Colorado COVID hospitalizations stay relatively flat, for now

Colorado’s COVID-19 situation looks stable for now, but rising hospitalizations on the East Coast and in parts of Europe suggest another wave could make its way here.

The Colorado Department of Public Health and Environment reported 179 people were hospitalized with COVID-19 across the state as of Tuesday afternoon. Hospitalizations have been bouncing between about 150 and 200 since late August, with no clear direction.

Cases increased by 260 to 4,290, which is roughly where they were two weeks ago. The percentage of tests coming back positive also increased to 6.2%, from about 5.1% a week earlier — a fluctuation that’s probably not significant, said Beth Carlton, an associate professor of environmental and occupational health at the Colorado School of Public Health.

Statewide, the amount of virus in the wastewater is also relatively flat, Carlton said. As of Tuesday, 16 wastewater utilities showed increases in virus concentrations, 17 showed decreases and 22 were plateaued.

“I think all signs point to a plateau,” she said.

That said, a “non-trivial” number of people are still contagious, so it’s a good idea to get your COVID-19 booster, Carlton said. Ideally, people who plan to travel or see vulnerable relatives on Thanksgiving should get their booster and flu shot before Halloween, so they have time to build immunity, she said.

The Centers for Disease Control and Prevention’s dashboard showed only Alamosa County was at the “medium” risk level, while Colorado’s other counties were at low risk. The community risk level is largely based on hospitalizations.

Transmission levels, which are largely based on cases, were a different story, with 44 of the state’s 64 counties deemed to have “substantial” or “high” transmission.

The state’s most recent modeling report showed hospitalizations would continue to fall unless there was a new variant. It’s possible that could happen, but trends on the East Coast and Europe could be warning signs.

About one in 37 people in the United Kingdom has COVID-19 now, though hospitalizations have increased more gradually. Trends in the United Kingdom aren’t a perfect predictor of what will happen in the United States, but the two have tracked together often enough that it’s worth keeping an eye on, Carlton said.

Nationwide, the decline in hospitalizations since mid-July has started to flatten out. Hospitalizations have started to rise in parts of the Northeast and Upper Midwest, though they’re still at manageable levels, according to data compiled by The New York Times.

The increase comes as new variants of the virus are increasing their share, though it’s not clear if they are what’s driving the hospitalizations. In the United Kingdom and Germany, which has also seen increased cases, there’s no clear culprit variant, Carlton said.

Nationwide, the BA.5 variant is in decline, accounting for just under 68% of infections, according to estimates from the CDC. Three weeks ago, more than 80% of infections were believed to be caused by BA.5.

Over those three weeks, BQ.1 and BQ.1.1 grew from about 1.6% of infections to about 11.4%. If that trajectory continues, the two BQs could account for the majority of cases in about a month, health officials told Politico. Both are subvariants of BA.5, however, which suggests that new variant-specific boosters could offer at least some protection.

The most recent variant data from the Colorado state health department is from Sept. 25. It shows BA.5 was found in 80% of sequenced samples and BQ.1 appeared in under 3%.

While the antiviral Paxlovid still works against the BQs, it appears the monoclonal antibody bebtelovimab doesn’t, meaning people at risk of severe disease have one less option available to them. Molnupiravir, another antiviral, also may not be a good option for many people, after a review found it didn’t do much to reduce the already low risk of hospitalization or death for people who’ve been vaccinated.

Evusheld, an antibody product that’s an alternative for people whose immune systems can’t form their own protection after vaccination, also appears to be ineffective against the BQs and another variant called BA.4.6, which accounts for about 12% of cases. While the group that relies on Evusheld is relatively small, its members would be at high risk if they got infected.

It’s not yet clear how concerning the new variants are, Carlton said. A variant’s potential for harm depends on how contagious it is, how good it is at evading the immune system and how sick it tends to make people, and none of those questions have a definitive answer at this point.

“I think they’re still in ‘watch closely’ mode, not ‘full-blown panic’ mode,” she said.

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