Travelers wait for a shuttle but to arrive at the Los Angeles International Airport onMonday, Dec. 20, (AP Photo/Jae C. Hong)

It is not yet time to panic over omicron.

But health officials are concerned that COVID-19 cases are shooting up in many places, and they implore folks to use their smarts when celebrating this holiday season.

“We’re not going to be exempt from the omicron variant,” said Andrew Noymer, an epidemiologist and demographer at UC Irvine whose crystal ball on the pandemic has been unnervingly accurate. “Cases will go up eventually. Hospitalizations will go up accordingly. The crystal ball is still a little fuzzy, though: It’s not at all clear exactly when it will peak, or how bad the peak will be.”

Stunning federal data updated Monday, Dec. 20, found that omicron has raced ahead of other variants in the U.S. and accounted for nearly three-quarters of new infections last week. Nationwide, omicron fueled 12.6% of new cases for the week ending Dec. 11, and 73.2% of new cases for the week ending Dec. 18.

“We will likely see COVID-19 cases continue to surge over the next month or so,” said Dr. Nancy Gin, regional medical director of quality for Kaiser Permanente Southern California, in a statement. “With the highly contagious omicron variant in our community, we are seeing rapid escalation of the number of positive tests related to that variant.”

Hospitalizations for severe COVID-19 cases are up about 20% over the past three weeks at Kaiser Permanente, which operates 15 hospitals and has 4.8 million members in Los Angeles, Orange, Riverside and San Bernardino counties. Gin said there’s adequate staffing to handle the situation right now, and some capacity for a modest surge.

“While we do not expect a surge of the magnitude of a year ago, were that to happen, staffing would be a more significant issue,” she said.

Going up

Julio Valladares, a 46-year-old COVID-19 patient, struggles to breathe while talking to a nurse at Providence Holy Cross Medical Center in Los Angeles, Tuesday, Dec. 14, 2021. (AP Photo/Jae C. Hong)

Omicron is far more contagious than the delta variant, but delta appears to remain the dominant strain in California — for now, anyway. Consider:

Los Angeles County reported 1,266 new and suspected COVID-19 cases on Nov. 17, and nearly triple that — 3,512 — on Dec. 19.
Orange County reported 341 cases on Nov. 17, and 449 a month later.
Riverside County reported 328 cases on Nov. 17, and 585 a month later.
San Bernardino County reported 222 cases on Nov. 17, and 536 a month later.

“California and the nation are entering the winter wave,” said Dr. Regina Chinsio-Kwong, Orange County’s deputy county health officer, by email. “So far, Orange County cases have been increasing, but hospitalizations and Intensive Care Unit rates remain steady.

“We expect to see more omicron cases, and higher cases overall of COVID-19 compared to previous surges. Hospitalizations and deaths from COVID-19 will likely predominantly occur amongst those who are unvaccinated, or partially vaccinated.””

Jose Arballo Jr., a spokesman for the Riverside University Health System, sees the rising numbers in the bigger picture.

“Overall, we are not really seeing a big jump, especially when you compare this year’s numbers to last year,” Arballo said by email. “Last year, we had 1,239 COVID hospitalizations compared to 317 today, (and) 242 in ICU last year compared to 82 today.”

Though COVID cases and hospitalizations are up slightly, Riverside County’s overall hospitalizations are up as well but have remained manageable, said Shane Reichardt, a spokesman for the Riverside County Emergency Management Department. COVID has accounted for about 15% of emergency department visits and 10% to 13% of total county hospitalizations.

Health care workers — some of whom say they’re short-staffed now — brace for yet another surge.

“Every day, nurses are told to care for 50 percent more patients than California’s safe nurse-to-patient staffing ratio law allows,” said Lourdes Morales, an ICU registered nurse who’ll be picketing at Alhambra Hospital Medical Center, in a prepared statement. “Having 50 percent more patients means I am responsible for an unmanageable number of caregiving responsibilities, many of which are critical for safe patient care.

“I go home feeling guilty, exhausted, and morally distressed knowing my patients needed more. I don’t feel like I’m giving the care that my patients deserve.”

Staffing challenges have been widespread as workers battle an ever-changing but unrelenting public health crisis.

“Hospitals are working through staffing challenges, but those are related to a number of issues, including but not limited to COVID,” said Riverside County’s Reichardt. “The system for augmenting staffing that has been in use during COVID is still in place and remains available to hospitals as staffing needs arise.”

Meanwhile, in neighboring San Bernardino County, neither hospital capacity nor staffing are concerns at the moment, said spokesman David Wert.

Dr. Matthew Zahn, Orange County’s deputy county health officer, said officials know from previous surges that their hospitals can respond to a large increase in cases. “However, these previous waves strained our county’s health care capacity, and severely strained the health care workers who provided that care,” he said by email.

Travelers wait in line to get tested for COVID-19 at Los Angeles International Airport on Monday, Dec. 20. (AP Photo/Jae C. Hong)

Staying alive

One of the reasons omicron is so concerning is that it has mutated to at least partially evade immune systems — even those primed to battle the coronavirus by vaccination. The new variant spreads quickly through the vaccinated as well as the unvaccinated.

“But unlike last winter, we now have the power to protect ourselves,” said White House Coronavirus Response Coordinator Jeff Zients at a briefing Dec. 17. “Our vaccines work against omicron, especially for people who get booster shots when they are eligible.

“If you are vaccinated, you could test positive. But if you do get COVID, your case will likely be asymptomatic or mild,” Zients said. “We are intent on not letting omicron disrupt work and school for the vaccinated. You’ve done the right thing, and we will get through this.

“For the unvaccinated, you’re looking at a winter of severe illness and death for yourselves, your families, and the hospitals you may soon overwhelm.”

Pfizer also has said that its investigational COVID-19 oral antiviral Paxlovid significantly reduces hospitalization and death in high-risk patients. The company is seeking emergency use authorization from the FDA, but it’s unclear how widely available it would be. It’s also many times more expensive than vaccines: Pfizer’s vaccine costs about $20, while the pills cost about $530.

“So, our message to every American is clear: There is action you can take to protect yourself and your family. Wear a mask in public indoor settings.  Get vaccinated, get your kids vaccinated, and get a booster shot when you’re eligible,” Zients said.

Millions of Californians, though, aren’t listening.

A child getting the first dose of Pfizer’s COVID-19 vaccine at Long Beach City College’s Pacific Coast Campus. (Photo courtesy of Long Beach Health Department)

Vaccine holdouts

In California, 78.3% of people age 5 and over have had at least one shot. But it varies widely by race and ethnicity, with Black residents having the lowest vaccination rates of the major groups.

While 94% of the state’s Asian residents have had at least one shot, just 68.7% of White, 60.4% of Latino and 57.8% of Black residents have, according to state data.

Vaccination rates also vary widely among counties.

In Los Angeles County, 87.7% of Asian residents have had at least one shot, along with 75.9% of White, 59.9% of Latino and 56.7 of Black residents.
Orange County has a small Black population, but it’s far more vaccinated than the state average for that group, while the number of vaccinated Latinos is considerably below the state average. Having at least one shot in O.C. are 94.6% of Asian, 70.4% of White, 69.7% of Black and 48.9% of Latino residents.
In Riverside County, 77.4% of Asian, 58.1% of White, 55.1% of Black and 51.8% of Latino residents have had at least one shot.
In San Bernardino County, 96.4% of Asian, 53.7% of White, 49.5% of Latino and 46% of Black residents have had at least one shot.

“We know that primary vaccinations and boosters make a big difference in preventing people from dying from COVID-19, so I am hoping we see a renewed interest to get vaccinated in the community,” said Kaiser’s Gin.

The worst-case scenario could look like last January in terms of the sheer number of COVID cases, but UCI’s Noymer expects deaths would be lower because of vaccination and booster shots. A best-case scenario would look more like the delta wave over the summer, and Noymer expects reality to split the difference and settle somewhere in the middle.

“There are still so many unknowns,” Noymer said. “There will be a winter wave for sure and it will be led by omicron, which will become the dominant variant the way delta did before it.”

It’s important to practice basic healthy habits, Riverside’s Reichardt said — covering coughs, frequent hand washing, staying home if you’re sick, using caution when it comes to large gatherings.

(Photo by Jeff Gritchen, Orange County Register/SCNG)

CDC Director Dr. Rochelle P. Walensky encouraged people to use “multi-layer prevention strategies” — masking in public indoor settings, keeping a safe distance from others, washing hands frequently, improving ventilation, and testing to slow transmission.

Those who are traveling over the holidays, or celebrating with large groups indoors, would be wise to invest in an N-95 mask and lots of hand sanitizer. Celebrating outdoors is preferable. And no indoor caroling or cheering the new year, Kaiser’s Gin said.

“I implore unvaccinated people to get vaccinated,” said UCI’s Noymer. “It’s not too late. I ask them to consider the tangible benefits of vaccination verses the psychic benefits of being able to brag that you’re still unvaccinated. People will not care, 10 years from now, about that. But they will care if you’re alive or dead.”

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