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Another wave of COVID is sweeping through Allegheny County, but this time it's different

The emergence of omicron, a new and potentially more contagious variant of the coronavirus, upended Thanksgiving weekends. Markets dropped. The Biden administration banned the entry of non-U.S. citizens from eight African countries. Scientists began rapidly digging into the data and trying to determine if the vaccines would continue to prevent severe illness.

The feeling: Here we go again.

The fear of omicron, though, ignores the fact that Allegheny County and Pennsylvania are already in the midst of an ongoing and unending wave of COVID-19 cases. It’s the fifth wave of the virus to hit the area.

Yes, things are different — serious illnesses among vaccinated people remain rare, and we have better treatments for people who are hospitalized. But October 2021 was COVID-19’s third deadliest month for Allegheny County, according to the county health department.

Take a look at this interactive chart, tracking COVID-19 cases in Allegheny County through the course of the pandemic:

In mid-June, WESA published a deep dive into the four waves of COVID-19 that Allegheny County had experienced over the previous year. At the time, the county was averaging fewer than 25 new cases a day. Vaccinations were widely available, and the state was reporting that more than half of Allegheny County residents were fully vaccinated and another 15 percent were partially vaccinated. The state would drop its mask mandate on June 28. Schools were planning for in-person learning for the fall, and more businesses were having employees return to the office.

But the delta variant, which had been in the country since March, was starting to rip through the United States — and Pittsburgh. By mid-July, cases started to pick up, and local health officials attributed the increase as likely being due to delta. Since then, cases have continued to climb locally. We thought it was time for another data dive.

Here, let’s zoom in on this recent wave of cases:

As of Dec. 1, the county’s seven-day average case count is 586 cases a day. That’s extremely close to where we were last Thanksgiving.

And it’s all delta — according to the Centers for Disease Control and Prevention, the delta variant is now responsible for 99.9% of all cases in the United States.

The difference between this wave of cases, of course, is the fact that a majority of the county’s population is vaccinated — state data shows that 62% of Allegheny County is fully vaccinated, with another 10% partially vaccinated. (Note: The state’s dashboard shows that 65% of county residents are fully vaccinated, but that excludes children under 10).

While it is possible for vaccinated people to still be infected with the coronavirus, they are far less likely to be hospitalized or die.

“We have a far better understanding of the virus and a far better understanding of what treatments can help patients who are severely ill,” said Dr. Arvind Venkat, an emergency medicine physician at Allegheny Health Network.

These treatments include monoclonal antibodies. And soon there may be an oral antiviral medication available to mild and moderately ill COVID-19 patients who are at a high risk of becoming severely ill.

This week, Gov. Tom Wolf said that “very few” Pennsylvanians were hospitalized and that he didn’t see a need to do anything “draconian” like suspending elective surgeries to free up hospital space.

But people are still ending up in the hospital, and most are unvaccinated —  according to the CDC, unvaccinated adults are nine times as likely to be hospitalized as the fully vaccinated.

According to the Pennsylvania Department of Health, nearly 4,000 patients are hospitalized with COVID-19 in the state. More than 500 of these patients are in Allegheny County.

That's the second-highest number of hospitalizations we’ve had since the beginning of the pandemic. And an analysis from NPR and the University of Minnesota show that hospitals in many counties in the commonwealth are under extreme stress.

Part of the reason for the continued rise in cases is due to what’s called seasonal forcing, or seasonal variation.

“The weather is getting colder and that allows the [viral] droplets to hang around in the air longer. So what used to be safe is no longer safe,” said Dr. Mark Roberts of the University of Pittsburgh’s Public Health Dynamics Lab.

But also, more people are socializing together inside, so “we can almost expect that the cases are going to increase,” said Bridget Calhoun, an infectious disease and public health expert at Duquesne University.

Vaccinations and new treatments could keep the county’s death rate lower in comparison to last winter. However, Calhoun is still concerned, considering how many people are still unvaccinated and how the public has become increasingly lax around masking and other mitigation efforts.

Even if COVID-19 hospitalizations don’t reach the same heights as last year, medical systems might struggle again to care for patients if a bad flu season is coupled with the ongoing staffing shortages among health care workers.

“Everyone expects that if they have a heart attack, if they have a stroke, the emergency department is going to care for them very rapidly,” said Venkat. “That can be very, very challenging in a situation where many of our beds are occupied by patients who are waiting for an inpatient bed.”

Local residents are still dying, too.

October 2021 was the third deadliest month for COVID-19 in Allegheny County, according to the county health department. State data show that 193 people in the county died that month.

While December 2020 and January 2021 had far more fatalities, what’s frustrating public health officials is that the majority of COVID-19 deaths are now avoidable due to the widely available vaccines.

Most people dying now are either unvaccinated or have underlying health conditions, which make their immune responses to vaccination less robust. The latter group is most dependent on herd immunity and therefore most hurt by those who remain unvaccinated.

“We are seeing younger and middle-aged patients predominantly because those are populations that, for whatever reason, have not gotten vaccinated…and are therefore ending up as patients in the hospital,” said Venkat.

What’s next?

It’s not clear what the winter will look like, especially because the efficacy of the existing vaccines against the newly identified omicron variant is unknown.

While this strain is likely already in the U.S., experts agree that the delta variant is currently driving case numbers, both locally and nationally.

“Given that the U.S. is sequencing around 10,000 specimens a day and omicron hasn’t been identified yet and almost all U.S. disease is caused by delta, the increase is most likely due to delta, not omicron,” said Dr. Lee Harrison, an infectious disease expert and head of the county’s board of health. (Note: California identified the first American case of omicron on Wednesday afternoon, after this interview was conducted.)

Public health officials and medical experts continue to urge the public to get vaccinated and boosted for COVID-19.

According to state data, some 207,000 Allegheny County residents — 17% of the county’s population — have received additional vaccine doses.

Of kids ages 5 to 9 years old, 23% are partially vaccinated; children this young are only now getting their second doses. In the 10–14 age group, 29% are fully vaccinated and 14% are partially vaccinated.

Scientists have estimated herd immunity won’t be achieved until 70 to 85% of the entire population is immune to the virus, either through vaccinations or immunity following the recovery from an infection. Even a high rate of immunity likely won't eliminate the virus, but it should prevent slow transmission and prevent most serious illnesses and deaths.

Getting kids vaccinated, encouraging adults to get boosters and continuing outreach to unvaccinated people are the keys to the future — or at the very least, how we can get the upper hand on the virus.

Patrick Doyle oversees WESA's digital strategy and products. Previously, he served as WESA's news director. Email:
Sarah Boden covers health and science for 90.5 WESA. Before coming to Pittsburgh in November 2017, she was a reporter for Iowa Public Radio. As a contributor to the NPR-Kaiser Health News Member Station Reporting Project on Health Care in the States, Sarah's print and audio reporting frequently appears on NPR and KFF Health News.