Polis’s easing of COVID-19 restrictions catches local health agencies off guard, raises “deep concerns” – The Denver Post

The governor posted the order on Facebook at 8:40 p.m. Wednesday, then, 32 minutes later, followed it with a tweet: all counties at Level Red, the state’s second-highest stage of COVID-19 restrictions, will move down a notch on Colorado’s dial framework next week.

Jennifer Ludwig, deputy director of the Tri-County Health Department, missed Gov. Jared Polis’s after-hours social media posts.

It wasn’t until the next morning, when she opened her inbox, that she discovered a string of messages about the announcement, news stories and, somewhere buried in there, an email she’d missed the night before from the director of the state health department.

The message had been sent about five minutes before Polis took to social media, serving to inform local authorities of the change — which will allow restaurants in Level Red counties across the metro area and much of the state to resume in-person dining at limited capacity Monday.

“We learned this about the same time that the public learned about it,” Ludwig said.

Her colleagues at public health agencies across Colorado also were surprised, some of them only finding out the news — which arrived so fast many of the details still need to be hashed out — on Twitter or Facebook. They expressed frustration Thursday about being left in the dark on a major change in state health policy for the second time in the same day, following Polis’s unexpected changes to Colorado’s vaccine rollout.

The governor cited improving statewide metrics in lifting certain restrictions in 33 counties, including Denver and the entire Front Range, but his action this week came as not all of those counties meet the individual requirements to downgrade to Level Orange.

And while hospitalizations have decreased in recent weeks, transmission of the novel coronavirus still remains high. The state still does not know how any potential gatherings over the Christmas and New Year’s holidays will affect case trajectory. Neither do public health officials yet understand the impact of the new, more contagious variant of the coronavirus confirmed to be in Colorado this week.

“It appears that if there’s enough pressure from the business and economic forces in the state that we will change the dial to meet those demands and that’s kind of frustrating,” said Mark Johnson, executive director of Jefferson County Public Health.

“We don’t believe that it in any way reflects the spread of the disease or how dangerous the disease is or our concern about what is going to happen with Christmas, New Year’s or the new variant that is more infectious,” he added. “We are sort of plowing into a wider, open area on the dial even though we have some deep concerns about it.”

For some local public health officials, it was the second time that day they were caught off guard by a public health announcement from the governor.

Polis, less than 12 hours before making his Level Red announcement on social media, held a news conference in which he revealed significant changes to the state’s phased approach for COVID-19 vaccine distribution.

He not only announced that Colorado was moving to the next part of Phase 1 of distribution by vaccinating health care workers with less contact with COVID-19 patients and first responders, but that he was adding roughly 1.19 million people — including anyone 70 or older — to that same stage at a time when vaccine supply is still severely limited.

“Everyone is confused,” said Katie O’Donnell, spokeswoman for Larimer County Department of Health and Environment. “There is not a streamlined plan.”

And so local public health officials spent the last days of 2020 fielding calls and more calls from Coloradans seeking the vaccine, even though not all county agencies or health providers were ready to begin vaccinating a wider pool of people.

“Once you start picking favorites”

In an interview with The Denver Post, Polis said he posted his Level Red announcement on social media because he wanted to give restaurants as much notice as possible to adjust to the changes before they go into effect Monday.

In his tweet, he said he based his decision to move the counties to Level Orange on new COVID-19 cases having been in “a sustained decline for 13 days” statewide, and the fact that only 73% of the state’s ICU beds were in use.

“We’re trying to tell everybody at the same time,” Polis said when asked why local public health officials weren’t informed sooner. “I mean, once you start picking favorites, obviously the word gets out and then even more people get offended that you didn’t share it with them. So we generally try to be transparent and communicative with the general public.”

Local public health officials said the governor has been reticent to share policy changes related to the pandemic, leaving them to play catch-up and struggling to communicate effectively to Coloradans during a crisis.

“It puts us little behind,” said Cali Zimmerman, spokeswoman for the Denver Department of Public Health and Environment.

The Colorado Department of Public Health and Environment issued a statement that said the agency notified local public health directors of the changes to the state’s color-coded COVID-19 restriction dial in an email. It did not say when that message was sent.

“I get that there’s, you know, thousands of people that want to know something before the general public, but the problem is if they are made aware of it. then the general public becomes indirectly aware of it because they’re talking to others and it gets out and it might not be exactly correct,” Polis said.

Risks posed by indoor dining

Polis’s announcement comes two weeks after two of the state’s leading public health experts — who also are members of the governor’s virus modeling team — wrote an op-ed published by The Post that said restaurants are “ideal locations for the spread of infections” and urged the closure of indoor dining to reduce COVID-19 deaths and illness.

“Indoors is riskier than outdoors because the walls and ceilings that enclose indoor spaces trap the virus, allowing it to build up in the air over time — much like cigarette smoke,” wrote Jonathan Samet, dean of the Colorado School of Public Health, and Elizabeth Carlton, an associate professor for the school.

Still, just a few weeks ago, Colorado launched its 5 Star State Certification Program that allows restaurants to see restrictions eased, including allowing eateries in Level Red counties to reopen indoor dining, if they meet rigorous safety guidelines.

Restaurants in counties moving to Level Orange next week that are certified under the program will not be able to operate under the next less restrictive stage on the state’s dial, in this case Level Yellow, until those counties meet the metrics for their new level and sustain them for at least 14 days, Tri-County’s Ludwig said.

“The benefit of having the 5 Star program while we were in Level Red is that it was a slow reopening and those business were also following very strict guidance. And all of a sudden it’s all businesses opening,” she said. “We are just hopeful that it will not result in additional spikes.”

For Arvada Mayor Marc Williams, the rollout of the 5 Star program followed so closely by a blanket reduction in restrictions was discouraging.

“We’ve got a private contractor do the inspections, do the enforcement, and I specifically asked the governor’s folks if this is really going to be necessary or are we going back to Level Orange in a way we don’t have to jump through these hoops, and the word was that the 5 Star program was the way to do it,” Williams said. “It feels like there’s a little bit of a yo-yo going on, and I don’t think it’s intentional misdirection, but it has us moving in different directions all the time, and that’s frustrating.”

“Close to being on the same page”

Since the novel coronavirus first arrived in Colorado, state and local officials have had to balance competing and simultaneous health and economic crises.

And in recent months, the state’s dial framework has become a point of contention — or more aptly, the adherence to its metrics — between state and local officials as they debate the appropriate level of restrictions to put in place as infections and hospitalizations surged.

In November, when transmission of the novel coronavirus surged to new heights, local public health officials asked the state to enact tougher restrictions. Agencies in the Denver area particularly wanted to move as a region or in a statewide manner, saying it would be more effective and that Coloradans travel from county to county.

But state leaders were reluctant to issue any kind of new stay-at-home order without additional federal stimulus money, even as counties surpassed the threshold for Level Red, which at the time was the highest level on the dial and would have triggered a shutdown. They were so reluctant that the state pushed back the criteria for a lockdown when officials finally started moving counties to Level Red by adding an even higher status: Level Purple.

Now, Polis has ordered the state health department to move counties collectively down to Level Orange starting Monday based on statewide, not local, conditions.

He said he wanted to do this because when other counties have lesser restrictions, individuals can travel through those counties and potentially spread the virus to those communities with less spread.

“We like to keep folks close to being on the same page,” Polis said.

COVID-19 case counts still in the red

Polis’ directive comes even though many of the Level Red counties do not meet the threshold to move to a lower level. In the dial framework, a county is assigned a level based on new cases, the percentage of tests that are positive and how hospitalizations are trending.

Only five of the 33 counties at Level Red on the dial system Thursday morning had case counts low enough to move to the less restrictive Level Orange, if the state followed its guidelines. Nine of the counties have case rates double the maximum for Level Orange, and one had six times the cases needed to move down a level.

More counties had cases numbers that could push them to move up a level than down. As of Thursday, 27 counties were in Level Orange and 19 of them had case counts high enough to move into Level Red. Gunnison County, which is in at Level Yellow, also had case counts in the red.

Johnson, the Jeffco public health director, acknowledged that a county could pass a public health order to make things more restrictive than the state, but he said that can be “dangerous.”

“I mean all of us have had death threats, public outcries that you’re killing business and you better watch your back,” he said.

Some local officials, such as in Denver, said they agree with the plan to move into Level Orange.

“Our hospitals are doing all right, but still in an area of concern, so it’s good we’re not going lower than orange,” Zimmerman said, adding, “We still need people wearing masks and physically distancing as much as possible.”

Others are concerned about what it could mean for transmission of the virus in the state, and any subsequent hospitalizations.

“We are hopeful that we will have information from CDPHE next week to better understand what happens if we start to see surges and what metrics will be looked at to make those changes,” Ludwig said.

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