COVID expert: Why surge in N.H., Vt. is much greater concern than Omicron

Dr. Ronald Nahass understands the interest in the Omicron variant (it’s new), the tracking of it to New Jersey (the first case was acknowledged this weekend) and the talk of travel bans and what’s happening in many of areas of Europe, where some countries are shutting down for the unvaccinated (let the policy debate begin).

Nahass, the founder and head of ID Care, the largest physician group for infectious disease specialists in the state, just thinks all the COVID-19 talk in the past week or so has been misplaced. Or, rather, is about the wrong place.

“There should be more talk about what is going on in New Hampshire and Vermont,” he said.

And there should be more talk about the Delta variant, he said.

“Those states are having a surge of COVID-19 cases, they are having a surge of COVID-19 cases caused by the Delta variant — which is the cause of 99.9% of cases everywhere,” he said. “Their hospitalization rates are as high as they’ve ever been.

“That should be the main concern right now.”

New Hampshire, in fact, has had the highest rate of new COVID-19 cases in the country for much of the past week. It’s a worry for Nahass for two reasons.

• New Hampshire (65% of population) and Vermont (73%) have roughly the same vaccination rate as New Jersey (68%).
• New Jersey tends to be about two weeks behind those states.

In other words, the recent surge in New Jersey — the state reported more than 3,000 new cases Sunday and the seven-day average is the highest it has been since April — may just be getting going.

“The trend is terrible,” he said. “We’ll see what happens over the next couple of weeks, whether we follow that pattern — and whether Omicron really ends up being something of concern that takes over. But, right now, we’re in the middle of a severe Delta surge in New Jersey, which is what’s driving most of our challenge at the moment.”

Nahass, whose group sees patients and works in facilities throughout the state, said he has seen it firsthand. He said he also has seen progress in the only thing we know will slow COVID-19: vaccinations.

While the Omicron variant isn’t the cause of the surge of cases, it appears to be the impetus for an increase of booster shots.

“We’re starting to see lines of people getting shots,” he said. “You can call it an unintended consequence or a good consequence or whatever. If it means we’re getting people vaccinated who had some vaccine hesitancy, that’s great.

“My fear is the so-called epidemic curve. When I see what’s happened in Vermont and New Hampshire — even in Germany and France — I fear we’re going to go through a pretty big surge over the next three or four weeks.”

Here’s what he doesn’t fear right now: Omicron.

The reason: It’s still unknown.

“I think it’s a normal expectation of what happens with viruses,” he said. “That there’s another variant is not particularly surprising. The question remains: What exactly does it mean, how is it going to affect us? We don’t really know that yet.”

For all of Nahass’ worry, he remains confident the state will be able to handle the surge. This latest surge — no matter its cause — will not set us back to the beginning of the pandemic, he said.

“I do think that we’re going to have a big surge of hospitalizations and our death rates will climb,” he said. “And that’ll be quite sad, knowing that most of those deaths were preventable. But we’ll get through it.

“We have learned, as health care providers, that we’re way better at managing COVID, which is good news.”

The mortality rate hovered around 20% for the initial wave and has dropped considerably with each subsequent wave, Nahass said.

“Now we’re looking at mortality rates around 2%-3%, which is still bad by most infectious disease standards, but, compared to where we started, that’s pretty good,” he said. “But it’s still tragic. And it gets us all frustrated who do this because it is preventable.”