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Connecticut’s COVID-19 Peak Could Still Be Weeks Away

Since overwhelming New York City in late December, the highly contagious omicron variant has seeped into Connecticut, spreading rapidly through the southern part of the state and then other corners as well.

Virus Outbreak-Connecticut
A researcher at Protein Sciences reaches for a vial in a lab, Thursday, March 12, 2020, in Meriden, Conn. The biotech company is currently researching a vaccine for COVID-19.
(AP Photo/Jessica Hill)
(TNS) - COVID-19 transmission in Connecticut is at its highest level of any time during the pandemic, and it might get worst before it gets better.

Since overwhelming New York City in late December, the highly contagious omicron variant has seeped into Connecticut, spreading rapidly through the southern part of the state and then other corners as well. As of Thursday, Hartford, New Haven and Fairfield counties were all averaging at least 200 daily cases per 100,000 residents.

Given how quickly COVID-19 numbers have risen and fallen in other countries where omicron has taken hold, experts say Connecticut can expect its outbreak to peak in mid- to late-January. Until then?

“We’re in for a rough few weeks,” Dr. Scott Roberts, associate medical director-infection prevention at Yale New Haven Health, said Thursday.

Here is what Connecticut residents can expect in the coming days:

COVID-19 case counts will continue to rise, likely until mid-January at least

Already, Connecticut is seeing record numbers of COVID-19 cases and an all-time high test positivity rate, as well as levels of hospitalization that are approaching those experienced in spring 2020.

For now, the surge shows no obvious signs of slowing, meaning more people will continue to get sick and hospitals will continue to fill up.

“We are bracing as a health system and really as a state for increasing positive cases and increasing people with COVID over the next few weeks until this peaks,” Roberts said Thursday.

If there’s any good news for Connecticut, it’s that other places that have experienced similar omicron variant outbreaks have seen cases slow about as fast as they rose. In South Africa, where omicron was first detected, cases spiked for just under a month before decreasing. Denmark has seen a similar pattern, while the United Kingdom and even New York City have seen some encouraging signs in recent days.

So when might Connecticut reach its COVID-19 peak and begin to see cases slow? Experts say that could come as soon as next week or not until later this month.

Dr. Ajay Kumar, chief clinical officer at Hartford HealthCare, said he expects the numbers to level off quickly.

“We think we are going to continue to have some increase in our hospitalization and community spread over the next couple of days and after several days — not weeks — we will see a decline in those numbers,” he said.

Others are less optimistic.

Pedro Mendes, a computational biologist at UConn Health who has modeled the COVID-19 pandemic, said his models forecast Connecticut’s COVID-19 hospitalizations will surpass spring 2020 levels before peaking between Jan. 15 and 20.

Dr. Ulysses Wu, chief epidemiologist at Hartford HealthCare, agreed that the state’s peak is likely at least a week or two away.

“The middle of January is when we really expect to see numbers start decreasing,” he said.

Wu said numerous variables make predictions difficult. Are fewer people gathering in large groups indoors now that the holidays are over? And to what extent will the omicron variant — which is more transmissible but results in less severe disease for vaccinated individuals — drive further increases in hospitalizations?

Dr. David Banach, hospital epidemiologist at UConn Health, said it’s tough to compare South Africa against the United States due to different demographics, different levels of vaccination and different levels of natural immunity.

“There’s some optimism that it may reflect what we saw in South Africa, but I think it’s too early to make definitive conclusions about that,” he said.

Unvaccinated people, those with underlying conditions will continue to face the greatest risk

One constant has remained through the last year of COVID-19 in Connecticut: enhanced risk faced by the unvaccinated.

Though the omicron variant evades vaccine protection better than previous strains did, unvaccinated people remain three times as likely to test positive for COVID-19 than vaccinated people, according to state numbers. Meanwhile, nearly 70% of people hospitalized with COVID-19 in Connecticut are unvaccinated, and the number is higher when looking specifically at people with severe symptoms.

Experts say people who have received not only their initial vaccine doses but also a booster shot are particularly well-protected. Hartford HealthCare officials said last week that of dozens of COVID-19 patients in their intensive care units, not one had been boosted.

Yale New Haven Health has had a similar experience, Roberts said. Only about 20% of patients hospitalized with COVID-19 are vaccinated, he said, and of those very few have had a booster shot.

“It still remains quite rare for a patient to be admitted to the hospital who is boosted against COVID,” he said.

When a boosted patient does arrive at the hospital with COVID-19, Roberts said, it is typically someone whose immune system is suppressed due to either medication or an underlying condition.

Banach said he sometimes sees patients, usually older, for whom COVID-19 combined with another condition to trigger severe illness.

“Imagine a patient who’s elderly with diabetes who comes in and has relatively mild COVID illness but it’s enough to tip them over because of their diabetes into a diabetic-related issue,” Banach said. “Or for patients with congestive heart failure, a mild respiratory illness can tip them over into a severe manifestation of their underlying illness.”

Young, healthy people who have received booster shots, on the other hand, can still catch COVID-19 and can still spread it to people more vulnerable than they are, but they are not likely to land in a hospital.

Major restrictions to slow the spread appear unlikely

Despite pleas from health care workers and state legislators and a petition signed by more than 1,500 residents demanding a statewide mask mandate, Gov. Ned Lamont has given no indication that he will impose new pandemic-related restrictions.

This past week, Lamont downplayed the severity of Connecticut’s COVID-19 outbreak, even while announcing the highest single-day positivity rate the state has ever recorded.

“I know, 24% infection, oh my gosh, but I think we have the tools now to continue living our life despite COVID, and I think we can continue living our life safely,” the governor said Tuesday. “Twenty-four percent infection rate is lousy and may get worse before it gets better. But we have the tools in place, provided you take advantage of the tools … to keep you safe and keep going about our lives.”

Lamont has required state employees to get vaccinated and recently arranged for free COVID-19 tests and N95 masks to be distributed to state residents. For now at least, it doesn’t appear that there’s more to come.

Some municipalities — including all four of the state’s largest cities — currently have indoor mask requirements for all residents, but local officials have limited authority to impose other restrictions.

By and large, Connecticut’s leaders have chosen to prioritize a sense of normalcy — at least for residents who feel comfortable embracing it — in place of aggressive action that might slow COVID-19′s spread.

Without official restrictions in place, public officials and health experts encourage individuals to wear masks and avoid crowded gatherings.

“Whatever people can do to be safe and weather this out, because now is not the time to be hospitalized,” Yale New Haven’s Roberts said.

Hospitals will scramble to find more space, staff

Already, Connecticut hospitals are packed, leading to long emergency room waits for patients and exhausting workloads for staff — more than 1,000 of whom recently had to miss time due to COVID-19 infections of their own.

Hospital officials say they have weathered the surge by converting unused space into intensive care units, moving patients to facilities where beds are available and reassigning staff to help treat those with COVID-19.

“Ultimately the hospital is only so big, so one of the challenges is going to be what do we do if that surge continues and we simply don’t have the space,” Roberts said. “Is there a procedural area where there are five open rooms and [we could] put COVID patients there? Or if two people have COVID could they go in the same room?”

Hartford HealthCare officials say they have expanded their hospital capacity by treating more patients through telehealth, thereby freeing up physical space in their facilities.

“Every patient that we’re able to treat outside of the hospital is a bed that we’re able to save in the hospital,” said Keith Grant, Hartford HealthCare’s senior system director for infection protection.

Meanwhile, Lamont announced Thursday that the state will now encourage nursing homes to accept COVID-positive patients who are discharged from hospitals, thereby shifting some burden away from health care facilities.

For hospitals, the last-resort option may be canceling certain procedures or other services that are not entirely time-sensitive — a decision that would free up space and staff but would also dent health system revenues.

“There’s a lot of discussions about postponing scheduled surgeries and other modalities we could do to weather the storm,” Roberts said. “I’m not sure that’s the route leadership is going to go, but everything is on the table.”

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