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Learning to live with COVID-19 in Routt County

Michele Lewis, a public health nurse for Routt County, is one of the faces of the frontline fighting the COVID-19 pandemic.
John F. Russell

STEAMBOAT SPRINGS — Given the loosening of restrictions, the 13 new COVID-19 cases in June aren’t really surprising, said Routt County Public Health Director Kari Ladrow.

But they do serve as a reminder of the continued need for vigilance.

“The virus isn’t going away,” Ladrow reminded the Routt County Commissioners at Wednesday’s meeting of the Board of Public Health. “We are in it for the long haul.”



As a handful of states set records for the most new cases in a single day, it is more than evident the virus is still here in the United States — and in no small way.

The goal still is to limit transmission in order to protect the most vulnerable and not overwhelm health care resources, but for places like Routt County that have successfully flattened the curve and prevented outbreaks from spiraling out of control, the future also consists of learning to live with the virus.



“We can’t live in a lockdown,” said Lauren Bryan, an infection preventionist at UCHealth Yampa Valley Medical Center in Steamboat Springs. “I think we expected this,” she said. “We are going to see outbreaks throughout the summer.”

The goal now, is “to suppress large outbreaks until we have effective treatment and a vaccine,” Bryan said.

And on that note, she added, there is a lot of encouraging news and developments both on treatment options and finding a vaccine.

“We need herd immunity,” Bryan acknowledged. But “it is far preferable to get that through a vaccine rather than have the disease decimate the population.”

Routt County Public Health Medical Officer Dr. Brian Harrington emphasized the difference between mitigation and suppression at Wednesday’s meeting. Suppression means getting to zero, he said.

“Mitigation accepts having cases but keeping it at a relatively low but stable rate,” Harrington said.

While suppression may still be an ultimate goal, it is important to “differentiate between the two and what we are willing to accept,” he said.

Ladrow described the current goal as “trying to maintain a manageable disease burden within the community.”

Bars and restaurants

At Wednesday’s Board of Health Meeting, the Routt County commissioners clarified that Governor Polis’ decision to close bars does not apply to Routt County because of the approved restaurant variance. Bars are still allowed to be open in Routt County if they are able to comply with all of the requirements of the county’s restaurant variance.

The commissioners also had a robust discussion on the state’s announcement to allow counties to apply for next phase of COVID-19 virus containment called Protect Our Neighbors.

“We learned that our restaurant variance supersedes any changes at the state level,” said Commissioner Tim Corrigan. “We don’t have to close our bars, and we will just continue to implement the Routt County variance as it is now.”

The majority of the new Routt County cases were traced back to small gatherings, and two involved people who traveled out of state where they contracted the virus before bringing it back. None of the June cases known about at this time involved visitors to Routt County who came sick and got tested here.

“Private gatherings are a considerable risk,” Ladrow told the commissioners.

The state’s public health order still limits private gatherings to 10 people.

“Coronavirus isn’t going away just because we are tired of it,” Bryan said. “We are going to keep seeing these oncoming waves, and we have to be prepared.”

The new local cases, and the more extreme situations happening in nearby states including California, Arizona and Texas, also serve as a reminder on the basics like hand washing and masks, Bryan said.

“It’s important to keep up the measures that inhibit transmission,” Bryan said. “It’s been very demonstrative recently that wearing a masks works. even a cloth homemade one.”

COVID-19: Follow our coverage

Before immediately heading to the hospital, people who are exhibiting symptoms of COVID-19 have several resources, including:

  • The Colorado Department of Public Health and Environment is providing a phone line to answer questions from the public about COVID-19. Call CO-Help at 303-389-1687 or 877-462-2911 or email cohelp@rmpdc.org for answers in English and Spanish, Mandarin and more.
  • UCHealth Yampa Valley Medical Center offers Ask-A-Nurse, a 24/7 call line staffed by registered nurses who can assess symptoms and provide advice on seeking care. In Routt County, Ask-A-Nurse can be reached by calling 970-871-7878.
  • Virtual Visits can be done from the comfort of your home and only require a computer or tablet with a working webcam, speakers and microphone, or a smartphone.
  • If patients are experiencing severe symptoms or having difficulty breathing, they should visit the hospital’s emergency department.

Take precautions in everyday life:

  • Frequently and thoroughly wash hands with soap and water for at least 20 seconds. If soap and water are not available, use hand sanitizer with at least 60% alcohol.
  • Cover coughs and sneezes with a tissue, then throw the tissue in the trash, or use your inner elbow or sleeve.
  • Avoid touching your eyes, nose and mouth with unwashed hands.
  • Stay home if you’re sick and keep your children home if they are sick.
  • Clean surfaces in your home and personal items such as cell phones, using regular household products.
  • Be calm but be prepared.
  • Employees at businesses and customers ​are required to wear a mask, according to a statewide public health order.
  • Limit distance between non-household members to 6 feet when indoors and outdoors.
  • The maximum group size for indoor activities is 10.

Bryan also emphasized the continued importance of 6-foot distancing.

Ladrow said the June cases were largely found to be person-to-person transmission — people in close proximity of each other, without masks, for an extended period of time. She described them as primarily being “several clusters of cases.”

Harrington said he was heartened to see an increased acceptance across the country that masks do matter, including from Vice-President Mike Pence.

As other states see huge spikes in cases, Ladrow and Harrington noted the importance of also looking at hospitalizations and deaths to get a bigger picture in terms of disease prevalence.

Based on June’s cases, blaming tourists doesn’t hold up at this time.

“There’s plenty of room amongst ourselves in our own community to do our best, and that’s where we should start,” Harrington said.

But the nationwide trends are without doubt concerning, Harrington added.

“I’m concerned about two months down the road when school begins,” he said, and getting into “cold and flu season.” Models currently predict Colorado will continue to see rising disease rates, Harrington said.

Before then, there’s July as the biggest month for tourism, he added.

And while eight of the 13 recent positive COVID-19 cases involved people younger than 30, Ladrow emphasized the young people involved with the positive cases and related contact tracing were very responsive.

“They acted quickly to prevent further transmission,” Ladrow said. “It’s important to recognize our youth when they are doing things right.”

And no one should be vilified for getting the virus, she said. Just as we wouldn’t vilify people who get the flu.

When it comes to traveling, Bryan suggests looking at the Johns Hopkins website showing daily trend lines for each state.

If traveling, Bryan recommends paying close attention to what is happening in your planned destination, as well as exercising caution during any type of gathering. Those will most likely be the higher risk situations as opposed to a brief encounter with a motel or gas station clerk, she noted.

For those shorter encounters, hand washing and hand sanitizer remain important precautionary measures, and if staying at a hotel, Bryan recommended wiping down high touch surfaces, like television remote controls and doorknobs.

If you do decide to fly, wear a mask, she said.

The fundamental theory is similar to avoiding radiation exposure, Bryan observed.

“It’s all about distance and shielding,” she explained. “And shielding is the only thing that will protect you on an airplane.”

And while Colorado is not seeing the drastic increase as in some other states, “We are never in a bubble,” Bryan said. “What happened in the rest of the United States of course affects Colorado and Routt County and the people who travel in and out.”

As Routt County is likely to see more cases, the importance of contact tracing, testing and isolation only increases as does cooperation from the whole community, Ladrow said.

Routt County has a team of 16 contact tracers, all volunteer, who go through multiple trainings. And the more they trace, the more they learn and improve the process, Ladrow said. The team leads spent their careers with the Centers for Disease Control.

Ladrow said the county is working on creating a form of payment for the contact tracers, though she noted some might still choose to do it on a volunteer basis.

Participating in contact tracing isn’t about getting anyone in trouble, Ladrow urged. Instead, timely participation can play a big role in testing and isolating additional cases and stopping further spread.

While the county does currently have adequate testing supplies, Ladrow said one of the challenges is in the turnaround time from the lab, which is now taking about three to five days.

Community testing is available by appointment, though public resources must be prioritized, Ladrow noted, in the event of an outbreak. But there are many other private providers offering testing, including to asymptomatic people.

Right now, community testing is available only to symptomatic testing. Appointments can be made by calling 970-870-5577.

In addition to Casey’s Pond, Ladrow said the public health department and private partners are working with businesses to provide diagnostic tests to employees with high public interaction.

On Wednesday, the community testing event set a record with 144 people getting testing in a single day, Ladrow said.

Whether any of those come back positive remains to be seen.

“The virus is amongst us and with us, and we need to learn how to live with the virus in our community and really focus on protecting the people who are most vulnerable,” Ladrow said.

To reach Kari Dequine Harden, call 970-871-4205, email kharden@SteamboatPilot.com or follow her on Twitter @kariharden.


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