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RI HEALTH

‘State of the Spread’ in Rhode Island shows dangerously overcrowded hospitals and Omicron variant worries

Health care leaders have said recently that a rise in COVID-19 cases and hospitalizations, although not as severe as previous waves, has strained their understaffed systems.

A medical team helps turn over a COVID-19 patient on a respirator inside the intensive care unit at Kent Hospital in December 2020 in Warwick, R.I.David Goldman/Associated Press

PROVIDENCE — Internal briefing materials shared with Rhode Island health and political leaders present a stark picture of overcrowded hospitals, with potentially worse to come if the Omicron variant of COVID-19 spreads more easily than previous variants.

The 54-page PowerPoint presentation, prepared by Department of Health contractors and dated Tuesday, shows that emergency departments at multiple hospitals right now are “dangerously overcrowded.” Hospitals use a tool called the NEDOCS score to rate emergency department overcrowding. The score goes up to 200. Anything above 180 is considered “dangerously” overcrowded. Roger Williams Medical Center, Landmark Medical Center, Kent Hospital, and the Miriam Hospital have been at 200 in the last week, the data shows. Rhode Island Hospital was at 198.

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Hospital leaders have said recently that a rise in COVID-19 cases and hospitalizations, although not as severe as previous waves, has strained their understaffed systems.

The “State of the Spread” briefing happens weekly. This most recent one stands out because it came as Governor Dan McKee prepares to announce his plan to deal with a rise in COVID-19 cases on Wednesday.

The briefing includes early Omicron modeling done by the state, which its authors acknowledge is a shifting and uncertain area — “sketchy,” they call it. They looked at what would happen if the Omicron variant spreads more easily simply because of a higher “R0,” or reproduction rate, without taking into account whether it can escape vaccines or previous infections.

The briefing stressed that the numbers presented in the model are “theoretical.” They don’t actually represent what they think will happen, but instead the rough outline of worst-case scenarios. What it does suggest, though, is that Omicron could send cases higher than they’ve ever been during the pandemic, even as hospitalizations and deaths could be proportionally lower than in previous waves because of vaccines.

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Positive tests for the coronavirus statewide peaked at above 1,600 during last December’s surge; the highest number so far this winter was 1,173, which was Monday. There are currently 266 people hospitalized with COVID-19, about half the peak from last winter. Hospital leaders have stressed that even lower numbers of COVID cases can be just as challenging as bigger waves when they’re so short-staffed.

Future models also will take into account whether immune escape — more people being susceptible even though they’ve been vaccinated or recovered from a previous infection — is also playing a role.

To be sure, previous modeling by the state has not always borne out. Former governor Gina Raimondo early in the pandemic released projections showing 2,000 to 4,000 hospital beds a day could be needed. It never went much higher than 500. COVID-19 has eluded not just efforts to stop it, but efforts to track its spread. And health leaders have since been careful to couch their analyses with uncertainty about the particulars, even as they warn about the general direction.

Nevertheless, the briefing illustrates with numbers and charts why health officials in Rhode Island are concerned about COVID-19, even without Omicron in the picture. Only two Omicron cases have been identified in the state so far as of Wednesday. The vast majority of COVID-19 cases are caused by the Delta variant of the coronavirus. And with that, cases are going up, hospitalizations are going up, and deaths are going up.

But there is encouraging news: It appears that the number of cases and the number of hospitalizations is diverging. In other words, proportionally fewer people who test positive for the virus that causes COVID-19 are needing to be hospitalized for it. The authors point to vaccine uptake as the reason.

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The presentation also shows that vaccines are helping keep people out of the hospital. People who did not complete a primary vaccine series are 11 times more likely to be hospitalized than people who did complete a primary vaccine series.

And people who got a booster shot are even more protected, the data suggests: People without a dose beyond their primary vaccine series are twice as likely to get infected with COVID-19, “which further emphasizes the significance of receiving an additional dose/booster beyond primary vaccine series,” the presentation says.


Brian Amaral can be reached at brian.amaral@globe.com. Follow him on Twitter @bamaral44.