Two administrators expect peak lies ahead
The resurgence of admissions to local hospitals began in late summer with the Delta variant of the virus that causes COVID-19 but has accelerated in the last month as the highly infectious Omicron has become the dominant variant.
NewYork-Presbyterian Hudson Valley Hospital in Cortlandt Manor had 42 COVID-19 patients on Wednesday (Jan. 5), nearly five times the number on Dec. 18. Three of the 42 were on ventilators, according to state data, and 28 were age 55 or older.
Putnam Hospital Center in Carmel is facing a similar influx. The hospital’s caseload of 29 COVID-19 patients on Monday was more than four times what it had on Dec. 12. Twenty-three of those patients were 55 or older, and four were on ventilators.
Across the Hudson River from Beacon, Montefiore St. Luke’s Cornwall Hospital in the City of Newburgh reported 86 patients with COVID-19 on Wednesday, including 10 on ventilators. Since Dec. 26, the hospital has admitted at least 10 new COVID-19 patients each day.
The state is now asking hospitals to report two totals: patients admitted “due to COVID-19 or complications of COVID” and patients admitted “where COVID was not included as one of the reasons for admission.”
As of Friday (Jan. 7), 58 percent of the COVID patients hospitalized statewide were admitted due to the disease and 42 percent admitted for non-COVID reasons. In the Mid-Hudson Region, which includes Dutchess and Putnam counties, 64 percent of COVID patients were admitted due to the disease and 36 percent for other reasons.
Dr. Mark Hirko is president of Putnam Hospital Center and Sharon Hospital in Connecticut (both part of the Nuvance Health System). Dr. Bobby Janda is the chief medical officer at NewYork-Presbyterian Hudson Valley Hospital. In separate interviews, each noted that people who are not vaccinated are most at risk as cases continue to rise.
How do those hospitalized by Omicron differ from previous variants?
Hirko: The unvaccinated are more severely ill compared to the vaccinated, excepting those vaccinated patients who are immunocompromised.
Janda: The infections are milder than the previous variants, with a majority of patients being treated and released from the emergency room to be followed up by their primary care doctors. Among patients who are hospitalized, the percentage of those requiring intensive care or ventilators is less. Having said that, we have started to see an increase in acuity [severity] in the past two weeks. We should not take this lightly, especially when we still have the Delta variant in our community.
Are you seeing evidence that Omicron does less damage to the lungs?
Hirko: Yes, but usually that’s in vaccinated patients. Unvaccinated patients still have a higher percentage of being more severely ill.
Janda: We have seen less hypoxia [low oxygen] among the Omicron variant and less cases of loss of taste or smell, but we still have some patients in the ICU. Separately, the sheer volume of positive cases in the community is putting a tremendous amount of stress on hospitals and inundating the health care system.
What percentage of your COVID-19 patients are unvaccinated?
Hirko: About 50 to 60 percent. Two weeks ago it was 75 percent unvaccinated.
Janda: We don’t have the exact percentages, but it highlights the importance of getting vaccinations and boosters. We know that disease among those who are vaccinated is much milder; we have seen much more severe disease in unvaccinated patients. Among the unvaccinated population we have observed more admissions to the ICU and longer stays in the hospital, other than respiratory system complications, and requiring ventilator support.
Have hospitalizations peaked?
Hirko: Projections are for a spike in infected patients over the next four to six weeks. What’s different with this surge is a large number of employees are infected, thereby affecting our ability to treat these patients.
Janda: I think hospitalization and positivity rates will likely go up this week into next as we come off the holiday season and family gatherings.
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