COVID Case Counts May be Losing Importance Amid Omicron

The explosive increase in U.S. coronavirus case counts is raising alarm, but some experts believe the focus should instead be on COVID-19 hospital admissions. And those aren’t climbing as fast.

Dr. Anthony Fauci, for one, said Sunday on ABC that with many infections causing few or no symptoms, “it is much more relevant to focus on the hospitalizations as opposed to the total number of cases.” Other experts argue that case counts still have value.

As the super-contagious omicron variant rages across the U.S., new COVID-19 cases per day have more than tripled over the past two weeks, reaching a record-shattering average of 480,000. Schools, hospitals and airlines are struggling as infected workers go into isolation.

Meanwhile, hospital admissions averaged 14,800 per day last week, up 63% from the week before, but still short of the peak of 16,500 per day a year ago, when the vast majority of the U.S. was unvaccinated. Deaths have been stable over the past two weeks at an average of about 1,200 per day, well below the all-time high of 3,400 last January.

Public health experts suspect that those numbers, taken together, reflect the vaccine’s continued effectiveness at preventing serious illness, even against omicron, as well as the possibility that the variant does not make most people as sick as earlier versions.

Omicron accounted for 95% of new coronavirus infections in the U.S. last week, the Centers for Disease Control and Prevention reported Tuesday, in another indication of how astonishingly fast the variant has spread since it was first detected in South Africa in late November.

Daily case counts and their ups and downs have been one of the most closely watched barometers during the outbreak and have been a reliable early warning sign of severe disease and death in previous coronavirus waves.

But they have long been considered an imperfect measure, in part because they consist primarily of laboratory-confirmed cases of COVID-19, not the actual number of infections out there, which is almost certainly many times higher.

The daily case counts are also subject to wild swings. The number of new cases recorded on Monday topped an unprecedented 1 million, a figure that may reflect cases that had been held up by reporting delays over the holiday weekend. The seven-day rolling average is considered more reliable.

Now, the value of the daily case count is being called into question as never before. Case numbers seem to yield a less useful picture of the pandemic amid the spread of omicron, which is causing lots of infections but so far does not appear to be as severe in its effects.

Case counts have lost relevance, said Andrew Noymer, a public health professor at the University of California, Irvine.

“Hospitalizations are where the rubber meets the road,” Noymer said. “It’s a more objective measure.” He added: “If I had to choose one metric, I would choose the hospitalization data.”

Even hospital numbers aren’t a perfect reflection of disease severity because they include patients admitted for other health problems who happen to test positive for the coronavirus.

Keeping track of COVID-19 admissions can tell doctors something about the seriousness of the virus and also the capacity of hospitals to deal with the crisis. That, in turn, can help health leaders determine where to shift equipment and other resources.