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What if we never need the $100 million coronavirus overflow hospitals Colorado is building?

One lease, for the Colorado Convention Center, costs $60,000 per day. But state emergency officials say the five makeshift medical centers are Colorado’s health care insurance policy.

Lt. Col. Larry Dale Caswell, Albuquerque district commander for the Army Corps of Engineers, speaks to reporters on Friday, April 10, 2020, in the Colorado Convention Center, which is being turned into a makeshift coronavirus hospital. (Jesse Paul, The Colorado Sun)
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Coloradans are slowly starting to go back to work, schedule haircuts and meet up with friends. Meanwhile, the state is constructing five makeshift medical sites with the potential to hold thousands of sick coronavirus patients when and if the wave does come. 

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The beds aren’t ready yet. And they aren’t needed, so far. 

The cost of this “insurance policy” in case the state’s hospitals become overwhelmed is huge: $70 million in construction costs, $30.7 million to lease the spaces until mid-January, and a potential $19.7 million in contracts with nine medical staffing companies that will supply the nurses and doctors. 

The lease for the most expensive location — The Colorado Convention Center in downtown Denver, which has yet to cancel its annual Great American Beer Festival scheduled for the fall — is $60,000 per day, whether there are patients or not.

Colorado is expecting that a public-assistance grant from the Federal Emergency Management Agency will cover 75% of the bills, with Colorado paying the other 25%. Still, that’s $25 million in state funds  — not counting staffing costs — at a time when Colorado budget writers are preparing to slash spending for education, prisons and health insurance for children.

Best-case scenario: Colorado won’t use a single overflow room. Months from now, crews will tear down the walls and remove the hospital beds, as if it never happened. The convention center and The Ranch at the Larimer County Fairgrounds, which costs the government $24,570 per day, will go back to hosting concerts, theater events and monster truck shows.

So far, no hospital in the state is worried about a shortage of intensive-care beds within the next week, a statistic tracked and reported by the state health department. Of the 1,078 ventilators in the state, 408 are in use. Colorado managed to flatten the curve on coronavirus infections through a statewide stay-at-home order and an economic shutdown, and now some projections predict the peak number of infections won’t arrive until the fall or early winter.

That’s all good news, but don’t assume we’re in the clear — or that taxpayers are spending $100 million to create “alternative-care sites” for no good reason, said Mike Willis, director of the Colorado Office of Emergency Management and leader of coronavirus preparedness. The state is beginning to open back up, but the pandemic is just getting started, he said.

“I absolutely do not think it’s over. In fact, I’m not really sure it’s gotten started yet,” Willis said in an interview with The Colorado Sun. “The stay-at-home order bought us time. We have never been under the impression that a stay-at-home order would make coronavirus go away.”

Willis hopes Colorado doesn’t need the alternative-care sites but said it’s way too soon to know. Not only does he worry about a second and third wave of infections, Willis isn’t even sure the first wave has finished. Colorado will need a backup plan if hospitals get overwhelmed, he said. 

“It’s the state’s insurance policy for our health care system, and like any good insurance policy, you really hope you don’t need it,” he said. “But we all sure know that we need to have one. I feel very strongly that we have to maintain our state’s health care insurance policy for quite a while into the future.” 

The leases for the sites — which also include St. Anthony North hospital on 84th Avenue in Westminster, St. Mary Corwin Medical Center in Pueblo and Western Slope Memory Care in Grand Junction — go from April through mid-January. 

The price per day is calculated based on rooms or square footage: $7,800 per day at St. Anthony, totaling $2.2 million through mid-January; $24,570 per day for the Ranch in Loveland, at 13 cents per square foot, totaling $6.9 million; $60,000 per day at the Colorado Convention Center, at $30 per bed, totaling $16.8 million.

Those costs are on top of what the state and federal government are spending to build walls, lay lines for oxygen and bring in hospital beds. 

State policymakers have tried to make construction decisions as responsibly as possible, consulting medical experts about the spread of the virus and the expected peak, Willis said. The Convention Center, for example, will have space for 2,000 beds — there are oxygen lines, walls and a fire-suppression system for that many rooms. But the items that don’t take as long to assemble — the beds, the water pitchers, the curtains — will go initially into just 250 rooms, not all 2,000.

Gov. Jared Polis speaks to reporters at the Colorado Convention Center on Friday, April 10, 2020. (Jesse Paul, The Colorado Sun)

At The Ranch, crews are plumbing accessible restrooms but won’t put in a nurses’ station with chairs and desks until needed. Construction there will accommodate 1,000 beds, although the opening target is 200. 

“In order to be good stewards of taxpayer dollars, we held off on the things that don’t need as much lead time,” Willis said. It’s a “more pragmatic approach than throwing everything together all at one time.”

The state also has tried to keep staffing contracts flexible, he said. Colorado signed contracts with nine medical staffing companies, which will provide health care workers as needed. The contracts can expand or contract, based on rates of infection and hospital capacity, Willis said. 

The purchase orders for the contracts total $19.7 million, but state officials have not yet spent any of that and the final bill will depend on how much staff is needed. The contracts include $5 million each for US Acute Care, Autumn Enterprises and Medefis staffing companies. 

Four of the sites are expected to open for patients, if needed, in June — with open dates ranging from June 4 to June 25. The fifth site, Western Slope Memory Care, is projected to open July 2. 

“If there is no demand, we’re not going to be paying to staff it,” said Kevin Klein, director of the Division of Homeland Security and Emergency Management in the Colorado Department of Public Safety. “We don’t want to pay for staffing them if we’re not going to use them, so we’re going to be judicious with our use. And we’re hoping that we continue to flatten the curve so we don’t overwhelm the hospital system and need to use them.” 

The Convention Center and The Ranch, which in normal times hosts county fair activities, concerts and livestock events, will take coronavirus patients who are recovering from COVID-19 and no longer need intensive care. The other three sites are for patients from nursing homes and senior-care centers who are infected with the virus and need critical care. 

When the alternative-care sites open, state health officials plan to run “validation exercises” — meaning they will operate them at capacity for a few days to make sure they run smoothly, Willis said. Afterward, the number of patients will depend on the need, he said. 

Colorado officials are concerned about a wave of infections in the fall, and the medical sites are about “planning for the worst, hoping for the best,” Klein said. 

“We hope that our social distancing policies, we hope that safer at home, we hope those, with businesses and the mask project and all these other things, keep that curve flattened enough so we don’t need to use it,” he said. “That would be ideal. But we want to keep the ability to turn them on in short order through what would be the next wave in the fall.”

Staff writer John Ingold contributed to this report.

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