The number of people in Northern Territory hospitals with COVID-19 has doubled in the past week and tripled from the number reported 10 days ago.
But experts say the surge isn't unexpected considering the territory's "vulnerable" population and caseloads reported over the past fortnight.
Yesterday, the NT recorded 286 cases of coronavirus and a record high of 78 hospitalisations.
The Monday prior, 39 patients were in hospital with COVID-19.
Ten days ago, 24 people with COVID-19 needed hospital care.
Although the territory's hospitalisation rate has been steadily increasing over the past two weeks, the number of cases reported in the jurisdiction has been gradually dropping, prompting Health Minister Natasha Fyles to yesterday claim the NT had "flattened the curve".
But how can hospital rates increase while cases are decreasing?
And what has been contributing the NT's hospitalisation numbers?
Hospitalisations follow high daily case numbers
After looking at the NT's daily COVID-19 case numbers over the past fortnight, Deakin University chair of epidemiology Catherine Bennett said she wasn't surprised by the high number of people in hospital with coronavirus on Monday.
Professor Bennett said if a patient needed hospital-level care because of COVID-19 this typically happened seven and 10 days after their initial positive test result.
"People are often fine for the first week, they might have normal symptoms, but it's the second week when they might get particularly unwell and maybe have to go to hospital," she said.
Ten days ago, on the 13th and 14th respectively, the NT recorded 550 and 546 daily cases — two of the highest daily tallies recorded to date.
"You have to look back at cases seven to 10 days ago and if they were on the rise, your hospitalisations will stay on the rise until those numbers start to level out," Professor Bennett said.
Professor Bennett said hospitalisations were also cumulative, which meant that although a patient was only counted once in the daily case total, but they could be counted every day for a week or more while receiving care in hospital.
"That makes that [hospitalisation] rate look like it's rising higher, but people haven't left yet, and you're adding a few more people in and that's pushing up the number," she said.
NT 'expecting' more COVID hospitalisations
On Monday, Acting Deputy Chief Health Officer Marco Briceno said 2 per cent of the NT's total number of active cases were in hospital.
Director of Infectious Diseases at Griffith University, Nigel McMillan, said the territory's hospitalisation rate, calculated against case numbers reported seven days prior, was higher than other states.
"It's probably twice as high as New South Wales in terms of the number of reported cases verses the number of hospitalisations one week later," he said.
Dr Briceno said NT health experts had been "expecting to see" higher hospitalisations because of its "demographics".
Even before the COVID-19 pandemic, the NT had Australia's highest rate of potentially preventable conditions.
Thirty per cent of Territorians are Aboriginal and Torres Strait Islander, and many have complex conditions that put them at risk of severe COVID-19 disease.
"We are now seeing more COVID affecting Indigenous Territorians, affecting people in high-risk settings and those individuals tend to have a higher need for hospital care," Dr Briceno said.
These high-risk setting includes remote Aboriginal communities, several prisons, and a dialysis hostel.
Australian Medical Association NT Branch president Dr Robert Parker was "concerned" that coronavirus had infiltrated remote Aboriginal communities, where there was substantial overcrowding and health concerns.
"There's very high rates of existing illnesses in remote communities, because of that, they're more prone to significant complications if they do get COVID," Dr Parker said.
John Paterson, chief executive of the Aboriginal Medical Services Alliance NT (AMSANT), said more cases in remote communities would likely lead a greater number of people with coronavirus needing hospital treatment, due to the health issues facing many residents.
Professor Bennett said another thing to consider was that not everyone in hospital with COVID-19 was primarily there for their coronavirus infection.
Half of people in ICU unvaccinated
Professor Bennett said Australia-wide, there was likely to be an under-reporting of COVID-19 case numbers.
"We'll never know how many cases we have now, we're not doing the same contact tracing we have in the past," she said.
According to NT Government figures, more than 95 per cent of Territorians 16 and older are now fully vaccinated.
But Dr Briceno said on Monday half of the people with COVID-19 who had been admitted to the ICU to date were unvaccinated.
Professor Bennett said this was a clear sign that boosters were working, and people should roll-up their sleeves to be vaccinated.
"When there are low numbers [of unvaccinated people] in the community, and they're making up 50 per cent in the ICU, that's telling you the risk you're under if you're not vaccinated," she said.
"Time is of the essence; Omicron waits for no one."
Professor McMillian agreed, describing COVID-19 as a "disease of the unvaccinated".
