Why COVID-19 omicron cases could yet overwhelm NSW hospitals

At the peak of the delta wave in September, about one per cent, or 1500, of the 150,000 daily tests in NSW were coming back positive.

COVID hospital admissions reached 1200, and 20 per cent of those patients were in ICU. Ten per cent, or 120, were on ventilators.

The positivity rate of the Omicron variant is tracking far higher than delta at about 6.5 per cent. NSW reported 11,201 new cases on Wednesday and 157,000 tests.

But, so far at least, the much higher case tally has led to a relatively low 625 hospital admissions, and only 10 per cent of these patients are in intensive care and 3.7 per cent on ventilators.

The hospitalisation rate per case could grow as people become sicker in coming weeks.

The issue for the health system is the sheer weight of omicron infections.

Hospital admissions are halfway to the delta peak, ICU numbers are a quarter of the way and ventilations one fifth of the way.

As omicron continues to spread, hospitals could be forced to deal with similar patient numbers to what they faced during the Delta outbreak, or even more.

How many more is an open question.

In the NSW Hunter region, where the omicron outbreak exploded after several super-spreader events in Newcastle nightclubs, hospitalisations due to COVID-19 have already surpassed the Delta peak of 30 on October 8.

Hunter New England Health reported on Wednesday that 31 COVID patients were being treated in the district's hospitals, up from 11 one week ago, and three were in ICU.

It is unclear to what extent Wednesday's startling case numbers, almost twice the state's previous record, reflect irregular testing and processing over the Christmas long weekend, but modelling cited by the government two weeks ago suggested NSW would have 25,000 cases a day by the end of January.

The author of that forecast, University of NSW associate professor James Wood, said at the time that his prediction of a four-fold increase in cases every week was "very preliminary".

What seemed to some like an astronomical figure could turn out to be conservative.

It is important to remember the daily case count reflects only confirmed infections.

Distinguished University of Newcastle researcher and physician Laureate Professor Nick Talley told the Newcastle Herald on Tuesday that the high 6.5 per cent test positivity rate pointed to a large number of infections remaining undetected, possibly up to five times the reported count.

This is likely when contact tracing and testing start to break down, as has happened in NSW in the past two weeks.

NSW chief health officer Dr Kerry Chant said on Wednesday that "there's probably more disease in the community than the numbers reflect".

It is too early in the Omicron wave to draw concrete conclusions from hospital numbers.

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But, even at this early stage, it is not hard to see how a 1700 per cent increase in daily reported case numbers compared with Delta could flood hospitals and ICU units.

The deaths of two women at a Warabrook nursing home over Christmas show that COVID-19 still poses a health threat, especially to the elderly.

The nursing home said on Wednesday that it found out 14 days ago that several staff members had come into contact with a person who had tested positive.

Since then, 20 staff and 15 patients have tested positive.

Health Minister Brad Hazzard could have been correct when he said "we're all going to get Omicron".

Hopefully, for the sake of the hospital system and health outcomes, we don't all get it at the same time.

This story Why Omicron could yet overwhelm hospitals first appeared on Newcastle Herald.