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Omicron wave threatens Montana hospital capacity

by Keith Schubert Daily Montanan
| January 12, 2022 1:00 PM

A coalition of Montana medical groups warned on Tuesday that hospitals are once again at risk of being extended beyond their caregiving capacity as the more transmissible omicron variant starts to spread across the state.

“This wave is different, and it has the potential to tax our hospitals more than any previous wave … the number of patients in our hospitals is higher than it has ever been at any other point preceding a pandemic surge,” said Rich Rasmussen, president and CEO of the Montana Hospital Association.

During the state’s last COVID-19 surge in the fall, COVID-19 patients, who were mostly unvaccinated, accounted for about 20% of all hospitalizations while hospitals were operating at or above capacity for 10 consecutive weeks, Rasmussen said.

Some people are experiencing milder symptoms with the omicron variant, but its high degree of transmissibility means many more people infected — pushing up the sheer caseload in hospitals.

“Without a slowdown to spread COVID-19, hospitals will once again be forced to consider a return to crisis or contingency standards of care … this means nonemergency procedures will be postponed,” he said.

As of Tuesday, the Department of Public Health and Human Services said it is aware of 174 omicron cases in Montana. And the variant accounted for 84% percent of specimens sequenced last week, compared to 70% the week before.

“At this point, we do consider the omicron variant to be the dominant circulating strain in our state,” said Dr. Maggie Cook-Shimanek, acting State Medical Officer at DPHHS, at Tuesday’s press conference. “It should be noted that more cases of omicron likely exist, but DPHHS and its partner labs don’t sequence every positive COVID-19 test that they receive.”

What makes the omicron variant so dangerous to hospitals is its ability to spread and infect people even with immunity.

“Our immunity that we have as healthcare workers, and the vast majority of our health care workers are immunized. The ability to pierce through that and have the potential of taking that person out of our workforce while they isolate or if they quarantine is what we’re concerned about,” Rasmussen said.

Last week, the state reported 6,305 COVID-19 cases – a 136% increase from the week before. But with at-home testing becoming more popular, the actual number of COVID-19 cases is likely higher than what the state reports, Cook-Shimanek said. The number of hospitalizations per day was also up 17% to 141 last week compared to the week before. And according to data from Johns Hopkins University, in the last two weeks, Montana’s daily case average increased from 159 to 894.

While cases are rising, the number of people getting vaccinated is not. Cook-Shimanek said state data over the past three weeks show even with a surge in cases from omicron, the number of people receiving their first dose of a vaccine has “stayed about the same, if not a little lower.”

About 53% of the eligible Montanans are fully vaccinated, a rate that is one of the lowest in the country and has remained mostly stagnant since last fall. In Montana, 13% of 5- to 11-year-olds and 38% of 12- to 17-year-olds are fully vaccinated, compared to national averages of 17% and 54%, respectively.

And the omicron variant is driving up pediatric hospitalizations. According to the Centers for Disease Control and Prevention, an average of 861 children aged 17 and younger are being hospitalized every day, with the majority being aged 5 and under who are not eligible to be vaccinated.

“So far, the symptoms of omicron do not appear to be more severe in children, and the increased hospitalization rates are likely due to the increased transmission of the virus in our communities,” said Montana Chapter of the American Academy of Pediatrics President Dr. John Cole. “More than 85,000 children have been hospitalized due to COVID-19 in the United States, and the cases and children are now increasing faster than ever due to omicron variants.”

Cole acknowledged that serious side effects and death from COVID-19 among children are rare but said secondary impacts like missing out on school because of quarantine or losing a caregiver by spreading the virus to vulnerable people in their households can majorly impact a child’s mental health.

Those speaking on Tuesday also referenced the burden of misinformation that has created a barrier for some to be vaccinated.

“We have an infodemic going as well as a pandemic, and sorting through misinformation, disinformation, what’s available, what’s not available, what’s recommended and what’s not recommended … those questions really are very best answered by individuals talking with their trusted providers,” said family medicine doctor Dr. Carley Robertson.

To help sort through the barrage of information, a handful of Montana health care and public health associations launched the “Your Best Shot MT” public health campaign to educate parents about getting their children vaccinated against COVID-19.