Fast-moving variants of the omicron can cause less severe disease on average, but COVID-19 deaths in the U.S. are climbing, with modelers predicting that between 50,000 and 300,000 Americans could die by mid-March when the wave subsides.

The seven-day rolling average of new daily COVID-19 deaths in the U.S. has been trending upward since mid-November, reaching nearly 1,700 on Jan. 17, still below the January 2021 peak of 3,300. COVID-19 deaths in nursing homes started a small increase in residents two weeks ago, although the rate was still 10 times lower than last year before most residents were vaccinated.

Despite signs that omicron causes milder disease on average, the infection is spreading at an unprecedented level across the country, and cases are surging in many states, meaning many vulnerable people will become seriously ill. If the projected upper bound materializes, the total U.S. death toll from COVID-19 will exceed 1 million by early spring.

“A lot of people are still dying because of the contagiousness of omicron,” said epidemiologist Jason Salemi of the University of South Florida. “Unfortunately, it’s going to get worse before it gets better.”

Sanmi Arreola, director of the health department, said morgues in Johnson County, Kansas, are starting to run out of space. More than 30 residents of the county have died this year, the vast majority of whom were not vaccinated.

But the notion that often less severe variants could still claim thousands of lives has been elusive for health experts. The math of it – a tiny fraction of a very large number of infections can lead to a very large number of deaths – is hard to imagine.

“Overall, you’re going to see more patients, even if you’re less likely to get sick personally,” said Katriona Shea of ??Penn State University and the White House’s combined projections.

Shea said the wave of deaths heading to the U.S. will peak in late January or early February. In early February, the weekly death toll could equal or exceed the peak in Delta and possibly even surpass the peak in the U.S. last year.

An unknown portion of these deaths occurred in people infected with the delta variant, but experts say omicron is also taking lives.

“It’s driven by omicron,” Shea said of the coming wave of death. The comprehensive model projected that between mid-December and mid-March, 1.5 million Americans would be hospitalized and 191,000 would die. Given the uncertainty in the model, the US death toll during the micron wave could be between 58,000 and 305,000.

However, it is increasingly clear that omicron is less risky than previous variants. New evidence from nearly 70,000 patients in Southern California suggests that omicron causes less disease than delta.

Not a Modern Healthcare subscriber? Register today.

A study posted online and cited at a recent White House briefing found that patients using omicron had a 53% lower risk of hospitalization for respiratory symptoms, a 74% lower risk of ICU admission and a 91% lower risk of death. The study, which has not been peer-reviewed, came from researchers at Kaiser Permanente and the University of California, Berkeley.

“It’s hard for me to say that this is good news outright,” said study co-author Sara Y. Tartof, a Kaiser Permanente research scientist. “Maybe in a sense, if you’re infected, your chances of getting seriously ill are lower, but from a societal perspective it’s a very heavy burden for us. It’s still a serious situation. , we need to keep our practices and actions known to protect us.”

Overburdened hospitals could also lead to more deaths, said Mark Lipsitch, scientific director of the Harvard TH Chan School of Public Health and the Centers for Prediction at the Centers for Disease Control and Prevention.

“As medical professionals tell us, where staffing is minimal and patients are overloaded, the quality of care starts to suffer,” Lipsitch said. “It could also lead to a higher death rate, but that’s not in any model I’m aware of.”