From the very beginning of the pandemic, when we called it coronavirus, political leaders tasked with making moment to moment decisions to protect public health have relied on a steady stream of data: new infections, breakthrough cases, variant dominance and tragically, deaths. But COVID hospitalizations have the most critical measure in determining the progress of the disease and if our health care system would collapse or not.
Hospitalizations were reported directly by medical centers and assumed to imply a certain severity, making them a proper gauge of the virus’ fluctuating intensity. However, these numbers came with a built-in problem that has only gotten worse in light of omicron’s staggering transmissibility and what so far seem like generally milder infections, particularly among the vaccinated: hospitals test everyone who enters their doors for COVID as a matter of course, so many people who went to the hospital for something else — like a broken bone or a bacterial infection — were tallied with the COVID cases if they tested positive after their arrival.
This confusion over what the numbers really mean is hampering our ability to respond. Parents are disconcerted over increasing COVID hospitalizations of children, but a recent CDC survey of six hospitals in several states found that, even during the much deadlier delta wave, almost a fifth of children “had incidental positive SARS-CoV-2 test results” that were “unrelated to the reason for hospitalization.” This proportion could be much higher with omicron.
This week, Gov. Kathy Hochul announced that New York would become the first state to collect better data by having hospitals report specific numbers for people admitted due to COVID complications and for those who test positive incidentally.
These statistics drive public policy, and so they should be carefully collected and shared: each hospital must follow the exact same rubric, and the state should endeavor to make them public as soon as possible. For crucial decisions around mandates and restrictions, this primary hospitalization number will be the clearest metric we have. It should be weighted accordingly.