Public health, hospital leaders open to looser COVID restrictions as cases and hospitalizations decline

COVID-19’s omicron surge is loosening its grip on many of the country’s hospitals, leading several states to relax mask requirements and other restrictions.

According to Centers for Disease Control and Prevention (CDC) data, new hospital admissions of patients with confirmed COVID-19 nationwide have steadily dropped nearly 44% from their peak seven-day average of 21,622 on Jan. 15 to 12,099 as of Feb. 6.

Current hospitalizations of patients with confirmed COVID-19 are similarly trickling downward. As of Feb. 8, the seven-day average has fallen about 32% from mid-January’s peak of 146,534 to 99,535, according to the agency.

The drop in hospitalizations is consistent across most of the country, according to a New York Times data analysis, with the exception of three states: Oregon (5% 14-day increase), Montana (5% 14-day increase) and Idaho (1% 14-day increase).

The data from hospitals strike a middle ground between the country’s plummeting daily COVID-19 case count and daily COVID-19 deaths, with the latter generally lagging changes in the other pandemic measures.

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At the peak of omicron in mid-January, the CDC received reports of a seven-day average of 805,624 new COVID-19 cases per day. Those reports have dropped over 70% to a seven-day average of 230,602 as of Feb. 8.

Reported deaths during the current wave have held steady since late January at roughly a seven-day average of about 2,300 to 2,400 per day. This is above the delta wave’s peak seven-day average of 1,924 daily deaths and well below the 3,421 recorded in January 2021.

Altogether, the numbers suggest what government, public health and hospital leaders say they hope is a multimonth lull in the COVID-19 pandemic or, more optimistically, a sign that the disease is beginning to settle in alongside other respiratory diseases like influenza as an endemic illness.

This week Anthony Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases and chief medical advisor to the president, told reporters that he believes the “full-blown pandemic phase” of COVID-19 is reaching its end and that many national-level public health restrictions such as indoor mask-wearing could be lifted during the coming months in favor of more localized guidance.

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The declines in cases and hospitalizations saw the governors of several states including New Jersey, California, Delaware, Connecticut and New York signal plans to lift mask restrictions or allow them to lapse in the coming weeks.

Facing similar pressures, the White House is reportedly weighing plans to shift its pandemic policies toward less disruptive alternatives, although CDC Director Rochelle Walensky, M.D., told press that the CDC is not currently announcing any changes to its masking policies.

Ashish Jha, M.D., dean of the Brown University School of Public Health, wrote in a tweet that although he leans toward waiting “a few more weeks” for further hospitalization drops before lifting mask mandates, he understands the pressure on government leaders and supports giving the public a “reprieve” on these policies when cases are declining.

“Over [the] next year or so, I can imagine masks used intermittently as need,” he wrote. “In a COVID surge next winter, a mayor might call for masking for a month to reduce spread. Masks on as surges start, off during quiet times.”

Raed Dweik, M.D., chairman of the Cleveland Clinic’s respiratory institute, told the AP this week that the system’s COVID-19 cases dropped to 280 from a pandemic high of 1,200. He said he hopes the dip in cases gives hospitals a chance to recuperate while keeping their guard up for a potential mutation and new wave.

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“We’ve had our hopes dashed before that. ‘Oh, this is the end of the pandemic and this virus,’” he told the AP. “Every time we say something like this, it’s kind of laughed at us, and it comes back with a new variant.”

In a Thursday interview with the Washington Post’s Dan Diamond, University Hospital President and CEO Shereef Elnahal, M.D., stressed that the challenge of omicron for his hospital and others wasn’t as much the incoming patients as it was the infections among staff.

Alongside personnel support from the National Guard, he credited the CDC’s controversial decision to reduce the out-of-work window for infected healthcare workers from 10 to five days as one of the “most helpful moves the federal government made to allow us to withstand this surge.”

The New Jersey hospital is now “in a much better place” with just under 200 people out of work, as opposed to the 350 to 400 it saw at omicron’s peak in January, he said.

“We’re not seeing anywhere near the case rates in our employees that we were seeing even just two to three weeks ago,” he said. “Again, this portends a good period of time, hopefully, where we will have a lull. But we should not be taking our eye off the ball in terms of preparation for the next wave. That means really establishing and recalibrating our metrics to understand when restrictions do need to be in place [and] making sure that we deliver oral therapeutics as widely as possible.”