North Texas COVID-19 surge ‘is inevitable,’ Parkland chief medical officer warns

North Texas hospitals are bracing for a COVID-19 surge that could occur in early January, triggered by the new omicron variant, a highly contagious strain that emerged here less than two weeks ago.

An increase in the number of omicron cases and hospitalizations in North Texas “is inevitable,” said Dr. Joseph Chang, chief medical officer of Parkland Health & Hospital System. Parkland, which recently closed most of its COVID-19 units as cases declined, now expects to open more.

“We can see it coming, and I bet it will start to escalate here in the next week,” he said. “I would be very surprised if we didn’t have to reopen at least one or two of our COVID services.”

On Monday, Harris County recorded its first variant-related death, Harris County Judge Lina Hidalgo said. The case would be the first recorded death linked to omicron in the United States. Hidalgo said the victim was a man in his 50s from eastern Harris County who was unvaccinated and had underlying health conditions. Just hours before the death was reported, Harris County raised its coronavirus threat level from “moderate” to “significant.”

Omicron has spread to nearly 90 countries, the World Health Organization said, with lockdowns ordered in several European countries. Omicron is now the dominant version of the coronavirus in the United States, accounting for 73% of new infections last week, federal health officials said Monday.

Figures from the Centers for Disease Control and Prevention showed a nearly six-fold increase in the share of omicron infections in a single week, the Associated Press reported. In much of the country, the prevalence of omicron is even higher. It is responsible for about 90% of new infections in the New York area, the Southeast, the industrial Midwest and the Pacific Northwest.

New York state broke its own record for single-day pandemic cases for the fourth straight day with 23,400 new cases on Monday. COVID-19 cases have risen 25% nationwide in the past two weeks, and in 14 states cases have increased by 40% or more, The New York Times reported.

North Texas hospitals are ready to change their services in response to an incoming surge of COVID-19, but health officials are concerned about their staff, who are exhausted after two years of battling the coronavirus.

How are North Texas hospitals preparing?

Parkland Hospital is as prepared as it can be for a surge of COVID-19, having dealt with previous waves of the virus, Chang said. In previous surges, reorganizing services for patients with COVID-19 could take up to a week. Now it can be done in less than 24 hours.

However, because the public hospital is always full, it is impossible for Parkland to preemptively clean floors and prepare COVID-19 beds like some other hospitals do.

“We literally need all of our beds, every day. If it’s not for COVID, it’s for something else,” Chang said. “So we really don’t have much else to do but wait and see.”

Staffing is also a looming issue for hospitals across the country, including North Texas. Finding enough nurses to cover an already busy hospital is hard enough outside of a coronavirus surge, experts say.

More than 97% of Parkland staff are vaccinated against the virus, but an omicron outbreak among healthcare workers is still a very real and worrying possibility, Chang said.

Dallas-Fort Worth hospitals have been looking for ways to supplement overworked and exhausted healthcare providers, said Steve Love, president of the Dallas-Fort Worth Hospital Council. Some hospitals are contracting with traveling nursing agencies and offering incentives to their staff as they face increased workloads, he said.

Baylor Scott & White Health’s chief medical officer, Dr Alejandro Arroliga, said he was also concerned about his staff – they haven’t had a break since the pandemic began nearly two years ago.

“Our workforce is tired,” he said. “Our workforce is emotionally drained, just like the rest of the country.”

Arroliga said Baylor is ready for the next wave of COVID-19 cases, which it expects to peak in the second week of January. The hospital system is following protocols established during previous case surges and is currently experiencing a relatively low COVID-19 case load.

What needs to change, Arroliga said, is not the number of beds available or the number of ventilators available. What needs to change are attitudes toward public health solutions, like vaccines, masking and social distancing, he said.

“It’s not a matter of… [us] as a health care system. We prepared,” he said. “But it’s a community problem.”

Hospital officials are concerned about the mental health of their employees, said Erin Carlson, associate clinical professor and director of graduate public health programs at the University of Texas at Arlington.

“We have healthcare providers who already know that they’re literally going to have to go back to their worst nightmare,” she said. “And that’s what should hurt all of our hearts is to think that they’re already working the battle of their careers and have to go back to it when it’s completely avoidable.”

Where is omicron spreading in the United States?

Dr. Anthony Fauci, the nation’s leading infectious disease expert, has warned that the country is likely to see record numbers of COVID-19 cases and hospitalizations as omicron spreads, The Washington Post reported.

In Houston, there are early signs that omicron is supplanting delta and other variants. Houston Methodist reported that 82% of new symptomatic cases of COVID-19 sequenced by the hospital were found to be the omicron variant as of Dec. 15. Just five days ago, only 32% of Methodist cases in Houston were omicron.

Last week, UT Southwestern released new COVID-19 forecasts for Dallas-Fort Worth. UT Southwestern expects the number of COVID-19 cases to remain stable or increase at the end of the year after about a month of declining case rates.

Parkland is already reporting a slight increase in hospitalizations for COVID-19 compared to the previous month. There were 39 active coronavirus patients on Monday, Chang said, rising from a previous average of 25 to 30 active patients.

The hospitalization rate still does not compare to past peaks when the hospital saw about 200 active patients at a time, he said.

What do scientists know about omicron?

New preliminary data from South Africa, where the variant was first detected, shows that omicron appears to cause less severe disease but is more easily transmitted. The recent findings haven’t been peer-reviewed — the gold standard of scientific research — but they match the earliest data on omicron’s behavior, the AP reported.

Both Pfizer and Moderna have released preliminary data showing that a booster dose of their vaccines may offer better protection against omicron, although the initial two-dose regimen appears to be less effective.

Antibody treatments from Regeneron and Eli Lilly have been the therapies of choice for the onset of COVID-19 for more than a year, but the two drugmakers recently warned that lab tests suggest their drugs will be much less effective. against omicron, the AP reported.

Competing UK drugmaker GlaxoSmithKline appears best placed to combat the new strain of coronavirus with its antibody treatment, although it is not widely available in the US

Even if the omicron variant is less severe than delta — and experts say it’s too early to be sure — that doesn’t necessarily mean there will be fewer hospitalizations, said Catherine Troisi, associate professor at epidemiology at the University of Texas Health Science Center in Houston.

“It’s very, very contagious, and a lot of breakthrough infections are popping up,” she said. “So even though it’s a lower percentage of people who need to be hospitalized, if you have more infected people there can still be a lot of hospitalizations.”

The Associated Press contributed to this report.