Nebraska omicron update: Delta trends make hospitals wary as cases continue to surge

OMAHA, Neb. (WOWT) - Infectious disease experts joined state medical officials for a discussion Wednesday afternoon on the COVID-19 omicron variant — how it is affecting hospitals across the state and what the next few weeks might look like.

On the panel:

• Dr. Gary Anthone, chief medical officer and director of public health at the Nebraska Department of Health and Human Services
• Dr. Matthew Donahue, acting state epidemiologist at DHHS
• Dr. Renuga Vivekanandan, chief of infectious disease at CHI Health-Creighton University
• Dr. Angela Hewlett, infectious diseases specialist at Nebraska Medicine and medical director of the Nebraska Biocontainment Unit

Dr. Anthone gave an update on how much the COVID-19 numbers have changed in Nebraska in about a month’s time.

“What we see in Douglas County is what we see across the state,” he said. “...Most of the hospitalizations over the last two-week period have been mostly concentrated in the metropolitan areas — Douglas County and Lancaster County — but we’re also seeing an increase in what we call our ‘community’ and ‘critical-access’ hospitals.”

SPIKES WE’VE SEEN BEFORE

The numbers are getting back to levels we were at more than a year ago.

Hospitalizations in the state did reach a high of 637 briefly in December, but then there was a sharp decline to 446 on Dec. 26. On Wednesday, the DHHS respiratory illness dashboard was showing 649 COVID-19 patients, the most since Dec. 15, 2020.

There was also a spike in Nebraska’s positivity rate: 26.3% as of Jan. 9 is nearly the highest rate reported in the entirety of the pandemic — the state started the pandemic with a positivity reading of 27.1%.

Nebraska is also getting close to the 15% rolling seven-day average that triggers hospital procedure reductions. Dr. Anthone said the average of COVID-19 patients in Nebraska hospitals hit 13.6% this past week. He said the state is working on a program to get those who are recovering out of hospitals and into recovery facilities.

Ventilator use is also up, he said; 75 ICU patients across the state are on ventilators.

“Even with the increase of patients in the hospital we often see a lag in the number of patients on the ventilator and in the ICU, it usually takes about two to three weeks for that number to catch up to the patient being hospitalized,” Dr. Anthone said.

The possibility that those trends continue is what’s concerning medical officials. But he sees some hope: Hospitalizations and ICU numbers have been down some in the last week, he said.

But others on the call weren’t so optimistic.

Dr. Donahue cases are still on the rise across the country, increasing in the south and northeast. And while the levels are proving hopeful in other parts of the world, delta trends in the U.S. didn’t follow global trends — “we didn’t fit that template.”

“The U.S. has not seen COVID-19 transmission like this in the two years we’ve been at it,” he said, noting that most states are still breaking records in case counts, which can be a precursor to hospitalizations, especially in areas with inadequate vaccination rates.

In Nebraska, between 1-3 and 1-4 people are testing positive in recent days, but anyone who might be just thinking about testing is probably positive, he said, which is why it’s so important to wear masks and isolate.

Dr. Vivekanandan said that’s very likely if you know you’ve been in close contact with someone who tested positive.

The numbers are worse than delta, Dr. Donahue said. At the peak of the delta variant in November 2020, Nebraska hit nearly 1,000 COVID-19 hospitalizations. In December 2021, the peak was 637.

“We can be thankful that the variant that’s been thrown at us is less severe; but because it’s reaching so many more people, hospitalizations are continuing to increase,” he said. “Many states setting records for new cases now are also setting records for hospitalizations.”

VACCINES STILL EFFECTIVE

But the increase in cases is no reason to doubt vaccines, Dr. Donahue said.

In December, fully vaccinated people were 11 times less likely — those with vaccine boosters were 46 times less likely — to be hospitalized with COVID-19, compared to those who are unvaccinated. That translates into about 3,200 hospitalizations and an estimated 700 deaths prevented in Nebraska just last month, he said.

“We know omicron is doing better than previous variants at evading some immunity, which is why there are more mild vaccine breakthroughs with omicron,” Dr. Donahue said. “However, we certainly haven’t seen any drop in vaccine effectiveness yet, not for preventing severe outcomes like hospitalizations or death — and that’s exactly what we need a vaccine to continue doing, and that’s exactly what it is continuing to do.”

Dr. Hewlett agreed, noting that of the 120 COVID-19 patients hospitalized at Nebraska Medicine facilities, most requiring ICU-level care are unvaccinated. And the medications that worked for delta don’t work for omicron, she said, and all Nebraska hospitals have small supplies of the ones that do.

Dr. Hewlett said she wished people would stop using the term “flurona” because “coinfection with respiratory viruses has actually been well known for a long time,” and there were cross-infections that happened with previous variants as well. But there haven’t been any proven cases of double-variant infection in a single patient, she said. One variant generally pushes the other out of the way.

What she has seen, she said, was that one variant doesn’t necessarily give you immunity against the other, even if they are essentially the same virus. There have been cases of patients with delta contracting omicron within a month or two, she said.

“People that had some immunity from delta — it’s not necessarily protective against omicron,” Dr. Hewlett said.

Omicron is also affecting hospital staffing levels — they’re not immune. Nebraska Medicine is experiencing “an unprecedented number of healthcare workers who are out sick right now,” Dr. Hewlett said. “...We have a very difficult time staffing our clinical services, so even things like clinics, outpatient situations — not even just for hospitalized patients — that becomes even more difficult when we’re seeing this large number of cases in our community and it carries over to our healthcare workers as well.”

Dr. Anthone said the biggest issue with hospital capacity is staffing, and that cases among staff are exacerbating that problem.

WHAT YOU CAN DO

Dr. Vivekanandan stressed the importance of wearing masks right now — N95s or KN95s if you can get them, and double-masking if you can’t. Dr. Hewlett said Omaha’s mask mandate was happy news and that Douglas County Health Director Dr. Lindsay Huse is doing the right thing.

“This was incredibly welcome news. ... Honestly, it was almost like we were cheering in the hallway,” Dr. Hewlett said. “...I think wearing a mask, honestly, is an act of kindness. It’s something that people can do — a very very simple act — that people can do ... to help protect the people around us as well as our community.”

The surge in cases isn’t just about the healthcare system — it affects other services we often take for granted, she said.

“Imagine calling 911 and not having someone respond, or calling the fire department and not having them respond to a house fire because we have too many who are sick. These things are actually happening in states that are very close to us right now. ... So if wearing a mask is all we have to do to try to protect our community, then I think that’s a very simple aspect of those layered interventions that can be done by individuals to help not only themselves but other people around them.”

Watch Wednesday’s livestream

Copyright 2022 WOWT. All rights reserved.