Omicron surge pushes Larimer County COVID-19 cases to historic highs: Here's what to know

The omicron variant is pushing Larimer County’s COVID-19 case counts to a level we’ve never seen before.

Larimer County blew past the previous case record more than a week ago. Since then, the 7-day case rate has doubled again. On Wednesday, it hit a new peak of 961 cases per 100,000 people, meaning more than 3,400 people tested positive for COVID-19 in a week. That case rate is more than double the previous all-time peak set back in November 2020 when the community didn’t have access to vaccines.

Larimer County Health Director Tom Gonzales estimates that the omicron strain is responsible for almost all new cases, judging by testing commissioned by the state health department.

So it’s clear that a lot more people have COVID-19 now compared with the earlier stages of the pandemic. But that’s not the only factor that sets this surge apart from its predecessors.

More: Here's why Larimer County won't add more COVID-19 restrictions amid omicron case surge

Gonzales told the Coloradoan he’s not planning to enact additional restrictions to deal with the surge because county experts predict the surge will come and go too fast for such policy to make a difference. He is, however, advising that people upgrade from cloth masks to well-fitting surgical masks, K95s or N95s.

And because a growing pool of evidence suggests that the omicron variant is milder than previous strains, it’s not clear whether the case surge will result in overwhelmed hospitals. The milder nature of omicron throws off the historic relationship between case rate and hospitalizations. Gonzales said the county expects an uptick in hospitalizations in the coming week, but he expects many of those cases will be less severe and not require ICU treatment.

Still, the sheer number of cases is likely to cause disruptions to the workforce and daily life. Already, omicron interfered with Fort Collins street plowing on Wednesday and Thursday, when many plow drivers were out sick.

And demand for tests has skyrocketed, causing long lines at testing sites.

Here’s an overview of what we know, and what we don’t know, about the omicron surge in Larimer County.

What does the omicron surge mean for hospitalizations?

This is a tough one to answer, though we can expect them to rise. Historically, there’s been a lag of a few weeks between rising case rates and rising hospitalizations. Gonzales expects to see the same here. Hospitalizations and ICU utilization increased this week, with the latter climbing above 100% again after finally dipping below 90% after New Year’s for the first time in weeks.

Gonzales said hospital patients infected with omicron are generally experiencing less severe symptoms compared to earlier in the pandemic, which could translate to relatively fewer ICU admissions. This may be because omicron causes milder illness than previous strains — a result of heightened immunity from vaccinations and previous infections as well as, perhaps, the variant’s inherent characteristics. A growing body of evidence suggests the omicron strain is less likely to multiply in lung tissue, and lung damage has typically been an important driver for severe infection.

But an extraordinary surge of COVID-19 cases could still have a significant impact on hospitalizations because of COVID-19’s exploitation of underlying conditions. Hospital staff are also more susceptible now to breakthrough infections, and they’re having to deal with the aftermath of yet another case surge after an exhausting 22 months.

Two factors may influence the omicron surge's effect on hospitalizations, epidemiologists say: Average age in the community and the vaccination rate. Larimer County's vaccination rate is about 65%. For comparison's sake, the vaccination rate in Weld County is about 58%; in New York City, it's more than 72%.

We’ll know more about hospital impacts in the next week, Gonzales said.

Am I at risk of infection if I’m vaccinated?

Yes. But less so if you’ve had your booster shot, and vaccines still are very effective against severe disease and death. If you get a breakthrough infection, your symptoms are likely to be much milder than if you hadn't been vaccinated, health officials say.

Omicron is spreading so quickly because it’s much more contagious than the delta variant and it’s better at evading immune defenses. This strain has significant mutations that make it less recognizable to the vaccine-equipped immune system, so more people who are double and even triple-vaccinated will get COVID-19 as the omicron strain continues to circulate.

The growing number of breakthrough infections is apparent in the county data. The 7-day case rate for fully vaccinated people is still lower than the case rate for people who weren’t fully vaccinated — 611 cases per 100,000 people vs. 943 cases per 100,000 people as of Dec. 30 — but the case rate for both groups had doubled in the preceding week. Before the omicron surge, the case rate for vaccinated people had remained below 200 almost continuously since October, even as the case rate for people who weren’t fully vaccinated increased significantly in the fall.

Data from the UK and South Africa suggest that two doses of the Pfizer or Moderna vaccine give you a 30% to 40% chance of avoiding a symptomatic omicron infection. A booster shot might increase that protection to about 70%-75%.

The protection against severe disease is higher. Studies from South Africa, as well as data from Pfizer, indicate that two doses of the Pfizer vaccine provide at least 70% protection against severe illness and hospitalization. A Pfizer booster increases that protection, according to a growing group of studies. Findings for the Moderna vaccine have been similar.

One study of Johnson & Johnson vaccine effectiveness found that one dose of the Johnson & Johnson vaccine provided 63% protection against hospitalization, and a booster increased that protection to 85%. (The study, and many other recent studies on omicron, hasn't yet completed peer review.)

What’s going on with cases, and when will we reach the peak?

The case rate is on track to continue the rapid escalation we’ve been seeing over the last few weeks. Once it reaches 1,000 per 100,000 people, that will mean 1 in 100 people in the county have tested positive for COVID-19 in the last week — but notice Larimer County’s test positivity rate is about 29%, substantially higher than it’s ever been here. The high test positivity rate means cases are likely higher than the county metrics indicate, though it’s impossible to know by how much.

One more caveat about the case rate: If you’re looking at the numbers on the Larimer County COVID-19 dashboard, the data for the last few days is likely an undercount of positive cases. That’s because tests have a longer turnaround time now due to high demand. As of Dec. 30, 75% of tests had a turnaround time of at least three days.

We don’t have a lot of data to go off to estimate when the peak will happen because only one place — South Africa — appears to have weathered the peak and is now seeing declining cases. (Cases in London may be starting to plateau, though, so watch the UK in the coming days.) For New York City, among the first places in the U.S. to experience the omicron surge, cases may peak in the first week of January, predicts epidemiologist and infectious disease modeler Jeffrey Shaman. He predicts other places will see later peaks.

Gonzales said Wednesday he thinks we’ll see both the rise and fall of the case peak in the next four to five weeks. County and state officials see the fast fall of the South Africa peak as an indicator that the same thing could happen here. However, South Africa’s population is younger than ours and it’s summer there, so it’s not clear if we’ll see the same pattern here in Colorado.

How can I protect myself?

You can get vaccinated, and get your booster if you’re eligible. You should also consider upping your mask game to combat omicron’s transmissibility. The best option is a KN95 or N95, which form a tighter seal around your nose and mouth. Hardware stores often sell them, as do online retailers (but do your research, because counterfeits abound). It’s worth watching a video or two about how to put the mask on correctly, which will boost the protection factor of the mask. You can check the fit of your mask by cupping your hands around your mouth and exhaling. No air should leak out.

If you can’t find a KN95 or N95, a securely fitting surgical mask is your second-best bet. There shouldn’t be gaps between the mask and the sides of your face. Some people loop the straps of the mask around their ears to ensure a tight fit.

MORE ON MASKS: Should you be wearing an N95 mask? Here's where to get them

Also consider the precautions recommended by the health department during times of high community spread: If you can work remotely, do so. Postpone indoor gatherings or consider holding them outside. (The county also recommends requiring vaccination for anyone attending your indoor event, but remember that vaccination doesn’t do a great job of stopping omicron transmission.) Practice social distancing. And get tested if you have COVID-19 symptoms.

Reporter Sady Swanson contributed to this story.

Jacy Marmaduke covers government accountability for the Coloradoan. Follow her on Twitter @jacymarmaduke. Support her work and that of other Coloradoan journalists by purchasing a digital subscription today.

This article originally appeared on Fort Collins Coloradoan: Omicron variant pushes Larimer County COVID-19 cases to historic highs