On the final day of November, the 7-day average of new COVID-19 cases stood at 283 per day in Alabama.

What a difference a new variant makes.

As the omicron variant of the virus has spread rapidly across the nation, the current 7-day average has surged to 8,044.71 new daily cases, which is more than 28 times the pre-omicron low point reached Nov. 30.

It’s also a new record high for the pandemic and confirms the fears of public health officials that omicron is much more contagious than the delta variant that caused a surge last year, as well as the original virus that triggered the pandemic in early 2020.

The Alabama Department of Public Health cannot confirm yet that the omicron variant is the main cause behind the current surge, because not enough test samples have been checked yet. But State Health Officer Dr. Scott Harris is pretty certain that omicron is the main culprit.

“We’re a little behind in doing that sequencing,” Harris said Tuesday in an online press conference by the Medical Association of the State of Alabama. “Given the way that this has just exploded and the ease with which it is spreading around, we don’t have any doubt about what we’re seeing. We’re seeing the omicron variant spread here in Alabama.”

The Centers for Disease Control and Prevention announced earlier this week that more than 90% of all infections in the nation over the previous week were attributed to omicron, which was first discovered in southern Africa in November. But there is still delta variant, which is far more likely to cause serious illness, circulating in Alabama and the country.

Harris said that full vaccinations, including booster shots for those eligible, work to prevent people from suffering serious illness or death from all variants, including omicron. But even fully vaccinated people can contract or spread the virus, especially the omicron variant, though they often see light or no symptoms.

The enhanced transmissibility of omicron means that many more people are likely to be infected. “The fact that it’s so much more infectious means we’re still going to see really large numbers of people getting sick,” Harris said.

That omicron surge is expected to reach its peak in mid- to late-January, Dr. Sarah Nafziger, vice president of clinical support services at UAB, said in a press conference Monday.

Strain on Hospital Care

In addition to sharp increases in new cases, Alabama hospitals are seeing spikes in the number of COVID patients in their beds. That’s causing a strain on those facilities, not so much in having enough rooms for those patients — as was the biggest problem in the delta variant surge last year, when more than 3,000 COVID patients stretched capacities to the brink — but in having enough health care workers to attend to the patients.

As of Thursday, 1,459 COVID patients were hospitalized across the state. That total is more than four times the number reported in early December.

Alabama Hospital Association President Dr. Don Williamson said in Tuesday’s conference that he had been hopeful that the weaker symptoms under omicron would mean fewer hospitalized patients, but that has turned out to not be the case.

“The simple raw number of cases is overcoming whatever offset there is in terms of severity,” Williamson said. “While (omicron) may be less severe on a population base, for an individual, you don’t know whether you’re going to be in the group that stays out of the hospital and stays out of the ICU or whether you’re going to end up in the ICU.”

“We got to 3,000 cases (in hospitals) last year. It is unfortunately possible that we could get to 3,000 again, at least at the rate we’re growing now,” Williamson said in a separate interview for WSFA television in Montgomery.

COVID patients being treated in intensive care units have more than doubled over the past month from 95 to Tuesday’s total of 229.

Emergency departments also are being overrun. Many hospitals, including UAB Hospital, have asked people to not go to emergency departments if they have only mild symptoms and want to be tested. Instead, UAB has asked those people to schedule an appointment for a test through the Jefferson County COVID Call Center, at 205-858-2221.  For symptoms such as stuffy noses or sore throats, UAB is also encouraging people to see their primary care doctor or go to an urgent care center, instead. Tuscaloosa’s DCH Regional Medical Center also has issued statements with the same advice.

As of Thursday, UAB reported 151 patients hospitalized with COVID, with 105 of those not having been vaccinated. Thirty were in the intensive care unit, with 17 on ventilators.

Record-High Positivity Rates

The state’s positivity rate, which is the percentage of tests for the COVID virus that return a positive result, has also gone through the roof. A month ago, the rate stood at just over 5%, near a threshold that most health officials consider to be acceptable. But as of Thursday, the positivity rate for Alabama had jumped to 42.3% — an all-time record. Jefferson County’s rate is slightly worse, at 43.8%.

The current death toll is still staying at or below levels seen late last year as the delta surge was winding down. The 7-day average of COVID deaths in the state stood at 12.57 as of Thursday but had been as low as 5.29 for much of the holiday period. Death counts, however, tend to lag movements in new-case numbers by as much as six weeks, and reporting of fatalities has been somewhat intermittent over the holiday period.

Harris said that the death rate among COVID patients was around 2% during previous surges, but the rate has been about 1% early in the omicron surge. Still, the much higher number of infections under omicron means that many people still will die, if that percentage holds up over the next few weeks.

Jefferson County has been hard hit by the rapid increase in cases. The 7-day average of new cases topped 1,000 per day for the first time on Dec. 31 and stands at 1,479 as of Wednesday. But just five deaths due to the virus were reported in the past week.

BirminghamWatch uses data for its analyses provided by the Alabama Department of Public Health and the Alabama Hospital Association.