Americans should focus less on the skyrocketing number of coronavirus infections and more on the number of hospitalizations and deaths, Dr. Anthony Fauci said Sunday on ABC’s “This Week with George Stephanopoulos.”
Over the past week, an average of more than 401,200 cases has been reported each day in the United States, doubling from two weeks ago and the first time the number has topped 400,000, according to a New York Times database (new case numbers are slightly depressed because fewer states are reporting after the New Year’s holiday). Hospitalizations were by comparison up 33 percent, however, to 92,300, while deaths had dropped 4 percent to an average of 1,249 daily.
Dr. Fauci, the government’s top infectious disease expert, noted that many new infections, especially in people who are vaccinated and boosted, result in no symptoms or mild symptoms, making the absolute number of cases less important than they were for previous versions of the virus.
“As you get further on and the infections become less severe, it is much more relevant to focus on the hospitalizations as opposed to the total number of cases,” Dr. Fauci said.
That advice is in keeping with what many epidemiologists have said all along. Despite the daily drumbeat of case counts, the number of positive tests has never been a perfect indicator of the course of the epidemic.
The number of tests has exploded because the Omicron variant seems to be much more contagious than Delta or other earlier variants and more people are getting tested for mild symptoms. What’s more, the official numbers are almost certainly an undercount, because many people are testing positive on rapid at-home tests or carrying the virus without any symptoms.
Yet, as Dr. Fauci told Mr. Stephanopoulos, the concern is not so much the mild or asymptomatic cases being picked up with widespread testing as it is the number of people with severe or fatal infections.
“The real bottom line that you want to be concerned about,” he said, “is are we getting protected by the vaccines from severe disease leading to hospitalization?”
So far, vaccines and boosters appear to be providing that protection. But the unvaccinated remain at risk.
“I’m still very concerned about the tens of millions of people who are not vaccinated at all because even though many of them are going to get asymptomatic and mildly symptomatic, a fair number of them are going to get severe disease,” Dr. Fauci said.
Also, even if Omicron is milder, as most evidence suggests, a higher caseload means more health care workers who can’t work because they test positive as well as more chances that people could get sick enough to require medical care.
“We have got to be careful about that, because, even if you have a less of a percentage of severity, when you have multi-multi-multi-fold more people getting infected, the net amount is you’re still going to get a lot of people that are going to be needing hospitalization,” he said.
Dr. Fauci also said that the Centers for Disease Control and Prevention may be reconsidering its guidelines for people who test positive for the coronavirus. The guidelines as of now do not require a negative test before people venture out after five days of isolation. But Dr. Fauci suggested that the agency may soon revise these guidelines to include testing. “I think we’re going to be hearing more about that in the next day or so from the C.D.C.,” he said.
