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Registered nurse Gail Balbier adjusts a patient’s IV pump inside one of the ICU units at UCHealth University of Colorado Hospital that are dedicated to patients with COVID-19. 

Colorado's hospital capacity is stressed beyond any previous point in the pandemic, state health officials said Wednesday, a metric that leaders have long said will drive any future public health orders. But those officials have remained vague about if any such orders are coming.

Though hospitalizations for COVID are lower now than they were in December 2020, there are still far fewer beds available now than at any other point in the pandemic. During last winter's peak, "we still had 1,800 additional beds available," Scott Bookman, the state's COVID-19 incident commander, told reporters. "Today, we're below that peak and only have an average of 959 (beds left). It's about 90% occupancy in both medical-surgical and intensive care beds."

Officials have said staffing and a rise in more typical hospitalizations — from trauma and illness — are both exacerbating the crisis.

What's more, the situation appears to be worsening, Bookman and Rachel Herlihy, the state's epidemiologist, said. Nearly 8.5% of the state's COVID-19 tests have returned positive on average over the past week, according to state data, the highest level since mid-December. Herlihy said the positivity rate can be a "leading indicator," meaning it may suggest an increase in cases over at least the next week, which will in turn mean more hospitalizations in the week or two after that.

State officials are "very concerned at this point about what we're seeing in our hospitals," Bookman said.

But he was repeatedly noncommittal when pressed about whether the state would institute any public health orders. The executive director of the state's Department of Public Health and Environment told the Board of Health last week that the state was considering a "potential policy response" to blunt the surge. Gov. Jared Polis, echoed by health officials, has said for months that the state would not institute any public health orders unless hospital capacity was threatened. 

Asked last week about the executive director's comments, Polis's office deferred comment to the health department. 

Though Bookman acknowledged Wednesday that threat is more substantial now than at any previous point, he said there was no number or threshold the state was considering as a trigger for some sort of health order, like masking. He repeatedly said the state was in "constant communication" with hospitals and local health departments. 

Several health departments, including in the metro area, El Paso County and parts of the Western Slope, contacted by The Gazette last week said they had not had conversations with the state about health orders or mitigation measures.

Bookman said Wednesday the state still believed that "local control and local orders are a key way" to control the pandemic because the situation varies across different geographic areas of the state. 

"Right now, we continue to evaluate hospital capacity, we continue to evaluate the trajectory of the pandemic, but most importantly we continue to work with our local partners who have the best understanding of what's happening and have the best way to mitigate the spread of the disease." 

Colorado's COVID-19 trajectory is markedly different than much of the rest of the nation. Though there have been bursts of stagnation or slight declines since cases began to rise again in August, Colorado's hospitalization and transmission rates remain among the highest in the nation. The national average of new daily cases has fallen by more than 50% compared to mid-September; in Colorado, it's continued to climb and now is near its highest point since mid-January.

Experts have said it's unclear why Colorado's situation is worsening while the nation's status improves. Herlihy repeated that Wednesday, saying she and other state officials were still looking for those answers. 

Asked about the state's own internal modeling for how the pandemic will unfold in the coming weeks, Herlihy said only that officials will be "taking a closer look at projections" and will have data to share "in the near future."

Jon Samet, the dean of the School of Public Health and a member of the modeling team that gives the state its projections, estimated Tuesday that the state may still be three to four weeks away from the peak of its current surge.

As of Wednesday morning, 1,187 Coloradans were hospitalized with confirmed COVID-19 cases, the most since Christmas Eve. Ninety-three percent of intensive care beds have been in use over the past week, with 119 — out of 1,634 overall — still available statewide.

Bookman presented data showing that El Paso County had far and away the highest number of new COVID-19 patients admitted over the past week, with 117. The second closest, Jefferson County, was half that, at 58. El Paso County had more hospitalizations over the past week than 33 other counties admitted combined. Twenty-one more had no hospital admits at all.

El Paso County officials told The Gazette last week that they had not talked with the state about any public health measures.

Bookman said the state is "starting to see a real, real tight hospital capacity in many areas of the state, and we're continuing to work with our hospital partners to ensure we're using every bed available in the state."

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