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What Can We Learn From Omicron?

by Kent Weber (2022-04-01)

The case numbers are now similar to where they were on Dec. 31-though they still remain higher than in any previous wave. The Northeast, including New Jersey, has seen a similar drop, while the nationwide case numbers have peaked but are falling more slowly, according to data analyzed by the New York Times. As the surge wanes, the country is likely to get a reprieve from high COVID-19 spread, particularly once the winter ends. The lull will provide an opportunity to prepare for the potential next wave, using lessons learned from the Omicron surge. Temple University chief medical officer Tony Reed. Federal and state governments found themselves reacting to the Omicron surge after it had begun. In some cases, including in Pennsylvania, aid is now coming to residents or hospitals-but not arriving until weeks after the peak. The lag, experts say, is because the infrastructure for it wasn't in place. Pennsylvania's acting health secretary, too, noted at a news briefing last week that it had taken some time to get funding in place for the state's recent initiatives. Courtney Boen, a University of Pennsylvania professor and sociologist. To meet the challenge, hospital officials around Pennsylvania used strategies developed throughout the pandemic, pivoting frequently and moving staff between jobs. In the next few weeks, some that have been overwhelmed hope to restart elective procedures, see patients who delayed care, and examine their responses. In interviews, public health experts and hospital leaders talked about what hospitals and the public need before the next surge. Continuing the push for vaccination is key, experts said, both in the United States and globally, because new variants will be able to emerge until most of the population is vaccinated. Data from the Omicron surge show that people who had received booster shots were highly protected from severe cases and hospitalization. A lull will provide an important window for vaccination efforts, allowing people time to complete immunizations before the next wave. It takes several months to get all three shots, so people who need first, second, or third doses should start now, experts said. County, state, and federal governments' efforts to improve vaccine access and outreach and employer vaccine requirements remain key, experts said. Some also recommended state or federal vaccine mandates. Jennifer Kolker, a public health professor at Drexel University. As Omicron infected even people who were vaccinated, wearing masks again became paramount. Now, experts said, communication is essential to help the public better understand when to wear masks and to combat confusion and fatigue. The public should view taking precautions as "good not just for me as an individual, but it's good for the community that I'm around every day, and it's good for my region," said Jack Lynch, CEO of Main Line Health. And states should consider imposing mask policies tied to virus transmission levels, experts suggested. That would mean a mask mandate would automatically go into effect if another surge arrived but would be dropped as soon as case spread improved. During the surge, hospitals often had nowhere to send patients who needed further recovery but were ready to be moved out of acute care wards. Not being able to transfer patients to nursing homes. Rehabs because of a lack of available beds or staff can cause a backlog of patients in emergency rooms. Strengthening that system, known as post-acute care, before the next wave is critical, said several hospital officials. Pennsylvania is aiming to address that temporarily with eight overflow sites that will take patients from hospitals. The sites will be at existing skilled nursing facilities; they'll open sometime in February and operate for about two months, a spokesperson said. Up to four more sites will open later in February. That type of aid "really would be a big help," said Donald Yealy chief medical officer at UPMC. But hospitals needed the aid a few weeks ago, Geisinger Health chief medical officer Gerald Maloney said last week. Increasing access to testing, masks, and other supplies is also critical. During the lull, a plan should be established, experts said, that would allow measures like the federal government's plan to provide free at-home tests to households to take effect more quickly. And after Omicron, it may be more politically palatable, Penn's Boen suggested. Having already seen an influx of patients who put off medical care earlier in the pandemic, doctors will also use the coming months to treat patients who need overdue care. That also includes hospitals resuming elective surgeries that were delayed during the surge. Solving the health-care staffing crisis that is impairing hospitals nationwide is one of the most urgent needs, short- and long-term, but possibly among the toughest to address. Hospitals are hoping to hire over the next several months, but with so many workers having left, "that pipeline is going to take time to rebuild," said Yealy of UPMC. And hospitals, which have partly weathered the surge by moving workers between jobs, could potentially reconsider how they use their workforce, Yealy said. They also may craft new contingency staffing plans or seek ways to relieve exhausted workers. Matthew Ferrari, director of the Center for Infectious Disease Dynamics at Pennsylvania State University. Meanwhile, Gov. Tom Wolf's administration offered what acting Secretary of Health Keara Klinepeter called "a short-term fix" last week, launching a "strike team" program allowing hospitals to request extra workers for seven- to 14-day periods. Since its start, the pandemic has laid bare the gaps in public health investment and infrastructure. More government funding would put public health entities in a stronger position for the next crisis, experts say-whether it means they have better capacity to open testing sites or more funding to cover higher supply costs and salary increases. Unlike the past, where we didn't know what the future was and we didn't know how bad it could be," said Ferrari, of Penn State, "now we don't know what the future could be, but we know how bad it can be.

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