Why Western states are seeing COVID-19 hospital admissions rise

Montana and Wyoming have seen increased hospital admissions due to COVID-19 over the last two weeks — 57 percent and 41 percent, respectively — giving some experts pause.

Those increases are even sharper for certain age groups, according to CDC data. In both states, 40- to 49-year-olds have been hospitalized with COVID-19 at a seven-day increase of 400 percent in Montana and 600 percent in Wyoming.

While those numbers are drawing attention, experts say there are several reasons for these inflated figures — none of which are cause for alarm. 

Utah also has seen an increase in hospital admissions for that age group, but only at 20 percent.  

"If you look at what's happening in Utah … there's been a substantial increase over about the last 14 days in [emergency department] visits due to COVID, and we've seen increases in pediatric hospitalizations as well as in adult hospitalizations," Andrew Pavia, MD, chief of the division of pediatric infectious diseases for Salt Lake City-based University of Utah Health, told Becker's

Dr. Pavia said the increases have been modest and nowhere near the surges seen for omicron or other variants, "but what we have seen is a reversal of pretty steady consistent declines over a two- to three-month period," he said. He also noted that trending increases throughout the West are in line with what is expected overall for this era of COVID-19, particularly now with the rise of SARS-CoV-2 strain XBB.1.5.

"I think the driver is very likely that XBB.1.5 has finally become the dominant variant that is circulating throughout the Western states and in our own data," Dr. Pavia said. 

Lower rates of bivalent COVID-19 booster vaccinations in the West may also be a contributing factor, he said. 

"If you look at vaccination rates, particularly booster rates in the U.S., bivalent vaccine uptake has been quite low. … Wyoming, Montana and Idaho have some of the lowest rates in the country outside of the Deep South," Dr. Pavia said. "I suspect that there's a combination of XBB.1.5 with its greater resistance to pre-existing immunity and the fact that you've got a large number of people who have not been boosted in the last two years, and therefore are more vulnerable."

Montana and Wyoming are part of HHS Region 8, which includes other Western states such as Utah, Colorado, South Dakota and North Dakota — all states that have a significantly lower population than many on the East Coast. Any one admission in states such as Montana or Wyoming accounts for what appears to be a significant increase in data but may only be one or two additional people. 

"A 400 percent increase represents one case. Our numbers are relatively small, so percentages can be misleading," Katy Peterson, vice president of communications and member engagement for the Montana Hospital Association, told Becker's. "We are not hearing from any of our clinical leaders that they are experiencing any significant spikes. Certainly not any that are impacting operations, capacity or access."

Wyoming health officials also told Becker's they are not concerned about any specific trends at this time. 

"At this point we are not watching a particular trend for COVID hospitalizations among that age group," Kim Deti, public information officer for the Wyoming Department of Health, said. "Based on self-reported hospital data, we had approximately 20 COVID-19 patients hospitalized statewide of any age as of [Feb. 28]. With numbers of that nature, it is difficult for trends to truly be meaningful over a short time period."


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