As an E.R. Doctor, I Fear Health Care Collapse More Than Omicron

As the Omicron tsunami crashes ashore in New York City [1], the comforting news that this variant generally causes milder disease overlooks the unfolding tragedy happening on the front lines.

As an emergency room doctor fighting this new surge, I am grateful that vaccines and a potentially less lethal variant have meant that fewer of my patients today need life support than they did at the start of the pandemic. In March 2020, nurses and doctors rushed between patients, endlessly trying to stabilize one before another crashed. Many of my patients needed supplemental oxygen and the sickest needed to be put on ventilators. Many never came off them. Our intensive care units filled beyond capacity, and yet patients kept coming.

Summary

Thankfully, this wave is not like that. I haven’t needed to put any Covid-19 patients on a ventilator so far. And the majority of patients haven’t needed supplemental oxygen, either.

We also have good treatment tools: cheap, widely available medications like steroids have proved to be lifesavers for Covid-19 patients. We now know that administering oxygen at high flow rates through the nose substantially improves patient outcomes. Although currently in very short supply, oral antivirals are highly effective at reducing Covid hospitalizations. The greatest relief has come from the vaccines, which keep people out of the hospital regardless of the variant. Yet these tools are still not enough to slow the rapid influx of patients we’re now seeing from Omicron, and the situation is bleak for health workers and hospitals.

In New York City, hospitalizations have tripled in the past few weeks alone. New Jersey is seeing its highest number of hospitalizations of the whole pandemic. In all, nearly every state and territory is seeing Covid admissions on the rise.

For most people — especially the vaccinated — Omicron presents as a sore throat or a mild inconvenience. But among the many patients in our hospital, the situation is serious. On a recent shift, I still saw “classic” Covid-19 patients, short of breath and needing oxygen. All of them were unvaccinated. I also saw elderly patients for whom Covid rendered them too weak to get out of bed. I treated people with diabetes in whom the virus caused serious and potentially fatal complications.

[1] This is what a sample footnote would look like.

[2] This is what another sample footnote would look like.