A virus that has packed Colorado children’s hospitals may finally be peaking, but flu and COVID-19 hospitalizations continue to surge into the holiday weekend.
dr Kevin Carney, associate chief medical officer at Children’s Hospital Colorado, said he believes the number of hospitalizations for respiratory syncytial virus (RSV) has stopped rising but hasn’t started falling yet.
All of the hospital’s units are operating at full capacity, he said. RSV typically causes common cold symptoms but can be dangerous for young children and older adults.
“We’re still dealing with a higher number of patients than we’ve ever had to deal with before,” he said. “I don’t see a scenario in the next month or two where we don’t have very busy emergency rooms and inpatient units.”
Statewide, only two pediatric intensive care unit beds were available as of Monday, said Scott Bookman, director of the Division of Disease Control and Public Health Response in the Colorado Department of Public Health and Environment. The number has fluctuated between zero and five in the last two weeks.
Children’s hospitals are using all available space, and facilities that wouldn’t normally treat children are admitting teenagers to their adult wards and slightly older babies than they would normally care for in their NICUs, Bookman said.
“They’re expanding capacity in every way they can… but there’s extreme stress,” he said.
State epidemiologist Dr. Rachel Herlihy said there was “no sign of RSV slowing down” and hospitalizations for the flu and COVID-19 continue to rise. Between early October and November 19, 295 people were hospitalized with the flu in Colorado, more than usual for this time of year.
The latest flu data from the Centers for Disease Control and Prevention is as of November 12. At the time, Colorado had “very high” transmission based on the percentage of outpatient health visits that were for a flu-like illness.
387 people were hospitalized with COVID-19 in Colorado on Tuesday, a 21% increase from the previous week. Nationwide, COVID-19 hospitalizations are relatively flat, although they are increasing in other western states, according to the New York Times.
The state health department recorded 8,163 new cases in the week ended Sunday, up about 600 from the previous week. About 12.2% of tests came back positive in the past seven days, down slightly from a week earlier.
All but six Colorado counties had “high” or “substantial” COVID-19 transmission based on their cases and positivity rates, according to the CDC. Community risk levels, based on cases and hospitalizations, were high in 11 counties: Archuleta, Dolores, La Plata, Logan, Mesa, Montezuma, Phillips, Prowers, Rio Blanco, San Juan and Sedgwick.
The hospitalization rate for RSV decreased. Between early October and November 12, 1,139 people, most of them children, were hospitalized in the Denver area. The health department does not collect statewide data on RSV, which was a relatively predictable virus prior to the pandemic.
There is no vaccine against RSV, so prevention relies on washing hands, covering up coughs, and avoiding people who are sick. Wearing masks in public also reduces the risk of multiple respiratory infections.
Herlihy urged anyone who has not yet received the flu shot and updated COVID-19 booster to do so as soon as possible. People at risk for serious illnesses should also have an antiviral medication schedule in place, she said.
The number of flu shots given this fall now exceeds the number given on the same date in 2021, although it hasn’t reached 2020 levels, Bookman said. About 21% of eligible people have received one of the new COVID-19 boosters, although the rate is higher for people over 65.
The first real data on the new boosters indicates that they are not a perfect shield, but offer some additional protection. According to one from the CDC. The effect was greater in younger people and in those who were at least eight months away from their last dose of the original formulation.
The study was based on data from community testing sites and did not assess the likelihood of serious illness. It’s also not clear how well the shots will work against new subvariants replacing BA.4 and BA.5, the versions of the virus they were meant to block.
The CDC estimates that BA.5 now accounts for about 24% of COVID-19 cases, and BA.4 accounts for only about 0.1%. The BQ.1 and BQ.1.1 variants, which are generally lumped together because they differ only by one mutation, are now thought to cause about half of the cases. All currently circulating variants belong to the omicron family.
BQ.1.1 and BQ.1 appear to be more contagious and better at escaping the immune system than other variants, although there’s no evidence they’re more severe, Herlihy said.
Because the variants are more evasive, some antibody-based treatments don’t seem to work well against them. While antiviral treatments like Paxlovid still work, the loss of these drugs comes as a blow to people with compromised immune systems, some of whom have relied on an antibody cocktail called Evusheld because they can’t build their own defenses after being vaccinated.
People don’t need to skip Thanksgiving gatherings entirely, but they do need to consider the risk of spreading the virus to those who are more vulnerable, including young children, Carney said. Families would do well to talk about who might be at risk and what risk they are comfortable with before gathering, he said.
“It’s much better to talk about it in advance than to wait and see what happens,” he said.
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