This past Tuesday saw Grand County officials workshopping about “pandemic preparedness” at the exact time that Colorado Governor Jared Polis declared a state of emergency. A scare just one week ago had a patient (falsely) suspected of having the coronavirus transported from Grand County to Denver on the same day that the state’s first positive case was confirmed out of neighboring Summit County. Middle Park Health has cancelled its annual Kremmling Health Fair. 60 students were absent from West Grand schools on Monday. And headlines in the past week have suggested that coronavirus fears are expected to impact the mountain resort economies (skyhinews.com), a travel ban will inevitably hit the US (zdnet.com), Colorado’s climate could slow the spread of the disease (denverpost.com), a key testing component is in short supply (usatoday.com), the IRS may extend the tax filing deadline (nytimes.com), and– on International Women’s Day– that coronavirus is “heaping more unpaid labor on women” (independent.co.uk).
It seems like a chaotic free-for-all. But what do we actually know? What are the real numbers? What steps are our leaders taking? What are the longer-term impacts on our individual, societal, and economic health? And what can we do to keep ourselves and our loved ones safe?
In truth, the answers to these questions and most of the others being asked about coronavirus do not have a simple or immediate answer. The answers will change as more information is gained. And the information will shift as greater understandings are reached.
Where Colorado stands
What is known is that, as of the time of production, early Wednesday, March 11, there were over 1,000 confirmed cases in the US and 17 confirmed cases in Colorado. Governor Polis did declare a state of emergency mere hours ago, to remain in effect for 30 days. According to Brene Belew-LaDue, Grand County Public Health Director, this declaration permits the Colorado Department of Health and Environment to expand testing criteria, testing availability, and lab processing; open alternative care centers; implement quarantine procedures; requisition necessary supplies; and possibly qualify for future federal reimbursements. The declaration also requests policy direction that could grant paid sick leave to workers in high risk jobs, such as food handling, hospitality, child care, health care and education if they have signs of respiratory illness and miss work for testing (a one to three day turnaround time), and for potential unemployment insurance and wage replacement for patients who test positive for the disease. He has asked private employers to voluntarily offer paid sick leave. And he has asked that insurance providers waive co-pays, deductibles, coinsurance and cost-sharing for those seeking COVID-19 testing.
Where Grand County Stands
At its regular meeting on Tuesday, the Grand County Board of County Commissioners (BOCC) discussed the applicability of current policies, such as those for temporary closure of County facilities, reduction or suspension of County facilities, and the snow closure procedure. An afternoon workshop was held where the Board, numerous staff, and a few community members considered how to make financial decisions and managing decisions around the coronavirus issue. Under the first agenda item, County Manager Kate McIntire requested that department heads complete a survey about their estimated financial needs, including supply costs and staff time, for preparation and response to a local coronavirus outbreak. The County will then order supplies through a single-point ordering system, in order to track coronavirus-related monies in the case of future reimbursements.
McIntire further initiated conversation about the potential impact on the County’s 2020 budget, if a decrease in tourism were to mean a decrease in sales tax revenues from now until the end of May. Numbers were discussed and Commissioners seemed to favor an extreme estimation, looking at what a 30% decrease from 2019 sales tax figures would look like. While this was evaluated to be about a $600,000 loss by Finance Director Curtis Lange, McIntire noted that “we budgeted a 7% increase over 2019 and have so far recorded a 35% increase. This adds some resilience in our budget for when things like this happen.” DiAnn Butler, Community Development Director, also pointed out that we’re headed into the slowest tourist season and that they impact may therefore be less than feared.
Commissioner Merrit Linke indicated that sales tax was a relatively small percentage of the County’s overall revenue. And Fraser Town Manager Jeff Durbin indicated that it was a much larger percentage for towns. He noted that, with sales tax accounting for 75% of Fraser’s revenue, their town board was already discussing which large capital projects could be postponed in case of a revenue shortfall, rather than redoing their budget. Commissioners Linke, Kris Manguso, and Rich Cimino determined that this would be an appropriate course of action for the County as well.
In the latter part of the meeting, McIntire introduced some resources for cooperative management planning, presenting a tiered response guide modeled after one from Fountain Colorado, and a sick-day policy adapted from Routt County. After discussion of the tiered plan, Commissioners and management agreed that the County is now in a Tier II stage, indicated by a statewide concern, with multiple confirmed in-state cases. Specific Tier II response calls for widespread attention to hygiene and sanitation in the workplace, “trial teleworking and staggered shifts authorized,” social distancing, minimizing of outside meeting attendance and internal meetings, that high-risk employees should work from home, and that sick employees stay at home. Community members are encouraged to do as much government business online or over the phone as possible. Many tasks, such as driver’s license renewal, can often be done through the appropriate County or State websites. Check there before visiting public offices.
Phase III would be triggered by multiple cases of sustained infection in Grand County. Employees would be directed to stay home if they or a family member exhibits symptoms. In-person meetings or events will be eliminated. Additional options for remote work will be explored, to the extent possible, and heightened sanitation and personal protection procedures will be enacted. Phase IV would mark the “full implementation of a response plan,” at such time that schools are shut down and regional social spacing is recommended by Public Health, or whenever deemed “to be in the best interest of the organization and/or community.” County buildings would be minimally staffed with no public access. Teleworking options and staggered shift work is maximized, with only essential services ongoing, unless provided remotely. And an Incident Command may be set up and coordinated with County authorities.
Finally, in the event of a quarantine Grand County Public health would guide “cancellation of public events, quarantine processes and procedures, et cetera.”Belew-LaDue advises that most direction is expected to come from the State as to which government services would remain imperative, which mandates may be loosened or adapted, and which services may be considered non-essential during various stages of emergency response.
Concerned discussion was had about pay, especially for new employees who may not have banked sick days or don’t yet have access to them. The offered policy from Routt County would see people using their sick days first, then vacation days, then possible sick bank days. County Clerk and Recorder Sara Rosene noted she would still worry that sick employees would come to work if they were trying to protect those paid days for future dates. Exchange went around as some seemed to suggest asking for sick bank donations while others, like Allen Pullium of Grand County EMS, advocated for “just paying sick employees as if they were at work.” Linke suggested loosening the policy for the next four weeks. HR Director Colleen Reynolds indicated at one point that there had not been enough guidance on the topic. And McIntire stated that “The BOCC is telling you today to do what you need to do in your departments to manage this pandemic.”
On Wednesday (after this edition went to print) Public Health and the Office of Emergency Management met with other emergency response planners, such as law enforcement, fire protection, and school officials, for a “table top exercise” to formulate a continuity for public health planning and operations. The goal of the meeting, according to Belew-LaDue was to “create a pandemic response to protect the health of residents of Grand County, protect the health of responders, and protect those who may need extra help with evacuation, et cetera.”
Where the Schools stand
So far, neither the West nor East Grand School Districts have announced any overt worry over the disease. West Grand officials have not expressed particular concern over the high number of student absences this week. And health professionals seem to support the conservative response. Belew-LaDue stated that “kids have proven to be remarkably resilient to the disease.” And Dr. Wisner of Middle Park Health explained that “We have been diagnosing more influenza A and B this year, which has likely led to more student absences. Clinic-wide we do not think that overall we have seen more illnesses, but more have been influenza. Certainly, the outbreak in November that caused the closure of the school was an anomaly likely caused by a virus that spread particularly easily and hit several other communities statewide.”
He goes on to say, “I have the sense that the community is being more vigilant about keeping/sending kids home from school if they have fevers or symptoms of illness. In the last week the scare over COVID-19 has brought more people into the clinic with upper respiratory symptoms and fever and we are now testing more people for influenza. In the past we might not have tested for influenza if they are outside of the treatment window (the first 48 hours of symptoms). I think that with the publicity and sensationalism that we have seen over COVID-19, people are hyper-vigilant about symptoms that may not have led them into the clinic or to keep their kids home from school in years past.”
Where we stand
That extra caution is certainly being encouraged by emergency and health personnel alike. Again, the best actions for preventing transmission of the virus are diligent hygiene practices, such as washing hands frequently with soap and water, regular cleaning and disinfecting of surfaces, avoidance of those who are showing signs of flu, and avoiding close or unnecessary contact with others when you are sick.
Belew-LaDue and other experts point out that wearing masks is unlikely to protect from the disease, though it could help those already infected from spreading the disease. Bacteria are transmitted most often when we touch our own faces, mouths, noses, and eyes. She especially discourages the purchasing of N95 respirator masks. “Even health care workers must be fit-tested, a 15-minute process, to ensure that bacteria isn’t getting in.” These masks are in low supply since the outbreak of COVID-19, and they are required for responders and health care workers that cannot avoid close contact with those showing symptoms of illness. She says that wearing disposable or regular cleaning gloves may help and that regular cleaning products, such as Clorox and Lysol, can be effective agents if used as directed.
For more information and recommendations on how to limit the spread of COVID-19 in Grand County, visit Grand County Public Health at www.co.grand.co.us/220/Public-Health or follow Grand County Public Health, Grand County Office of Emergency Management, and CDPHE on Facebook.