Colorado hospitals and officials are preparing for COVID-19 hospitalizations to continue to surge in the coming days, a top state health official said Wednesday. Though a peak may be approaching and overall capacity remains stable, hospital officials warn they're still facing a critical crush of patients.
After an autumn wave stretched Colorado hospitals to their tightest moments of the pandemic, December brought a reprieve and a steady decline in COVID-19 patients. But the wildfire-like spread of the omicron variant has swiftly reversed those trends: As of Wednesday, there were more Coloradans hospitalized with COVID-19 than there had been in November 2021, and officials said the overall hospitalization record, set in November 2020, may be surpassed imminently.
Rachel Herlihy, Colorado's state epidemiologist, told reporters Wednesday that 1,577 people are hospitalized with COVID-19, one more than the high of the delta wave from this past fall. Since Christmas Day, 585 people infected with the virus have been admitted to the hospital, and the steep incline has yet to show signs of slowing.
New modeling from researchers at the Colorado School of Public Health, presented by Herlihy, indicate a number of scenarios for the state's hospitals in the coming weeks. Herlihy said it was "likely" that Colorado would end up somewhere between two of them: one it's already surpassed, of 1,479 patients by Jan. 11, and the other that's much higher, 2,144 patients by Jan. 15.
The state's overall record for its most COVID-19 patients at one time is 1,847, set on Dec. 1, 2020. Herlihy said the hospital peak in Colorado may come in the next week, despite the fact that both case and the positivity rates - changes to which signal a surge growing or subsiding - continue to climb.
Tori Burkett, the epidemiology and disease intervention program manager for the Denver Department of Public Health and Environment, said in an email that county officials expect the hospital peak to "likely surpass the previous 2020 peak in the next few weeks."
Herlihy said preliminary data indicates that 65% of patients currently hospitalized with COVID-19 in Colorado are there because of the virus. But that means 35% have "incidental" cases, meaning they may have gone to the hospital for another reason and tested positive subsequently. The ratio in previous waves, Herlihy continued, was between 80% and 90% of COVID-positive patients hospitalized for the virus.
That does not mean, she and others said, that those "incidental infections" can simply be discounted. Herlihy said that infections in other patients may complicate their primary medical issue; it complicates their treatment, as they need to be isolated; and it may extend their length of stay.
COVID-19 infections "continue to be a significant strain on the health care system," she said.
At UCHealth, roughly a third of the 362 patients infected with COVID-19 in the hospital are being treated for complications from the virus, said Michelle Barron, the system's senior medical director of infection prevention and control. The other two-thirds are likely incidental cases. She compared that to August, when only three of 80 COVID-19 patients had incidental cases.
What's more, Barron said UCHealth was seeing what health and hospital officials had reported elsewhere: generally milder disease. She said roughly a third of the system's COVID-19 patients are in the intensive care unit.
"Compare that to delta - using that same ratio without going into specifics, it would be more like 50% to 60% who required intensive care unit care," she said.
Jaya Kumar, the chief medical officer at Swedish Medical Center in Denver, said her facility would send between 30% and 40% of infected patients to the ICU during the delta surge. Now, she said, it's between a fifth and a quarter.
What Kumar and Barron are seeing in their hospitals is reflected statewide. There were 122 ICU beds available in Colorado as of Wednesday afternoon, reflecting about 8% of capacity remaining. While that number is high compared to much of the rest of the pandemic, it's improved from November and early December, when the state would routinely have fewer than 100 - if not fewer than 80 - left at any given time.
Scott Bookman, the state's COVID-19 incident commander, told reporters Wednesday that capacity overall was in better shape. He said there was "no indication of any need" to activate the crisis standards of care for hospitals here, which, while never used thus far in the state, would involve rationing care to certain patients.
Still, despite the stable capacity and relatively mild presentation of omicron patients, officials warned the situation is not strong overall. Kumar and Barron both said COVID-19-infected patients - even those in the hospital for some other reason - are still strains on resources, and the presence of the virus lengthens a patient's stay and complicates their treatment.
"These patients are sicker," Kumar said of COVID-infected people in the hospital for other reasons. "If you have COVID on top of another illness, it prolongs your length of stay. It increase the complications that are happening in these patients. You end up staying longer, with more severe illness. ... This is not easy on our caregiving team because (those patients) need special resources."
"The hospitals are still full, whether it's because they are all COVID, partial COVID, some COVID, some delayed care, some emergent needs - COVID only exacerbates that issue," added Stephanie Sullivan, spokeswoman for HealthONE.
Kumar said during the delta wave of this past autumn, Swedish had a vacancy rate of 20% because of staffing challenges, something that's increasingly plagued hospitals as the pandemic has dragged on. That situation has only worsened with omicron, she said: The variant's emergence has led to more cases in vaccinated staffers, taking health workers out of the already diminished front-line ranks.
"We have to block beds because we don't have enough staff to take care of patients in those beds," she said. "We have to slow down surgeries because we can't do so many surgeries a day."
Even though a smaller ratio of omicron cases are ending up hospitalized compared to the delta wave, Barron said the record-high number of new infections poses a continued, serious risk.
"I'm still trying to figure out how this is going to play out," she said. "But the sheer number of infections, we're still going to end up overwhelmed."