COVID-19 hospitalizations surge again

After the wonderful news about the Pfizer vaccine yesterday, today we are faced with the harsh reality of this third peak of the COVID-19 pandemic. 

Data from the COVID tracking project has shown that hospitalizations have now risen sharply in response to the increase in infections. The hospitalization numbers, which may be a better marker for disease activity given that changes in therapy have reduced mortality, show increases across the United States and raise concerns that the country’s health systems may become overwhelmed.

While before one might have attempted to dismiss infections as a result of increased testing, the increase in hospitalizations makes that unlikely.

Interestingly, the Midwest leads the increase in infections and has much of the new hospitalization activity. The Midwest also has much lower per-capita hospitalizations than were seen in the Northeast’s April outbreaks.

Despite this, some Midwest states are posting alarming per-capita numbers. In both North and South Dakota, one in 2,000 residents is hospitalized with COVID-19. Only Michigan and Illinois don’t have daily records, mainly because so many people in those two states were hospitalized in the first peak. 

Several confounding issues: Areas that had first peak outbreaks but were quiet through the second peak are now having hospitalization increases. NYC is a prominent case, with an impressive uptick of cases. Deaths have not increased as proportionally as hospitalizations, but they tend to trend later than hospitalizations. This may suggest that the small increases in COVID deaths currently being observed portend much greater increases over the next few weeks. 

It is not clear what course this third peak will take. Will it respond to infection control measures and wane like the first two? How extensive will the increases be given the timing of this in the fall before the holidays? And what actually is driving this peak? Is it the result of movements associated with back to school or back to work activities? Are increased travel and restaurant activities to blame? When must we intervene to manage hospital overload?

We need to follow this very closely and see if the current restrictions we have in place will begin to tamp things down.