Coloradans are more likely to encounter someone with coronavirus now than at any point during the pandemic, state health officials say. Hospitalizations because of COVID-19 have surged to a new high. The state’s health care capacity is at risk of being overwhelmed in a matter of weeks.
Yet Gov. Jared Polis has declined to place Colorado under statewide lockdown status as he did in the spring, when the prevalence of coronavirus appears to have been less than it is now.
“This is not about lockdowns. It hasn’t been about lockdowns since March or April. It’s about an aggressive, balanced approach that’s not being implemented,” Polis said in an interview with The Colorado Sun, echoing Dr. Deborah Birx, coordinator of the White House coronavirus task force.
Polis said he feels it’s a matter of ensuring Coloradans follow the public health recommendations he’s been harping on for months and taking action on the local level.
“At this point, people know what they need to do to contain the virus,” Polis said. “How do we know that? They did it in August. We avoided that second wave that hit the Sun Belt.”
The Sun interviewed Polis and Colorado’s top epidemiologist, Dr. Rachel Herlihy, about why they aren’t pursuing another statewide lockdown and how they plan to tackle the most recent surge of COVID-19 in the state. Here’s what they said:
Why Polis feels a statewide lockdown isn’t appropriate now when it was in the spring
Another lockdown — or so-called stay-at-home order — isn’t warranted, Polis said, because of the advances Colorado and the world have made toward understanding and managing coronavirus.
“We’re learning a lot more,” Polis said. “In March and April, we had very little testing. Negligible testing relative to the size of the infection rate. Quite literally, it was impossible to find out who was contagious. It was impossible to screen asymptomatic people out from working in nursing homes and as first responders.”
Now, Colorado has the capacity to test tens of thousands of people a day between the state’s own lab and private testing providers.
Treatment protocols for COVID-19 have also dramatically improved, driving down death from where it was in the spring, Polis said.
“The fatality rate for people who were hospitalized was around 20%. One in five who entered the hospital in March and April didn’t make it out,” he said. “Now that’s down to about 5%. Still very deadly, still tragic for many families. But one quarter the fatality rate of the initial wave.”
Finally, Polis said Colorado’s hospital capacity — both in terms of supplies and beds — has been dramatically expanded since the spring. That includes emergency care sites, like the field hospital built at the Colorado Convention Center, and also internal work hospital systems have done to prepare.
The governor said one persistent issue is the shortage in health care personnel.
Dr. Herlihy, who works for the Colorado Department of Public Health and Environment, agreed with Polis’ assessment.
“Our understanding of this virus has really evolved in the last couple of months,” she said. “So we have the tools in our public health and health care toolbox.”
How much does the economy factor into the governor’s decision-making?
The governor said he considers both health and economic impacts when imposing new coronavirus restrictions, though oftentimes they go hand in hand, especially when it comes to lockdowns.
“Lockdowns are not healthy for people,” he said. “I think we knew that in March, but we had to take the lesser of two evils given where we were.”
The adverse effects include mental health challenges as well as people’s tendency to avoid routine medical care.
“It’s a very blunt instrument,” he said.
A new lockdown could also lead to more job losses, and that has implications ranging from people becoming homeless to Coloradans not being able to buy groceries, he said.
“It’s all part of the larger public health picture,” he said. “… The public health toll and the economic toll of lockdowns is extensive.”
Is a statewide lockdown 100% off the table?
No, Polis said. But it appears to be very unlikely.
Polis said he would really only consider implementing another statewide lockdown if Colorado’s health care capacity starts to get overwhelmed. That hasn’t happened yet and the overflow capacity the state spent millions of dollars building hasn’t been utilized. Some of the overflow sites have even shut down.
“Look, if the Convention Center is filling up and there’s not enough beds, then we simply look at the lesser of two evils and the calculation might change,” Polis said. “Certainly I share the goal with everybody in Colorado to avoid a lockdown, really, however we can.”
Right now, he is focused on deploying as many tools as possible — increased testing, better treatment protocols, contact tracing, less-serious restrictions — to prevent the state from reaching the point where a lockdown may be needed.
Adams County, Denver and Pueblo have enacted overnight curfews. Will that work?
Even if a statewide lockdown doesn’t happen, a number of cities and counties could be forced to shut in their residents if coronavirus caseloads and hospitalizations keep increasing. State health officials have made it clear that they don’t want that to happen, so they’ve endorsed other, new approaches.
One of those approaches has been the overnight curfew. In the past two weeks, Adams County, Denver and Pueblo have enacted them in an attempt to stave off a lockdown and drive down cases.
“We want to do everything that we can to avoid (a lockdown),” Bob McDonald, head of the Denver Department of Public Health and Environment, said Friday as he announced Denver’s 30-day curfew.
But at the same time, McDonald didn’t provide proof that the strategy would work and conceded that the city has tried many things to drive down coronavirus cases and hospitalizations and they haven’t worked.
Herlihy said she’s hopeful the curfews will be effective because case numbers are growing fastest among people in their 20s and 30s.
“We do know that population is the group of individuals that is, probably, most likely to be out in the evenings, to be socializing, to potentially be in households or bars or other locations where transmission could readily occur,” she said. “We also know when alcohol is involved that individuals’ judgment can lapse and that can certainly contribute to risky behavior and transmission of the virus.”
What about the confusing county-by-county approach?
Throughout the pandemic, Colorado has battled to keep people informed as cities and counties enact area-specific rules aimed at slowing the spread of COVID-19. What may not be allowed in Denver, may be OK in Aurora.
Polis acknowledged this during a recent news conference, saying that people across the state should be taking as many precautions as possible and not trying to find local loopholes or exceptions.
“Nobody should be staying home and not socializing because they are in this county or that county,” he said. “You should be doing it everywhere in our state right now. Cancel your plans to see others who are not in your household for the next few weeks. Put them off.”
That said, when Polis announced Colorado’s first statewide lockdown on March 25, he did so, in part, because of conflicting rules across the state. He worried that if people in Denver were ordered to shelter in place and people in Weld County weren’t, it would create a situation where Denverites would crowd into Weld County.
“More and more people are going to fewer and fewer stores and retailers in fewer and fewer locations, creating a greater public health crisis,” he said at the time.
This is also worth noting: The governor has in the past cast doubt on the efficacy and enforceability of implementing certain COVID-19 restrictions only to turn around and enact them days later. That’s how the first statewide lockdown came about, as well as Colorado’s statewide mask-wearing mandate.
Should people still feel safe to patronize businesses?
The governor is now urging Coloradans to avoid interacting with people outside of their households for the next few weeks.
So does that mean people should stop patronizing businesses and visiting restaurants?
Polis says no.
“The science shows that the biggest risk for transmission is if you’re in that 10- to 15-minute range within six feet of somebody,” he said. “That is what happens in a normal social environment. When you see your friends, you’re with them for more than 15 to 20 minutes. You might be with them for a few hours. That is a much greater risk than going to a clothing store and buying a shirt and checking out while you’re wearing a mask and the person behind the counter is wearing a mask.”
Polis said for people who still want to patronize restaurants, the most important thing is to not go with people outside of your own household.
“If you’re meeting four other people from four other houses, you are increasing the likelihood of you getting the virus exponentially. That’s what we want to avoid,” he said. “Going out with your family: low to medium risk. The higher risk is if you’re interacting with people from different households in sustained ways, especially indoors.”
How is Colorado’s contact-tracing system handling thousands of new cases each day?
Colorado health officials’ goal has been to contact trace up to 500 coronavirus cases a day. Since Oct. 14, the state has had a seven-day average case count in excess of 1,000.
In recent days, there have been more than 3,000 new cases reported.
“There certainly is strain on our public health systems,” Herlihy said. “There’s strain on our contact-tracing systems.”
Herlihy said that’s what makes the new Exposure Notifications Express smartphone system being offered to Coloradans so critical. It can alert people to when they’ve been exposed to someone who later tests positive for coronavirus and does the work of a contact tracer automatically.