Syracuse, N.Y. – As the number of coronavirus cases rises sharply in Onondaga County, so has the number of people sick enough to be hospitalized.
As of Wednesday, Syracuse’s three hospitals had 29 patients being treated for Covid-19, the disease caused by the new virus. That’s the highest number since July 30, and three times as high as the lowest point, in late September.
Public health officials say the hospitalizations aren’t surprising: More cases in the community will eventually mean more patients in hospital beds. While the rise in sick people is concerning, doctors say that so far this wave of hospitalizations is nothing like the first wave that crashed in the spring.
On a day in early April, 25 patients lay in the intensive care unit, compared to six this week. On Memorial Day, hospitals had 85 Covid-19 patients.
And doctors say they’re in a much better position now to treat Covid-19 patients than they were a few months ago, when the virus was new and treatments were few.
“We know a lot more about Covid than we did at the beginning,” said Dr. Seth Kronenberg, the chief operating officer and chief medical director at Crouse Hospital. “Everybody has had experience with treating patients as well. It’s a different experience than it was.”
Still, the recent increase in hospitalizations is worrisome, doctors say.
“It is concerning because we already have in our area and in the United States a health care system that going into Covid was pushed to its capacity,” said Dr. Kathryn Anderson, a professor of medicine and immunology at Upstate Medical University. “Where do we find the wiggle room to keep doing things as we have been in our hospitals while maintaining space for Covid cases?”
This week’s Covid-19 numbers are both worse and better than they seem. They’re actually worse than the July totals because in late summer many of the people brought from nursing homes to hospitals had recovered, but couldn’t be sent back until they tested negative. Of the 28 people in the hospital July 30, county officials said then, just 15 of them needed to be there.
In essence, that means this week’s number of people needing treatment for Covid-19 is double what it was three months ago.
Looked at another way, the current numbers are better than they appear. Patients are now being diagnosed and sent to the hospital earlier in the course of their disease than in the spring and summer, so they’re not as sick when they arrive. In addition, doctors have more tools in their arsenal to treat patients.
“Now we’re starting to see patients who are coming in less severely ill than they did at the beginning,” Kronenberg said. “The combination of that with treatment regimens, and all of the facilities and expertise of the clinicians, is that we’re seeing better outcomes.”
Those advances could help save lives. The Centers for Disease Control and Prevention found that 6.7% of people diagnosed with Covid-19 in April died, compared to 1.9% in September. More younger people are being diagnosed with the disease, and they are less likely to be hospitalized and die than older people.
Tracking hospitalizations is crucial in understanding how the virus is spreading. The daily tally of new cases can be skewed by the number of tests conducted, but hospitalizations reflect the impact and spread of the disease apart from testing.
“That’s where the rubber meets the road in terms of impact of Covid on our our community,” Anderson said.
County Executive Ryan McMahon said Friday that hospitalizations had fallen to 24, with just four people in intensive care, but suggested they would rise again soon after the county set a new record for confirmed cases.
“They’re a little bit better than yesterday, but again, we’ve had close to 170 cases in the last 48 hours, so I think those (hospital) numbers are in jeopardy,” he said. “There’s always been a direct correlation between case numbers and hospitalizations.”
Hospitalizations tend to lag a week or so behind confirmed cases. It can take that long for someone to get sick enough to need hospital care.
The county just set two new daily records for confirmed cases -- 70 on Wednesday and then 99 on Friday -- and McMahon admitted that people, including himself, are getting tired and letting down their guard.
These trends add uncertainty to the picture. Even if people changed their behavior today, especially by avoiding gatherings, he said, it could be weeks before the numbers drop significantly. In the meantime, more people could end up in the hospital.
Onondaga County is in line with the statewide trend of hospitalizations: rising but still nowhere near the peak in the spring. At the height of the pandemic, in early April, more than 18,000 New Yorkers were in the hospital. That bottomed out at 410 in early September, but has climbed to nearly 1,100.
Hospital beds are slowly filling up just at the time they’re usually needed most. Flu season starts in the fall and peaks in mid-winter, and officials fear the area’s health care system could be overwhelmed by the convergence of two respiratory illnesses.
“It is a big concern,” Dr. Indu Gupta, commissioner of the Onondaga County Health Department, said recently. “You have two infectious diseases that are going side by side.”
The state Department of Health launched its 2020-2021 seasonal flu tracker on Friday. So far, Onondaga County has had just one case.
Kronenberg said that whatever awaits hospitals this winter, they’ll be ready this time.
“The message we have is that we’re fully prepared,” Kronenberg said. “We have all the facilities, the PPE, the treatment regimens, and all the experience from Covid in the spring.”
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