John Scarffe, Colorado. The Colorado Department of Public Health and Environment (CDPHE) conducted a remote media availability on COVID-19 cases in Colorado on Wednesday, November 4, 2020, at 11:10 a.m. Two days earlier, on November 2, CDPHE released a new public health order. 

The new public health order is similar to past orders, but integrates Protect Our Neighbors, Safer at Home, and Stay at Home orders together, and it makes a series of technical updates requested by stakeholders. It went into effect at midnight on November 3.

Heidi Bosk moderated the November 4 media session that began with statements by CDPHE officials and concluded with a question and answer session with the media. Bosk introduced Dr. Rachel Herlihy, state epidemiologist with CDPHE, who went over the basics of COVID-19.

The virus that causes COVID-19 is a novel virus, first identified in 2019, so people don’t have immunity to it. The virus is spread by droplets that can travel farther than six feet, and can be contracted by touching surfaces and then touching the eyes or mouth. 

The State has seen 2,000 cases per day at the highest rate and is now seeing a rise in hospitalizations, Herlihy said. The State has experienced three waves of the pandemic, with cases highest in April, then fewer cases in the summer, but at current transmission rates, the State will exceed the April level this fall.

In the last few weeks, the positivity rate has more than doubled. Herlihy suggested that everyone get a flu shot. Residents should take advantage of the 50 testing sites in the state, reducing contact with people outside of their households and wearing masks. People who have symptoms should get tested and then isolate themselves for seven days. If they test positive, they should isolate themselves for 14 days.

Dr. Jon Samet, dean of the Colorado School of Public Health, said that hospital counts and transmission curves have been getting steeper through October. Transmission control is dropping for each age group, and case rates are going up in all age groups.

“It’s not just older people in the hospital,” Samet said. The state has a rise of rate infection among those who are older and a drop in transmission control. The State could exceed the capacity for critical care facilities.

The holidays are coming, and people will get together. If transmission control drops by 10 percent, critical care will exceed capacity. “Heading into the holidays on a steep curve could make it even worse,” Samet said.

The epidemic is worsening with colder weather coming. Holiday travel will be riskier. Contacts among people not in the same household should be reduced. 

Dr. Eric France, chief medical officer with CDPHE, said the bad news is that the hospitalization rate is going up. How do we not spread this virus? 

Avoid in person gatherings. Stay at home when you are sick. Wash hands and wear masks. We should isolate or quarantine ourselves a full two weeks, and we must get tested.

Isolation is what we do when we are ill for 10 days since the symptoms appeared, a day without fever, and symptoms are improving. If exposed, stay at home for 14 days. 

The November 2 news release said the new public health order includes streamlined guidance and clarification on the dial framework. According to the website: “We are at a pivotal juncture. We need to change course in November to prevent more Coloradans from getting severely sick.”  

Colorado’s dial framework has five levels to guide county response to COVID-19. Counties move back and forth between levels, depending on three metrics. Levels are based on the number of new cases, the percent positivity of COVID tests and the impact on hospitals, and local considerations. As the dial moves left, toward Protect Our Neighbors, more people can participate in various activities.  

The lowest level is Protect Our Neighbors, the second is Level Blue, Safer at Home; the third is Level Yellow: Safer at Home, the fourth is Level Orange, Safer at Home High Risk, and the highest is Level Red: Stay at Home.

France said Adams and Denver Counties are at the orange level. During the next few days, 18 counties could be moving to stay at home level, and they will work with the state to implement plans to control this spread. 

According to the Dial, the highest number of cases concentrate on the I-25 corridor from Fort Collins to Colorado Springs. Boulder County qualifies for Level 2, Safer at Home, with between 175 to 350 incidences in the past two weeks. Gilpin County received the lowest category of Protect Our Neighbors, but Gilpin had 37 tests for the virus on November 3.

 During the media question and answer session, Herlihy said several factors contribute to why the disease is spreading more now. It spreads more indoors and seasonality may be associated with the virus. 

She suggested returning to efforts that were successful in the spring and summer and doubling down on strategies. France said that nobody wants to stay at home. 

“We need to start thinking about what to do to keep from crossing over to stay at home,” he said, including curfews and reducing gatherings. It begins when positivity rates are too high. If things aren’t moving, the State can move to stay at home.

Regarding transmission in schools, Herlihy said that transmission in schools varies by age group. Case numbers are smaller with younger students, and staph infections also are involved. With high school students, they see a larger number of cases with outbreaks. 

Cases of individuals with COVID in jails who are not out in the community are not counted in case counts, but staff would contribute. Herlihy said the mixing of households and gatherings is where transmission occurs. Fourth of July and Labor Day saw more transmissions than any other time. 

France said the goal is to avoid stay at home and to mimic what we did in April. 

To see updates on the dial, go to covid19.colorado.gov.