“A long winter already”: Colorado’s RSV hospitalizations keep falling, but trajectory of flu and COVID are unclear

A virus that disproportionately hospitalized young kids is receding in Colorado, but the picture is more ambiguous for flu and COVID-19 as the winter holidays approach.

The hospitalization rate for respiratory syncytial virus, or RSV, continued to fall over the last week in Colorado, and the influenza hospitalization rate appeared to drop, too — but it’s not clear if that represents a trend. Statewide COVID-19 hospitalizations remained essentially level, however.

While it’s a good sign that hospitalization rates haven’t continued to climb, it’s too early to say the worst is over, said Talia Quandelacy, an assistant professor of epidemiology at the Colorado School of Public Health. Typically, flu cases and hospitalizations rise following the holidays, but this has been an unusual season, with flu cases taking off significantly earlier than they have over the last decade, she said.

“It’s hard to anticipate what effect the holidays will have,” she said.

On Saturday, Gov. Jared Polis extended the state’s disaster recovery order for another 30 days, noting that almost all pediatric intensive care beds were in use, and that shortages of other hospital beds are possible in the coming weeks.

Scott Bookman, director of the Colorado Department of Public Health and Environment’s division of disease control and public health response, said the state isn’t projecting a bed shortage, but is working with hospitals to be prepared should one or more of the major respiratory viruses surge in the coming weeks.

Hospitals have been adding beds as they see the need and getting creative in finding spaces to care for children, he said.

“It’s been a long winter already,” he said. “As we look forward, we want to be prepared for whatever may come.”

RSV

The clearest trend is in RSV hospitalizations. Those dropped for the third time in the last four weeks in Colorado, though they still remain slightly above last year’s peak.

While most people who get RSV only develop a cold, 1,867 people have been hospitalized with the virus in the Denver area since early October. The majority are children, though adults have accounted for about a quarter of hospitalizations in recent weeks.

At the worst point in November, children’s hospitals were reporting unprecedented numbers of severely ill patients, and sometimes there were no beds available in pediatric intensive care units anywhere in the state. Now, about five or six of the roughly 90 pediatric intensive care beds in the state are open any given day, Bookman said.

About 92% of all general hospital beds and 88% of intensive care beds in the state were full this week. That’s a slight improvement from 94% of general beds and 90% of intensive care beds that were in use last week. The number of beds available has increased since late October, but the week-over-week improvement was mostly due to fewer people receiving hospital care.

Flu

The picture was less clear for the flu than for RSV. The hospitalization rate dropped over the last week, though it’s too early to say that the worst is over, since last year’s season had two peaks, Quandelacy said. So far this season, 1,291 people in Colorado have been hospitalized with flu.

That’s unusually high for this time of the season, mirroring a pattern nationwide. The Centers for Disease Control and Prevention reported almost 26,000 people were hospitalized with flu in the most recent week, for a rate compared to population that’s about 10 times higher than what’s been seen in early December over the last decade.

Dr. Eric France, chief medical officer for the state health department, advised anyone who hadn’t gotten the flu shot to do so now, because the virus is widespread throughout the state. The rate of influenza-like illness was “very high” in Colorado as of Dec. 3, as it was in more than half of states, according to the CDC.

More than 1.6 million people in Colorado have gotten flu vaccines, which is slightly more than in 2021, but fewer than in 2020.

France said that while the state isn’t requiring masks, it’s a good idea to wear one, especially if there are upcoming gatherings you don’t want to miss because of a flu or COVID-19 infection.

“I don’t think any of us want to spend three days with fever, chills, low energy, headaches,” he said.

COVID-19

The trajectory is least clear for COVID-19. Hospitalizations were essentially level, with 395 reported Tuesday afternoon, compared to 399 at the same time last week. It’s difficult to tell if that’s a continuation of the decline seen in the previous week, or the start of a plateau, Quandelacy said.

Cases were down, with 6,166 reported in the week ending Sunday. The percentage of tests coming back positive also dropped from a week ago, though it still averaged a relatively high 9.7% over the last seven days.

Wastewater data offered a mixed picture. Virus concentrations were rising in 30 watersheds, falling in six and stable in and stable in 25. For most of the Front Range, the wastewater data suggested stabilization.

“The wastewater surveillance seems to show some sites starting to trend downward but not clear if that signals other utilities will start to show decreases soon,” Quandelacy said.

Colorado’s COVID-19 deaths started rising in November, roughly doubling from 26 in the week ending Oct. 30 to 58 in the week ending Nov. 20. It’s not clear how deaths have trended in more-recent weeks, because of a delay in reporting.

Seven Colorado counties were still considered high-risk, based on their COVID-19 cases and hospitalizations: Boulder, Broomfield, Fremont, Logan, Moffat, Routt and Sedgwick. The CDC recommends that everyone 2 and older wear masks in indoor public spaces when their county is listed as high risk.

Cases and the positivity rate suggested transmission was “substantial” or “high” in 57 of Colorado’s 64 counties, though, so people who don’t want to get the virus now might consider additional precautions throughout the state.