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COVID in Oregon: BA.2 lacking punch despite high case count

Rapid test for COVID-19. (Getty)

PORTLAND, Ore. (KOIN) — As is the case in more than half of the country right now, Oregon is going through yet another COVID-19 wave.

This time it’s the BA.2 variant becoming the most dominant strain. But masks are still off and gatherings are still happening. So how bad is this latest wave and what does it mean for Oregon’s future?

The obvious answer to the first part is that any wave is bad, and this one is certainly causing more people to get sick and others dying from COVID-19. What we can do is compare this wave to the ones Oregon has already gone through, and this comparison shows the destruction left behind from the virus is waning with each new variant.

First start by looking at new cases since the BA.2 wave in Oregon started going up six weeks ago. During the week of March 24-30, there was 1,763 cases in Oregon. March 30 also has 84 patients in the hospital and 15 in the ICU. Now six weeks later, Oregon had 8,046 new cases with 151 hospitalizations and 28 ICU patients. That means over the six weeks of the BA.2 wave cases have gone up at a rate of 4.2x, hospitalizations up 1.8x and ICU patients up 1.9x.

Now let’s compare that to the other two biggest waves Oregon suffered through: the delta wave and the omicron wave. The omicron wave hit over the winter and began to spike around Thanksgiving. Over the next seven weeks before the surge peaked, cases went up from 4,197 to 55,882 with hospitalizations up from 391 to 888, and ICU patients going from 97 to 153. That means cases were up at an astonishing 13.1x, but the hospitalization jump stayed at only 2.1x and ICU’s at 1.6x. Not too much different than BA.2.

As for the deadliest wave Oregon felt, the delta surge really started to ramp up July 4-10 in 2021 and also took nearly seven weeks to peak. It saw cases go up 12.3x (from 1,278 to 15,709), hospitalizations go up 6.7x (from 140 to 937) and ICU’s go up 8.4x (from 30 to 253).

Rate of Increase for Each Wave

DELTAOMICRONBA.2
CASES12.313.34.6
HOSPITAL PATIENTS6.72.11.8
ICU PATIENTS8.41.61.9

The easiest thing to draw from these numbers is that with each wave, the severity of the virus is creating fewer serious medical conditions that need hospitalization. And it might be even lower with the BA.2 variant.

One thing we need to take into account when looking at these numbers is the near certainty that the number of new cases for BA.2 is vastly undercounted. The Oregon Health Authority estimated a few weeks ago that undercount could be 5-to-10 times lower than in reality. The easy access we have now of home test kits allows people to find out if they are sick and stay home without ever recording their positive results to OHA. But unlike cases, you can’t undercount hospitalizations and patients in the ICU.

So for a guess at how many actual cases there are in Oregon, we’ll be conservative and say it’s a 5-time undercount. That would put our guess at cases around 40,230 total for the last week. And while that’s extremely high, it doesn’t change the number of hospitalizations as of Wednesday at 181. That means only one patient is in the hospital for every 222.3 new cases of our estimation over the previous seven days.

Now to compare that to our earlier waves. The peak for omicron was 55,882 new cases over seven days with 811 patients in the hospital on the final day of that week. That gives us a ratio of 68.9 new cases for every one hospital patient with COVID. During the week that saw the delta variant peak, there was 15,709 cases with 937 hospital patients on the final day for a ratio of 16.8 to 1.

DELTAOMICRONBA.2 (ESTIMATED CASES)
PEAK CASES IN A WEEK15,70955,88240,230
HOSPITAL PATIENTS937811151
RATIO16.8:168.9:1222.3:1

Now it’s likely that cases during the delta and omicron waves were also undercounted, but not nearly at the rate as the BA.2 variant’s undercount. And even if you raise cases in both delta and omicron, it would take an unlikely massive undercount during times when home tests, the cause for today’s major undercount, were either not widely available or non-existent at the time.

And remember, the 40,230 cases we’re using is only if cases were undercounted by 5 times. If it’s 10-times too low, the cases-to-hospital patient ratio goes up to 532.8 : 1. That shows how despite cases rising sharply again, the severity is decreasing.

This matches up with what national health experts have been saying. Even with vaccines waning in potency, so many people have either gotten fully vaccinated, gotten COVID, or both that it’s bringing down COVID’s danger through some level of immunity. It’s not slowing down cases but is limiting how many of those turn into people needing medical attention. That in turn is freeing up our hospitals that have been so badly overwhelmed during the last two years.

Another positive sign is where each wave has started from, especially in hospitalizations. The week omicron began to rise there were still 403 patients in the hospital with 91 in the ICU. During the BA.2 wave, Oregon hit pandemic lows with only 89 patients in the hospital (April 12) and lows of 14 patients in the ICU (on numerous days, last on April 24). So if hospitalizations are rising at nearly the same rate between omicron and BA.2, starting at a lower point means ending at a lower point.

And the good news is using the patterns of previous waves, Oregon shouldn’t get much worse than this. The state is six weeks into the BA.2 surge starting. That’s just one week less than how long it took for both the omicron and delta surges to peak. Over the winter, OHA set a bar of 400 hospitalizations for when mask mandates could be rolled back. Meanwhile, today near the peak of BA.2 there is not even half of that.

This doesn’t mean Oregon is out of the woods yet. Dr. Deborah Birx spoke to “Face the Nation” on KOIN 6 this Sunday warning that more waves are on the way this summer and autumn. She warned about a summer surge in the southern states, just like there was in both 2020 and 2021. That means we’ll likely see a wave again in the late summer to fall in the Pacific Northwest just as we did in 2020 and 2021. But with each wave we’re seeing the potency of the virus dropping. So following the patterns, the next wave and the one after that will likely have high case counts, but resulting in lower and lower rates of hospitalizations.

COVID-19 isn’t going anywhere for a long time, but we have the tools to weaken it. Getting vaccinated helps control its severity, and getting tested lets you know if you’re positive to avoid more at-risk friends and loved ones. These steps are working in Oregon and they’ve brought us from a full-blown pandemic to new waves that are going by without the need for mask mandates to return.