Health officials now believe the new coronavirus was circulating in Colorado as early as mid-January, about six weeks before the state even had the ability to test people for the disease and even further out from when Gov. Jared Polis would launch his administration’s response in earnest.
The Centers for Disease Control and Prevention provided the Colorado Department of Public Health and Environment with test kits in early February, but they didn’t function properly, according to Emily Travanty, the state health department’s scientific director.
It wasn’t until Feb. 27 that the state’s lab received and implemented a fix from the federal government. But by then, we now know, COVID-19, the disease caused by coronavirus, was already beginning its havoc-wreaking spread across Colorado.
For instance, on the same day the state obtained the ability to test people for coronavirus, a deadly cluster was forming in Colorado Springs at a bridge tournament filled with older, vulnerable Coloradans. Four people would eventually die.
“We were really in a reactionary mode instead of being able to be in front of it,” Travanty told The Colorado Sun in an interview Wednesday.
Polis told The Sun that the state has done the best job it can with the information it has. He has blasted the federal government for not providing more testing resources from the start, calling it infuriating that America wasn’t able “to mount a proper, more targeted response.”
“We really are only as good as the information and data we have,” Polis said.
The new revelations about the virus’ early circulation in Colorado show just how difficult it has been for public health officials to track and try to slow the disease. Polis has called coronavirus a “ghost” for good reason, and the consequences of undetected infections are now being felt in almost every county.
New confirmed cases, hospitalizations and deaths have been relentlessly growing for more than a month straight.
The CDC did not respond to a request for comment from The Sun, but the agency has told other news outlets that it’s investigating what went wrong. The Trump administration has been taken to task for stumbles that may have allowed the coronavirus to proliferate in Colorado and far beyond.
Other states also received the faulty test kits and their responses, similarly, were delayed as a result.
“It was very frustrating at the time,” Travanty said.
State health officials, as they waited weeks for a fix to the test, were forced to send samples to the CDC for analysis. But only a limited number could be accepted by the agency because it was processing tests from across the nation, creating what Travanty described as a “bottleneck.”
Colorado sent fewer than two dozen samples to the CDC before it had the ability to test on its own. All of the results came back negative.
“We couldn’t just test anyone who met our criteria at that point,” Travanty said. “We had to rely on the CDC to accept the samples and perform the testing for us.”
Despite the negative test results, however, the virus was already very much spreading in Colorado.
By the time Polis announced the state’s first cases of coronavirus on March 5, the disease had taken a galloping start, leaving Colorado’s ability to get a handle on the situation in the dust.
Polis declared a state of emergency on March 10 when Colorado had just 17 confirmed coronavirus cases. “We hope that these actions provide reassurance that we are aware of the risk and taking every reasonable step that we can to contain the spread of the virus and protect our most vulnerable,” he said as he announced the emergency declaration.
As of Wednesday, nearly 200 people had been killed by the virus in Colorado, and health officials believe there could be tens of thousands of people infected. Testing has lagged so much, however, that there are only about 5,600 confirmed cases.
“If you look, you’ll find positive tests”
Dr. Rachel Herlihy, Colorado’s epidemiologist, said modeling from the University of Colorado is what indicates the virus was in Colorado in mid- to late-January. But that estimate comes with a big asterisk since there’s no way to be certain.
Dr. Jonathan Samet, dean of the Colorado School of Public Health, says his team of epidemiologists derived the January introduction date by projecting backwards from the first cases identified by the CDPHE.
“What is really built into it is the transmission dynamics,” he said. “In other words, how long it takes for somebody to go from being infected to being symptomatic, symptomatic to detected.”
Researchers don’t know if the disease was introduced in Colorado by one or multiple people, but that the latter seems most likely, he said.
The first U.S. case was confirmed Jan. 20 in a 35-year-old man in Washington state. But it later became clear that the virus was potentially — if not likely — already becoming much more widespread in the U.S.
Herlihy admits “we don’t know precisely” when patient zero arrived in Colorado, or where that person was located in the state. “There’s a very strong possibility that cases went undetected across the U.S., including here in Colorado.”
The state’s mountain communities are thought to have been a prime transmission engine for the disease. A combination of international and out-of-state travelers mingling with locals traveling to and from the high country made the spread of the virus across Colorado possible.
Boulder County said early on that it believed the virus was spreading in its community after people were infected in Colorado’s mountain towns.
“We have travelers from all over the world that go to those communities,” Herlihy said. “And we think that’s potentially where some early introductions in Colorado may have occurred.”
In fact, the first confirmed case in Colorado was a California man who became ill while visiting Summit County. He had traveled to Italy with a companion who later tested positive for the coronavirus.
In Aspen, a 21-year-old woman visiting from Australia in early March was connected to at least nine others who later tested positive for the disease.
Joni Reynolds, head of health and human service for Gunnison County, said a Front Range resident was actually one of the first three positive cases in her jurisdiction, which has one of the highest infection rates in the state. (Lisa Merck, a Crested Butte woman who tested positive for the virus, said she was showing symptoms on Feb. 19 as she returned from a trip to Hawaii.)
“There’s an adage in public health that if you look, you’ll find positive tests,” Reynolds said. “But first you’ve got to look. And so my bias is that we started looking earlier than they started looking elsewhere in the state. Our response started a little sooner than they did in the Front Range. And I think that may be why there’s a perception that cases started here and went there. But my presumption is that we had cases throughout Colorado, we just hadn’t tested throughout Colorado.”
By March 10, state public health officials were already warning that community spread was likely occurring.
Polis said a slow national response played a role in the proliferation of the virus in Colorado. He suggests that if action were taken earlier by the federal government, the disease could have been stopped in Colorado.
“As a nation, we were several months behind on testing and information that was actionable that could have been taken early to — for instance, at the national level — bar visitation from European countries,” the governor said. “That would have prevented, for example, many of the folks who brought the virus to our mountain resort areas without us knowing it.”
More testing would have allowed for an earlier realization that the virus was spreading to the U.S. from Europe. (Travel from Europe wasn’t halted by Trump until mid March.)
“Had that information been available earlier, the nation could have instituted stricter travel restrictions that would have likely prevented if not every case in Colorado, many of them,” Polis said.
“That’s just the nature of the virus”
Polis said looking back that he doesn’t have any regrets about the state’s response or any decision he’s made.
He’s faced criticism for both being too aggressive and for not being aggressive enough in responding to the crisis.
“We’re making the decisions at every moment with the best data we have,” he said. “I always wish I had next week’s data today. But that’s not possible. … I wish we had data about what was going on today rather than what was going on five days ago or 12 days ago. That’s a frustrating place to be. But that’s just the nature of the virus.”
Since people can be infected with the virus for up to 14 days before they show symptoms, the disease has been hard to track for officials worldwide. They’ve mostly been relegated to using models to try to predict the future.
And from the beginning the virus was difficult to identify. The majority of people who are infected with COVID-19 don’t need medical care and when it started circulating in Colorado it was the height of flu and common-cold season.
The first confirmed cases were among people who got sick after traveling to countries with widespread infection. They felt unwell, recognized that they may have been infected with coronavirus because of their travels and sought medical help because of that fact. It’s impossible to know if there were others who were infected in January, February and even March but didn’t think it was coronavirus.
“Remember, this is a respiratory virus and respiratory infections are common. So sorting that out would be a challenge,” said Dr. Samet. “… The challenge here is, in part, the nonspecificity of it. You have everything ranging from people feel just fine, probably out on the ski slopes, to people with colds to people who people who end up on ventilators. That’s a hard range to cover.”
Colorado’s ski areas were shut down starting on March 15. Restaurants and bars were ordered to close to in-person dining starting on March 17. The statewide stay-at-home order, now in effect until April 26, wasn’t enacted until March 26.
Polis says he will continue trying to stay one step ahead of the virus where possible.
“Even if you had all the testing in the world, it would only give you a picture of where you were five or six days ago,” he said. “It’s always about trying to anticipate the next move based on the data that we had and the trajectory it’s on.”
And it’s clear that Colorado is still trying to catch up.
“There are more victims ahead of us than there are behind us,” the governor said Wednesday.