For Dr Rina D’Abramo of the MetroHealth System in Cleveland, it’s difficult when patients in the emergency room tell her they have not been vaccinated.

“You can hear it in their voice when you say, ‘Are you vaccinated?’” said D’Abramo, who works at a hospital in the Brecksville suburb. “They shrink down and are like, ‘No. Now I know why I need to be vaccinated.’ ”

Unfortunately, there are plenty of people in Ohio and the rest of the US too who have not yet learned that lesson, even as infection rates nationally start to surge again amid fears of the possibly highly contagious new Omicron variant.

Ohio is one of the states that has seen the largest recent increases in hospitalizations due to Covid as the number of cases climbs across the country. There has been 19% increase in hospitalizations over the past two weeks in the United States, according to a New York Times analysis of data.

Ohio has a daily average of more than 4,400 people hospitalized due to Covid, which ranks fourth among states and represents a 29% increase over the past two weeks.

While the increased number of people vaccinated against Covid had inspired hopes that Americans would be able to experience a relatively normal winter, the rise in Covid cases; holiday gatherings; and unanswered questions about the Omicron variant have sparked fresh concerns and warnings from doctors and public health officials in the US.

“The yellow caution light has gone on because I think our progress in vaccination has slowed,” said William Schaffner, an infectious diseases expert at Vanderbilt University School of Medicine.

Forty percent of the US population has not been fully vaccinated, and the number of doses administered each day has decreased from about 3.3m in April to about 1.7m today, according to the Times.

Ohio is surrounded by states that have also seen a recent surge in Covid cases and hospitalizations. Pennsylvania and Michigan each have a daily average of more than 4,500 patients hospitalized, representing a more than 20% increase over the past two weeks. Illinois and Indiana have seen a 49% increase in hospitalizations.

D’Abramo diagnoses about 10 patients daily with Covid, and about 98% of them are unvaccinated, she said.

That trend has strained the capacity of hospitals in the Cleveland area. MetroHealth, Cleveland Clinic and University Hospitals announced last week that the surge has forced them to postpone some non-urgent surgeries.

“This action frees resources for patients with immediate and life-threatening needs and manages the demands on frontline caregivers, who have served with distinction throughout the pandemic,” reads a joint announcement.

At Beaumont Health, the largest healthcare system in Michigan, the emergency room and other parts of the hospital are full, primarily with patients who are not vaccinated, said Dr Matthew Sims, a Beaumont physician and director of infectious disease research.

“With Covid patients, they have to be in rooms. You can’t go into overload conditions where you turn conferences rooms into emergency rooms or hallways into wards. You can’t do that sort of thing when it’s a contagious disease,” said Sims.

Beaumont, like other hospitals in Michigan and across the country, has also had to contend with a staffing shortage. The federal government recently agreed to send 22 healthcare providers to a Beaumont facility in Dearborn and 22 providers to Spectrum Health in Grand Rapids, the Detroit News reported.

In addition to the shortage, “everyone who works in healthcare is getting very tired. We have been dealing with this for two years straight, and it wears on us,” said Sims.

Doctors continue to not only urge people to get vaccinated against Covid – and for those who are eligible to get a booster shot – but also to encourage people to wear N95 or KN95 masks during indoor gatherings and if possible, to gather outdoors or open doors and windows to improve filtration, said Dr Celine Gounder, an infectious disease specialist and epidemiologist at New York University.

Gounder also suggested that people take rapid Covid tests before holiday gatherings.

“I think we have chosen one of the most painful paths through the pandemic in this country” because of people’s refusal to get vaccinated, Gounder said. “I think we have prolonged our pain unnecessarily.”

Gounder and others now wait for more data on the Omicron variant, which has been detected in 19 states and 50 countries, National Public Radio reported Tuesday.

Researchers in South Africa have reported that Omicron may be more infectious but less severe than other forms of the virus.

While Schaffner emphasized that we are still awaiting more information, if the variant proves more infectious and much less likely to produce hospitalization, “then Omicron might actually be a bonus because we would be vaccinating, but Omicron would also be spreading among the unvaccinated, making them mildly ill and offering them some protection.”

That “would get us closer, faster, to so-called herd immunity, which would lead us to a more endemic circumstance,” rather than a pandemic, Schaffner said.

In the meantime, D’Abramo, the Ohio emergency physician, continues to grapple with the pandemic inside and outside her hospital. Two unvaccinated friends with a 10-year-old child recently became very sick with Covid, she said.

The wife remains on an ECMO life support machine; the husband was hospitalized for two weeks and is now home.

“To me, that’s a tragedy. There is no way to say she wouldn’t have gotten sick if she was vaccinated, but most likely, she wouldn’t have,” D’Abramo said.

At the hospital, she routinely has Covid patients waiting for beds in the intensive care unit. D’Abramo must decide whether to intubate them and connect them to a ventilator.

“I don’t ever come home from a shift and be like, ‘That was a nice, normal shift.’” D’Abramo said. “It’s nonstop and it does kind of feel like you get beat down because you are getting beat down by something that I thought would maybe be over this winter.”

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About half of parents said their 12- to 17-year-old has gotten at least one COVID-19 dose as the vaccination uptake among the age group has slowed in recent months, a Kaiser Family Foundation (KFF) poll found.

The November survey determined that 49 percent of parents said their 12- to 17-year-olds received at least one shot, and just 1 percent of these parents plan to get their children vaccinated right away, according to an update to KFF’s Vaccine Monitor published on Thursday.

Those percentages align with results from September and October, indicating the vaccination rate has flattened within the teenage age group in the fall after eligibility expanded to adolescents in the spring.

Thirteen percent of parents of teenagers said they want to “wait and see” before getting them vaccinated, and 3 in 10 parents said their adolescents would “definitely not” get the COVID-19 vaccine.

Among parents with 5- to 11-year-olds, 16 percent said their child had gotten at least their first shot during the first month the vaccines were available to the age group, while 13 percent said they plan to get their child vaccinated right away.

Still, almost a third of these parents said they expect to “wait and see,” and another 29 percent said their child will “definitely not” get vaccinated.

Most parents said there’s not enough information about the vaccines’ effectiveness, side effects and safety in children, despite scientific organizations nationwide and worldwide having designated the shots safe and effective for children.

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Tottenham’s Premier League game at Brighton on Sunday has been called off because of the Covid outbreak at the London club, as every top flight club was told to reintroduce “emergency measures” to limit infections.

Spurs said on Wednesday that eight players had tested positive, causing their Europa Conference League match against Rennes on Thursday to be postponed. The match at Brighton now also needs to be rearranged.

Tottenham’s Conference League tale of disaster awaits its latest twist

Tottenham’s manager, Antonio Conte, has described everyone at the club as “a bit scared” amid an escalation of positive Covid cases that prompted the first-team area of the training ground to be shut.

A Premier League statement read: “Brighton & Hove Albion’s home fixture against Tottenham Hotspur, due to be played on Sunday 12 December at 2pm, has been postponed following a Premier League Board meeting this afternoon.

“Tottenham asked for the match to be rearranged following a significant number of positive Covid-19 cases among players and relevant staff. This led to First Team facilities at the club’s training centre being closed after consultation with the Premier League and UK Health Security Agency.

“The Premier League Board has taken the decision to postpone the game following guidance from medical advisers, with the health of players and staff the priority. The postponed fixture will be rescheduled in due course and the Premier League wishes a quick recovery to those with Covid-19.”

After confirming the postponement, the Premier League board wrote to all 20 clubs advising of a return to “emergency measures” last seen in the summer, when a series of Covid outbreaks disrupted pre-season preparations. The measures will mandate the wearing of masks indoors, limit time spent in close contact – such as in medical treatment rooms – and also likely involve the return of spot inspections to make sure measures are being followed.

The change came alongside uncertainty over new government Covid measures known as “plan B”. Official government guidance says that as of next Wednesday, sports events “will be required by law to check that all visitors aged 18 years or over are fully vaccinated, have proof of a negative test in the last 48 hours, or that they have an exemption”.

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