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As COVID-19 cases in the United States spike due to the Omicron variant, many health experts have argued that hospitalizations are a better metric to use when considering the effect of the pandemic.
This is partly because the Omicron variant—which the CDC said accounted for 95 percent of new U.S. cases last week—has shown to be more contagious, but less severe than prior strains.
While over the past two weeks COVID-19 cases have reached a record-breaking daily average of 480,000, hospitalization numbers were not as dramatic. The current national average of 14,800 hospitalizations per day is 63 percent higher than last week, but it still falls much lower than last year's record of 16,500.
Health experts say that the hospitalization figures do a better job of showing the vaccine's efficacy. Dr. Anthony Fauci chimed in on the issue Sunday while on ABC, saying that with many newly infected individuals showing little to no symptoms, "it is much more relevant to focus on the hospitalizations as opposed to the total number of cases."
Some have also pointed out that case counts are not always reliable. For example, there were over 1 million new cases recorded Monday, but that was likely because of an increased amount of testing and delays over the holiday weekend.
Andrew Noymer, a public health professor at the University of California, Irvine, said hospitalization counts are a "more objective measure."
"If I had to choose one metric, I would choose the hospitalization data," he said.
Dr. Wafaa El-Sadr, director of ICAP, a global health center at Columbia University, said the case count does not appear to be the most important number now.
Instead, she said, the U.S. at this stage of the pandemic should be "shifting our focus, especially in an era of vaccination, to really focus on preventing illness, disability and death, and therefore counting those."
Daily case counts and their ups and downs have been one of the most closely watched barometers during the outbreak and have been a reliable early warning sign of severe disease and death in previous coronavirus waves.
But they have long been considered an imperfect measure, in part because they consist of laboratory-confirmed cases of COVID-19, not the actual number of infections out there, which is almost certainly many times higher.
For one thing, the skyrocketing increase reflects, at least in part, an Omicron-induced stampede among many Americans to get tested before holiday gatherings, and new testing requirements at workplaces and at restaurants, theaters and other sites.
Also, the true number of infections is probably much higher than the case count because the results of the at-home tests that Americans are rushing to use are not added to the official tally, and because long waits have discouraged some people from lining up to get swabbed.
But also, case numbers seem to yield a less useful picture of the pandemic amid the spread of Omicron, which is causing lots of infections but so far does not appear to be as severe in its effects.
Keeping track of COVID-19 admissions can tell doctors something about the seriousness of the virus and also the capacity of hospitals to deal with the crisis. That, in turn, can help health leaders determine where to shift equipment and other resources.
Still, health experts are not prepared to do away with case counts.
"We should not abandon looking at case numbers," said Dr. Eric Topol, head of the Scripps Research Translational Institute, "but it is important to acknowledge we're seeing only a portion of actual number of cases."
Ali Mokdad, a professor of health metrics sciences at the University of Washington in Seattle, said that for each new infection detected, the U.S. is missing two cases. But he said tracking the number of positive test results is still important as Omicron makes its way across the land.
Case numbers can point to future hot spots and indicate whether a wave of infection has peaked, Mokdad said.
Also, case counts will continue to be important to people who are vulnerable because of age or health reasons and need a sense of the virus' spread in their communities so they can make decisions about precautions, he said. Hospitals, schools and businesses need to plan for absences.
"To give up on knowing if cases are going up or down, it's flying blind. How can we as a country not know the epidemic curve for infection?" Mokdad said.
If testing has lost its relevance, he said, it is because the U.S. never developed a way to consistently and reliably monitor infections.
"It's not acceptable to cover failure by changing the rules," he said.
The Associated Press contributed to this report
