Evan Faber’s 78-year-old father, Michael, has for the last three years had difficulty walking around his home in Colorado Springs, Colorado. The Fabers hope that a spinal surgery scheduled for late December at a local hospital will help restore his balance and motor function.

But now they are worried that the hospital will have to postpone the operation.

That’s because a recent surge in Covid-19 cases around the state has increased the number of unvaccinated patients needing care and prompted concerns that hospitals may have to ration services for other issues.

“If you have been waiting for an elective procedure for the last 18 months and are finally scheduled – you’re vaccinated, you don’t have Covid – your procedure might still get canceled if a hospital is totally full,” said Dr Anuj Mehta, a pulmonologist with Denver Health who serves on the governor’s expert emergency epidemic response committee. “While this is a pandemic of the unvaccinated at this point – and the surges in the hospital are entirely being driven by unvaccinated folks – it is having a massive bleed-over effect on to the entire population.”

There are about 1,300 patients hospitalized with Covid-19 in Colorado, according to the New York Times data; that’s the highest number since December 2020, when more than 1,900 patients were hospitalized.

That number has increased by 15% over the last two weeks, the third largest increase in the country, and at a time when the national picture for the US is of a Delta variant surge that is firmly on the way down.

The trend in Colorado can be attributed in part to the almost 40% of the state population that has not been vaccinated and people again gathering indoors without masks. It also shows that, despite the national downward trends of infections, regional spikes can still happen that can cause havoc in state healthcare systems.

“We clearly have events taking place in Colorado, as elsewhere, that are spreading infection,” said Dr Jon Samet, an epidemiologist who directs Covid-19 modeling for the state. “I know everyone would like for it to be 2019 all over again, but that’s not the case.”

The state had also not had surges on the scale of other states, said Dr Michelle Barron, senior medical director of infection prevention and control for UCHealth.

Other states “had flames from the get-go, whereas we have been smoldering along this whole time, and we are finally hitting that peak of saturation and seeing flames finally,” said Barron.

Thirty per cent of Colorado hospitals are anticipating a shortage in the number of intensive care unit beds and 37% are anticipating staffing shortages within the next week, according to data from the Colorado department of public health and environment.

“Staffing is becoming increasingly a problem, which is true everywhere throughout the country. We are seeing healthcare workers really burned out from everything the last two years,” said Mehta. “It just raises concerns that we are pushing the limits of how many patients we can take care of. We are still taking great care of everybody” at Denver Health, “but we are filling up fast.”

In response to the surge, Governor Jared Polis, a Democrat, on Sunday issued a pair of executive orders that allow the state to direct healthcare facilities to redirect patients to other centers and for the implementation of a protocol for healthcare workers to decide in an emergency who should be treated first.

Mehta would also like to see the governor issue a statewide indoor mask mandate, something Polis has declined to do.

“If we were to continue masking indoors, I think we would see a significant drop in transmission and hospitalization, and that would free us up to do the routine medical stuff that we do all the time,” Mehta said.

Even though people who have been vaccinated against Covid face a very low risk of hospitalization, they still, of course, face other risks. The UCHealth system is seeing record number of patients with non-Covid issues, according to a spokesperson.

“A year ago, most schools and businesses were virtual, and there were capacity limits on restaurants and other businesses,” Dan Weaver vice-president of communications for UCHealth stated in an email. “Now, with few people staying at home, we are seeing large numbers of traumas, other injuries, and non-Covid healthcare needs.”

Even among healthy Colorado residents, the pandemic continues to affect their lives. Stephanie Danielson, a Boulder resident, had 60 children in her son and daughter’s Cub Scouts pack a year ago; there are now 10, in part because of ongoing concerns about the virus.

The pack gathered for a hike in September for the first time in more than a year – and afterwards learned that a parent had tested positive for Covid.

“As a leader, it felt defeating because we are trying so hard to bring back some normalcy to each other’s lives, and our very first time, we had this happen,” said Danielson, who works at Moxie Sozo, a branding agency in Boulder.

Faber, the 40-year-old CEO of the company, just got a vaccine booster and said his life has not changed much because of the surge. But he continues to worry about his father, a retired restaurant owner.

“Everything is so volatile, it’s a waiting game to see if [the surgery] will still happen,” said Faber. “It’s the circle of people just outside of the direct impact from Covid that are dealing” with the surge, “and I know there are more severe examples than this”.