After a brief reprieve over the weekend, COVID-19 hospitalizations have climbed again and now stand above 1,500 for the first time this year, state officials said Wednesday.

The continued rise puts the state "fairly close" to being in line with projections that its hospital capacity will be overwhelmed by the end of December.

With 1,526 confirmed COVID-19 patients in the hospital Wednesday, there are nearly 150 more now than there were on this day in 2020, when the state was surging toward its worst moments of the pandemic. The peak then — of 1,841 — came on Dec. 2. Colorado is still below that level, and it's added nearly 300 patients total since Nov. 1 — fewer than between Nov. 1 and Nov. 17, 2020.

Still, projections released last week indicate that, even under improved uptake of treatment and boosters, the state is likely to surpass 2,000 patients in five weeks. 

Rachel Herlihy, the state's epidemiologist, told reporters Wednesday that despite the small weekend dip, the state is "fairly close to what those projections were showing last week." Scott Bookman, Colorado's incident commander for COVID-19, said there were 75 intensive care beds left statewide.

The last time there were this many Coloradans hospitalized with COVID-19 was Dec. 11, 2020, a week before vaccines first arrived in the state. The current surge has lasted longer than last year's, likely a combination of seasonality, the increased transmissibility of the delta variant and other factors that researchers don't yet fully understand, experts have said in recent weeks.

Bookman said the state is in a "precarious position" with its hospital bed situation and that capacity is at its worst point of the pandemic thus far. The number of available hospital beds can fluctuate on a daily, even hourly, basis. But 94% of ICU and 93% of acute care beds have been in use on average over the past week.

Eighty-two percent of COVID-19 hospital patients in the state are unvaccinated, accounting for 1,211 hospital beds as of Wednesday morning. There are more unvaccinated people hospitalized right now than total patients at nearly any other point in the pandemic, including in the spring waves of 2020 and 2021. Only from Nov. 15 to Dec. 24 of 2020 were there more total hospitalizations than there are unvaccinated patients now. 

"The burden of the unvaccinated on our health care system is truly extraordinary," Bookman said. He, Gov. Jared Polis and other state officials have repeatedly called the current situation the "pandemic of the unvaccinated."

Herlihy presented data showing that the unvaccinated are 10 times more likely to be hospitalized, 13 times more likely to die and nearly four times as likely to be infected than their vaccinated neighbors. 

Still, waning immunity is playing a role in spreading the virus. Eric France, the state's chief medical officer, said a third of recent COVID-19 infections have been among vaccinated residents. It's why the state has pressed the need for boosters for adults who are months away from completing their initial series of vaccinations.

Though COVID-19 is surging at levels unseen in a year, the virus is not the only pressure facing hospitals. Staffing shortages, some of which existed before the pandemic and have been exacerbated by burnout, have suppressed the number of beds available. Increases in trauma and more typical hospital cases have added to the strain.

Polis has thus far refused to implement a statewide mask order, despite a growing call from public health officials in the metro area and across the state. He has, however, moved forward plans specific to hospitals: He's called for a surge of 500 new beds, which would require a sharp increase in staffing. Among other efforts, he's also set goals of giving booster shots to 75% of the state's eligible population and of delivering monoclonal antibody treatments, which can help prevent hospitalizations, to at least 50% of infected patients who qualify. 

Both of those are going to be difficult goals to achieve, health and industry officials have said over the past week. Doug Farmer, of the Colorado Health Care Association, and Cara Welch, of the Colorado Hospital Association, both said last week the surge of new beds would require hundreds of staff members between hospitals and long-term care facilities.

Farmer said that would be "near impossible," given the staffing shortage for health care workers nationwide. But the state has said it plans to use National Guard personnel, retired providers and out-of-state contractors to reinforce the workforce.

John Douglas, executive director of the Tri-County Health Department and a supporter of a statewide mask mandate, said Tuesday it is unlikely the state would hit either its monoclonal antibody or booster goals in time to stave off the worst of its projections.

Bookman said Wednesday that the state is still in preliminary stages of studying capacity and available bed space. Hospital officials have said the infrastructure exists between what's available in traditional spaces now and in outpatient or closed hospitals. But staffing is the significant barrier. 

On Monday, the state Department of Public Health and Environment said in an email that Colorado has brought in 100 staffers from federal sources, staffing contracts and from the Colorado National Guard. They included six non-medical staff; 30 people who can distribute medications under physicians' guidance; 29 certified nursing assistants; 14 licensed practical nurses; and, 21 registered nurses.

One federal team of providers has already been deployed to Parkview Medical Center in Pueblo, and the state has requested two more, the agency said.

Bookman said the state is still "working to scale our monoclonal antibody efforts across the state" and that he didn't have data yet on the amount of uptake or administration yet.

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