Colorado COVID-19 raises an urgent warning for California

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California is entering the holiday season with an uncertain view. Optimistically, new weekly coronavirus cases have become stable across the country; The vaccination rate is higher than in many other states, and there are few signs right now of a large winter increase.

But the deteriorating conditions in Colorado provide a cautionary tale of how it can go south quickly, even in a state where many residents are vaccinated.

Colorado “may be a precursor to what we could ultimately see here in California when it gets cooler for us,” said UCLA epidemiologist Dr. Robert Kim-Farley. Cooler weather hits Colorado earlier than California and sends people indoors, “leading to higher potential for COVID transmission.”

In Colorado, 62.8% of all residents are fully vaccinated, almost identical to California’s 62.7%. according to US Centers for Disease Control and Prevention. But the differences in weekly rates are large: CDC data shows California currently has the 10th lowest of all states, and Colorado has the eighth highest.

While Los Angeles County has about six inpatients covid-19 patients for every 100,000 residents, Colorado has 27 – a figure not seen in LA County since February.

Although the overall vaccination rate of Colorado and California is relatively high and above the national rate of 59%, they are still too low to stop the persistent, widespread transmission of the virus. And some experts say California may face it aggravated pandemic conditions when the weather cools.

And that could mean that the coronavirus will easily be able to find the nearly 40% of Californians who are not fully vaccinated.

Data continues to show unvaccinated accommodation falls disproportionately victim to the pandemic. In California, health officials appreciate it unvaccinated people are seven times more likely to get the coronavirus, 12 times more likely to need hospitalization and almost 17 times more likely to die. And in Colorado, 80% of hospitalized covid-19 patients are unvaccinated.

“The burden of the unvaccinated on our healthcare system is truly extraordinary,” said Scott Bookman, the Colorado Department of Public Health’s covid-19 incident commander. told reporters in a news briefing.

The increase in Colorado shows how good but not exceptional vaccination levels can not eradicate the threat from the coronavirus – especially given the continued dominance of the highly transmissible Delta variant, says Dr. Kirsten Bibbins-Domingo, Chair of the UC San Francisco Department of Epidemiology and Biostatistics.

“In fact, one of the striking things this week is that even our most vaccinated state, Vermont, is starting to see an increase, an increase, in cases,” Bibbins-Domingo said.

Such increases are much more than an individual risk. Someone who gets the coronavirus can continue to transmit it to those who are unvaccinated – including children who are too young to get the injections – or those with weakened immune systems or who are at greater risk for serious illness.

And although Colorado has a better vaccination rate than the country as a whole, there are still some communities with very poor prices, where less than a third of the population is vaccinated.

“And we’re seeing the largest increase in hospitalizations and, unfortunately, covid deaths in those parts of the state where we have low vaccination coverage,” said Elizabeth Carlton, an environmental epidemiologist and associate professor at the Colorado School of Public Health. an interview.

Computer models published on one California website offer a range of opportunities – both good and bad – for the state’s winter.

Under the best case scenario – if many people get booster shots, counter diminishing immunity – cases of coronavirus can remain relatively stable or decrease. But there are scenarios where the peak of winter is almost as bad as last winter: if the population’s immunity declines faster than the population gets boosters and there is a significant increase in infections.

“There is a potential for a sharp increase starting at the end of January 2022 and reaching its peak in mid-February, and the figures are worrying because … the cases may be almost as high as the cases we experienced in January last year, “in Dr. Regina Chinsio-Kwong, Deputy Chief of Health for Orange County. But if the vaccination rate rises rapidly and booster uptake is high, “we actually have the potential to really stave off an increase.”

Some areas are preparing for the worst. In Fresno County, where Delta growth has never stopped and hospitals have been under duress for months, officials are preparing for a tough winter.

And the trends are disappointing globally. “Worldwide, we are entering a wave of cases. It’s almost everything driven by what’s happening in Europe and the United States,” said UC San Francisco epidemiologist Dr. George Rutherford at a meeting at City Hall on campus. of failure to vaccinate. “

Still, overall, it differs from November last year, which may herald a milder winter rise in California. The state’s weekly fall rate has fallen since the beginning of the month, from 112 falls per week for every 100,000 inhabitants to 102.

In addition, California’s stricter covid control measures could help dampen a winter wave. Much of Colorado has declined to reintroduce mandates for indoor masks since the Delta strike, while some of California’s more densely populated areas – including Los Angeles County and much of San Francisco Bay Area – reintroduced worm orders by midsummer.

Some cities in California have gone even further. Los Angeles, San Francisco and Berkeley require guests to show up at indoor restaurants, bars and gyms proof of vaccination as a condition of entry. These strategies “will help curb” an expected increase in viral transmission when people go indoors and plan vacation trips, Kim-Farley said.

The different approaches can help explain why Colorado’s Delta growth has not stopped, while California’s falls have declined significantly.

Colorado is fast approaching its record high number of hospital stays, with as many as 1,847 COVID-19 patients treated in a single day last winter. From Friday1,518 people with covid-19 were in Colorado Hospital, 82% of its highest scores.

By comparison, covid-19 hospital stays in California is just about 15% of the peak was reported in early January.

Colorado has activated its crisis care standards for staff, enabling hospitals to downgrade healthcare services to meet demand.

“We really need to make sure we do everything we can to protect the capabilities of our healthcare system, which is so, so threatened right now,” Bookman said.

Colorado is not an extremist. There are other warning signs of covid-19 across the country, including in two other states that have a vaccination rate similar to California’s: New Mexico (63.2%) and Minnesota (62.1%).

“Hospital capacity is extremely tight,” said Jan Malcolm, commissioner of the Minnesota Department of Health, in a statement. statement. The U.S. Department of Defense is sending two emergency medical teams with 22 employees each to help hospitals in Minneapolis and St. Louis. Cloud.

In New Mexico, there have been as few as 10 vacant intensive care units throughout the state in recent days.

“Someone who has a heart attack right now may or may not have access to intensive care in New Mexico,” Dr. David Scrase, the State’s Acting Secretary to its Department of Health, sa in a news briefing. New Mexico moves 40 to 80 patients a week out of the state for hospital care.

Hospital staffing is also a major problem.

“So many of our hospital workers are exhausted, or retiring, or quite frankly giving up their care careers because of the relentless work in hospital environments today,” Scrase said.

In rural northwestern New Mexico is the San Juan Regional Medical Center – which serves the Four Corners region bordering Arizona, Utah and Colorado – appealing for retired nurses, respiratory therapists and housekeepers to return to work to help crush patients.

“Our situation right now is difficult. In every single aspect of healthcare, we are seeing extremely high volumes of patients suffering from flu-like or covid-like illness,” said Barbara Charles, Vice President of San Juan Health Partners, in a statement. “Most of these patients are unvaccinated. This overwhelms our healthcare system.”

In California, while covid-19 hospital admissions have stabilized, they have still flattened out at a relatively high rate compared to previous interruptions. Before this summer’s Delta increase, there were as few as two COVID-19 patients in hospitals for every 100,000 inhabitants; the price rose to 21 during the summer peak, but has since stabilized at a rate of eight.

“The fact that hospital admissions have plateaued and not collapsed means that the virus still finds people it can infect and hospitalize. And that worries me,” says Bibbins-Domingo. “It’s a sign that this pandemic is not over.”

When people gather for Thanksgiving in a way they have not done since the pandemic began, it will be important to have conversations with family and friends about things that can be done to increase security: asks unvaccinated people to get their syringes, suggests that vaccinated adults receive booster doses, possibly asks guests to take quick tests or hold outdoor gatherings.

Not having those conversations is risky, health experts warn. “To bury your head in the sand and just say, ‘Yeah, you know the curve is going down, that’s not a reasonable thing to do,'” Bibbins-Domingo said. themselves and their loved ones during the holidays. But choosing not to do anything does not make sense to me. ”

Despite potential danger signals, some are optimistic that LA County will not follow Colorado’s path. Outbreaks in schools have remained low, and the region did not see an increase in covid after Halloween.

“We know we can have celebrations, do them with some safety modifications, yet everyone enjoys and not make it lead to a significant increase. And that’s what we hope will happen during Thanksgiving,” said LA County Public Health Director Barbara Ferrer.

Vaccinate children 5 to 11 An age group that was just eligible for vaccinations this month – and get more adults their booster shot will also be important.

Data from LA and Orange counties, as well as Colorado and New Mexico, show that there have been recent cases where 5- to 11-year-olds have had the highest cases of coronavirus among all pediatric groups.

And booster shots are important in restoring COVID immunity, which declines months after the first vaccination.

“When we compare the incidence of covid-19 disease between those who are vaccinated with two doses, and those who have received a booster dose, the disease rate is significantly lower for those who have received their booster syringe, which shows that our boosters work.” CDC Director Dr Rochelle Walensky said during a news briefing.

Even in highly vaccinated San Francisco, health officials have discovered a recent increase in coronavirus cases.

But if one assumes that booster uptake is sufficient, even if hospital stays increase after an increasing number of cases, computer models suggest that “hospital admissions will not increase to the extent that our healthcare system would be overwhelmed”, Dr. Grant Colfax, San Francisco’s health director, said in a news briefing. “It is certainly within the possibilities, but I want to emphasize that if people follow the recommendations … I hope we will not see anything like what we saw last winter.”

San Franciscans have already begun enthusiastically vaccinating their children. Already 28% of 5- to 11-year-olds have received at least one dose of the covid-19 vaccine; however, the interest rate is 11% in LA County and Orange County, according to The Times tracker.

Even with precautions, Governor Gavin Newsom has said he expects California to see increased pressure from covid-19 this winter.

“We should expect that we will see an increase in cases. We have an increase in potential stress on our system,” Newsom said recently. “I do not say that to scare people. I do not say that for any other reason than to be on a par with people. “

“This virus, this disease,” he added, “does not take the winter off.”

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