There are fewer than 100 intensive care beds left in Colorado as of Friday afternoon, a state health official said, an unprecedented capacity crush that’s driven by multiple health surges washing over hospitals at once.

State and hospital officials have sounded increasingly urgent alarms about capacity in recent weeks, a situation exacerbated by COVID-19 levels reaching heights unseen in nearly a year. But the virus is one of several factors pushing capacity into this uncharted territory, from staffing shortages to increased trauma cases and the adverse effects of care delayed earlier in the pandemic.

In early December 2020, when there were more than 1,800 residents hospitalized with COVID-19, there were still 1,800 total beds available, Scott Bookman, the state’s incident commander for COVID-19, told reporters Friday. Now, though there are hundreds fewer COVID-19 patients, there are 815 beds left available. For the first time, hospitals moved this week to allow patients to be transferred between any facility in the state, without that patient’s consent. 

Bookman called the capacity situation “incredibly concerning.” As of Friday morning, 93% of ICU beds statewide were in use, the highest rate of the pandemic. Ninety-two percent of acute care beds are occupied, another high. The seven-day average for both is at or above 90%. 

“Obviously we’re all disappointed that we’re here, today, after the first vaccines arrived in the state in the middle of December last year,” Bookman said. “I really did think that we were moving beyond this part of the pandemic, and unfortunately, this is where we find ourselves today.” 

Since the beginning of the pandemic, COVID-19 has generally not threatened to overload ICU or standard hospital beds on its own. Hospital and state officials have long warned that the virus has the potential to push capacity over the edge because hospitals still must deal with typical patients. Last month, for instance, state epidemiologist Rachel Herlihy said roughly 40% of occupied ICU beds were in use by COVID-19 patients. An official with HealthOne told the Gazette last week that patients infected with the virus make up 12% of the system’s overall volume. 

Such is the case now, officials have said. Bookman echoed what hospital officials told the Gazette last week: Because so many Coloradans delayed care last year out of fear of hospitals or emergency rooms, patients are coming to the hospitals now with more serious medical issues that require hospitalizations and longer stays in those beds. Another factor is the amount of people now moving about the state “has increased the amount of trauma cases out there,” Bookman said. 

In a bid to preserve beds and staff, the state has blocked hospitals from offering nonemergent cosmetic procedures. But there’s no prohibition on other procedures; hospital officials have warned that delaying those surgeries again will only further extend the delayed care repercussions that facilities are weathering now.

But the largest strain, officials have said, is an exhausted and depleted health care workforce. There are fewer ICU and standard beds now than there were during the peak last year, in part because there are fewer workers to care for the patients who could occupy them. 

“We have the space,” Cara Welch, spokeswoman for the Colorado Hospital Association, told the Gazette last month. “It’s a matter of if we can staff the space. That’s really where we’re trying to work with the state on what solutions are available.” 

“Our health care workforce is tired,” Bookman said Friday. “Our health care workforce is worn out. It’s not just an empty bed; it comes with a nurse and a doctor and a respiratory therapist and all of those support services. That is all coming together right now to create this challenge.”

It remains unclear, he added, why Colorado is being hammered now, with its high vaccination rate and with September surges elsewhere in the United States largely abating.

Vaccinations, Bookman and other state officials have repeatedly said, are the “way out of this pandemic.” State data shows that 80% of hospitalized COVID-19 patients here are unvaccinated. Those who haven’t been inoculated have also been nearly five times more likely to die of COVID-19 than those who’ve been vaccinated, said Beth Carlton, of the Colorado School of Public Health. 

“Most deaths are preceded by a long hospital stay,” added Glen Mays, also of the public health school. “If left unchecked, we know that high volumes of unvaccinated COVID-19 patients will over-crowd hospitals and diminish access to care and quality of care for vaccinated patients who need care for other conditions, ultimately leading to higher mortality for all patients.” 

Asked Friday if he or other health officials had asked for a return of a statewide mask mandate, Bookman repeated the recent state refrain: The pandemic is not consistent across Colorado, and the state Department of Public Health and Environment is continuing to act in an advisory capacity to local authorities and health agencies.