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Colorado has seen its number of patients currently hospitalized with COVID-19 continue to spike back up since late December, but the latest surge in hospitalizations stands out from previous upticks.

That’s because among recent COVID hospitalizations, only roughly 65% were identified with a primary diagnosis of COVID-19, according to the state public health department — meaning that for as many as 35% of the hospital patients with the virus, COVID is a less important or “incidental” finding, such as for patients who are admitted for other reasons but test positive for COVID later.

By contrast, the “baseline value” — the rate of COVID hospitalizations with a primary diagnosis of COVID that was typically seen before the omicron variant surge — was around 80% to 90%, according to data provided by the state health department.

Seeing that number decrease so dramatically is associated with the rise of omicron, said Rachel Herlihy, the state epidemiologist.

“And I think, honestly, it goes to the fact that we have so much virus transmitting in our community right now,” Herlihy said in a Jan. 13 interview. She added: “We estimate that between 1 in 10 and 1 in 15 people in the state are (currently) infectious with COVID.”

So it’s natural to see people ending up in the hospital for reasons other than COVID and then testing positive later, Herlihy said.

‘With’ and ‘due to’

Data on the state’s COVID-19 website — via the “Hospital Data” icon — show patients hospitalized “with” COVID, not just those who are hospitalized “due to” the disease, according to Herlihy.

That’s despite the fact that a graph on the site is labeled “Patients Currently Hospitalized for COVID-19.” Clicking on an “i” information icon brings up a window that explains that the “currently hospitalized” data reflects those “hospitalized with confirmed COVID-19,” not “due to.”

Information that breaks down how many patients are hospitalized due to COVID is “not real-time data” — state officials have to dig into that separately, Herlihy said.

The state public health department collects data about currently hospitalized patients in two ways: through data sources called EM Resource and the COVID Patient Hospital Surveillance system, or COPHS. EM Resource provides daily data about bed and resource utilization and availability in hospitals across the state.

On the other hand, “COPHS includes daily reports from hospitals with detailed information about each COVID-associated hospitalization. Because COPHS includes more detail, the data takes more time for health systems to compile and send to us,” said a statement from the Colorado State Joint Information Center, which takes questions for the department.

The statement added: “In either system, some of these hospitalizations are due to COVID (i.e. the most important reason the patient was admitted was related to COVID), while COVID is a less important or incidental finding in other hospitalizations.”

COVID numbers still crucial for hospitals

But even though not all COVID-related hospitalizations tracked by the state are “due to” COVID, it’s still a crucial type of data for the state to pay attention to, according to the department.

Even in cases when people are hospitalized with COVID rather than due to it, the disease still complicates their hospitalization — either by making them more ill “or making it more challenging for health care providers to provide care to those individuals,” Herlihy said during a Jan. 12 news conference.

For example, members of a care team will have to wear additional personal protective equipment, increase room cleaning, avoid putting infected and non-infected patients in close proximity, and take other steps to avoid disease transmission, the information center’s statement said. 

The strain on the hospital system matters for a stressed health care workforce, Scott Bookman, state incident commander for COVID-19, said during the news conference.

“Our frontline health care workers have been doing this for almost two years now,” Bookman said.

Before now, the proportion of COVID-related hospitalizations that were due to COVID had been largely consistent going back to the early months of the pandemic in Colorado, according to state data.

Another unique characteristic of the omicron-driven surge is that hospitalizations may not take long to reach their peak for this wave of COVID.

“We obviously don’t have a perfectly clear crystal ball on this, but if Colorado was to follow the trends predicted in our modeling data and also follow the experience of other (places),” then the state could see hospitalizations peak within two weeks, Herlihy said on Jan. 13. The peak may even arrive by the “end of this week into next week,” she said that day.