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Interview'Impact is less dramatic' but 'things are ramping up fast'

View from a COVID ward: With Omicron, even the sickest patients are breathing easier

At Hadassah Hospital, Prof Zvi Fridlender describes a race for more beds as cases grow, alongside relief new variant isn’t leaving patients gasping for air as its predecessors did

Nathan Jeffay

Nathan Jeffay is The Times of Israel's health and science correspondent

A member of Hadassah Medical Center's staff cares for a coronavirus patient on December 27, 2021. (Olivier Fitoussi/Flash90)
A member of Hadassah Medical Center's staff cares for a coronavirus patient on December 27, 2021. (Olivier Fitoussi/Flash90)

Throughout four coronavirus waves, patients gasped for air as Prof. Zvi Fridlender of Hadassah Medical Center darted between them, trying to help. This time around, to his relief, they are breathing easier.

“With Delta, I would walk around and see this patient is deteriorating with breathing, this one needs oxygen, and this one will soon need ventilating,” the senior physician said on Monday, as he prepared to open and head his hospital’s third coronavirus ward, which was expected to receive its first patients on Tuesday.

“With Omicron, we don’t have the same extent of deterioration happening before our eyes; the impact is less dramatic.” That is the case even among serious patients, Fridlender noted.

This assessment from Hadassah’s wards and others appears to corroborate a growing body of research suggesting that Omicron doesn’t infect cells deep in the lungs as much as it hits those in the upper airways.

In one of the most influential studies, Dr. Michael Diamond, a virologist at Washington University in St. Louis, Missouri, infected animals with a range of variants, and found that the concentration of virus in those infected with Omicron was ten times lower than others.

Despite his relief over the limited effect on patients’ lungs, Fridlender spoke with a sense of urgency during his interview with The Times of Israel.

Prof. Zvi Fridlender of Hadassah Medical Center (courtesy of Hadassah Medical Center)

Israel’s Omicron spike is so pronounced that the new ward is the third to open at Hadassah in the space of two weeks. Until a dedicated ward was opened on December 27, coronavirus patients were so few and far between that they were isolated within rooms in internal medicine wards.

At the time, there were seven coronavirus patients at Hadassah; now there are 52, with four in critical condition and 15 in serious condition. Nationally, there were 13,053, with 143 in hospitals, 87 of them in serious condition on December 27. Now, two weeks later, there are 115,010 Israelis infected, with 523 in hospital and 205 in serious condition.

“Things are ramping up very quickly here,” Fridlender said. “Not long ago we opened the first ward, three days ago we opened the second, and we’re now about to open the third.”

The main COVID-fighting weapons in wards are the same as in previous waves, though there is an additional line of defense on the home front: newly approved pills made by Pfizer and Merck that are given to patients at home, to prevent deterioration.

This image provided by Pfizer shows its anti-COVID pills. (Pfizer via AP)

Those who reach the hospital are commonly given antiviral treatments like remdesivir, and steroids like dexamethasone. As in past waves, those who are vaccinated tend to respond better and fare better, Fridlender reported.

One part of the arsenal that is far more rarely used today is the ventilator, which was thought to be the ultimate piece of medical equipment in the first wave. “We’re simply not in the same constant race to help people breathe, to catch them in time just before they fall into serious difficulty breathing,” said Fridlender. “There isn’t the same level of pressure. This makes a huge difference.”

He said this is the latest of several changes that have made coronavirus wards feel less isolated and intense as the course of the pandemic progressed, commenting: “Departments are different now in many ways. At the start of the pandemic, there were no visitors, but that changed, and now family members visit in full protective gear, and this has brought about a big change in how wards feel.”

Patients diagnosed positive for COVID-19 who are hospitalized at the Hadassah Ein Kerem Hospital coronavirus ward receive a visit from family members (Olivier Fitoussi/Flash90)

Fridlender is reassured by Omicron’s apparently lighter impact on people than its predecessors. “I assume that if the virus doesn’t change, then with this strain the proportion of seriously ill people will remain low,” he said, adding that this doesn’t mean Israel is out of the woods.

The current variant spreads so fast that it may infect such large numbers that serious illness among just a small minority could put major pressure on healthcare, he believes. He warned: “Even if a relatively small proportion of people is very sick, the numbers could be such that we have a large number of sick people.”

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