As some states across the country see an uptick in COVID-19 cases and hospitalizations, Colorado seems to be making tentative strides in containing the virus.
Dr. Ivor Douglas, an ICU pulmonologist at Denver Health, said the number of patients in his ICU is far below its peak in April.
“The volume of very gravely ill patients with COVID-19 has settled to a low plateau,” Douglas said.
At the same time, he said, those patients still in the hospital have acute health problems related to the virus.
“The patients that we're caring for presently are people that have been gravely ill, many of them for well over a month and a half,” Douglas said. “We're caring for a good number of patients who are life-support dependent [and] critically ill.”
Hospitalizations from COVID-19 in the state have plummeted from a high of 888 cases in mid-April to 151 in the most recent count. At the same time, hospitalizations in neighboring states like Utah and Arizona have been on the rise, with Arizona at an all-time high for the state for hospitalized patients with COVID-19.
Many epidemiologists and doctors said they had reserved judgment on the trajectory of the virus until enough time had passed since the state’s stay-at-home order was lifted in late April.
Dr. Michelle Barron, the Medical Director for Infection Control and Prevention at the University of Colorado hospital, is feeling encouraged but remains cautious.
“I think that we're kind of at that critical crux in terms of determining ... whether we will hopefully continue to be able to see a decline,” Barron said.
Barron echoed other experts in saying that a decline hinges on people wearing masks, washing hands and social distancing. If they don’t, she said to expect an upsurge.
If there’s any sign that Gov. Jared Polis is optimistic, it’s his slow but steady moves to reopen the state for business. Another sign may be that Polis, who has been doing press conferences about the virus several times a week since early March, announced Thursday that he will do just one press conference a week for the foreseeable future.
Hotspots and racial disparities
At the same time, worrisome outbreaks have continued in the state.
The Boulder County Health Department has been warning residents of a recent outbreak in the Hill neighborhood near the University of Colorado Boulder where 108 people, mostly college-age residents, have tested positive for the virus. The city said some of those attended recent protests against police violence, while others attended parties in the area or recently traveled out of state.
It’s still too early to tell whether the rise in cases will turn into something bigger.
There’s also continued concern among state officials about the disproportionate number of Blacks and Latinos affected by the virus.
In Denver county, for example, Latinos make up about 30 percent of the population but account for more than half of all infections and hospitalizations. Black people are about 8.5 percent of Denver's population but comprise about 15 percent of hospitalizations for COVID-19. They also account for 16 percent of all deaths in Denver county due to the virus.
Weld and Adams counties also show significant disparities. The number of novel coronavirus cases among Hispanics is over 50 percent in both counties, but Latino residents make up just 30 percent of the population in Weld county and 40 percent in Adams county.
Testing and contact tracing
Colorado still has a long way to go when it comes to testing for the virus and contact tracing, which experts say is key to controlling the spread of COVID-19.
Polis said earlier that he wanted to be testing as many as 8,500-10,000 people a day by the end of May. While testing has ramped up significantly, the state has yet to reach even the low end of that range on a single day. The number of daily tests administered in Colorado averaged 5,741 over the last five days, nearly 3,000-a-day below the goal.
The state has also boosted its hiring of contact tracers, though a recent report from the University of Colorado School of Public Health indicated the state will need an additional 1,000-1,600 contact tracers to effectively contain the virus. Current estimates are that the state has hired just a few hundred at this point, but it’s hard to get solid numbers.
Each county health department runs its own contact tracing program and does some of its own hiring, so there are concerns that while some counties may be more prepared than others to meet the challenge.
Experts say one of the reasons South Korea has been successful in containing the virus was that they've had a robust, centralized system.
A big challenge for contact tracers is likely to be whether they can convince citizens who may have been exposed to answer their calls. Many citizens are suspicious of calls from people they don’t know and worry about the privacy of their health information.
Sarah Tuneberg, who heads up the state’s testing and containment efforts, said it’s critical that people respond to these calls.
“This is a really important process that helps us all open society back up and be part of society,” Tuneberg said. “We are working really actively taking every possible step to protect privacy [and] protect people's health information.”
Making inroads in research
There are numerous studies in the state looking into the virus and possible treatments.
Since the beginning of the pandemic, Colorado has been experimenting with treatment for COVID-19 using plasma from recovered patients. UCHealth has since started a clinical trial to collect data and ultimately determine if plasma benefits those who are treated. Researchers are also looking at when is the best time to give plasma, and what makes a good donor.
So far, there are anecdotal reports of patients recovering, even a short time after receiving the plasma. Dr. Chris Ciarallo, a physician at Denver Health who got COVID-19 and then was treated with convalescent plasma, said he felt the results almost immediately.
Within about two hours, I noticed that I wasn't warm anymore,” Ciarallo said. “My heart wasn't beating out of my chest [and] within two hours I had an appetite.”
Douglas, the ICU doctor at Denver Health, acknowledged what he’s learned about COVID-19 since he started treating patients several months ago is vast yet he and other doctors worry that so much about the disease still remains a mystery.
“I think we're very much in the infancy of really applying the science of critical care and infectious disease medicine to this problem,” Douglas said.