the full impact of Omicron was known.

“What we’re bracing for right now is really doing everything we can to avoid a work force shortage,” said Dr. Jeremy Cauwels, the chief physician for Sanford Health, in the Upper Midwest, where more than 400 employees across the hospital system were off work with the virus this week.

Christina Ramirez, a biostatistician at the University of California, Los Angeles, said it was too early to tell where the United States was in its surge. Omicron passed through and peaked in South Africa in about a month, but countries like Denmark and Germany look more like a “jagged sawtooth,” she said. “You get a couple days where it goes down, goes back up and goes back down.”

“We’ve been fooled by the virus before,” Dr. Ramirez said. “The next couple of weeks will be very telling.”

Even as some cities were seeing new cases slow, reports of infections were continuing to rise sharply nationwide. About 150,000 people with the virus are hospitalized across the country, more than at any previous point of the pandemic. That data includes patients who were hospitalized for other reasons and were found to have Covid.

Several times throughout the pandemic, surges driven by new variants caused cases to rise steadily for a period of time before falling again. Scientists suggest that both biology and behavior help drive that pattern. When cases rise, people may become more cautious, and as more people get infected, the virus will have more trouble finding susceptible hosts. Because Omicron spreads so quickly, this cycle might be faster than earlier surges.

Complicating experts’ understanding of the trajectory of the Omicron surge in the United States have been questions about the reporting of new cases. People have increasingly turned to at-home tests to confirm their infections, and many of those are not counted in official data. But the case trend lines, which as recently as a week ago showed rapid growth almost everywhere in the country, remain helpful in outlining the broad pattern.

In Chicago, Dr. Allison Arwady, the public health commissioner, said on Thursday that she was “much less worried than I was even three, four, five days ago” about the city’s outlook. With cases spiking to record levels in Chicago, a labor dispute between City Hall and the teachers’ union canceled classes for a week. By Thursday, with school back in session, there were signs that reports of new cases and test positivity may be leveling off, even as hospitalizations continued to increase.

“It is still too early in terms of being able to clearly say this is the peak, we’re on the way down,” Dr. Arwady said. “But I think we are seeing some signs of certainly flattening across many different metrics.”

New York City has averaged about 38,000 new infections a day over the past week, down slightly in recent days but still near the highest rate of the pandemic. Gov. Kathy Hochul of New York said this week that it “looks like we may be cresting over that peak,” but that transmission remained high.

At University Hospital in Newark, the number of patients with Covid has held about steady at 150 for the past five days. Dr. Shereef Elnahal, the president and chief executive of the hospital, said he was hopeful that the rapid spike in hospitalizations since late December had finally leveled off.

“With all the caveats, God willing, knock on wood, we are beginning to see a plateau in daily hospitalizations,” Dr. Elnahal said.

The slowing of cases in some places did not ease the immediate crisis in many of the country’s hospitals. President Biden said on Thursday that he was sending 120 additional military medical personnel to six states — Michigan, New Jersey, New Mexico, New York, Ohio and Rhode Island — where hospitals had been overrun.

Mr. Biden also said he was directing his staff to purchase an additional 500 million at-home coronavirus tests for distribution to Americans, doubling the government’s previous purchase. It remained unclear when the first of those tests would be available.

Omicron began to surge before Christmas in urban centers in the eastern half of the country, including many of the places where daily caseloads have recently started to fall. But much of the United States, particularly the West and in rural portions of the South and Midwest, did not see a similar spike until around New Year’s. In those regions, daily cases continue to rise swiftly.

Whenever the Omicron wave finally recedes, it is uncertain how much protection the nation might have against future outbreaks — whether small and sporadic or more widespread surges.

“I think that’s the million-dollar question,” said Bertha Hidalgo, an epidemiologist at the University of Alabama at Birmingham. “I would hope that we would not see a new variant of concern quickly and the immunity we build to Omicron is long-lasting.”

Evidence from prior variants suggests that immunity from natural infection only lasts so long, Dr. Hidalgo added.

Across the country, officials in places with hopeful glimmers in their data were adopting a cautious approach to interpreting those numbers.

Dr. Ngozi Ezike, the director of the Illinois Department of Public Health, said on Wednesday that it was “too soon to tell” whether the worst of Omicron had passed in her state. Hospitalizations statewide had declined slightly on one recent day, but it was unclear whether that would become a trend.

“You really want to see a consistent decline,” Dr. Ezike said. “I will be the first to announce it when we can say that pretty confidently. Crossing my fingers and toes, but I just don’t want to get ahead of ourselves.”

Michael D. Shear and Tracey Tully contributed reporting.

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