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Omicron hasn’t peaked in U.S., surgeon general says, warning that ‘next few weeks will be tough’

Residents take self-administered coronavirus tests in Sacramento on Jan. 12. (David Paul Morris/Bloomberg News)
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The United States has not yet reached a national peak of the omicron variant, the nation’s top doctor said, urging caution even as the explosion of cases has started to plateau in some areas.

“We shouldn’t expect a national peak in the next coming days — the next few weeks will be tough,” U.S. Surgeon General Vivek H. Murthy said Sunday on CNN.

Omicron showing signs of peaking in D.C. and Maryland

Case counts fueled by the highly contagious variant have started to level off in some parts of the country hit early by the latest wave. In the District of Columbia and Maryland, experts said the omicron-fueled surge was showing signs of peaking in recent days, after a winter wave began to slow in other Northeast cities, including New York and Boston.

Omicron waves appear to slow in New York City, other major metropolitan areas

While that’s good news, Murthy said, “the challenge is that the entire country is not moving at the same pace. The omicron wave started later in other parts of the country.”

Coronavirus cases spiked globally in the first weeks of 2022, despite record-high vaccination rates. Here’s how the omicron variant took off. (Video: Jackie Lay, John Farrell/The Washington Post)

The national peak of this variant, whenever it is reached, is less important than the point when the decline starts to mean relief for health systems and the return of normal activity, said Gabe Kelen, chair of the department of emergency medicine at Johns Hopkins University.

Kelen, comparing the surge to flooding during a hurricane, said in an interview that talking about the peak of the variant is like asking, “Where’s the high-water mark?”

“But it doesn’t matter — the real question is: When will the water recede?” he said. “We’re at such high numbers that even as we’re coming down, we’re still overwhelmed. Hospitals will still be overwhelmed.”

Even in places where case numbers are starting to slow, he said hospital visits, admissions and intensive care unit numbers “are going to stay up, probably for several more weeks.”

The seven-day average of coronavirus cases in the United States exceeded 800,000 for the first time Friday, according to data tracked by The Washington Post, exceeding that level again on Saturday and Sunday. Also on Friday, 23 states set a record for seven-day average of cases, and all but three states had hit such a record within the previous week.

Ahead of the weekend, the United States reached a record for coronavirus hospitalizations, with a total of 159,589 people in U.S. hospitals with covid-19 on Friday.

The hospitalization count nationwide set records on six consecutive days after earlier this month surpassing the record of 142,273 hospitalizations set Jan. 14, 2021, during a previous peak of the pandemic in the country.

In the CNN interview, Murthy also stressed the impact of the surge on hospital resources.

“This is also why it’s so important that we are surging resources to hospitals that are struggling,” he said. “It’s why it’s so important that we all double down on precautions that we’re taking.”

He said a lesson from this surge is that “vaccines are still working very well to keep people out of the hospital and to save their lives. That’s why we want everyone to get vaccinated, to get boosted, as soon as they can.”

Kelen predicted that “assuming nothing new happens,” health systems in some parts of the country may start to see some relief in mid-February or into March.

“The rest of January and a good piece of February are going to be tough,” he said. “Though different parts of the country will see it differently.”

Justin Lessler, an epidemiology professor at the University of North Carolina at Chapel Hill, echoed that there will be “a few more tough weeks” even in places beginning to see a peak, in part because of how high case levels are.

“We’re up so high that it’s going to take several weeks to get down,” he told The Washington Post.

He stressed that the peak itself is no reason for people to let their guards down — it will take time for case levels to drop to where they were before the omicron-fueled surge began.

“So people should maintain caution and not start celebrating as soon as we see the peak,” he said.

Anthony S. Fauci, President Biden’s chief medical adviser, also warned in recent days not to necessarily count on the omicron variant to drive the coronavirus into an endemic phase.

“We do not know that — and we have to be openly honest about that,” Fauci said Monday during a virtual panel session of the World Economic Forum, when asked if this would be the year “we go from pandemic to endemic.”

Fauci explained that his definition of “endemicity” is when there is a “non-disruptive presence, without elimination.”

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He described multiple phases of a pandemic, where a “control” phase would mean that “you have it present, but it’s present at a level that does not disrupt society.”

“I think that’s what most people feel when they talk about endemicity, where it’s integrated into the broad range of infectious diseases that we experience — for example, cold-weather upper-respiratory infections, the parainfluenzas … the rhinovirus, the adenoviruses,” he said. “You want to get it at a level that doesn’t disrupt society.”

As to whether the omicron variant could drive the coronavirus into that phase, Fauci said, “I would hope that that’s the case, but that would only be the case if we don’t get another variant that eludes the immune response.”

“It is an open question as to whether or not omicron is going to be the live-virus vaccination that everyone is hoping for,” he added.

Lessler said scientists will be debating “exactly when the virus moves from pandemic stage to endemic stage for a while.”

He said people largely use “endemic as a proxy for the point when we don’t have to take exceptional measures to respond to waves of the disease.”

“It’s possible, and I sincerely hope that after omicron we’re in that zone. That’s completely plausible that that’s where we’ll be, but we can’t be sure of that,” he added. “And I think we have longer to wait before we can start to see this virus as a known, understood entity rather than something that is surprising us at every turn.”

Jacqueline Dupree and Andrew Jeong contributed to this report.

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