“Tipping point” feared from strain on Colorado hospitals
"Tripledemic" of COVID-19, flu and RSV raises possibility that non-emergency surgeries
Flu and COVID-19 hospitalizations are rising in Colorado at a time when pediatric capacity is already strained by a surging respiratory virus, leading health providers to fear they could have to postpone surgeries again if too many people get sick in the coming weeks.
Clinics in the Uchealth system recorded 1,160 positive tests for influenza in the last week, which was a “huge jump” from 495 cases a week earlier, said Dr. Michelle Barron, the system’s senior medical director of infection prevention and control.
While most of those people will recover at home, some inevitably will need hospital care, which is
a problem when COVID-19 hospitalizations are also rising and respiratory syncytial virus, or RSV, continues to put a severe strain on the capacity to care for pediatric patients, she said.
“The more people that get it, the more chances there are that someone will have a complication,” she said of the flu. “I feel like we’re again at the tipping point.”
The country is facing a “tripledemic” of COVID-19, flu and RSV, a virus that typically causes colds but can be severe in young children, said Dr. Oswaldo Grenardo, chief clinical officer for Centura Health. There’s some capacity in the adult system to absorb additional patients, but pediatric care is already strained, he said.
As of last week, 379 people in Colorado were hospitalized with COVID-19. While that’s well below the peaks set in fall 2020 and 2021, it’s more than double the number hospitalized three weeks earlier. The flu hospitalization rate, while still manageable, is higher than is typical at this point in the year.
An early flu season isn’t a neutral thing, with the same number of cases and hospitalizations shifted forward, Barron said. People are more likely to bring the virus to vulnerable relatives if it’s widespread ahead of Thanksgiving and Christmas than they are if the season peaks in January or February, potentially increasing the number of people who become seriously ill, she said.
For now, hospitals are mostly talking about the possibility of shifting resources around, like having flu clinic areas so that patients with respiratory viruses don’t infect others, Barron said. But if too many people get sick in the coming weeks, postponing nonemergency care to free up space could be back on the table, so it’s important for people to get vaccinated and stay home if they’re sick, she said.
“We have actions that can impact this,” she said.
For now, most of the strain is on pediatric units that are dealing with more than double the number of RSV hospitalizations seen at last year’s peak. Older adults and people who have compromised immune systems also can have severe RSV infections, but it disproportionately affects children.
Hospitalizations for RSV remain high, but they aren’t skyrocketing at the rate they were earlier this month, said Dr. Kevin Carney, associate chief medical officer at Children’s Hospital Colorado. The hospital hasn’t needed to use the tent it set up outside the emergency room much in the last week, but it has converted some additional spaces within the facility to serve as patient rooms, he said.
Usually, RSV infections go down when children are away from school and daycare over holidays, but the Children’s Hospital isn’t banking on that, since viruses have been behaving in unusual ways and flu hospitalizations could increase in the near future, Carney said.