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Case counts may be losing importance amid omicron

The explosive increase in U.S. coronavirus case counts is raising alarm, but some experts believe the focus should instead be on COVID-19 hospital admissions. And those aren’t climbing as fast.

Dr. Anthony Fauci, for one, said Sunday on ABC that with many infections causing few or no symptoms, “it is much more relevant to focus on the hospitalizations as opposed to the total number of cases.” Other experts argue that case counts still have value.

As the super-contagious omicron variant rages across the U.S., new COVID-19 cases per day have more than tripled over the past two weeks, reaching a record-shattering average of 480,000. Schools, hospitals and airlines are struggling as infected workers go into isolation.

Meanwhile, hospital admissions averaged 14,800 per day last week, up 63% from the week before, but still short of the peak of 16,500 per day a year ago, when the vast majority of the U.S. was unvaccinated. Deaths have been stable over the past two weeks at an average of about 1,200 per day, well below the all-time high of 3,400 last January.

Public health experts suspect that those numbers, taken together, reflect the vaccine’s continued effectiveness at preventing serious illness, even against omicron, as well as the possibility that the variant does not make most people as sick as earlier versions.

Omicron accounted for 95% of new coronavirus infections in the U.S. last week, the Centers for Disease Control and Prevention reported Tuesday, in another indication of how astonishingly fast the variant has spread since it was first detected in South Africa in late November.

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 primarily of laboratory-confirmed cases of COVID-19, not the actual number of infections out there, which is almost certainly many times higher.

The daily case counts are also subject to wild swings. The number of new cases recorded on Monday topped an unprecedented 1 million, a figure that may reflect cases that had been held up by reporting delays over the holiday weekend. The seven-day rolling average is considered more reliable.

Now, the value of the daily case count is being called into question as never before.

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.

FILE - A man is swabbed for COVID-19 at a walk-up testing site at Farragut Square on Dec. 23, 2021, just blocks from the White House in Washington. The explosive increase in U.S. coronavirus case counts is raising alarm, but some experts believe the focus should instead be on COVID-19 hospital admissions. And those aren't climbing as fast. (AP Photo/Jacquelyn Martin, File )
FILE - Medical staff transport a patient from a COVID-19 ward to the intensive care unit to be put on a ventilator, at the Willis Knighton Medical Center in Shreveport, La., Aug. 17, 2021. The explosive increase in U.S. coronavirus case counts is raising alarm, but some experts believe the focus should instead be on COVID-19 hospital admissions. And those aren't climbing as fast. (AP Photo/Gerald Herbert, File)
FILE - A member of the Salt Lake County Health Department COVID-19 testing staff performs a test outside the Salt Lake County Health Department, Dec. 28, 2021, in Salt Lake City. The explosive increase in U.S. coronavirus case counts is raising alarm, but some experts believe the focus should instead be on COVID-19 hospital admissions. And those aren't climbing as fast. (AP Photo/Rick Bowmer, File)
FILE - A worker, left, rests for a second between patients, as another person, right, is tested for COVID-19 at a walk-up testing site at Farragut Square, Dec. 23, 2021, just blocks from the White House in Washington. The explosive increase in U.S. coronavirus case counts is raising alarm, but some experts believe the focus should instead be on COVID-19 hospital admissions. And those aren't climbing as fast. (AP Photo/Jacquelyn Martin, File)
FILE - People line up for coronavirus tests on Wall Street in the Financial District in New York on Dec. 16, 2021. The explosive increase in U.S. coronavirus case counts is raising alarm, but some experts believe the focus should instead be on COVID-19 hospital admissions. And those aren't climbing as fast. (AP Photo/Ted Shaffrey, File)
FILE - Medical staff tend to a patient with coronavirus, on a COVID-19 ward inside the Willis-Knighton Medical Center in Shreveport, La., on Aug. 18, 2021. The explosive increase in U.S. coronavirus case counts is raising alarm, but some experts believe the focus should instead be on COVID-19 hospital admissions. And those aren't climbing as fast. (AP Photo/Gerald Herbert)
FILE - People line up to take a COVID-19 test at a free testing site in Chicago, on Dec. 30, 2021. The explosive increase in U.S. coronavirus case counts is raising alarm, but some experts believe the focus should instead be on COVID-19 hospital admissions. And those aren't climbing as fast. (AP Photo/Nam Y. Huh, File)
FILE - A COVID-19 patient, struggles to breathe while talking to a nurse at Providence Holy Cross Medical Center in Los Angeles, on Dec. 14, 2021. The explosive increase in U.S. coronavirus case counts is raising alarm, but some experts believe the focus should instead be on COVID-19 hospital admissions. And those aren't climbing as fast. (AP Photo/Jae C. Hong, File)
FILE - People wait in line in their cars to be tested for COVID-19 at a drive-thru testing site at Zoo Miami, Monday, Jan. 3, 2022, in Miami. The explosive increase in U.S. coronavirus case counts is raising alarm, but some experts believe the focus should instead be on COVID-19 hospital admissions. And those aren't climbing as fast. (AP Photo/Rebecca Blackwell)