Hope on the horizon: Group is studying how, when to lift COVID-19 restrictions
STEAMBOAT SPRINGS — Conversations are happening locally about how and when to lift the socially and economically crippling restrictions mandated by the state and Routt County in response to the COVID-19 pandemic.
A group, charged with that specific task, has been meeting, and it is expected its recommendations will be brought to Routt County commissioners in the coming days or weeks.
The fact those conversations are happening at all is a good thing — though it means there is still a long way to go before anything even somewhat resembles life pre-coronavirus.
“I’m really concerned about the sacrifices we’ve asked our citizens to make to control the spread of COVID-19,” said County Commissioner Tim Corrigan. “We understand the economic devastation that has been imposed. I get how hard it is for people who may be out of work and struggling to pay their rent or mortgage and are scared about the future.”
There are scenarios being run by federal agencies looking at what would happen if all mitigation efforts were to disappear versus what would happen if schools remain closed, one quarter of Americans work from home and some social distancing continues.
A third scenario keeps another 30-day stay-at-home order in place.
Not surprisingly, the projections show fewer restrictions lead to more deaths.
Policy makers across the country are facing difficult choices. How many additional deaths are acceptable? And how to weigh those deaths against the painful impacts shutting down society is having on people’s mental health and the ability for many people to meet their basic needs.
Financially and emotionally, people are reaching a breaking point. But if restrictions are lifted too soon and COVID-19 makes a resurgence, the process could begin all over again.
“We understand how hard this is,” Corrigan said. “We are as motivated as anyone to start transitioning back to normal. As soon as we can do so without threatening public health, we will.”
There are some very positive signs, at the local, state and national levels, that the mitigation measures imposed are indeed working to slow the spread of the virus and keep health care systems from becoming overwhelmed.
“By virtue of our citizens really making an effort to socially distance, wear masks and work from home — it has worked to date to flatten the curve and slow the spread,” Corrigan said.
The University of Washington model shows Colorado hit its “peak resource use” on April 17. That measures all hospital beds, intensive care unit beds and ventilators.
As of Sunday, there were 422 deaths in Colorado due to COVID-19, with two of those in Routt County.
UCHealth Yampa Valley Medical Center has only seen four COVID-19 hospitalizations thus far.
While there is still information to be obtained on precisely which restrictions are most effective, Routt County Public Health Medical Officer Dr. Brian Harrington said social distancing is clearly working.
“Between closing schools and banning large groups, staying at home, staying 6 feet apart, wearing masks and travel restrictions, we still need to see which provides the biggest bang for the buck,” Harrington said.
That way policy makers know which restrictions to loosen first.
“The rate of increase of new cases has slowed, and our number of hospitalized patients is growing more slowly, but it is essential that Coloradans continue to practice social distancing,” Dr. Richard Zane, UCHealth chief innovation officer and emergency services executive director, said in a April 14 article in the Denver Post. “The minute we let up, we will likely see cases spike, again.”
On Wednesday, Colorado Gov. Jared Polis set April 26 as a target date to lift the statewide stay-at-home order, adding the state is in a crucial period of data collection in determining whether the restrictions are working and whether a decline in numbers can show Colorado is on the downward side of the curve.
The county will keep a close eye on what the state is doing, Harrington said, adding he senses “a bunch of things aligning this week.”
On Wednesday, a drive-through community testing site was offered for the first time to anybody exhibiting symptoms in Routt County. Of 61 tests administered, four came back positive, four are pending and two people need to be retested.
Harrington is cautiously interpreting that low positive ratio and the fact only 61 people signed up to be tested as a reason to be optimistic.
On Saturday, 103 people were tested. The results are anticipated in the next day or two. And those numbers are something public health officials are watching closely.
Until those two community events, testing was severely restricted.
Wednesday’s and Saturday’s results aren’t a scientific sampling, noted Harrington, but they will provide some of the best data thus far on the community’s current disease burden.
Routt County’s numbers — in terms of positive cases, hospitalizations and deaths — remain relatively low and haven’t shown signs of exponential growth.
The goal now, Corrigan said, is to move into what Polis describes as Phase 2 — the stabilization phase.
Phase 2 will last awhile, Polis said, “two months, three months, 10 months — however long it is until there’s a cure or a vaccine.”
Under stabilization, large gatherings would still be banned, but more businesses could open with mitigation plans, their own screening requirements and social distancing restrictions.
“We need to see a sustained decrease in cases,” Corrigan said. “And that needs to be on a solid track for two weeks.”
As always, testing is key.
We need to have the capacity to “test anybody anytime and get those results back quickly,” Harrington said.
County officials are planning more community testing — always dependent on supplies — and the hospital is now testing anyone who has a referral from their provider and makes an appointment. Harrington said Routt County isn’t there yet when it comes to testing capacity, but is getting closer.
“The next thing — if and when we get to the point where we are performing an adequate number of tests — is doing a first rate job on contact tracing and isolating anyone who may have come into contact,” Corrigan said.
That will require more manpower than the county currently has, he said.
There are also antibody tests, which public officials are actively working to bring to Routt County as the U.S. Food and Drug Administration begins to issue approvals.
Even with those, however, Harrington noted, Routt County doesn’t have enough data to say that someone who tests positive— meaning they have been exposed to the virus — is immune or for how long they are immune.
“I think we are all anxiously watching what the efficacy of the tests are,” Corrigan said. “As we go along, it may become an important part of returning to normal. But it’s not ready for prime time yet.”
Front line and health care workers also have to have adequate supplies of personal protective equipment, Harrington said. The more businesses allowed to open, the more PPE — including things like hand sanitizer — will be required.
Corrigan points to five criteria being looked at in terms of moving into the stabilization phase: a decrease in cases, adequate hospital capacity, testing capacity, public health staff availability and strong mitigation plans in place for those who can reenter the work place.
“The good news is we are headed in the right direction on all five,” he said. “If we can sustain the metrics over the next two weeks, we will be in a good place to start relaxing the public health orders.”
At this time, Harrington points to a number of reasons for hope, including being closer to a treatment.
“Something we are doing is having a positive effect,” he said.
Still, he said, “We need to get more information. We need data because we just don’t have that much.”
And despite the pain, angst and fear that can feel overwhelming, Harrington stressed the county is not yet on the other side of the pandemic.
“We are not out of this yet,” Harrington said. “If we jump off the train now and say everything is fine, we will have to go back and do it all over again.”
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