Early signs suggest the Omicron wave is peaking in some parts of the US, but relief is far from near

By Deidre McPhillips, CNN

The Omicron surge has driven Covid-19 cases and hospitalizations to record highs in the United States. This week, however, officials have started to call out very early signs that the wave is peaking — or at least plateauing — in parts of the Northeast.

But case rates are still higher in this region than any other, and experts say it will be weeks before any change can be declared a trend.

The US overall is reporting an average of more than 786,000 Covid-19 cases each day, double what it was two weeks ago, according to data from Johns Hopkins University.

Yet, seven states have seen case rates start to level out, changing less than 10% week-to-week: New Jersey, Maryland, Ohio, Georgia, New York, Kansas and Mississippi. And in Washington, DC, they’re down 19% from last week. But only in DC has this been a pattern for more than a week.

On Tuesday, New York Gov. Kathy Hochul said that recent case trends are “a glimmer of hope.” She specifically noted an apparent plateau in average daily case rates in New York City.

The New York City health department’s data tracker indicates that while the test positivity rate is “stable,” case trends are “increasing,” as are hospitalizations and deaths. Also, data for the most recent 10 days is considered incomplete.

“We remain squarely within our Omicron wave in New York City, whether looking at cases, hospitalizations, or deaths due to COVID-19,” according to a statement from the city’s health department. “Although there are preliminary signs that the level of cases may be plateauing, we need to continue following the data closely in the coming days to discern the trend.”

In a briefing Tuesday, Philadelphia Health Commissioner Dr. Cheryl Bettigole said that judging from a collection of metrics, the city “may be at peak right now.” Data from the city shows that the test positivity rate dropped for the first time in months, from 45% positive in the last week of December to 36% in the first week of January.

But she noted that the trends remain in flux.

“The thing about watching things like this is you’re watching a graph, you’re doing your best to project, and there’s no certainty to any of this,” she said. “I think we’re going to see it wiggle over the next few days, and then it’s just a question of whether we can hold it together and manage not to expose ourselves.”

Not a clear trend yet

There are a few reasons it’s hard to declare what longer-term trends in case rates will be in real-time, Dr. Andrew Pavia, an an epidemiologist and infectious disease doctor with the University of Utah, told CNN.

Shortfalls in testing are one complicating factor.

“Testing resources are challenged in many places and there may be a plateau simply because there is not much more capacity for PCR tests,” he said. Many home tests are not counted in the officially reported figures either.

The most recent days of reporting are often an undercount as data catches up, but this may be especially exaggerated as the health care system is pushed to the brink.

“Overwhelmed and understaffed health departments could be falling behind in reporting,” he said.

Pavia also notes that there is day-to-day fluctuation as large testing events or certain superspreader events could bring in a large bunch of cases at one specific time.

“Consistency over a long enough period to determine a true trend is key,” he said. “The bottom line is that we need several more days of data before we can exhale in those jurisdictions.”

In New Jersey, average daily cases have dropped slightly in recent days, but weekly tallies are still up about 6% compared to a week ago, according to data from Johns Hopkins University.

“We’ve had two days of a slight downturn, so we’re looking at a silver lining,” New Jersey Health Commissioner Judith Persichilli said on Monday. “That’s why I keep telling everybody it’s a prediction. Omicron is a funny variant that shoots way up and then, for example in South Africa came down just as quickly. We can only hope that that occurs.”

New Jersey state epidemiologist Dr. Christina Tan said that the Northeast region may see cases peak before other parts of the US.

Pavia agrees that the patterns will shift from place to place.

“The duration of the spike is likely to be different in different places, related to speed of spread, superspreader events, vaccination and immunity levels, and the apparent rates will be influenced by testing capacity,” he said.

And states lagging in the timeliness and completeness of their reporting make it challenging to compare them.

A quick rise and fall?

Some models predict the United States could reach a Covid-19 case peak in the coming weeks. And trends from South Africa would indicate a drop that happens nearly as quickly as the rise.

But the situation in South Africa could be different than in the US for a number of reasons, including that a larger share of the South African population had prior infections and a larger share of the US is vaccinated and boosted, Dr. Rochelle Walensky, director of the US Centers for Disease Control and Prevention, said last week.

“I do think in places that we are seeing this really steep incline, that we may well see also a precipitous decline,” she said. “But we’re also a much bigger country than South Africa, and so it may very well be that we see this ice pick-shape, but that it travels across the country.”

And while there are indications that Omicron causes less severe disease than Delta, the sheer number of cases will likely lead to a wave of hospitalizations and deaths.

Hospitalizations have already reached a record high, with more than 151,000 people hospitalized with Covid-19 and near record numbers in ICUs, too, according to data from the US Department of Health and Human Services.

And after weeks of holding steady, deaths have also started to increase sharply. Nearly 1,800 people are dying of Covid-19 each day, up nearly 50% from a week earlier, according to JHU data.

“Let’s hope it is really the peak, and not a false summit, as we say in the mountains,” Pavia said.

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