With Omicron, A Key COVID-19 Metric Has Become Highly Misleading

Every day, hundreds of thousands of Americans catch the Omicron variant of COVID-19. If they end up in the hospital, for whatever reason, the Centers for Disease Control and Prevention (CDC) will report them as a COVID-19 hospitalization.

From adults with broken arms to children in mental health crisis, a vast portion of Americans who test positive for COVID-19 in hospitals are not there for COVID-19 at all. And yet, much of the media continues to report indiscriminately on record numbers of cases and skyrocketing hospitalizations.

This problem existed before Omicron. In September, researchers published a paper that found that in VA hospitals, more than a third of COVID-19 hospitalizations were asymptomatic. Since May 2021, two published articles estimated that child hospitalizations for COVID-19 were overestimated by up to 40%.

But the CDC hasn’t changed how it collects and presents hospitalization data. Today, more and more public health officials and journalists are beginning to recognize the shortcomings in the use of hospitalizations as a meaningful metric to gauge the state of the pandemic.

Dr. Cody Meissner, an expert in pediatrics and infectious diseases at Tufts Children’s Hospital, said it’s problematic that the CDC hasn’t updated its reporting practices: “The CDC hasn’t really done that, because it’s obviously extra work, they have to gather extra information.

“There are a lot of these kids who are in hospital especially now because Omicron is so contagious they test positive but they have a completely unrelated illness like trauma so they need to be hospitalized but that hasn’t helped. nothing to do with COVID-19. But the CDC still considers them a COVID hospitalization.

Every hospital in the country tests every patient for COVID-19 upon admission. This means that even asymptomatic cases, where the hospitalization has nothing to do with the virus, are reported as COVID-19 related hospitalizations.

“What I hear from colleagues in the hospital world in New York is that up to half of recent hospitalized Covid-19 cases (almost all of Omicron) are people who have registered for other reasons (adults or children) and then tested positive with asymptomatic Omicron,” said Dr. John Moore, professor of microbiology and immunology at Cornell University. “Remember that PCR tests can detect very low levels of virus for some time after an active infection has been cleared.”

This testing protocol does not apply to any other virus or respiratory disease comparable to COVID-19, whether pneumonia, influenza or other forms of SARS, said Dr. Monica Gandhi, professor of medicine and infectious disease expert at the University of California. San Francisco: “Historically, we have never screened patients for respiratory virus when patients are admitted to the hospital with non-respiratory symptoms, with the exception of COVID-19. WE did this for SARS-CoV-2 before vaccines because asymptomatic transmission could occur and the virus causes severe illness in some people.

“So we isolate patients with SARS-CoV-2 in their noses from other patients (and use different PPE as healthcare providers around them), even if they have non-COVID-defined disease. .”

It can be difficult to determine what proportion of reported COVID-19 hospitalizations this corresponds to, but there are some estimates, and they are high. (RELATED: Judges Sonia Sotomayor and Stephen Breyer read obscene misinformation about COVID-19 into court filing)

“This happened about 40% of the time for pediatric hospitalizations during careful records review early in the pandemic, with adult COVID deaths possibly down to 25% lower taking this into account. screening phenomenon,” said Gandhi. “This accounting becomes even more important in the context of a highly transmissible variant like Omicron…NYC data shows that 50% of hospitalizations in NYC are for reasons other than COVID.”

Gandhi and his UCSF colleague, Dr. Jeanne Noble, believe that more than two-thirds of hospitalizations at their hospital are unrelated to COVID-19.

New York Democratic Governor Kathy Hochul recently announced that her state would begin reporting COVID-induced hospitalizations and incidental positive tests. But most other states aren’t following suit, and Omicron is making the problem worse due to the fact that it’s much more contagious, but also less severe, than previous variants.

“Due to the unique characteristics of Omicron, there has been a discrepancy between those hospitalized with COVID-19 and those hospitalized with COVID-19. It really wasn’t a major proportion of cases with earlier variants, but it’s becoming more common due to the spread of Omicron and the fact that many people are fully vaccinated and have extremely mild or no symptoms Dr. Amesh Adalja, a senior fellow at the Johns Hopkins Center for Health Security and infectious disease expert, told The Daily Caller.

“Omicron is a game-changer in this regard because it definitely skews the stats,” Moore wrote. “In other words, until now, ‘accidental infections’ just didn’t matter that much and didn’t impact policy/perceptions. Now it looks different.

Moore added that the data is even more skewed in highly vaccinated areas because serious infections are rare in vaccinated people, while hospitalizations in unvaccinated people are more likely to be related to COVID-19 than accidental.

So what is the best metric to use to gauge how hard COVID-19 is hitting certain communities? There’s no consensus, but the experts who spoke with the Daily Caller had some ideas.

“A better measure might be to look at people in hospital who are Covid-positive and also receiving dexamethasone,” Adalja said. Dexamethasone is a medicine recommended by health authorities for patients who need supplemental oxygen or mechanical ventilation.

“What matters most are serious infections and therefore the number of admissions and deaths in intensive care. They are the ones who need to be tracked,” Moore explained.

Deaths rise as Omicron sweeps the country, CDC says. Although they are not increasing at nearly the rate of cases or hospitalizations, which may be a sign of things to come with a highly immune population and a dominant, milder variant.

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