Nearly 9 million Americans called out sick in January due to the record-breaking surge of Omicron cases throughout the country, according to a U.S. Census Bureau survey conducted earlier this month.

That is by far the highest tally since the census bureau began to survey “out sick” workers in April, 2020. The latest survey, conducted between Dec. 29 and Jan. 10, includes people who called out sick after testing positive, as well as those who called out to take care of someone with COVID.

The previous high was January, 2021, when 6.6 million Americans called out sick during the pandemic’s first wave, before vaccines were introduced to the general population in the U.S.

Omicron’s severe impact on the U.S. labor market comes as employers are struggling to find workers across all sectors. On top of that, the so-called “Great Resignation” has shown no sign of slowing down—in November of last year, 4.5 million people quit their jobs—the highest number on record.

Labor shortages in recent weeks have hit several industries particularly hard, including trucking, air travel, food sales and essential services like garbage collection and policing, according to The Washington Post. This has contributed to continued supply chain issues that have impacted consumers for months.

And there are signs the Census Bureau’s survey may not even fully account for Omicron’s impact on workers nationwide.

A survey published in December 2021 by Harvard University's The Shift Project found that roughly 65% of workers who reported feeling sick between September and November of 2021 worked through their illness, primarily because of financial reasons and because of fear of reprisals.

Omicron’s effect on the labor market serves as another reminder of how the country’s economic outlook is tied to its health

“Time and time again, we see that this economic recovery is tied to the pandemic,” said Luke Pardue, an economist with payment service Gusto in an interview with CBS News last week.

Still, there is hope that the Omicron’s peak is on the horizon.

On January 23, Dr. Anthony Fauci, the White House’s chief medical adviser, said he was “as confident as you can be” that Omicron cases across the U.S. will peak in February.