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What will happen if Omicron peaks in all 50 states at the same time?

December 28, 2021, 10:44 PM UTC

Over the last two years, COVID-19 has created a well-worn path across the United States. Each variant thus far has taken hold of the coasts, our ports of entry, and then slowly snaked its way inwards, eventually burrowing itself deep into America’s heartland. 

The timed spread has proved helpful in the allocation of medical resources among states. Nurses and doctors came from across the country to help overburdened hospitals in New York in March of 2020; by late spring, New York was past its peak in new cases and could send resources back to states like Michigan

But Omicron, the new and highly contagious COVID-19 variant, is taking the path less traveled—and epidemiologists are afraid that will make all the difference. 

“Omicron is spreading at a rate we have not seen with any previous variant,” WHO Director-General Tedros Adhanom Ghebreyesus said during a COVID update in Geneva this month. It has been less than a month since the first case of Omicron was detected in the U.S., on Dec. 1, and the variant already accounts for 60% of all new COVID cases in the country, according to data from the Centers for Disease Control and Prevention

That spread is evenly distributed across the country, accounting for at least half of all cases in every region except one in the very middle of the country (what the CDC calls “region 7,” which includes Iowa, Kansas, Missouri, and Nebraska). 

That raises the possibility of a perfect-storm scenario, where hospitals across the country are overwhelmed by a wave of Omicron cases at the same time—making it impossible for health systems in different regions to help each other.

While a recent report by the Imperial College London found a reduction in the risk of hospitalization for Omicron infections compared to the previously dominant Delta variant, hospitalization rates, especially amongst the unvaccinated, are still soaring around the country, and resources and ICU beds available are very tight

The seven-day national average of daily COVID-19 cases grew to 243,000 on Monday. That’s a 105% increase in just two weeks. There are 71,400 Americans hospitalized with the virus, a 6% increase over the 14-day average. 

Even in the absence of a simultaneous 50-state crest, U.S. hospitals may not be in great shape to cope with Omicron. Dr. Mike Ryan, executive director of the WHO health emergencies program, said this month at a press conference that hospitals are not fully prepared for this wave. 

“Health systems are weaker now than they were a year ago in reality,” he said. “So unfortunately, sometimes you can get up after the first punch, but it’s very hard to get up after the second. And that’s the difficulty. We’re relying on health workers of the health systems that have been weakened by this response.” 

New York State has already reported that it has run out of monoclonal antibodies, a key treatment for those suffering from severe COVID, at its hospitals. The CDC recently cut guidelines for quarantine after testing positive for COVID-19 from 10 days to five, in part because so many healthcare workers were infected with the virus that hospitals were having trouble remaining functional.

“With this one, all 50 states are in the soup at the same time. It’s like every state is being hit by a viral hurricane,” Michael Osterholm, a professor and director of the Center for Infectious Disease Research and Policy at the University of Minnesota told The New York Times. “We’re already stretched so thin,” he said.

“Instead of seeing the regional surges we were seeing with Delta—much of the West right now is very low level with Delta, parts of the South—I think Omicron is going to be a national viral blizzard,” Osterholm later told CNN

President Biden has said he will prepare and deploy 1,000 military service members, including doctors, nurses, and medics, to hospitals across the country in January and February. 

About 61% of Americans are fully vaccinated, and only 30% of them have received their boosters.

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