This week’s Board of Health meeting updated the community on Covid-19 updates, the role of Public Health, and the phases of reopening.
Charley Spikert – Epidemiologist
Typhoid Mary
Mary Mallon was an Irish immigrant who came to the US in 1884and was responsible for an asymptomatic spread of Salmonella typhi. This resulted in a cluster of 24 typhoid cases and one death. An investigator was brought in and discovered that the outbreak was from Mary not washing her hands while cooking. She was quarantined and said she wouldn’t go back to cooking. She changed her name and began cooking again which started another outbreak that led to 24 more people being infected and 2 deaths. She was put back into quarantine for the remainder of her life. This is important because it is one of the first cases of an asymptomatic spreader.
Super Spreaders were identified in Chicago, San Francisco, and Colorado Springs. These people were mild to asymptomatic but still spread it to many people resulting in several fatalities. The majority of cases have been contracted indoors with multiple people, talking closely and loudly, singing, and the like. Cases contracted in retail and outdoor activities happen less frequently.
It takes fewer than a thousand particles to cause an infection. If the population as a whole commits to 65% social distancing we can keep future infections under control. We need to adhere to The Commitments of Containment. The more we adhere to these commitments, the less problems we will have opening up, and the less risk we will have for moving backwards. We want people to reduce what they would normally do by 65%. It is critical that people over 60 socially distance over 65% of the time to stay safe.
CDPHE modeling predicts the next spike may be in August. It is becoming a concern in the scientific community that people are not socially distancing. Our threshold of concern is an increase to 18 per week.
You can you find the most recent data on our dashboard (https://covid19.pitkincounty.com/covid-19-stats/)
So far at Aspen Valley Hospital, there have been 452 people tested. There have been 23 positive tests, 407 negative tests, and 22 pending. In the last week the number of tests has increased to 100 with 1 positive. The one positive was an asymptomatic patient. There will be a new case coming from someone who was tested in Garfield County but is a resident of Pitkin County so that will be added to the count for Pitkin.
Cases:
Colorado – Decreasing. It will be a few weeks before we see results from Memorial Day and protests. (47 cases per 10,000 people)
Garfield County – Stable with a few new cases (25 cases per 10,000 people)
Pitkin County – Stable (33 cases per 10,000 people)
Eagle County – Increasing (109 cases per 10,000 people)
We are doing well in Pitkin County.
Movement Throughout the Roaring Fork Valley
Movement between counties in January, February, and March saw an increase. In April, movement between counties dropped off but it is beginning to increase again. There have been higher levels of traffic recently but we are still not seeing much from the front range.
Dr. Kim Levin
Aspen Valley Hospital has remained in a stable position for a month. We are 3-4 weeks out from seeing data from Memorial Day and the beginning of Phase 2. One patient with COVID -19 like symptoms was tested this week but they tested negative. There are currently two health care workers out with COVID-19 like symptoms but we still have a full, healthy staff.
Our daily visit count is below 10 a day at the respiratory tent. We started testing April 24th and have seen a high number of those testing negatively with very few testing positively. It is great to see with the increase in testing that there is a low number of positivity rates. We are waiting to see how things unfold as we begin to open up more.
We ask everyone to adhere to The 5 Commitments of Containment. These practices work and we must communicate with each other around town. We ask people to be kind to each other and focus on education. The only way we will be able to safely open, without overwhelming the hospital, is to continue with commitments.
We want to honor the protests that have been happening across the country. The message of hope and having a voice is very important. People have more energy than ever to make change. Racism itself is a public health issue. COVID-19 disproportionately affects vulnerable populations. We all have a voice and we need to do everything we can to ensure a better future. Vulnerable populations need to be protected so we do not see a spike that might potentially overwhelm the hospital. We must continue to operate at 65% of what you usually do. If we are only committing to 45% there is a high likelihood that this will lead to a spike.
Q: Have we seen any spikes from opening businesses on April 29th and May 9th?
A: There has not been a spike seen from opening businesses on April 29th. Unfortunately it is still too soon to see data for May 9th. It is possible to see this spike as more data comes in.
Karen Koenemann – Public Health Director
Starting to focus on big level strategic vision. It is crucial to look further ahead when this pandemic could go for 2 years.
In the beginning of the pandemic it seemed like a sprint with few resources. We are now in a marathon with more resources that we can share with the public. The goal is to figure out how to sustain ourselves for the long term.
Mission statement
- We are working with communities to promote health and prevent disease by protecting and enhancing environments, policies, and systems that support positive outcomes
Vision
- Systems in place to sustain a healthy and thriving community
Health Equity Statement
- We believe in the catalyzing power of equity to engage and enrich our communities as we identify challenges and design solutions together
Systemic racism is a public health issue. COVID-19 has surfaced this and laid it out for everyone to see. We all have a responsibility to fight racism and inequality.
Our Commitments:
- We will work from within to promote inclusion.
- We acknowledge our individual places of privilege and we will work to dismantle systems of oppression.
- We will be self-compassionate and compassionate towards others.
- We will model by living our lives as vessels of kindness and hope.
- We will educate ourselves on systemic issues of racisms and other “isms.”
- We will listen to people of color and other marginalized communities and advocate for those who have been silenced.
Goals:
- Slow transmission
- Preparing for a surge in the health care system
- Protecting the most at risk to severe illnesses
- Mitigate impacts
- Create organizational infrastructure to maintain a long-term sustainable response
- Prepare for antiviral and vaccine distribution
- Proactively reimagine the future and build community health social and economic resilience
We are trying to build a better future for everyone. The better we do form a public health perspective, the more we can show how safe our community actually is. We are working our hardest to give the community a chance for a strong, long term recovery. The more measured we are while reopening and the more systems that we have in place will lead to a better economic recovery. Currently we are building more positions within the Public Health Department to help with the COVID-19 response.
Kara Silbernagel – Pitkin County Policy and Project Manager
Road map to reopening
- I will maintain a 6 foot distance from anyone not in my household
- I will wash my hands frequently
- I will cover my face in public
- I will stay home when I am sick
- I will seek testing immediately and self-report if I experience symptoms
Upholding these commitments is crucial to continue to reopen and move on to the next phases.
5 Criteria
- Sustained decrease
- Hospital is safely able to treat patients
- Testing can be performed for all those who have COVID-19 like symptoms
- Active and timely monitoring can be accomplished
- Clear protocols are in place that require social distancing
This is based on data to move on while also maintaining these criteria. If we see any changes then we will have to pull back.
Phase 2 Timeline:
June 1 – Summer Day camps, outdoor recreation (playgrounds, outfitters, and guides), ski areas with approved COVID-19 Business Safety Plan
June 5 – Places of worship
June 8 – Gyms/fitness centers, recreation centers, pools, organized recreational sports
June 15 – Events and gathering size increases to 50 (Local jurisdiction must be met as well)
June 22 – Short term rentals that are not professionally managed
June 25 – Phase 3
One Community Item
Q: What is being done about restaurants/bars having too many people?
A: Consumer protection positions are being added to help monitor and educate these businesses on best practices. This position will not be limited to just the food industry but all businesses. This position entails educating and helping businesses follow best practices. The position is pretty similar to a food inspector but this will be for COVID-19 related issues. The first contact is educational and then there will be a second contact which is a follow-up to see how the business has been adhering to the guidelines. If guidelines are not being followed at this point, this group will enforce the guidelines. This can be a criminal or civil enforcement. So far in Pitkin County, we have come close to enforcement but luckily it has not happened. The top priority for this group is education and understanding.
Thank you for joining us.
