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Due to the COVID-19 pandemic, a sign is posted on the window asking customers to please wear a mask inside the Hope Tank social enterprise gift store on Broadway on April 6, 2021 in Denver, Colorado. (Kathryn Scott, Special to The Colorado Sun)

As the number of people infected with the coronavirus continues to rise in Colorado’s hospitals, Denver Mayor Michael Hancock on Tuesday announced that people visiting public indoor spaces in Denver metro counties must wear a mask.

Businesses that don’t want to impose a mask order will be allowed to verify patrons’ vaccination status, instead. Under this option, only people who are vaccinated may be admitted.

Denver’s order joins identical orders covering Adams, Arapahoe, Broomfield, Boulder and Jefferson counties.

The new orders go into effect on Wednesday. They apply to all indoor public spaces and anyone older than age 2. 

The orders will remain in effect until early January.

“Regional protective actions have become necessary to reduce the dangerous pressure on our hospitals,” Hancock said.

MORE: Denver-area businesses may start checking your COVID vaccination status. Here’s how to get proof on your smartphone.

Dr. John Douglas, the executive director of Tri-County Health Department, which covers Adams and Arapahoe counties, said enforcement of the orders would be driven largely by complaints. He encouraged businesses to take the orders seriously, calling it an “all-in-this-together” effort.

Other public health leaders cast the new orders as ways to help residents — especially those most concerned about COVID — feel more comfortable supporting businesses despite the current high rates of virus transmission.

“Tomorrow, the people of Jefferson County and the metro area will be safer than they are today,” said Dr. Dawn Comstock, the executive director of Jefferson County Public Health.

Colorado’s worsening COVID problem

The orders come as Colorado’s COVID situation continues to worsen.

Hospitalizations of people with COVID-19 are still rising. The increase in new infections has flattened somewhat over the past week, but the state still ranks eighth nationally for the number of new infections and the number of people hospitalized, according to The New York Times’s COVID tracker.

Public health leaders are increasingly worried about what the next few months hold for the state — as people gather for the holidays and other respiratory viruses, notably the flu, could also send waves of patients to the hospital.

“Our system is on the brink of collapse,” Denver Health CEO Robin Wittenstein said. “And I don’t say that to be a fearmonger. We truly are at the point where we cannot continue to do what we are doing without help from people in the metro region.”

At the same time, metro health officials were reluctant Tuesday to place blame for the situation on the people in their counties — and especially not on those who are vaccinated. Many metro area counties have higher-than-average vaccination rates, but hospitals in the region are also taking in patients transferred from lower-vaccinated parts of the state.

“Let’s be clear about why we’re doing this,” said Bob McDonald, the executive director of the Denver Department of Public Health and Environment. “This is not a failure of Denver. This is not a failure of the public health system. We are here today because too many people chose not to get vaccinated, even though they were eligible.”

Gov. Jared Polis, speaking to reporters on Tuesday, said he supports the Denver-area mask mandates.

“I certainly support our public health departments in helping to protect the health of the general public,” he said.

As for a statewide mask-wearing order, that’s not on the table.

“I’ve made it clear that it’s not something we’re considering as a state,” he said. “If communities want to wear masks, they can implement that.”

Nevertheless, he encouraged Coloradans to wear masks whenever they are visiting public indoor spaces.

Here are five charts that explain where things stand in Colorado’s fight against coronavirus and why health officials are so concerned.

The number of new infections remains at the highest level of the year

About 3,000 people a day are testing positive statewide for a coronavirus infection, numbers not seen since last December.

A chart from the Colorado Department of Public Health and Environment shows the average daily number of new coronavirus cases in Colorado through Nov. 22, 2021. (Provided by CDPHE)

The state’s highest infection rates of the pandemic — above 5,000 new cases a day — occurred last year at this exact time. Within a few months, the numbers last year dropped after health orders were enacted. There is some hope that COVID’s mysterious seasonality may kick in soon. But health officials have repeatedly said that cases won’t fall on their own, leading to calls for a statewide mask order.

“This cost-effective, short-term measure is critical to a comprehensive approach for mitigating the current COVID-19 surge and reducing hospitalization rates in the near term,” the Colorado Association of Local Public Health Officials wrote in a letter to Gov. Jared Polis earlier this month.

Almost every county is getting hit hard

Remember the COVID dial — that system Colorado used for a while to determine the level of restrictions that should be in place in each county?

If you go by the original dial metrics, all but four Colorado counties would now be under a lockdown order because their infection rates are so high. Some counties in Colorado are registering rates of more than 1,000 cases over the prior two weeks per every 100,000 people.

A chart from the Colorado Department of Public Health and Environment shows the two-week cumulative COVID-19 case rate in Colorado counties as of Nov. 22, 2021. (Provided by CDPHE)

The state no longer uses those per-capita numbers for recommending public health measures. Widespread vaccination means that higher case rates aren’t as worrisome on their own. But, as some other charts below will show, the current surge is still following familiar patterns — leading health officials to believe that taking action to knock down new infections is needed.

There are worrying signs that the surge won’t end soon

In addition to high case rates, a lot of counties — especially along the Front Range — have really high rates of tests coming back positive.

Adams, Arapahoe, Jefferson, Douglas, El Paso and other counties have positivity rates over the last week above 10%. Denver, with a rate around 8%, isn’t doing much better.

A chart from the Colorado Department of Public Health and Environment shows the rates at which COVID-19 tests are coming back positive in Colorado counties as of Nov. 22, 2021. Counties in red have the highest percentages of positive tests, while counties in green have the lowest. (Provided by CDPHE)

Health officials look for positivity rates below 5% to feel comfortable that they are capturing all the infections that are out there and that the spread of the virus is under control. Rates as high as they are now in the metro area suggest that the surge will rumble on.

More people are dying now of COVID than have at any other time this year

While health leaders had previously hoped that widespread vaccination would render case surges far less harmful, the current spike is showing some old patterns.

The average number of people with COVID dying per day in Colorado — around 30 — now rivals the peak of the state’s first COVID wave, way back in the spring of 2020.

A chart from the Colorado Department of Public Health and Environment shows the average daily number of deaths among people who have coronavirus in Colorado through Nov. 22, 2021. (Provided by CDPHE)

Vaccines are effective at preventing death. The state says people who are vaccinated are 12.5 times less likely to die of COVID than people who are unvaccinated. Those who died who are vaccinated are also older on average than those who are unvaccinated, according to state data.

“This is the worst-case scenario right here,” McDonald said of the rise in deaths. “We need to drive those numbers down.”

The state’s hospitals are running out of room

On Tuesday, Colorado reported that its hospital intensive care units are about 95% full. There were 81 ICU beds available statewide and none available in almost all of the southern third of the state.

A chart from the Colorado Department of Public Health and Environment shows the percentage of ICU beds available in hospitals by region as of Nov. 22, 2021. Statewide, ICUs are 95% full, with only 81 open beds. (Provided by CDPHE)

Hospital acute care units — for patients who aren’t sick enough to need the ICU — are also crammed.

The capacity crisis isn’t due to just COVID. Hospitals are short staffed, making it difficult to find enough workers to cover beds. They are also seeing high numbers of patients coming in who delayed medical care during the pandemic, leading to worse health problems now.

This is why hospital officials have been reluctant to postpone elective procedures during the current wave. They’ve learned that procedures remain only “elective” for so long.

But COVID is a big part of the problem.

According to federal data, 14% of Colorado’s total hospitalizations right now are for COVID and 40% of the state’s ICU beds are taken up by COVID patients. The state is behind only New Mexico for having the highest percentage of ICU beds occupied by COVID patients.

Many health leaders also see rising COVID cases as the part of the problem that can be most rapidly fixed. Among those in the hospital with COVID right now, 83% are unvaccinated, according to state data.

“If you could decrease our COVID hospitalization by even 10 to 15%, that has huge impacts for our margins,” Dr. Michelle Barron, an infectious disease specialist at UCHealth University of Colorado Hospital said earlier this month.

The majority of ICU beds that are available in the state are in the metro area. But, because Colorado has switched to a statewide transfer center for moving patients around, those beds aren’t just needed for people in the metro area. They’re needed for people across the state, including those places where hospitals no longer have room.

That is why metro area officials said they needed to act. If hospitals in the metro area become overwhelmed, the impacts could ripple across the entire state. And they could harm people who are vaccinated — and people who don’t even have COVID.

“If we don’t reduce this stress now, the impacts on capacity will mean those who need care, whether they have COVID or something else, could see that care being reduced or even rationed,” Hancock said. “And that will cost lives.”

The Colorado Sun — Desk: 720-432-2229 Jesse Paul is a political reporter and editor at The Colorado Sun, covering the state legislature, Congress and local politics. He is...

John Ingold is a co-founder of The Colorado Sun and a reporter currently specializing in health care coverage. Born and raised in Colorado Springs, John spent 18 years working at The Denver Post. Prior to that, he held internships at the Rocky Ford Daily Gazette, the Colorado Springs...