Alabama COVID Hospitalizations Multiply More Than Tenfold Since Thanksgiving, Closing in on Pandemic Highs

SARS-CoV-2 virus particle. Source: National Institute of Allergy and Infectious Diseases, CC BY 2.0 via Wikimedia Commons.

The recent spike in omicron-derived COVID-19 cases has far exceeded any other new-case numbers since the pandemic began in early 2020. Omicron often has had symptoms that are mild or even non-existent, keeping victims out of hospital beds — until the new year arrived.

Since then, admissions of patients with COVID have skyrocketed, whether the virus was the primary problem or was found when a patient sought treatment for another issue. Across Alabama, hospitals report 2,946 patients who are COVID-positive as of Tuesday, more than 10 times the 271 patients reported on Thanksgiving Day.

The current totals are approaching the record for the pandemic set Jan. 11, 2021, when 3,074 inpatients were positive for the coronavirus. The highest total during the delta surge was 2,890 on Sept. 1; the omicron surge total passed that mark Tuesday.

But while the current total is fast approaching a record, in terms of the percentage of patients infected who have to be hospitalized, it’s still quite a bit lower than during the other two surge periods.

Because omicron is much more contagious, it has infected many more people than either delta or alpha. But more of those people have suffered mild symptoms or none at all, and the current 7-day moving average of new cases is hovering around 13,000 a day, compared to a high of just over 5,500 on Sept. 1. So the number of hospitalized patients is about 22% of the daily new case average now, compared to 72% last January or more than 52% on Sept. 1.

Put another way, inpatients account for a much smaller percentage of a much larger number of cases than in the past.

Dr. Sarah Nafziger, vice president for clinical support services at UAB Hospital, said that what they are dealing with in terms of raw patient numbers and impact on the hospital staff “is far beyond any previous surge.”

UAB’s previous peak was with the surge centered around the Christmas holidays in 2020, carrying over into January 2021. Nafziger said currently about a quarter to a third of COVID-positive patients, plus those who are still hospitalized and in need of care but no longer contagious, are critically ill and on a ventilator. Another group of patients are on high-flow oxygen therapy and might still be in intensive care units at other hospitals.

“Just like in previous surges, we have a big chunk of really sick patients with COVID that’s putting a burden on our resources. It takes resources away from other things (that staff) would normally be devoted to, such as beds with someone who is recovering from heart surgery or cancer treatment,” Nafziger said, adding that most of those infected have not been vaccinated.

For instance, when a COVID patient has to be taken to another part of the hospital for a procedure such as an X-ray, the process isn’t as simple as just putting someone on a cart. Nafziger said that staffers have to plan ahead to make certain that COVID patients don’t endanger others who haven’t been infected. A normally simple move can then become complicated, tying up additional resources.

As of Tuesday, UAB Hospital has 259 patients with active COVID infections, plus 87 who are no longer positive for the virus but still in need of hospital treatment. Of those patients, roughly 40% came to UAB for treatment of some other issue, particularly unplanned reasons such as accidents or for other reasons such as childbirth, and were discovered to be infected with COVID after admission.

The state’s hospitals are having a difficult time dealing with the latest surge, not just because of the sheer number of patients but also of how omicron has affected their own workers.

Dr. Sarah Nafziger. Source: UAB

“The thing that’s really different about this surge is the tremendous impact it’s had on our staff. It’s very demoralizing,” Nafziger said. “We’ve had skyrocketing numbers of staff members who personally are affected with COVID and who have infections. Most those were from being out for the holidays, their kids were out and about, people gathering for different things. Our staff is just like everybody else — they got infected, too. So we have a large number of employees out sick. … That impacted our staffing much more than it has in previous surges.”

However, staff members who are infected are usually out of action for shorter periods of time than during previous surges, many for as little as a week, Nafziger said. That’s because the symptoms of the omicron variant are typically less severe than alpha or delta.

In Tuesday’s report by the Alabama Hospital Association, there were 1,530 intensive care beds throughout the state and 1,463 of those were occupied, technically leaving just 67 beds free.

Of the occupied beds, 586 are holding COVID patients.

Out of AlaHA’s nine regions, two are exceeding official ICU capacity. The East Central Region is 13% over capacity, while the Southeast Region is 3% over. Jefferson County is close to reaching capacity, with 5% of all beds vacant.