Colorado’s RSV, COVID and flu hospitalizations all rising

Questions about hospital capacity if three viruses continue to surge

More Coloradans are hospitalized for COVID-19, flu and respiratory syncytial virus, or RSV, than were a week ago, putting the state in a potentially precarious position heading into a major holiday.

As of Tuesday afternoon, 379 people were hospitalized statewide with COVID-19 — an 18% increase from a week earlier. That’s on top of a 47% jump in the previous week, and puts hospitalizations at their highest level since late February.

While it’s nowhere near the level reached in mid-january, when 1,676 people were hospitalized with COVID-19 during the omicron surge, the concern is that there’s less capacity in the health care system to absorb an influx of patients, said Beth Carlton, an associate professor of environmental and occupational health at the Colorado School of Public Health.

During previous COVID-19 surges, flu and RSV were almost entirely absent.

“Given the compounding flu plus RSV plus COVID, it could put some strain on an already strained hospital system,” she said.

The Colorado Department of Public Health and Environment doesn’t release the number of people currently hospitalized for flu and RSV, a virus that usually causes colds but can be severe in young children and older adults. It does give the hospitalization rates compared to population, though, which allows for comparisons over time.

The rate of hospitalizations for RSV is 280% higher than it was at last year’s peak — literally off the charts, with the state having to reformat its dashboard at least twice — and 895 people have received hospital care in the Denver area for RSV since Oct. 1. The vast majority are children, though two long-term care facilities have reported outbreaks.

The flu hospitalization rate is higher than it was at this point in recent years, but hasn’t spiked at this point. The state has recorded 164 flu hospitalizations since Oct. 2.

Last week, Children’s Hospital Colorado raised the alarm that it was operating at or above capacity consistently, and asked the public to take precautions, particularly around infants and toddlers. There’s no vaccine for RSV, but handwashing,

wearing masks and avoiding sick people can reduce the odds of getting it.

Colorado isn’t the only state where capacity is a concern: The Oregon Nurses Association called for hospitals to delay elective procedures until demand for beds has gone down; a children’s hospital in Michigan reported every bed was full as of Friday; and three hospitals in San Diego put up tents outside to handle patients who were overflowing their emergency rooms.

So far, there’s no sign any of the viruses are peaking. The state doesn’t track cases of RSV, but the percentage of tests coming back positive has continued to rise, reaching 23% in the week ending Saturday. It’s not a perfect measure, but when the positivity rate is going up, it generally signals that a pathogen is spreading more widely.

As of Nov. 5, Colorado had high flu activity, based on the percentage of outpatient health care visits that were for flu-like illness, according to the Centers for Disease Control and Prevention.

About 12.6% of COVID-19 tests have come back positive over the last seven days, a slight increase from 12.3% a week earlier. The state recorded 7,556 cases in the week ending Sunday, which was about 1,000 more than in the previous week.

More than half of Colorado’s counties are now at medium risk, based on their COVID-19 cases and hospitalizations, according to the CDC. Rio Blanco County was considered high risk, with about 15 hospital admissions for COVID-19 per 100,000 people, and roughly 4% of hospital beds used by people with the virus.

All but nine counties had substantial or high community transmission, based on their case counts and the percentage of tests coming back positive.

Nationwide, hospitalizations for COVID-19 have increased slightly since midoctober, according to data compiled by The New York Times. Over the last two weeks, they’ve risen in the Mountain West, but fallen in the Northeast.

It’s not clear how long COVID-19 infections might continue to rise in Colorado, Carlton said. In the previous two years, spread took off in November, then started to subside in December, but it’s not clear if the same thing will happen this year, she said. (In December 2021, the reprieve was short-lived, because the omicron variant arrived in the United States around Thanksgiving and promptly spread like wildfire.)

“Whether we can bank on things starting to decline in a month, I don’t know,” she said.

Recent upticks in Europe only lasted a few weeks, but

they had a different mix of variants than the United States is currently seeing, Carlton said. Populations in northern and western Europe also were more likely to get a booster shot, according to STAT News.

Nationwide, the BA.5 variant only accounts for about 30% of infections now, according to estimates from the CDC. The BQ.1.1 and BQ.1 variants, which are believed to be better at evading the immune system than BA.5, continued to expand their share to about 24% and 20% of cases, respectively. All of the currently circulating variants are in the omicron family.

The most recent variant data in Colorado is from Oct. 23. At that point, BA.5 was found in 69% of sequenced samples, and BQ.1 and BQ.1.1 accounted for a combined 16%.

The best thing people can do to limit the impact of viruses in the coming weeks is to get their flu shots and COVID-19 booster shots as soon as possible, Carlton said. You should stay home if you feel sick, even if you test negative for COVID-19, because RSV and the flu can be severe for older people and young children, she said. Wearing masks in public also reduces the odds of infection.

“It’s important that we work to make Thanksgiving not a giant respiratory disease spreading event,” she said.