When she was making the rounds at Forbes Hospital in 2021 during the Delta and Omicron waves, usually six or seven of Dr. Amy Crawford-Faucher’s 20 patients were there because of COVID-19.
“Now we might have zero to two, and unusually, those people are not very sick from their COVID,” said Dr. Amy Crawford-Faucher, who is Allegheny Health Network’s vice chair of family medicine.
Crawford-Faucher’s experience tracks with what’s reflected in data from Pennsylvania’s Department of Health and the Allegheny County Health Department. Unlike the previous two years, the winter holidays brought little to no increase in severe coronavirus illness or fatalities. In fact, the number of hospitalizations in Allegheny County for the first week of January 2023 is a nearly 80% drop compared to a year ago.
That’s a welcome surprise as respiratory illnesses often spike during cold months when people spend more time inside: The full social calendars many people keep between Thanksgiving and New Years can throw fuel on the fire. In fact, for Allegheny County, the four deadliest months of the pandemic — in descending order — were December 2020, January 2021, January 2022 and December 2021.
It’s possible this atypically low level of COVID-19 illness might be because the virus was more active during April of last year, said UPMC’s Dr. Graham Snyder, who oversees infection prevention for the state’s largest hospital system.
Another potential factor is that new variants are now emerging much more rapidly.
“They’re coming so quickly one after the other, that we’re no longer seeing a definite spike,” said Snyder. “The curves [and] spikes are overlapping, so when you add them up it looks like a steady line of activity.”
People most likely to experience adverse outcomes from a COVID-19 illness are those who are older, with weakened immune systems, and the unvaccinated, said Dr. Amesh Adalja, an infectious disease physician and senior scholar at the Johns Hopkins Center for Health Security. At the same time, he notes the population now holds a lot of immunity due the vaccines and booster doses, along with those who have survived previous COVID-19 illnesses.
“The virus is contending with a very immune population,” said Adalja, who is on staff at UPMC Shadyside, Pittsburgh’s VA hospital, and Butler Memorial Hospital. “Even if some of these new Omicron variants can infect you, despite your prior protection and your prior immunity, they’re really unable to cause severe disease to the degree that they once could.”
That means an influx of COVID-19 patients overwhelming the medical system is no longer a looming threat. In fact, Crawford-Faucher believes there are likely many Allegheny County residents walking around and unaware they’re infected with COVID-19: “I think a lot of it isn’t even coming to our attention because, frankly, people aren’t testing … Or they got it and it’s a mild case, and they just live with it.”
That’s not to say that COVID-19 is toothless. Since the first week of October 2022 the Allegheny County Health Department has reported 139 confirmed and 21 probable COVID-19 deaths among residents: In comparison, during the same period, just five people died from the flu.
“We need to still be concerned about it,” said Crawford-Faucher. “I think the most realistic way for us to do that these days is by boosting.”