A virus that has overwhelmed children’s hospitals in Colorado may finally have peaked, but flu and COVID-19 hospitalizations continue to rise heading into the holiday weekend.
Dr. Kevin Carney, associate chief medical officer at Children’s Hospital Colorado, said he believes the number of hospitalizations from respiratory syncytial virus, or RSV, has stopped rising but has not yet begun to decline.
All units of the hospital are working at full capacity, he said. RSV usually causes cold symptoms, but it can be dangerous for young children and the elderly.
“We’re still dealing with more patients than we’ve ever handled,” he said. “I don’t see a scenario in the next month or two where we don’t have very busy emergency departments and inpatient wards.”
Statewide, only two beds were available in pediatric intensive care units as of Monday, said Scott Bookman, director of the Colorado Department of Public Health and Environment’s Division of Disease Control and Public Health Response. The number has varied between zero and five over the past two weeks.
Children’s hospitals are using all the space they have, and facilities that wouldn’t normally treat children are admitting teenagers to their adult wards and slightly larger-than-usual babies being cared for in their neonatal intensive care units. Bookman said.
“They are expanding capacity in every possible way … but there is extreme stress,” he said.
State Epidemiologist Dr. Rachel Herlihy said there is “no sign of RSV slowing” and hospitalizations for flu and COVID-19 continue to rise. Between early October and November 19, 295 people in Colorado were hospitalized with the flu, which is higher 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 that time, Colorado had “very high” transmission, based on the percentage of outpatient health visits that were for influenza-like illness.
As of Tuesday, 387 people had been hospitalized with COVID-19 in Colorado, a 21 percent increase from the previous week. Nationally, hospitalizations for COVID-19 have been relatively stable, although they are increasing 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, up from just under a week earlier.
All but six counties in Colorado have had “high” or “significant” transmission of COVID-19 based on their cases and positivity rates, according to the CDC. The level of risk to the community, based on cases and hospitalizations, was high in 11 counties: Archuleta, Dolores, La Plata, Logan, Mesa, Montezuma, Phillips, Prowers, Rio Blanco, San Juan and Sedgwick.
Hospitalization rates for RSV have fallen. Between early October and November 12, 1,139 people, most of them children, were hospitalized in the Denver area. The Department of Health 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 washing hands, covering coughs, and avoiding people who are sick. Wearing masks in public also reduces the risk of many respiratory infections.
Herlihy urged anyone who hasn’t gotten a flu shot and the updated COVID-19 booster to do so as soon as possible. People who are at risk of severe illness should also have a plan to get antiviral drugs, she said.
The number of flu shots given this fall already exceeds the number given on the same date in 2021, although it hasn’t reached 2020 levels, Bookman said. About 21% of eligible people received one of the new COVID-19 boosters, although the rate was higher for people over 65.
Early real-world data on the new boosters suggests they’re not a perfect shield, but they do offer some additional protection. The different groups who received a dose of the new vaccine were 28 percent to 56 percent less likely than people who only had the older vaccines to test positive for the virus between mid-September and Nov. 11, according to study published by the CDC. The effect is greater in younger people and in those who have been at least eight months since their last dose of the original formula.
The study was based on data from community testing sites and did not estimate the chances of severe disease. It’s also unclear 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 has estimated that BA.5 now accounts for about 24% of COVID-19 cases, and BA.4 is responsible for only about 0.1%. The BQ.1 and BQ.1.1 variants, which are usually grouped together because they differ by only one mutation, are now thought to cause about half of cases. All currently circulating variants are in the omicron family.
BQ.1.1 and BQ.1 appear to be more infectious and better able to evade the immune system than other variants, although there is no indication that they are more severe, Herlihy said.
Because the variants are more elusive, some antibody-based treatments don’t seem to work well against them. Although antiviral treatments such as Paxlovid still work, the loss of these drugs is a blow to people with compromised immune systems, some of whom have relied on an antibody cocktail called Evusheld because they cannot build up their own protection after vaccination.
People shouldn’t forgo Thanksgiving gatherings entirely, but they should consider the risk of viruses spreading 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’re comfortable with before getting together, he said.
“It’s better to talk about it up front than to wait and see what happens,” he said.
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