New York City health systems say they’re prepared for winter COVID upswing and omicron variant

COVID-19 positivity rates have been increasing in the city and state in recent months, but the city’s health systems said cases have been within their capabilities to handle. They added that even if the omicron variant adds a surge on top of Delta, they do not anticipate any disruptions in supplies or services downstate.

As of Sunday, the state’s seven-day COVID-19 test positivity rate average exceeded 4%—a level last seen around May.

“This upswing hasn’t been surprising,” said Dr. Bruce Lee, professor of health policy and management at the CUNY Graduate School of Public Health. Evidence suggests respiratory viruses increase in transmission during drier and colder weather, Lee said, and people staying indoors more as COVID precautions relaxed probably drove rates up.

“Public health planners had already anticipated a winter surge,” he said.

But local health systems cited adequate capacity to handle the recent increase in cases, especially downstate. The city’s seven-day positivity rate was about 2%, according to state data.

“We’re not even close to filling up our capacity that we saw in spring last year,” said Dr. Bruce Farber, chief of infectious diseases at Northwell Health. As of Monday, the Long Island health system was on average at 82% capacity. The majority of recent COVID cases have been unvaccinated individuals, but there was no need to curtail any services, Farber said.

A big part of the ease had to do with experience, said Dr. Laura Iavicoli, assistant vice president of emergency management at NYC Health + Hospitals.

“This looks like the beginning of a fourth wave,” Iavicoli said, “and given our modeling, it looks like we will not surpass two-thirds of what we saw in the third wave this summer.”

Gov. Kathy Hochul’s declaration of a state of emergency, permitting hospitals to implement a flex and surge strategy and cancel elective procedures if needed, was probably less relevant to downstate hospitals, said Dr. Brian Bosworth, chief medical officer at NYU Langone Health.

“The governor said she wanted the flex to help hospitals that were in danger of running out of beds adjust capacity,” Bosworth said. “That seemed to concern mostly institutions upstate.”

Local health systems also said they had adequate supplies and personal protective equipment for the current surge and beyond.

Dr. Bernard Camins, medical director of infection prevention at Mount Sinai Health System, said the institution had a stable supply since the summer of last year, having drawn lessons from the shortage experienced during the spring surge of 2020.

What local institutions are keeping an eye out for, however, is how the omicron variant plays out in the city.

“It’s too early to say omicron will cause a surge,” Lee said. Although early reports suggest it might have increased transmissibility compared with Delta, it is not clear it can outcompete the other variants circulating, he said.

“People were worried the episilon variant seen in California was going to spread nationwide, but that got outcompeted by Delta instead,” he noted.

“One thing is clear is that the recent upswing is over 99% Delta,” Iavicoli said. That variant spread is still not over, she said, adding New Yorkers need to remain vigilant about masking as they head into the winter.

In case omicron does result in another surge, health systems are beginning preparations. NYU Langone is considering increasing the amount of variant sequencing it does with its positive tests, Bosworth said. Mount Sinai’s pathogen surveillance team is in the process of expanding its surveillance lab capacity to detect the omicron variant earlier, Camins said.

Bed capacity remains top of mind, and system-wide briefings on how to turn beds in units for COVID use have been distributed, Iavicoli said. Similarly, Northwell has playbooks available to extend its bed count to levels seen during the spring surge last year, to more than 5,000 beds, a Northwell spokeswoman said.

It’s never too early to start preparing for the omicron variant, Bosworth said, adding it could already be on our shores.

This story first appeared in our sister publication, Crain’s New York Business. 


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