STEAMBOAT SPRINGS, CO, December 9, 2020 – The Board of Health conducted its weekly meeting and discussed the continuing number of cases that keep Routt County at a Level Red. Participants also discussed the upcoming vaccine distribution and that the State of Colorado will receive less than 47,000 cases for the first batch of immunizations. The second Town Hall on Vaccines will be held on Friday, December 11th at 10:30 am and can be viewed at the , the and Ch6.
Roberta Smith, Routt County Public Health Director, gave a statewide update for the Commissioners, “Statewide transmission control estimates are up to 73%, but mobility data is showing that more people are starting to go out more. It is still important to stay home and limit your interactions and gatherings. It’s important to note that all counties in Colorado, except six have incidence levels that are in Level Red and the others in Level Orange. Modeling suggest 1 in 40 people in Colorado have COVID-19. We need to be vigilant to get to a lower level.”
Routt County epidemiologist, Nicole Harty gave her weekly update. “What level are we at according to the metrics? Our Incidence rate remains more than twice the threshold Level Red. Our positivity rate remains in the Level Yellow and hospitalizations have seen no change and are in still Level Yellow. Is it time to move to a different level? No. Incidence remains well above the threshold for Red, positivity remains elevated. Are we moving in the right direction? Maybe. Case counts decreased from their peak the week of Nov 16. It is too soon to say if we are trending in the right direction. We are now more than two weeks out from moving to Level Red, so we have begun to realize the impact of capacity limits and gathering restrictions. It appears moving to Level Red contributed to decreased disease transmission within our community. It also appears that people gathered over Thanksgiving and we continue to see cases as a result of gatherings over Thanksgiving. There are two things going on, and the extent to which one is impacting our case counts more than the other is hard to say. Secondary transmission as a result from Thanksgiving is possible through about the end of the month. Gatherings over the holidays for the next few weeks are likely to lead to increased cases in our community and have the potential to move us in the wrong direction.”
Dr. Fritha Morrison, Routt County epidemiologist added, “We are still very uncomfortably, comfortably in Level Red. Even if we had zero cases next week, we would be well above the case count threshold for Red. Our distribution of asymptomatic vs symptomatic disease is currently a bit skewed. We only had about 15% of cases be asymptomatic, which is on the low side. We always know we are missing cases, but we are certainly missing some of the asymptomatic ones this week.”
Ms. Harty said there was an update on hospitalization data to match the state’s system. The COVID-19 Dial hospitalization metric is designed to capture hospital capacity. For us here in Routt County, this metric looks at anyone who has been hospitalized at UC Health Yampa Valley Medical Center (YVMC) with COVID-19 in the past 14 days. This metric includes hospitalizations regardless of residency. We do not believe this accurately captures capacity at YVMC because two hospitalizations every day would be 28 hospitalizations in 14 days, which would be yellow on this metric, but likely more concerning than yellow would suggest. We are keeping track of both the number of Routt residents hospitalized anywhere as well as COVID-19 hospitalizations at YVMC in the Most Recent Week and Most Recent Two-Week table. 26 Routt residents have been hospitalized with COVID-19 since the beginning of the pandemic. I updated this metric last night to accurately capture all hospitalizations since March. The sizeable increase in this number from last week is artificial. We only have had one new resident hospitalization in the last week.”
Brooke Maxwell, Public Health Nurse had an update as well, “An outbreak is defined as two or more confirmed cases in a workplace or facility in a 14-day time period. An outbreak does not always mean that a business is doing anything wrong and often times the disease transmission happened outside of the workplace. What really is more important, is to understand is the type of businesses. For example, if there is an outbreak at a restaurant and that restaurant has been in contact with Public Health we are helping them with their mitigation plan. The outbreak (or rather the positive cases) are no longer in the restaurant working, those employees are at home in isolation or quarantine. It’s the same as with the school outbreaks, the affected students and the teachers are removed from the environment. And it remains safe for everyone else to continue to attend school. As a member of the community, you should be able to walk into any business and determine for yourself if the behavior you see is risky and if it is a place you want to patronize. The blessing in disguise this week (is that the CDC has lessened quarantine times to 10 days if you remain asymptomatic. We do still recommend that you quarantine for 14 days if possible. Please stay home from work and school when you have any symptoms and while you wait for test results.”
The Commissioners asked for more clarification on outbreaks and if state restrictions have been unnecessarily harsh in restaurants since they seem to be a low cause of transmission Ms. Smith said, “ I think it is important to understand the setting itself. Indoor dining with masks off for a prolonged period of time is a high-risk setting. We need to limit indoor prolonged contact without masks on. There have been studies and we know that the droplets are going to spread and going to spread beyond the table. Plus, indoor spaces don’t have great ventilation.” See video.
Dr. Morrison added, “We are unable to say exactly the cause of each outbreak, but we can say that more of our outbreaks happen indoors, when masks are off, food and drinks are involved, and it is for a prolonged time of close contact.” Dr. Harrington continued that “things we could get away with during the summer, when disease prevalence in our community was low, we just can’t get away with now. The risk is greater because there is more disease in our community.”
County Medical Officer Update
County Medical Officer, Dr. Brian Harrington, gave his weekly update, “I do want to give a shout out to the school districts in our county. While many school districts across the state have shut down in person learning, our school districts continue to offer at least partial in-person learning. I credit the administration, teachers and staff, students, and their families with their continued efforts to make in-person learning work.
“How do we characterize our very high-test positivity rate, case count, and recent deaths? During the past month, we have been at the worst local level by far that we have measured during this entire pandemic. While our data from last week is not yet fully mature, we have seen indications that our case rates may have somewhat plateaued. The meaning, and danger, of our current level of COVID-19 disease transmission in Routt County has not changed. Half of our 16 deaths have occurred within the last seven weeks. One way of looking at deaths in Routt County might be to say that fatalities have been just an issue with our long-term care facilities. However, that is not an accurate statement. We have at least three documented deaths just in the past seven weeks of Routt County residents who were not residents of a long- term care facility. We have seen rather young individuals, well below age 60, critically ill, sometimes intubated, and sometimes transferred to higher levels of care. We are at the most dangerous period of this pandemic for Routt County.”
“So, our counts tell us where are currently. But looking at our trends gives meaning to the recent past, and to where we may be going. A relative stabilization of counts, or even a decline, would indicate that efforts in recent weeks like the move to the Red Dial level have resulted in a change in our transmission rate. This recent data stabilization trend is mirrored at the state level. A relative stabilization gives us hope that things will not get worse, and we can drive the disease prevalence down and achieve an R naught of less than 1. If we have stabilized, it does portend where we are going and would imply our recent efforts have had an impact. We will hopefully not breach our local and state hospital capacities.”
Ms. Smith said that Public Health is preparing for vaccine distribution but cautioned that the first batch will be a low number since the state only has 46,800 does for the first round. “The Colorado Department of Public Health and Environment (CDPHE) continues to update the priority level for vaccine distribution. And we are ramping our Public Health Department’s capabilities and working with partners to identify other locations in the county to distribute the vaccine as we get more doses.”
Dr. Harrington added, “The Public Health department and our local hospital are getting ready to begin administering the new COVID vaccines perhaps as early as next week. We are digesting the new detailed vaccine trial information released yesterday. We all need to develop our own understanding and trust in these new COVID-19 vaccines. I encourage folks to watch our town hall discussions about the vaccine. This week one of our panel members will be Dr. Tom Campbell, who has been involved at the state level with the vaccine trials and should be able to provide some helpful information. I also recommend that Routt County citizens talk with their primary care providers. As primary care and preventive health specialists, family physicians, pediatricians and general internists work with vaccines every day and have the best understanding of their critical role in keeping our population healthy and safe.”
There has been continued discussion about the Five Star restaurant program that allows restaurants to operate at 25% even in higher levels. Ms. Smith said, “Many counties have similar protocols, like we do in Routt County, but it is not called a Five Star program. CDPHE is reviewing the program for restaurants and it will probably be out for review on December 18th. If enacted, there could be a roll out for the certification process in February. At present, counties in Level Red or Orange are not eligible for any type of variances.”
The next Board of Health meeting will be Wednesday, December 16th at 10:30 am
The next Vaccine Town Hall is on Friday, December 11th at 10:30 on , and TV6.