Early Data Hints at Omicron’s Potential Toll Across America

The extremely transmissible Omicron variant is spreading quickly across the United States, making up a vast majority of U.S. cases after becoming dominant in the week before Christmas.

The Centers for Disease Control and Prevention has said that it is still too soon to predict the full impact Omicron could have on deaths and illness across the country. But data in some of the earliest-hit cities is beginning to show what the future could hold.

In cities hit early by Omicron, Covid deaths have begun to spike

Death trends are sharply up in these three cities but are not approaching last winter’s peaks quite as fast as increasing case rates. The chart below shows death rates shifted by three weeks to allow a clearer comparison of the peaks and dips in cases and deaths.

New York City
Covid-19 cases and deaths
50
100% of last winter’s peak
Deaths 21 days later
Cases on Dec. 18
Sept. 1, 2020
Sept. 22, 2020
Dec. 18, 2021
Jan. 8, 2022
Boston
Covid-19 cases and deaths
50
100% of last winter’s peak
Deaths 21 days later
Cases on Dec. 17
Sept. 1, 2020
Sept. 22, 2020
Dec. 17, 2021
Jan. 7, 2022
Chicago
Covid-19 cases and deaths
50
100% of last winter’s peak
Deaths 21 days later
Cases on Dec. 17
Sept. 1, 2020
Sept. 22, 2020
Dec. 17, 2021
Jan. 7, 2022
Source: New York Times database of reports from state and local health agencies. Note: Case and death curves show seven-day averages and are scaled to the highest number for each metropolitan area from Sept. 1, 2020, to Dec. 1, 2021.

In New York City, Boston and Chicago — cities with some of the country’s earliest Omicron surges — deaths have followed cases at a slightly reduced scale than in previous peaks. But because of the extraordinarily high case count, even a proportionally lower death toll from the current case curve in the United States could be devastating.

In early-hit cities, hospitals are seeing more patients testing positive for Covid-19 than at any time last year. Because of the sheer infectiousness of the Omicron variant, many who arrive at the hospital for other ailments test positive for the coronavirus. Some doctors have also said that patients who do have Covid as a primary diagnosis are faring better than during previous waves.

Even so, the number of Covid-19 patients who need intensive care or mechanical ventilation is approaching levels not seen since last winter. And the sheer number of patients is overwhelming to hospitals, where staffing shortages are putting health care workers under immense strain.

Health care workers were already quitting their jobs in record numbers before the Omicron wave. Now, many more are out sick with the hugely transmissible variant. With fewer staff members available to care for them, even a smaller number of patients can overwhelm emergency departments and intensive care units.

New York City
Hospitalized Covid-19 patients
50
100
150% of last year’s peak
Hospitalized
In I.C.U.
Ventilated
Jan. 1, 2021
Jan. 6, 2022
Washington, D.C.
Hospitalized Covid-19 patients
50
100
150% of last year’s peak
Hospitalized
In I.C.U.
Ventilated
Jan. 1, 2021
Dec. 30, 2021
Chicago
Hospitalized Covid-19 patients
50
100
150% of last year’s peak
Hospitalized
In I.C.U.
Ventilated
Jan. 1, 2021
Jan. 6, 2022
Shows seven-day averages. Sources: New York State Department of Health, Government of the District of Columbia, Chicago Department of Public Health. Anomalies from Washington, D.C., intensive care data have been smoothed.

Since vaccines became available, those who are vaccinated have been far less likely to be hospitalized with severe Covid-19 than those who are unvaccinated. Early data from New York City shows that the vaccination gap in hospitalizations became even wider during the first weeks of the city’s Omicron surge.

Vaccinated patients are more likely to experience milder disease, doctors have said, and a vast majority of Omicron patients who require intensive care are unvaccinated or have severely compromised immune systems.

New York City
50
100 Covid-19 hospitalizations per 100,000 people
Vaccinated
Unvaccinated
Oct. 9, 2021
Dec. 18, 2021
Note: Data is age adjusted. Recent data may be incomplete. Source: New York City Department of Health and Mental Hygiene.

Unvaccinated older people are particularly vulnerable to severe illness from Covid-19. About 12 percent of people in the United States ages 65 and older are not fully vaccinated, according to C.D.C. data. Many parts of the country where that rate is estimated to be highest are also places where surges fueled by the Omicron variant have not yet begun or are only just beginning. Those places include parts of the Midwest and the Mountain West and more rural areas across the country.

Estimated unvaccinated share of residents 65 and older
5
10
15
20
25%
No data
Miss.N.C.Okla.Va.W.Va.La.Mich.Mass.IdahoFla.Neb.Wash.N.M.P.R.S.D.TexasCalif.Ala.Ga.Pa.Mo.Colo.UtahTenn.Wyo.N.Y.Kan.AlaskaNev.Ill.Vt.Mont.IowaS.C.N.H.Ariz.N.J.Md.MaineHawaiiDel.R.I.Ky.OhioWis.Ore.N.D.Ark.Ind.Minn.Conn.
Sources: Centers for Disease Control and Prevention; Texas Department of State Health Services; Colorado Department of Public Health & Environment; Massachusetts Department of Public Health; U.S. Census Bureau | Note: No C.D.C. data available for some counties. Georgia and Vermont were excluded because more than a quarter of their data is missing. Data from Texas and Colorado excludes shots given by most federal agencies. On Dec. 9, 2021, the C.D.C. capped its vaccination rate figures at 95 percent. Note: Data is as of Jan. 7, 2022.