Focus more on COVID-19 hospitalizations, less on case counts, Fauci says

The Omicron variant has triggered an unprecedented spike in new cases. Anthony Fauci said the spike in hospitalizations isn’t at the same pace as infections, but he noted it’s still early.

The Omicron variant has spread like wildfire across the country, with some states seeing record peaks of infections and startling spikes of new cases.

Hospitalizations are rising in many states as well, with some states seeing pandemic peaks in recent weeks. Anthony Fauci, the White House’s chief medical adviser, said the rise in new COVID-19 cases is “unprecedented”, but the spike in hospitalizations isn’t quite mirroring the surge in new cases.

In a shift, Fauci said on ABC’s “This Week” that the number of hospitalizations stands as the most crucial number to watch.

“As you get further on and the infections become less severe, it is much more relevant to focus on the hospitalizations as opposed to the total number of cases,” Fauci said.

Fauci offered some caveats on hospitalizations due to Omicron. He noted COVID-19 hospitalizations are often a lagging indicator and said big spikes in hospitalizations can occur weeks after a wave of new infections.

He noted some encouraging signs from South Africa and the United Kingdom that Omicron is less severe, and those requiring hospitalizations were discharged in a shorter amount of time.

Given the rapid spread of the Omicron variant, Fauci said the big concern is that tens of millions of Americans remain unvaccinated and could be at higher risk of severe illness and hospitalization. Healthcare systems could be overwhelmed if they see continued spikes in hospitalizations.

“Even if you have a less of a percentage of severity, when you have multi-multi-multi-fold more people getting infected, the net amount is you’re still going to get a lot of people that are going to be needing hospitalization,” Fauci said in the ABC interview. “And that’s the reason why we’re concerned about stressing and straining the hospital system.”

Hospital leaders across the country have warned the spike of Omicron cases and hospitalizations is threatening their ability to provide care. With staffing shortages and more patients coming in for non-COVID reasons, some hospital officials said this is the most challenging time they have faced in the pandemic.

Some states have asked hospitals to postpone non-urgent surgeries, and many systems have taken that step on their own.

States such as Ohio, Maryland and Delaware have record numbers of COVID-19 hospitalizations in recent days.

Health officials have said they are concerned the rapid spread of Omicron could add to staff shortages if more doctors, nurses and other healthcare professionals are infected.

Just before the holidays, the U.S. Centers for Disease Control and Prevention reduced the isolation time for healthcare workers if they are infected. Healthcare systems can reduce isolation time even more if they are facing severe staffing shortages, the CDC said.

In interviews on ABC and CNN Sunday, Fauci also said the government may look to add a negative test to go along with its reduced isolation guidance for the general population.

On Dec. 27, the CDC said those who are asymptomatic or aren’t running a fever only need to isolate themselves for five days, but should wear a mask around others for five days. Previously, the CDC said those who are infected should isolate for 10 days.

Fauci acknowledged criticism from some healthcare leaders and said there may be a recommendation to get a negative test after five days. While he said the likelihood of transmission drops after five days and the new recommendations are aimed at dealing with the big spike in Omicron infections, Fauci said additional guidance from the CDC would be coming soon.