BALTIMORE — January is poised to be Maryland’s most deadly month of the coronavirus pandemic, according to state data, even as the number of new infections reported daily trends downward.
State health officials track fatality data in two ways: when deaths are reported and when they actually occurred. By both measures, Maryland is either ahead or projected to surpass previous peaks.
Health officials already have added more COVID-19 deaths to the state tally this month than in any previous month since March 2020 with 1,475 fatalities, passing a previous record set last May of 1,364. These are deaths that could’ve happened in January or earlier but are newly confirmed to have been due to COVID-19.
Meanwhile, at least 1,406 COVID-19 fatalities have occurred in January, according to the department, already eclipsing its previous record of 1,392 deaths in a month, set in December 2020. In all, at least 13,078 Marylanders have died of COVID-19.
Gov. Larry Hogan and other officials statewide warned that the death toll could be high over the next several weeks even as the number of new cases reported each day declines. That’s because deaths tend to lag infections by as much as a month, according to researchers and public health experts.
“We do anticipate the number of deaths to continue to rise in the short term before peaking, and then also beginning to decline, along with all the rest of the metrics,” Hogan said recently.
At a state Board of Public Works meeting Wednesday, Hogan said the vast majority of deaths caused by the virus continue to be among people who are not vaccinated.
The heavy case loads, hospitalizations and deaths have followed the rise of the new omicron variant, which the World Health Organization identified as a “variant of concern” just after Thanksgiving. Though researchers believe omicron to cause less severe illness than previous strains, it is far more contagious, infecting more than 357,000 Marylanders since December, according to state data.
“In Maryland, we had an extraordinarily large peak in cases — many more omicron cases than any previous wave. So, that’s going to be reflected in the death count several weeks later,” said Dr. Eric Toner, an emergency medicine physician and senior scholar at the Johns Hopkins Center for Health Security. “We have to keep in mind that the number of cases we had here in Maryland was quite high.”
Maryland’s 14-day average case rate has fallen from a peak of more than 12,500 earlier this month to about 6,000, according to the latest figures. The number of people hospitalized in the state also has decreased to 2,103, down from a peak of nearly 3,500.
The state’s case rate is now among the lowest in the country, Hogan’s office said Wednesday, with the testing positivity rate dropping 58% and the case rate down 67%. The Republican governor said the state is “doing everything [it] can” to get everyone inoculated against the virus, which he called the best defense against new variants.
But, so long as thousands of people continue to test positive each day, the number of people getting hospitalized for the virus in Maryland will continue to be high.
The state’s emergency departments have been crushed by high volumes of patients seeking treatment, not just for COVID-19, but also for the flu and other respiratory viruses. Several acute-care hospitals have shifted to crisis-mode standards of care in recent weeks, allowing them to keep up with demand by temporarily suspending certain documentation requirements, redeploying staffs and postponing some surgical procedures.
Omicron’s rampage in Maryland will soon be replicated across the country, public health experts say. In the U.S., more than 18 million people have been infected in the last 28 days, according to the Johns Hopkins University COVID-19 dashboard, and there have been close to 49,000 deaths in the same period. There have been more than 72 million cases reported since March 2020 and more than 872,000 deaths in the U.S.
With 264 deaths per 100,000 people, the U.S. death rate trails only Brazil’s, and is about tied with Argentina, according to the Hopkins dashboard. There were 2,911 U.S. deaths reported Tuesday.
The numbers, while high, still trail behind previous U.S. peaks. The country hit an all-time daily high in deaths in January 2021, with 4,442. It has reached 53,225 deaths this month, below its record high of 96,654 last January.
Dr. Greg Schrank, an epidemiologist at the University of Maryland Medical Center in Baltimore and a professor in the university’s medical school, said last winter’s surge and the current surge aren’t easily compared, however. The previous high marks for cases and deaths were fueled by a different variant, and vaccinations were not yet widespread.
While studies suggest that omicron generally causes less severe disease — one recent study found a 50% reduction in hospitalizations — Schrank said that doesn’t mean hospitals will have light loads.
“It’s still a deadly and dangerous virus and we’re seeing it play out with the daily death rate,” he said.
Most of those with severe disease are unvaccinated, or not boosted, he said, and are older or have underlying health conditions.
But not everyone hospitalized was particularly vulnerable. Schrank noted that “some of the older patients were pretty robust and not sick before they came with COVID pneumonia.”
And even with a drop in cases and hospitalizations, the lag in time between illness onset to severe disease may mean deaths won’t begin to drop for the next couple of weeks to a month from now.
Researchers and modelers believe that urban areas in the North and Northeast will have more sustained declines before the rest of the country. Western Maryland and the Eastern Shore now lead the rest of the state in the 14-day average case rate per 1,000, a situation that could pose more problems due to less widespread vaccination there.
In the Baltimore area, Dr. John Chessare, president and CEO of the Greater Baltimore Medical Center, said the Towson hospital’s workload has notably improved, thanks to the lessening case rates and the efforts and due diligence of area residents who have heeded state officials’ warnings about stress and strain.
“It is now clear to everyone that things are starting to get better,” Chessare said in recorded remarks, adding that state testing centers have helped divert some patients from utilizing emergency departments for nonemergent needs.
Of the 57 patients currently hospitalized for COVID-19 at GBMC, 10 are in the intensive care unit, two of who have been vaccinated, Chessare said.
The situation is similar across the MedStar Health network of 10 hospitals, where about three-quarters of the patients hospitalized with COVID-19 are not immunized, said Dr. Terry Fairbanks, the system’s chief quality and safety officer and an emergency department physician.
Fairbanks said booster doses have proven critical to keeping people out of hospitals. About a fifth of the critically ill and dying patients at MedStar hospitals are not boosted, he said, making it increasingly obvious that the definition of “fully vaccinated” is changing.
“The public doesn’t understand the critical importance of being boosted,” he said. “They feel good about being vaccinated and they kind of stopped there. Without a booster they are not fully protected from getting COVID, transmitting COVID or becoming seriously ill.
“We know what works best is getting vaccinated and boosted and masking and being around only people who are masked and distancing,” he continued. “It’s absolutely important. I know people are tired of it.”
A number of patients at MedStar hospitals have come to get treated for the health care problems they put off earlier in the pandemic, Fairbanks added. But COVID-19, he said, remains the dominant problem, straining health care providers and services.
“When we look at graphs, they can be misleading. Our hospitals are still full,” Fairbanks said. “We’re not seeing a decrease in ICU patients and we’re setting records with deaths of COVID patients. I think there is a misconception about omicron when people say it’s less severe. It’s so much more contagious, there are more cases and so overall it’s more deadly.”
Hopkins’ Toner said it’s possible the death rate has peaked already in Maryland, though it might take a bit longer to say for sure. But people should not confuse declines in deaths with the end of the pandemic, he said.
“We were surprised by delta and omicron, so we should keep our guard up,” Toner said. “Even though case counts are coming way down, we’re still at a level where it’s high as we’ve ever been before.”
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Baltimore Sun content editor Steve Earley contributed to this article.
