CRH braces for looming omicron wave

Columbus Regional Hospital is anticipating another spike in patients and is prepared for the prospect of rationing care as hospital officials across the state brace for a potential wave of omicron infections on top of a surge that has already strained resources.

Surge plans are in place at CRH for “anticipated higher volumes” of patients amid renewed pleas from local officials for people to get vaccinated and stark warnings from the Centers for Disease Control and Prevention: “We are expecting a surge of COVID-19 cases in the coming days to weeks.”

CRH has already started prioritizing severely ill patients and has delayed some surgeries as the hospital contends with a surge in admissions due to COVID-19 and other medical conditions that drove its inpatient head count about 10 days ago to the highest in the hospital’s 104-year history.

Since then, the total inpatient census has declined somewhat, though officials still characterized the situation at the hospital earlier this week as “very severe.”

COVID-19 accounted for about 1 in 4 hospitalizations at CRH earlier this week, and 80% of those patients were unvaccinated.

“As it has gotten worse, we’ve had to prioritize acutely ill patients and delay some surgical cases,” said Dr. Slade Crowder, CRH vice president of physician enterprise operations and associate chief medical officer. “I think, as we would continue to surge, we would continue to have to make hard decisions about prioritizing the sickest patients, and that can mean more of delaying other care in other venues to free up resources and staff.”

Like a ‘fire burning across the country’

In only a handful of weeks, the new omicron variant of COVID-19 has lived up to dire predictions about how hugely contagious it is, quickly becoming the dominant variant in the U.S., accounting for about three-quarters of new infections, The Associated Press reported.

The speed with which it’s outpacing the also very contagious delta variant is astonishing public health officials across the country and comes right as travel is increasing due to Christmas and New Year’s Eve and many people let down their guard.

Local officials characterized the lightning-quick spread of omicron as a “fire burning across the country.”

“If you are not vaccinated, you are going to get exposed to omicron if you haven’t already,” Crowder said. “Nearly everyone who lives in the world is either going to have antibodies from having had COVID or having been immunized. I think that’s playing out right now.”

However, much remains unknown about the new variant, which was first identified by scientists in South Africa last month, including the extent to which it causes more or less severe illness than previous variants, according to wire reports.

Some early studies have hinted that omicron infections may be milder than those caused by the delta variant, though those findings have not yet been peer-reviewed — the gold standard in scientific research — and have some limitations, according to the AP.

But health experts are quick to stress that any potential reduced risk of hospitalization could be more than offset by omicron’s ability to infect many more people and evade vaccines.

“Given that it does have greater transmissibility, then there would expected to be a proportionally larger number of people who get the illness and who may require hospital care,” said Dr. Tom Sonderman, vice president and chief medical officer at CRH. “… That causes us concern as this variant approaches and has the potential to reach so many people.”

Bartholomew County Health Officer Dr. Brian Niedbalski said the public should be “vigilant” as omicron spreads, warning that the new variant can still cause severe disease and death.

“Although it generally appears to have milder symptoms when compared to the delta variant, it also seems to be having higher transmission rates. Either variant can continue to cause severe disease and death, especially in the unvaccinated,” Niedbalski said.

Vaccines

Early studies suggest the vaccinated may need a booster shot for the best chance at preventing omicron infection, but even without the extra dose, vaccination still should offer strong protection against severe illness and death.

However, just 47% of vaccinated Bartholomew County residents who are currently are eligible for booster shots had gotten them as of Wednesday, according to the most recent figures from the Indiana Department of Health.

Overall, about 31,000 eligible Bartholomew County residents had not gotten vaccinated at all as of Wednesday morning.

Health experts say anyone who’s survived a bout of COVID-19 still should get vaccinated, because the combination generally offers stronger protection.

“We know that the vaccine will help protect against severe disease, hospitalization and death,” Crowder said. “The best thing you can do to protect yourself from omicron is exactly what it was for delta and before delta, which is get vaccinated, wear a mask, wash your hands and socially distance.”

But what is currently unclear, Crowder said, is how well the vaccines work against the omicron variant compared to the delta variant, how much protection previous COVID-19 infections afford, and how likely breakthrough infections are.

The CDC says breakthrough infections in people who are fully vaccinated are likely to occur. Prior infections don’t seem to offer much protection against an omicron infection although, like with vaccination, it may reduce the chances of severe illness, according to wire reports.

“That data is fluctuating,” Crowder said. “You see one study go one way versus one (going) another, so I think it’s too early to say.”

In the meantime, Indiana hospitals continue to be stretched thin.

As of Tuesday, 2,940 people in Indiana were hospitalized with COVID-19, up from 1,209 on Nov. 6, according to the Indiana Department of Health.

Just 252 of the state’s 2,067 ICU beds were available as of Tuesday — the lowest number of available beds so far during the pandemic, according to state records. Nearly 37% of the ICU beds were occupied by COVID-19 patients.

The top seven days with fewest ICU bed availability in Indiana during the pandemic have all occurred since Dec. 15.

“When we reach out to our partners and see how they’re doing, I have not heard the level of concern and challenge through the entire pandemic that I think we’ve heard in the last several weeks,” Crowder said.

“All hospitals in Indiana really are struggling and are concerned with where we are currently and where we could go,” Crowder added.

The Associated Press contributed to this report.