Omicron in Tennessee: COVID-19 cases up nearly 102% week over week, hospitalizations also rising – The Tennessean

New COVID-19 cases have surged in Tennessee in recent days, with at least one region of the state recording its highest ever infection levels amid the spread of the highly infectious omicron variant. 

Tennessee recorded a nearly 102% week-over-week increase of cases between Dec. 21 and Dec. 27, with 31,459 new cases recorded even with a drop in testing over the Christmas holiday. The state recorded 15,606 cases in the previous seven-day period. 

COVID-19 hospitalizations are also increasing in the state, though not at the dramatic rate seen in the case surge. Hospitalizations rose nearly 28% between Dec. 21 and Dec. 28, when 1,394 people were hospitalized with COVID-19. Critical patients requiring ICU care also increased by about 48% since the beginning of the month. 

Initial data may indicate some good news: Omicron appears to cause less serious disease in the fully vaccinated, despite its highly infectious nature. Experts say this could lead to a “decoupling” of case rates and hospitalization rates, which in previous waves have followed similar curves. But Dr. William Schaffner, a virus expert at Vanderbilt University Medical Center, said it’s too soon to determine how omicron will play out in Tennessee. 

Good news? Omicron may pass quickly, pose small threat to vaccinated, experts say

“We’re right in the middle of it, and most of us are not ready to draw hard conclusions. As you look at the country, it’s clear there are parts of the country that are being hit very hard,” Schaffner said, referring to overwhelmed hospitals in Michigan. “There is a concern that all of the traveling and all of the gatherings during the holiday season will catalyze transmission, so we would have more hospitalizations.”

Record-high case numbers could be on the horizon for Tennessee

The Nashville-Davidson region seven-day average is still below its previous record high — 817 in December 2020 — but its current case slope has charted a precipitous rise since mid-December. The region recorded a seven-day case average of 131.6 on Dec. 14. By Dec. 26, it was 612.7. 

The Memphis-Shelby region is currently seeing its highest ever infection levels, with a seven-day case average of 1,047 on Dec. 26. The region’s previous seven-day record was 849 on Sept. 11. But Memphis is not yet seeing a similar climb in hospitalizations, the Commercial-Appeal reported this week. 

Tennessee Department of Health Commissioner Dr. Lisa Piercey said last week current case numbers are likely a “significant underestimate” of the number of active infections in Tennessee right now, given the rise in at-home testing. Piercey said the department in January would transition away from daily case reporting, instead relying on weekly trend reports. 

“We believe the vast majority of at-home testing is not coming across our radar, so we don’t really know what the case burden is,” Piercey said. “That is going to continue and probably increase in the future, which is another reason daily reporting of numbers isn’t as relevant anymore.”

COVID testing: How easy will health insurers make it to get free, at-home COVID-19 tests?

Schaffner said case counts and positivity rates are still useful, offering a sense of the landscape of disease spread in Tennessee. But widespread vaccinations and 

“Looking at case counts and percent of tests that are positive still offer you some sort of sense” of the landscape of disease spread in Tennessee, Schaffner said. “If the proportion of tests remains pretty high, you’ve got to conclude that the virus is widespread. It’s simply infecting a lot of people. … But because omicron is capable of infecting even vaccinated people and making mild disease, a case is not (the same) from a public health point of view as it used to be. Back in the beginning, a case pretty much meant hospitalization. It certainly doesn’t mean that now.”

Flu season a concern with rising COVID numbers

Even if emerging trends back up anecdotal data seen in places like South Africa, which saw little threat from an early omicron wave to fully vaccinated people, omicron could spread widely enough to trigger a surge of severely ill patients. A new surge of hospitalizations would severely tax hospital systems that are struggling with understaffing and recovering from a deadly fall wave. 

Impact on hospitals: Southern hospitals have lost thousands of workers. Those who remain are exhausted.

Tennessee also remains one of the least vaccinated states in the country, leaving a large portion of Tennesseans at high risk for developing severe complications if infected.

Only 51% of Tennessee residents are vaccinated, and just 16% have received a booster shot, according to CDC data. 

More: In Tennessee, the death toll of the delta surge is higher than you think

“Even if omicron is less severe — even if the proportion of people that are severely ill is small — if it affects many, many people, it will still mean many people will require hospitalization,” Schaffner said. 

Schaffner is also watching another respiratory illness with concern: influenza. Flu vaccine uptake is below average this year, Schaffner said, likely a result of vaccine fatigue and other factors. But the same populations who are at risk of developing severe complications from COVID-19 are also vulnerable to the flu, and a combination of the two could swell hospitalizations. 

“The early CDC data looks as though we’re going to have at least a moderate influenza year, which means that influenza and COVID could come together to create a twindemic, and that would really strain our health care system,” Schaffner said.

Reach Melissa Brown at mabrown@tennessean.com.

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