As Colorado shifts toward an endemic response to COVID-19, the state health department is looking to the private sector for help in rethinking strategies to deal with the presence of the virus forever, and appears to be trying to shed its central role in limiting its spread in the process.
The Colorado Department of Public Health and Environment suggested in a document that it could make the transition as early as this summer.
“This virus is going to be with us for the foreseeable future, and we anticipate being able to manage the response more like other prevalent diseases when the time is right,” Scott Bookman, the head of the agency’s disease control division, said in an email to The Colorado Sun. He said the state is preparing for a “variety of near and long term scenarios.”
The state is trying to figure out how it will contract out the emergency functions it currently performs while working with hospitals to make sure they have enough staff, according to an agency document. It’s also trying to sort out how and whether to continue efforts to limit the spread of the virus in places like schools and prisons.
The changes could mean the public sees a lot less of the state government’s response to COVID-19 as it folds more of its response into the normal function of public health institutions. That could look like an end to daily case updates while community testing and vaccination sites mostly go away.
The state health department last week issued a request for companies to submit proposals to help Colorado come up with plans for the transition.
“Eventually the transition will be made from a pandemic to an endemic,” the request states. “With this transition in the near future, the Colorado Department of Public Health and Environment (CDPHE) is in the process of creating a transition plan that will in effect, move away from the emergency response plans of the pandemic and return to more historical public and private health plans.”
The concept of treating COVID-19 as endemic, more akin to the seasonal flu, has been batted around in the public health world as the eventual next step, and some countries are already trying to move in that direction.
“COVID is not going away, it’s going to be with us for many, many years – perhaps forever, and we have to learn to live with it,” UK Health Minister Sajid Javid told Sky News last month.
Similarly, Bookman said that, “transitioning toward a healthcare system-centered response is part of a national discussion as officials across the country acknowledge that COVID-19 will be with us for the foreseeable future.
“For the past two years, we have responded to this pandemic, quickly scaling up testing sites, distributing vaccines, ensuring health care systems had the personal protection equipment they need and protecting hospital capacity. In the beginning, we knew very little about this virus. We are in a different place now.”
Despite the intention to shift over to an endemic response Colorado health officials also want the transition plan to be flexible enough to go back into an emergency response mode if hospital capacity is stretched in the fall or winter, or if a more virulent variant begins to spread widely. The request for proposals shows CDPHE officials intend to break the transition down into two different plans.
On one hand, state officials want to come up with one plan for a new public health approach.
The document lays out a threshold for when the state would transition to an endemic response, that is, when the U.S. Centers for Disease Control and Prevention declare “that individual cases no longer need to be tracked and emergency surge capacity of testing, vaccination, therapeutics and public health orders are no longer required to protect hospital capacity.”
Once that happens, the CDPHE wants companies to help them figure out which functions state and local public health agencies will continue to perform and which functions they should stop performing.
Other questions posed to bidders: What would trigger an emergency response to protect hospital capacity in the future? Will “workforce gaps” stifle the state’s ability to “move to an endemic response this summer?” Do schools and jails need to continue working to contain the spread of the virus? How will vulnerable populations be protected? What needs to be done to continue tracking the disease?
On the other hand, state health officials are also looking to develop a transition plan for health care providers in Colorado, involving how the state will work with hospitals to make sure they have enough staff, how it will maintain access to COVID-19 testing and support for vaccination, and how it will protect places like long-term care facilities and prisons.
The work would also involve reaching out to and meeting with relevant groups, which could include hospitals, schools and the public. The state also wants companies to come up with a plan to shift emergency functions it currently performs to health care contractors.
CDPHE has fast-tracked its search for companies to help with the plans, allowing just 10 days between announcing the bid and the due date for proposals. The normal protocol calls for 30 days between advertising the bid and the submission deadline. The request for proposals listed a total budget of $100,000 to $170,000. Proposals are due Friday by 2 p.m. and state officials are looking to sign contracts by Feb. 15.