COLUMBUS, Ohio (WCMH) — The highly contagious omicron variant of COVID-19 has been the dominant driver of new cases in Ohio since late December.

The latest genomic sequencing by the Ohio Department of Health on Monday shows more than 77% of cases surveyed in the two weeks ending Jan. 1 were omicron. And CDC sequencing as of Tuesday shows the variant was 99.5% of cases surveyed nationwide last week.

As omicron pushes cases to record levels, NBC4 spoke to Dr. Mahdee Sobhanie, an infectious disease specialist at the Ohio State University Wexner Medical Center, to analyze the current surge.

What do these record case numbers mean?

“Because we are coming off a long holiday weekend where people gathered with one another, I think that’s what the reflection is,” Sobhanie said of January’s high case numbers

Ohio saw an uptick in delta variant cases after Thanksgiving, but Sobhanie noted omicron’s higher transmissibility, “the easing of social distancing” and “the decrease in mask compliance” contributing to the current surge.

Ohio’s 14-day average of onset cases, the measure ODH recommends looking at instead of daily case counts sometimes affected by backlogs, sits at 20,701 as of Monday. ODH reported 19,538 new infections that day.

The state’s highest day yet, Jan. 4, saw 31,430 onset cases. (The number of infections on a single day are preliminary and expected to rise for at least 14 days after.)

OSU Wexner professor Dr. Carlos Malvestutto told NBC4 last week that because of at-home tests, the 20,000-cases-per-day mark could actually be between 60,000 and 100,000 cases. Only PCR tests, the most sensitive kind that are usually swab tests done by medical professionals.

“I do think that the case numbers are much higher than what we’re currently seeing,” Sobhanie said. He added that asymptomatic people and those who just don’t get tested also don’t get counted.

Cases have been so unprecedently high during the omicron wave that ODH case counts last Friday (41,455), Saturday (26,117) and Sunday (50,299), included backlogged infections. The department said an enhancement to the system is now implemented to better keep up with new cases.

When will omicron peak?

“I think we all expect that there should be a peak in January, and that we should be seeing this descend,” Sobhanie said.

Many things factor into that, however. He cautioned that K-12 and college students returning to classrooms may affect the expected downward trend, as could mask compliance and large gatherings “in different areas where it’s very difficult to socially distance.”

“I do think just still implementing some of these social mitigation measures are going to be important in terms of decreasing kind of the spread of omicron,” Sobhanie said. “But I do think that the surge that we saw should be coming down.”

Robert Wyllie, chief of medical operations at the Cleveland Clinic, told reporters about two weeks ago that the Cleveland area has “begun to peak” after being the first region in Ohio to be hit by the omicron wave.

ODH data reflects that, per an NBC4 analysis of Cuyahoga County cases and Franklin County cases since Dec. 1. Notice how non-preliminary daily case counts (those that are more than 14 days ago) are falling in Cuyahoga but not yet in Franklin:

What to think of hospitalizations

The omicron wave has brought coronavirus hospitalizations to record levels throughout Ohio. But although hospitalization data lags behind cases by a week or so, the proportion of omicron cases that put infected people in hospital beds is lower than previous variants.

Studies have shown omicron to be a less severe variant, but Sobhanie cautions that unvaccinated people and those with underlying conditions should not bet on having an easy time.

“The one thing that kind of worries me is that there’s a thought process that omicron is more of a mild disease,” he said. “And it may be mild for those who are boosted and have an intact immune system. It could be a little bit more of a severe disease for those who are boosted but they have underlying comorbidities or who don’t have an intact immune system.”

ODH data from last Wednesday shows more than 94% of Ohioans hospitalized for COVID-19 have not been fully vaccinated.

Sobhanie said he didn’t know the exact percentage of Wexner coronavirus patients who are unvaccinated, but he noted the “vast majority” he is seeing who need a higher level of care, such as oxygen or an ICU bed, are unvaccinated.

Will deaths skyrocket, too?

Deaths from COVID-19, which lag weeks behind case and hospitalization data, have yet to show any movement related to the omicron wave.

In South Africa, where omicron was first detected and has already peaked, the federal government reported only a “marginal increase” in deaths. That country’s population, however, is younger than Ohio’s, but the Buckeye State is more vaccinated.

“I think that you have to look at infections and deaths in terms of buckets,” Sobhanie said, such as looking at how omicron affects people who are vaccinated versus unvaccinated, and looking at the comorbidities that could weaken a person’s fight against the virus.

“Really, at the end, we want to be able to say to a particular patient, ‘Listen, if you have high blood pressure, diabetes, if you’re immunosuppressed, this is what omicron means for you going forward,'” Sobhanie said.

Bottom line: Get vaccinated

The overwhelming scientific evidence and advice from medical leaders remains that getting vaccinated is the best way to prevent catching COVID-19 or limit its worst effects.

New shots have been pretty consistent in Ohio since early December at just under 10,000 per day, but only about 61% of Ohio’s population has gotten at least one shot. That’s eighth-lowest in the U.S., according to the CDC.

Sobhanie said he would like to see everyone vaccinated, because unvaccinated people have worse coronavirus cases, which is more strain on the health care system. But with about 6 in 10 Ohioans with one shot of a vaccine, he said he would like to see the number “be close to 90-some percent.”

“I don’t think it’s a one-answer-fits-all for why certain individuals are vaccine-hesitant over others,” Sobhanie said. “I do think it’s incredibly important during the pandemic that that everybody has a doctor that they trust, that they can sit down and listen to and talk to.”