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What an omicron hospitalization looks like

ARI SHAPIRO, HOST:

Omicron has pushed U.S. hospitalizations to record levels, but who's actually ending up in the hospital, and what are the symptoms like with omicron? NPR's Will Stone has some answers.

WILL STONE, BYLINE: Most people who get omicron don't end up in the hospital, and the risk of hospitalization is lower than it was with the delta variant. But when Dr. Taison Bell looks around his hospital at the University of Virginia, things don't look any better.

TAISON BELL: We're still working just as hard to try to keep people alive with omicron as we were with delta.

STONE: That's because it is still COVID - a lethal, unforgiving disease for some. And while it's fortunate that omicron is not as bad as delta, it's so wildly contagious that the absolute number of people who are very sick is huge.

BELL: This narrative that it's a milder disease - from the perspective of a health care system, you know, nothing about this has been mild for us at all.

STONE: And Bell says 3 out of every 4 symptomatic COVID patients in his hospital are not vaccinated.

BELL: I just kind of know that if they're young or middle-age and, you know, don't have a lot of underlying medical problems and they're in the ICU with COVID, you know, they're going to be unvaccinated patients.

STONE: When it comes to the vaccinated, their risk of ending up hospitalized is still far lower than the unvaccinated, but they are there. Dr. Errol Ozdalga at Stanford has combed through hundreds of patient records to figure out who they tend to be.

ERROL OZDALGA: They may have been vaccinated. But the thing is, all of them are pretty severely immunocompromised or predisposed.

STONE: Like cancer patients on chemotherapy, organ transplant recipients or those with chronic lung diseases. But boosters really help. Doctors say they rarely see a boosted patient in the ICU. The CDC just found a booster is 90% effective at preventing hospitalizations with omicron. Ozdalga says boosters are key.

OZDALGA: There's no doubt that for many of these patients, if not all, that the booster saved them from having symptoms or maybe getting sicker.

STONE: So that's who is in the hospital, but what about how the disease behaves compared to earlier surges? Dr. Sonja Bartolome is treating COVID patients in Dallas at UT Southwestern Medical Center.

SONJA BARTOLOME: More people are coming in with upper-airway wheezing and coughing and those sorts of things and not leading with the really bad low oxygen levels we saw in previous surges.

STONE: Bartolome says that earlier, in almost every COVID patient, the lungs were affected. But now only about 40% of the omicron patients need oxygen. And studies have found the variant doesn't infect cells deep in the lungs as well as delta.

BARTOLOME: The way the virus is acting and its dominant symptom is definitely different this time, but it can do all the same things.

STONE: Which is to say, Bartolome's hospital still has lots of people on ventilators. But the proportion of patients is lower. This is holding true elsewhere, like at the University of Nebraska Medical Center, where Dr. Kelly Cawcutt works.

KELLY CAWCUTT: So far, it just does not appear that we are seeing as many patients entering the ICU with that severe level of illness in general.

STONE: She says more patients are arriving with other symptoms.

CAWCUTT: They've had a lot of GI problems. They may have had vomiting or diarrhea. They're feeling weak. They are dehydrated.

STONE: And research shows hospital stays are now about three to four days shorter compared to delta. Hospitals are also dealing with patients who get admitted for something else and test positive, like a patient with a broken ankle and no other symptoms. But Milad Pooran, an ICU doctor in Maryland, says omicron can be involved in tricky ways, like a patient with diabetes who shows up with a life-threatening complication known as diabetic ketoacidosis.

MILAN PURAN: Who oh, by the way, they're COVID positive - you have to appreciate that the COVID initiated the stress. That was the stressor that tipped them into the diabetic ketoacidosis.

STONE: For any patient, Pooran cautions that omicron can still be unpredictable.

PURAN: And I can't tell on Day 1 - there's really no good single lab test or clinical exam that's going to tell me that, hey; I think you're going to do OK.

STONE: He says, it's a disease that is still doing a lot of damage, especially as long as people continue to underestimate it. Will Stone, NPR News. Transcript provided by NPR, Copyright NPR.

Will Stone