Long Island sees state's highest seven-day COVID-19 positivity rate

COVID-19 hospitalizations are increasing rapidly on Long Island amid a spike in cases that pushed the region’s seven-day positivity rate to the state’s highest, while hospital officials fear that the highly contagious omicron variant could fuel a further rise in patients that may strain systems.

The 9.32% seven-day average of coronavirus tests coming back positive on Saturday stood as the highest rate on Long Island since the 9.70% number reached on Jan. 8, 2021, which was the post-2020 peak.

The number of COVID-19 hospitalizations on Long Island rose more than 41% in the two weeks between Dec. 4 and Saturday, from 406 to 574, state data shows.

But that’s still far fewer than the 1,012 COVID-19 patients in Long Island hospitals on Dec. 18, 2020 — despite a higher COVID-19 positivity rate in 2021 caused at least in part by omicron. The seven-day positivity rate was 6.19% on Dec. 18, 2020.

The dominant variant for the past several months, delta, also is more transmissible than the coronavirus of a year ago. Omicron is expected to become the dominant variant within a few weeks, federal health and hospital officials said.

Increases in hospitalizations were expected during the holidays, and hospital officials said widespread vaccinations likely will prevent numbers from reaching last winter’s levels.

But omicron's especially high level of contagiousness makes it worrisome, Long Island medical experts said.

"If the unvaccinated population can catch omicron again, even if they’ve been infected previously, and if it is causing significant disease, then hospitalizations will escalate exponentially over the next few weeks," said Dr. Adhi Sharma, president of Mount Sinai South Nassau hospital in Oceanside.

"Once you get enough infections, you can overwhelm the hospital systems," even in regions with relatively high vaccination rates such as Long Island, he said.

Dr. Mangala Narasimhan, director of critical care services for Northwell Health, the state’s largest health care system, attributed the region having a higher positivity rate than upstate — despite higher vaccination rates on the Island — to greater population density. Although hospitalization rates remain higher upstate, they’re increasing more quickly on Long Island and in New York City.

"I think it’s just omicron and how contagious it is, and how closely packed people are," Narasimhan said.

Western New York had the state’s second highest seven-day positivity rate on Saturday, at 9.09%. New York City stood at 6.04%.

Another statewide daily record for positive cases

The state Saturday broke records set Friday, and before that, Thursday, for the most positive test results on a single day during the pandemic. The record is now 22,478, out of more than 267,000 results, although early in the pandemic tests were scarce, so coronavirus infections then were greatly undercounted, experts have said.

Just like last year, case and hospitalization numbers have increased in recent weeks after cold weather moved people to socialize more in higher risk indoor settings, and as the holidays led to large gatherings.

Last year on Long Island, COVID-19 hospitalizations rose precipitously between Thanksgiving and mid-January, reaching a post-2020 peak of 1,701 on Jan. 18.

Although Northwell Health, with 11 Long Island hospitals, is not expecting hospitalizations to surge to last winter’s levels, "We are preparing in case they do and we’re wrong," Narasimhan said.

Omicron makes predictions difficult, because hundreds of thousands of Long Islanders remain unvaccinated, hospital officials said.

Dr. Bettina Fries, chief of infectious diseases at Stony Brook Medicine, said the effect of omicron will vary greatly across Long Island.

"We still have ZIP codes on Long Island with very low vaccination rates, so they’re going to be super vulnerable to getting sick, and the ones who have [medical] risk factors may get sick enough to need to be admitted" to the hospital, she said.

Fries said even if COVID-19 hospitalization numbers don’t surpass last year’s levels, hospital systems could be stressed if enough employees get ill from omicron and can’t care for coronavirus patients and those in the hospital for other reasons.

"We could be facing serious staff shortages," she said.

Omicron appears to on average cause less severe illness than previous variants. But it is so contagious that it may infect many people across essential professions, Fries said.

"Across all essential services, if you have 20% of policemen sick, and 20% of firemen sick, that’s going to be a problem, even if they’re not sick enough to come to the hospital, but they’re sick and stay at home," she said.

The transmissibility of omicron is why Sharma is worried about a larger spike in hospitalizations than expected. It may infect so many people that it leads to a major increase in those sick enough to require a hospital bed, he said.

"We are very concerned about the upcoming holiday, and what that will mean with regards to how people congregate," Sharma said.

He urged Long Islanders to keep holiday celebrations as small as possible and to take coronavirus tests before gatherings.

Experts: Vaccinations, high-grade masks key to variant fight

Narasimhan said vaccinations will greatly blunt omicron’s impact. On Long Island, 77% of all Nassau residents are fully vaccinated and just over 70% of Suffolk residents have completed a vaccination series, state data shows.

Fully vaccinated is currently defined as two shots of the Pfizer-BioNTech or Moderna vaccines, or the single dose of Johnson & Johnson, although federal and state officials said the definition may eventually change to mean boosted.

The large majority of hospitalizations at Northwell are of unvaccinated people, Narasimhan said.

COVID-19 hospitalizations at Northwell, which has 22 hospitals systemwide, rose 41% over the past two weeks, to 415 as of Sunday morning, from 294 two weeks before, on Dec. 5, said Northwell spokesman Joe Kemp. That’s still fewer than half the 930 COVID-19 patients in Northwell hospitals on Dec. 19 of last year, he said.

"The unvaccinated people are just as sick as they were" a year ago, Narasimhan said. "If you walk in the ICU, it’s striking: They’re all unvaccinated."

On the other hand, "the vaccinated people are in and out of the hospital in a couple of days, if they come to the hospital at all," she said.

Vaccinated patients tend to be much older than unvaccinated people and have weakened immune systems, she said. Still, an 80-year-old fully vaccinated patient tends to fare significantly better than a 40- or 50-year-old unvaccinated patient, some of whom are struggling on ventilators, Narasimhan said.

Hospitalizations of people with booster shots are "very rare," she said.

Even those who were fully vaccinated more than six months ago are much more protected against serious illness or death than unvaccinated people, Fries said. But indications are that booster shots are needed to significantly reduce the chance of infection, she said.

Anyone who received the second dose of a Moderna or Pfizer-BioNTech vaccine more than six months ago, or a Johnson & Johnson vaccine two months ago, is eligible for a booster.

Fifty-eight New Yorkers died Saturday of COVID-19, including four Suffolk and two Nassau County residents.

Fries urged Long Islanders to also wear masks in indoor public spaces, preferably a more protective mask such as a KN95 rather than a cloth mask, or to double-mask.

"Everybody now has to focus on wearing masks," she said. "That’s the only thing that’s going to slow this down."

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By David Olson

david.olson@newsday.com@DavidOlson11

David Olson covers health care. He has worked at Newsday since 2015 and previously covered immigration, multicultural issues and religion at The Press-Enterprise in Southern California.