COVID hospitalizations’ ‘decoupling’ matters because severity does not increase with cases
HONOLULU (KHON2) – As the number of COVID cases in Hawaii increases, hospitalizations are not increasing at the same rate – a trend seen elsewhere in the world where the omicron wave struck before Hawaii. Always Investigating is exploring the data and what it means for this phase of the pandemic.
COVID should always be taken seriously because even a fraction of people in need of hospital care can grow into large numbers as the overall number of cases increases. But experts said the reduced severity of the cases shows we are flattening the elusive curve.
Receive news wherever you are with KHON 2GO, KHON’s morning podcast, every morning at 8 a.m.
With several thousand cases a day, Hawaii is bracing for the worst-case scenario if hospitals are overrun. Hospitalizations tend to delay positive counts for up to two weeks.
Still, with more than 21,000 cases in just two weeks, the number of hospitals as of Dec.31 was 141 – 18 in intensive care and 10 on ventilators.
âThis follows what we are seeing in other places that have been exposed to omicron before us, such as South Africa or Europe,â explained Professor Monique Chyba of the University of Hawaii at Manoa with HiPAM. “Hospitalizations are less than they were with Delta.”
the Hawaii Pandemic Applied Modeling Working Group (HiPAM) is a team of scientists, mathematicians and epidemiologists from Hawaii modeling COVID trends. They show a dizzying projection of the number of cases that have been largely accurate, but hospitalizations are lower than even their most optimistic forecasts, and even they wonder why.
âIn the beginning, we were working with data and numbers from other geographic locations, and while you can sort of transpose it, it’s a different population, different demographics,â Chyba explained. âSo it’s very difficult. And we’re seeing it (lower than expected actual hospitalizations) – yes, that’s great. The dots are below and this is where you want to be.
This trend is called “decoupling” where the trends in cases change at a different rate than hospitalizations – it is more pronounced with omicron. But it has happened throughout the improvement of our collective ability to manage, treat and vaccinate against the virus.
When COVID first struck in 2020, our first shock wave came that summer, with a peak of 354 cases in a single day, followed weeks later by a peak of 315 hospitalized at the same time – an 88% correlation of the worst case day of that wave to his worst day in hospital.
In the second wave in January 2021, a peak in cases of almost 300 per day was followed by a hospital peak of 129 – a correlation of only 44%, thus representing a peak case-hospitalization decoupling of half of the last wave .
The third wave in fall 2021 saw hospitals surpassed with 473 maximum hospitalizations which followed a peak of 1,600 daily cases – as bad as that was, the case-hospitalization correlation had decoupled to 29%.
Wave four, the peak to date is 3,500 and 141 hospitalized. This is a maximum case-hospitalization correlation of only 4%. We are probably still on the rise of this wave, and it is not known how far it will go.
âWe’re looking at a peak (case) by, I would say, the second half of January,â Chyba said. “And then with a little delay, like the end of January, for the probable (peak) hospitalization.”
It’s a reminder of why omicron shouldn’t be taken lightly, as even one or two percent of going to the hospital out of tens of thousands of cases could crush the healthcare system.
âBecause there are so many cases, the chances of you going to the hospital will be less,â Fan said, âbut there will always be many, many cases that will go to the hospital. that neighboring islands have a much lower hospital capacity to begin with. “
Experts said severity measures, such as hospitalizations, should take center stage for data highlights and policy interventions.
“The cases are not the right goal post or the right benchmark for us to be a measure of panic or dismissal,” Fan continued. âWe should try not to go both ways, and say ‘oh, it’s alright’ with 3,000 cases or the same measure of being ‘oh, my God, the heavens are falling on us’ with 3,000 cases.’
Find more COVID-19 news: cases, vaccinations on our Coronavirus News page
If there is good news, what goes up must come down.
âThe silver lining, I would say, from my perspective, is that, as we saw with the delta during the summer, you go up quickly, but you also go down quickly,â Chyba said. âWe are moving faster than we did with the delta. However, once we start to break this transmission, we will go down very quickly. “