In early August, as coronavirus infections and hospitalizations first began rising in Colorado following a summer lull, Gov. Jared Polis stood before reporters to answer questions about the worrying trend.
Asked when he might consider reissuing a statewide mask mandate or other such aggressive virus-fighting actions, he was clear.
“We will not overwhelm our hospitals,” he said then. “We will take the steps necessary to avoid doing that.”
Later, he added: “We don’t wait until we’re overwhelming our hospitals. We watch the trend, and we act before we are overwhelming our hospitals.”
Colorado is about to overwhelm its hospitals.
When Polis made his vow, on Aug. 12, there were 514 people hospitalized in Colorado with COVID-19. On Wednesday, there were 1,431. The state’s intensive care units were 95% full.
Epidemiologists expect more hospitalizations are on the way. The percentage of coronavirus tests coming back positive statewide is at nearly 10% — double the goal for well-controlled transmission. In a handful of counties, test positivity tops 20%.
Models now forecast that by the end of the year, if things remain on the same track, hundreds more coronavirus patients will need a hospital bed than the state currently has space for.
Yet Polis has not given any indication that he intends to issue a mask mandate to slow the virus’ spread and give hospitals breathing room. Some public health experts in the state believe it would help.
“I do think that a statewide indoor mask mandate, potentially, could help the system right now,” said Dr. Anuj Mehta, a critical care pulmonologist at Denver Health who has sometimes advised the state on policy during the pandemic. “I think a statewide mask mandate — my personal opinion — would augment our ability to address some of the acute surge issues.”
Issuing orders — but not on masks
Polis and state health leaders have taken other measures to address the spike in hospitalizations. They have called in federal teams to help out in overworked hospitals. They have issued orders on hospital staffing and on patient transfers designed to make sure every last bed in the state can be used.
On Wednesday, Polis said the state would work to add 500 additional hospital beds in Colorado and would expand access to booster shots for the already vaccinated and to monoclonal antibody treatments for those in the early days of infection.
He said his administration would work with cities and with the operators of event venues to encourage them to require vaccination for attendees of large, indoor events.
“We know we need to do better; we are going to do better,” he said during a meeting with a group of his pandemic advisers. “And we are going to be working on policies that drive more Coloradans to get the life-saving vaccine.”
If things get bad enough, he said the state may have to activate crisis triage protocols at hospitals.
But Polis, in recent public statements, has repeatedly declined to entertain the idea of reissuing the kind of statewide public health orders on masking or social distancing that he issued earlier in the pandemic. He has insisted that now is a different time in the pandemic and there’s a question of fairness: About 80% of people in Colorado’s hospitals with COVID are unvaccinated; so why should the majority of Coloradans who are vaccinated have to suffer through more restrictions?
“I think most Coloradans are sick and tired of wearing masks to protect people who don’t seem to want to protect themselves,” he said earlier this month.
Fewer calls for state action
Health leaders are also approaching the matter with more caution.
Yes, many say, a policy that would increase mask-wearing seems like a good idea. But they aren’t saying it too loudly, in recognition of the complex dynamics that exist around the topic.
“It seems like the problem there, put pretty simply, is that it’s so unpopular now to call for mask mandates,” said Dr. Jonathan Samet, the dean of the Colorado School of Public Health. “These measures have been made unpopular and politicized, which complicates implementing them. But I think everything that we can do to reduce transmission would help.”
The Colorado Hospital Association, which represents the very facilities that could soon be overwhelmed, does not intend to call for a new statewide mask mandate, though it does encourage people to wear masks in crowded spaces.
Samet said there’s also a question of where such an order should come from. Would people be more likely to comply if the state issued it or if a local government did?
State health officials have said they believe new orders should come from the locals.
“The spread of COVID-19 across our state is not consistent; it’s not uniform,” said Scott Bookman, the state’s COVID-19 incident commander. “So we do still believe strongly that local control and local orders are the key way to ensure that the right mitigation measures are put into place.”
At least four counties across Colorado have reissued indoor mask orders: Boulder, Larimer, San Miguel and Pitkin. But others have issued only “public health advisories.”
The Colorado Department of Public Health and Environment and the Metro Denver Partnership for Health issued one such advisory last week asking — but not ordering — Coloradans to wear masks in crowded indoor public spaces, regardless of vaccination status.
“Taking COVID-19 precautions now will not only prevent additional COVID-19 hospitalizations, but will help ease the state’s strained hospital capacity, which puts every Coloradan who may experience a health emergency or have routine health care needs at risk,” the advisory stated.
Another sign of how far away Colorado is from a new mask order: State health officials can’t yet prove that issuing one now would alter the hospitalization trend in the coming weeks.
Dr. Rachel Herlihy, the state epidemiologist, was asked during a meeting Wednesday what modeling projections show for the impact of a potential mask order. She said the state is gathering that information but doesn’t have it yet.
“There are a number of analyses that are underway,” she said.