With Florida reporting record new COVID-19 cases and South Florida leading the surge, all eyes are now on hospitalizations, which generally increase about two weeks after a spike in infections.
Anecdotal reports and emerging evidence strongly suggest that the highly contagious omicron variant causes less severe illness than prior strains of the coronavirus, though public health experts emphasize that if more people get sick with COVID-19 — even a mild case — then the number of people hospitalized is likely to grow, too.
So far, Florida’s rapid increase in cases has not translated into a dramatic surge in hospitalizations. South Florida hospitals are reporting a rising number of COVID-19 inpatients, though many of those patients are being diagnosed after they’ve entered the hospital for a medical reason unrelated to the disease, such as a car accident or to deliver a baby.
No hospitals in Florida have canceled elective surgeries or filled hallways and conference rooms with patient beds as occurred during the delta wave in the summer and the surge in winter 2020. And recent data from Scotland and South Africa suggest that people infected with the omicron variant have a lower risk of hospitalization than those who contracted an earlier version of the virus.
But the high number of new COVID-19 infections in Florida also includes health care workers, leading nurses and doctors who’ve contracted the virus to miss work for days and forcing some hospitals to cancel appointments for medical procedures because they’re understaffed.
“As our nurses gather with their families and as we seem to be seeing more breakthrough cases and rapid spread, it is resulting in more staff needing to be quarantined,” said Mary Mayhew, president of the Florida Hospital Association or FHA.
Anticipating the potential for hospital staffing shortages due to the resurgence in cases, the Centers for Disease Control and Prevention last week updated its guidance for healthcare workers who test positive for COVID-19 and shortened the recommended isolation time.
As of Monday, Florida hospitals reported 2,400 inpatients with COVID-19, about 4.5% of beds in use, and an additional 325 people in intensive care, about 5.6% of ICU beds in use, according to hospital data from the Department of Health and Human Services.
The FHA resumed daily reporting of COVID-19 hospital use, citing the rise in admissions and the need for hospitals to monitor trends and ready their surge plans. The group had discontinued reporting hospital use in October after hospitalizations from the delta wave had receded to about 2,250 statewide.
“We’ll continue to see more cases, as experience indicates that this is spreading rapidly and is more contagious,” Mayhew said, adding that she was “encouraged” that hospitalizations remain relatively low compared to the peak of the delta wave, when hospitals reported more than 17,000 inpatients with COVID-19 statewide.
South Florida physicians and hospital administrators said they too are also cautiously optimistic that the rapid rise in new cases hasn’t led to an explosion in patient admissions for COVID-19, but that the next two to three weeks will likely tell whether the omicron wave of cases will overwhelm hospitals with severely ill patients.
With 27 of the county’s 31 hospitals reporting, there were 667 inpatients with COVID-19 in Miami-Dade on Sunday, including 63 in ICU beds. As of Monday morning, Broward hospitals reported 527 inpatients with the disease, though it’s not clear from the county’s COVID-19 dashboard how many patients were in intensive care or how many hospitals were reporting.
At Memorial Healthcare System, the public hospital network for south Broward County, the number of inpatients with COVID-19 has increased from less than 40 on Dec. 13 to about 240 on Monday, said Dr. Marc Napp, senior vice president and chief medical officer.
“Right now we’re starting to see numbers in the hospital go up. What we don’t know is if it’s going to continue to go up or if it’s going to peter out,” Napp said. “I don’t see it coming back down very soon based on how it’s rising. How far will it go? Will it be like September and October? I don’t know.”
Napp said that a week ago Memorial saw a near record number of visits to its six hospital emergency rooms from patients who had COVID-19 symptoms or who were concerned about an exposure — but who were not severely ill enough to be admitted to the hospital.
Now more patients are being admitted, Napp said, and even though many of them were hospitalized for a medical reason other than COVID-19, they still require more resources for infection control, such as negative pressure rooms, respirator masks, gowns and other protective gear.
“These are people who we have to treat like COVID patients but who don’t require special treatment for COVID,” Napp said.
And though fewer of Memorial Healthcare’s COVID-positive patients have been admitted due to severe disease as of Monday, Napp expects that number will grow.
“This happens to be an extremely infectious disease that’s going to spread across the community very rapidly,” he said. “There are members of the community who are going to be susceptible. Those who are unvaccinated or undervaccinated, or have a condition that leaves them with a weakened immune system, such as cancer or maybe they recently had a bone marrow transplant or a kidney transplant, those people are still going to get sick.”
Jackson Health System, Miami-Dade’s public hospital network, reported 212 inpatients with COVID-19 on Monday — about a 150% increase over the 83 inpatients reported on Dec. 19.
But the share of Jackson Health inpatients diagnosed with the disease after being admitted for an unrelated medical reason outweighed those whose primary reason for hospitalization was COVID-19. Of the 212 inpatients with COVID-19 reported at Jackson Health, 127 or 60% were diagnosed after being admitted for another reason, according to the hospital system’s internal tracking report.
At Baptist Health South Florida, there were 270 patients with COVID-19 across the system’s 11 hospitals in Miami-Dade, Monroe and Palm Beach counties as of Monday, said Dr. David Segarra, chief medical officer for Baptist Hospital Miami. That’s a nearly 300% increase from the 92 patients with COVID-19 that Baptist Health reported on Dec. 20.
Segarra said that like Memorial Healthcare and Jackson Health, Baptist Health is also seeing many asymptomatic patients who discover they’re COVID-positive after being admitted for another reason. He suspects the omicron variant may result in more mild disease for many because it cannot bind to lung cells as efficiently as prior versions of the virus.
“That is very important,” Segarra said, “because we’re not seeing those COVID pneumonia cases, nor are we seeing that terrible body response to the pneumonia, and we’re not seeing as many patients that at this point — and it’s very, very early — are progressing to the ICU.”
There were three patients in the ICU at Baptist Hospital Miami. “Typically, with as many patients as we’ve had before, we would have seen a lot more,” Segarra said. “So I’m keeping my fingers crossed and hoping and praying for the best.”