Colorado flu and COVID hospitalizations continue to rise, RSV remains high

A virus that’s overcrowding Colorado’s children’s hospitals may finally be reaching its peak, but hospitalizations from flu and COVID-19 continue to climb into the holiday weekend.

Dr. Kevin Carney, associate chief medical officer at Children’s Hospital Colorado, said he thinks the rate of hospitalizations from respiratory syncytial virus, or RSV, is no longer rising, but not yet beginning to fall.

All departments of the hospital are running at full capacity, he said. RSV usually causes cold symptoms, but can be dangerous for young children and older adults.

“We are still dealing with larger numbers of patients than ever before,” he said. “I don’t see a scenario in the next two months where we don’t have very busy emergency and inpatient departments.”

Statewide, only two beds were available in pediatric intensive care units as of Monday, said Scott Bookman, director of the division of disease control and public health at the Colorado Department of Public Health and Environment. The number has fluctuated between zero and five over the past two weeks.

Children’s hospitals are using all available space, and facilities that wouldn’t normally treat children are taking teens into their adult wards and babies slightly older than they normally care for in their neonatal intensive care units, 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 is “no sign of RSV slowing down”, and flu and COVID-19 hospitalizations continue to rise. Between early October and November 19, 295 people in Colorado were hospitalized with the flu, which is more than normal for this time of year.

The most recent flu data from the Center for Disease Control and Prevention is as of Nov. 12. At the time, Colorado had a “very high” transmission rate, based on the rate of outpatient health visits for flu-like illness.

On Tuesday, 387 people were hospitalized with COVID-19 in Colorado, a 21% increase from the previous week. Across the country, hospitalizations from COVID-19 are relatively flat, though they are rising in other states in the West, according to data compiled by The New York Times.

The state health department recorded 8,163 new cases in the week ending Sunday, an increase of about 600 from the previous week. About 12.2% of tests came back positive in the past seven days, which was slightly down from a week earlier.

All but six counties in Colorado had “high” or “substantial” transmission of COVID-19, according to the CDC, based on their cases and positivity rates. 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 number of hospitalizations 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 before the pandemic.

There is no vaccine for RSV, so prevention relies on hand washing, covering 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 received the flu shot and the updated COVID-19 booster to do so as soon as possible. People at risk for serious illness should also have a plan to get antiviral medication, she said.

The number of flu shots given this fall now exceeds the number given on the same date in 2021, though it hasn’t reached 2020 levels, Bookman said. About 21% of eligible people have received one of the new COVID-19 boosters, although the percentage is higher for those over 65.

Initial real-world data on the new boosters suggests they aren’t a perfect shield, but provide some extra protection. According to a study published by the CDC. The effect was greater in younger people and 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 sub-variants that replace BA.4 and BA.5, the versions of the virus they were supposed to block.

The CDC estimated that BA.5 now accounts for about 24% of COVID-19 cases, and BA.4 only accounts for about 0.1%. The BQ.1 and BQ.1.1 variants, which are generally grouped together because they differ by only one mutation, are now believed to cause about half of the cases. All variants now in circulation belong to the Omicron family.

BQ.1.1 and BQ.1 seem more contagious and better able to evade the immune system than other variants, though there’s no sign of them being more serious, Herlihy said.

Because the variants are more evasive, it seems that some antibody-based treatments don’t work well against them. While antiviral treatments like Paxlovid still work, losing those drugs is 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 vaccination.

People don’t need to forego Thanksgiving gatherings altogether, but they do need to consider the risk of spreading viruses to those who are more vulnerable, including young children, Carney said. Families would do well to talk about who might be vulnerable and what risk they feel comfortable with before they get together, he said.

“It’s much better to talk about that in advance than to wait and see what happens,” he said.

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