Overnight on Friday, BJC Healthcare, the largest system in the St. Louis region, sent out an email to tens of thousands of residents in the area, warning them not to come to emergency rooms to be tested for COVID-19. Or to urgent care facilities. Or to convenience care facilities, because all those facilities are already overloaded with people who are symptomatically ill from COVID-19. As for testing, only those who are already ill are getting a test. Not because of a test shortage, but because of a patient overflow.

For those who are experiencing symptoms, the email encourages recipients to seek an at-home test or get in line at a public testing facility, but above all, the message is to stay out of the ER. The same email also notes that procedures and surgeries are being postponed “because our nurses, staff and facilities are stretched to the limit during this latest COVID surge.”

How severe is the strain being placed on the health care system by omicron? Well, no such email was sent during any previous surge during the pandemic, not even when Missouri was leading the nation in cases at the beginning of the delta wave. And St. Louis is far from alone.

From Maine to Arizona, systems aren’t just on the brink of collapse. They’re there.

This is where we are, at the end of the first week of January 2022: It’s not just that the number of patients is skyrocketing, it’s that nurses, doctors, and other health care workers are also out sick.

Omicron is adding patients to the system more rapidly than in any past surge. It’s not just more people, it’s more people, more quickly.
More health care workers are falling ill than in past waves. After two years of pandemics, hospitals and health care staff are already operating at the ragged edge. There have already been retirements, and thousands of health care workers have simply died. Now they’re sick, just as the system is being flooded.
The omicron wave is hitting nationwide. This isn’t a crisis that’s primarily focused in one region. It’s everyone, everywhere, all at once. So unlike past waves, it’s not possible to shift people from area to area to address immediate needs.

The biggest problem the nation faces right now isn’t a shortage of tests, it’s a shortage of health care.

KOLD, ARIZONA:

WTOP, Washington, D.C.:

WGME, Maine:

WKOW, Wisconsin:

Mississippi Free Press:

As The Atlantic reported on Friday, omicron may be milder than delta on an individual level, but it’s high level of transmission means that it’s anything but mild when it comes to the health care system. “When a health care system crumbles,” writes science correspondent Ed Yong, “this is what it looks like.”

Emergency rooms fill. Waiting times get longer. Surgeries get postponed. Tests get overlooked. And in time, health care delayed becomes healthcare denied. 

That email from BJC Healthcare in St. Louis includes this plea: “If you’re not yet vaccinated, it’s not too late. The vaccine remains the best way you can combat this virus and keep yourself and your loved ones safe, well and out of the hospital.”

To that, please add a mask. A good one. An N95 or KN95 mask. Wear it, even in the briefest of encounters.  

There will again be time for a wonderful, relaxing meal at your favorite restaurant. There will again be the opportunity to make that trip you’ve always dreamed about. But this isn’t that time.

On Friday, The New York Times reported on projections about where the omicron wave is going. That model first projects what already seems obvious:  January 2022 will see more cases of COVID-19 than any other month of the pandemic. Whether the rapid rise in cases is really followed by the rapid fall that some have predicted is still up in the air. It depends on us, and what we do now.

Eventually, this surge will be over. When it’s over, it may really be the time to think about doing all those things you’ve put on hold. But to get that time, first you have to live. You have to survive the crisis happening right now.