Most Coloradans may have to wait well into 2021 to get a vaccine against the coronavirus, the state’s epidemiologist said Tuesday.
Drug manufacturer Pfizer on Monday announced its vaccine could be available starting around the end of the year, and that preliminary studies show it could be up to 90 percent effective in preventing the virus.
Gov. Jared Polis predicts the state could get 100,000 to 200,000 doses in December and early January, with the first inoculations going to health care providers.
In the meantime, the virus rages through Colorado at record levels and state epidemiologist Rachel Herlihy warned against too much optimism.
“We know that the first doses of the … vaccine aren't going to arrive probably until near the first of the year,” Herlihy said. “And it's going to be smaller numbers of doses than we will ultimately need. It's really not going to be until several months into 2021 that we'll have sufficient numbers of doses to start seeing an impact of the vaccine on our immunity in the state. So we have many months to go, unfortunately, until we can see real, significant impact from that vaccine.”
Herlihy and Polis spoke to Colorado Matters about the spread of the virus and the continuing pressure to control its spread.
Polis rejected calls from local health officials to issue stay at home orders for particularly hard-hit counties, but continued to press residents to wear masks and limit socializing to people in their immediate households.
Polis on Thanksgiving:
The governor urged Coloradans to limit social contacts until the surge in virus cases comes under control.
“If you want to spend indoor time, non-socially distanced, with loved ones who are high-risk— aunts and uncles, grandparents, et cetera, the best course of action will be to quarantine yourself for 10 days or two weeks prior to Thanksgiving to make sure you're not bringing something in that can kill them or has a very high chance of having a severe health effect, if you're an asymptomatic carrier.
The other thing that many families are doing, including our own, is we were simply delaying when we're going to have an intergenerational Thanksgiving until some things were safer, and many families are doing that as well.”
Herlihy on the state’s contact-tracing app for smartphones:
The app went live Oct. 25. It notifies people if they’ve been in contact with someone who tests positive for the virus. It’s currently making between 10 and 20 notifications a day.
“There is some early data that suggests if you can see 15 percent of the population adopt this tool that you can have an impact and that's close to where we are in the state right now. So we think it can have an impact. We'd certainly love for it to have a larger impact than it's having right now. We'd love that 10 (to) 20 number to grow to hundreds of notifications a day. And, and that's really why we need Coloradans to participate.”
Polis on an upcoming deadline to renew federal money for virus control:
“A lot of the money we're using for testing, for tracing, expires in December, and they need to act to continue that.”
Polis on whether state and local governments need to beef up control efforts:
“It's not what your county or state tell you … I think the most powerful motivator for people is people want to stay alive and stay healthy, and so we give them the very best science-driven data about what we need to do as a people, as Coloradans, to get through this … the mask wearing, being careful — but the biggest thing is just reducing your interactions with others outside of your household. We've got to do that in the next few weeks.”
Herlihy on schools:
“If you look at our data specifically, you'll see that many of the cases that have occurred have occurred in staff. We know that adults seem to be more likely to transmit this virus to each other.
We know that things are different based on the type of school environment that you're in. We know that high schools are very different from elementary schools. We know that the mitigation measures that we have in place, the recommendations that we issued to control transmission in schools, are working … but you know we need those strategies to stay in place and to ensure that schools are open to our students that need them.”
Herlihy on high transmission rates at restaurants:
“Social interactions are a place where this virus is being readily transmitted, and so those are household gatherings with multiple households, gatherings occurring at restaurants where multiple households are coming together. Those sorts of settings are places where we are continuing to see high rates of disease transmission.”
Ryan Warner: This is Colorado Matters from CPR News. I'm Ryan Warner. You don't often hear the words optimism and coronavirus in the same sentence, but there was new reason to hope with Monday's announcement of a promising vaccine. It could start rolling out by the end of the year. Here's GovernorJared Polis speaking at a press conference just a few hours after the news from drugmaker Pfizer.
Gov. Jared Polis: The Pfizer vaccine is effective at over 90 percent of the time. That's a very good number. Just to put that in context, flu vaccine (is) more (in the) 50 - 60 percent range. Ninety percent-plus is sort of the gold standard for vaccines that work. If enough people are inoculated with a 90 percent effective vaccine, it ends the pandemic.
RW: A caveat that it's been 90 percent effective in a sample of less than a hundred people, the efficacy could drop with the full trial. A vaccine can't come fast enough. Case numbers are setting new records in Colorado. More than a thousand people are now hospitalized with COVID-19. In some communities, the virus is moving so fast local officials have cracked down to slow the spread. And Gov. Polis is with us, welcome back to the program.
JP: Hi Ryan, how are you?
RW: I'm doing well. And in a few minutes, we're going to hear as well from the state's epidemiologist, Dr. Rachael Herlihy. But Governor, first off, how convinced are you that this vaccine is a tipping point and not hype?
JP: Well, people can take the news of the vaccine two ways. And one way is very dangerous. One way is very positive.
People might, I hope not, be led to think that somehow this is over and they can ease the social distancing. To be clear, the vaccine is not a cure. It doesn't help you once you've got COVID-19. It prevents you from getting it. And if people get the vaccine in December or January, they get the second dose a month later, immunity builds a couple of weeks later. Even after you get the shot, it takes a month or two to build the immunity. So the way that I hope people take it is, there's light at the end of the tunnel. Let's double down on social distancing. Let's double that, I know it's hard not to see your friends. I know it's hard not to live the lives you want to live, but now we know this is only for a couple more months here, there's a light at the end of the tunnel.
The data is very strong. It's more than just a hundred, that's the people who got coronavirus. This is a test of 40,000 people. And then 90, who were in the placebo group got coronavirus, 10 who were in the actual vaccine got it. So it's 40,000 people, very positive. Of course, we're looking for more data. There's other vaccines out there, but this is very, very exciting and a good reason for us to double down on delaying our social plans and avoiding others.
RW: I want to pick up on what you said there about the timeline, that some people could start to be inoculated, what did you say by the end of the year? I imagine what, those would be frontline healthcare workers, people who are particularly vulnerable, that wouldn't be all of Colorado, right?
JP: That's right. It's likely it would be healthcare workers first. They're obviously the greatest risk. Some of them have come down with COVID. They deal with patients with COVID. So that first hundred thousand is largely healthcare workers, then it goes out to first responders and others, and then early next year, likely people over 65 and then the general population a few months into next year.
RW: We'll talk more about this potential vaccine with the state's epidemiologist as well. But I want to talk about what happens in the meantime, Governor. Local governments, Denver, Pueblo, just as examples, have set curfews and taken other steps to curb the spread of the virus. But last week, the heads of public health departments across the state wrote your Department of Health asking for more. They point out that you as governor have the power to impose stay-at-home orders in counties that exceed a threshold for illness. And they want you to do that, county by county. Here is one of the signers of that letter, Dr. John Douglas of the Tri-County Health Department, which serves Arapahoe, Douglas and Adams Counties.
Dr. John Douglas: Our public health mitigation measures are not working as effectively at the current case rates. We just don't have enough people to call everybody who's infected and do a case investigation. We don't have nearly enough people to do contact tracing.
RW: Gov. Polis, I want to be very clear that some of these public health officials say they are getting death threats, that they may not be empowered by their cities or counties to take drastic measures, but they say you have the authority. You have that sway. Why not exercise a stay at home power county by county?
JP: Well, the stay at home period was a very blunt instrument that I think I share the hope of every Coloradan that we never need to use again. We have so many more weapons at our disposal now. Obviously the statewide mask mandate, which did go statewide, started out in several counties, we renewed that. The increased testing. The hospitalization surge — one of the reasons that we had to take those drastic steps in March is we only had our normal hospital capacity. Now we've built thousands of additional hospital beds for both COVID and non-COVID to make sure that patients can get the best quality care. So we're in a much better place today. We have much more targeted interventions. It's really about figuring how working with our local health authorities, they can be effective as we learn more and more about the virus and reducing the spread.
RW: I think what they're saying is you've got the bully pulpit in a way that they do not, to take surgical action county by county, and it's a power you're not using. Help them understand why not.
JP: Well, I think we're using the bully pulpit. I hope you watch my regular press conferences, and I hope that most people haven't tuned it out. The biggest message over the last week or two has been ‘delay your social plans, avoid socializing with others outside of your households.’ All of these health orders only are beneficial so long as people actually follow them and do them. So for instance, Ryan, did you even know that it's been a health order statewide for weeks that there's no groups of 10 or more, or with more than two households? Is that something that you're aware of or not? You can't have three households sitting together?
RW: I did know that.
JP: And yeah, you may know that, but a lot of folks don't and yet that's a statewide order. So what matters is what people do. It's not what your county or state tells you to do because honestly your city and county and state are not checking on whether you're getting together with one other household or two other households. But I think the most powerful motivator for people is people want to stay alive and stay healthy, and so we give them the very best science-driven data about what we need to do as a people, as Coloradans, to get through this. And right now, of course, the mask wearing, being careful -but the biggest thing is just reducing your interactions with others outside of your household. We've got to do that in the next few weeks.
RW: Would you acknowledge that something's not working though?
JP: Well, clearly Coloradans are tired of this virus, as am I, as is everybody, but the virus is not tired of us. It is still wreaking havoc. I'm hopeful that the vaccine, the promise, the light at the end of the tunnel, the nearing the end of the marathon, inspires people to double down on social distancing these next couple of months, which is absolutely critical, until there's enough dosage of the vaccine to really make a difference.
RW: I'd like to bring in Dr. Rachel Herlihy, the state's epidemiologist. Doctor, welcome to the program.
RH: Good morning. Thank you so much for having me.
RW: Do you see a pattern in the latest outbreaks? I mean, types of hotspots beyond nursing homes, which were hit hard early on.
RH: Yeah. So at this point in the state, we are really seeing widespread transmission of this virus. We know that all age groups are being impacted. We're seeing hospitalizations of course, in older Coloradans, but also in individuals in their 40s and 50s as well. We know that as the governor mentioned, that social interactions are a place where this virus is being readily transmitted, and so those are household gatherings, gatherings with multiple households, gatherings occurring at restaurants where multiple households are coming together. Those sorts of settings are places where we are continuing to see high rates of disease transmission.
RW: Restaurants specifically you said?
RH: Yeah. So as the governor mentioned, we have an order in the state right now that says, no more than 10 individuals and no more than two households. And we know that individuals at times are continuing to gather with more than one other household. And when those gatherings occur in whatever setting they're occurring, whether that's in a private home or at a restaurant or another setting, that those are opportunities for the virus to spread from house to house.
RW: The governor has asked the public to limit social interactions again, to people in their households. And at that Monday press conference, Governor, you said together, we can save Christmas by doing this. The state's seven-day test positivity rate is at almost 12 percent. Public health officials say it needs to be around five. Dr. Herlihy, is just a few weeks of this kind of good behavior enough to, as the governor says, save Christmas or whatever holiday you celebrate?
RH: Yeah. So we do need to implement some strong interventions in the state in the next week or two to really reverse the course. And I think this is why we're really appealing to the public to change their behavior, to limit their interactions with others so that we can see that change in trajectory. We really need to see the cases plateau, level out and then start to decrease, and that needs to happen soon.
RW: Dr. Herlihy, testing rates are up dramatically and the state has asked Coloradans to turn on that smartphone app that will alert them if they've been in contact with someone's who tested positive. What rates of adoption are you seeing on that app, and is it helping?
RH: Yeah, so we have seen large numbers of Coloradans that have started using that app. We're seeing 10 to 20 activations of that system on a daily basis, meaning that we are seeing it used for exposure notification, letting folks know that they've potentially been in contact with someone that has COVID-19. So it is a really important new tool that we've added to our toolbox. And I would encourage Coloradans to take a look at it, check it out and certainly add it to your phone. And that's the website we're using, addyourphone.com. So individuals should check it out.
RW: Did you say 10 to 20?
RH: Ten to 20 right now, notifications we believe are occurring through that system.
RW: A day?
RW: Meaning telling people they've been exposed?
RW: Okay. Is that enough to move a needle from a public health standpoint?
RH: There is some early data that suggests if you can see 15 percent of the population adopt this tool, that you can have an impact and that's close to where we are in the state right now, so we think it can have an impact. We'd certainly love for it to have a larger impact than it's having right now. We'd love that 10, 20 number to grow to hundreds of notifications a day. And that's really why we need Coloradans to participate.
RW: All right, let's pick this discussion up after a break. My guests are Colorado's governor, Jared Polis, and the state epidemiologist, Rachel Herlihy, This is Colorado Matters from CPR news.
You're back with Colorado Matters from CPR News, I'm Ryan Warner, and we are getting an update on COVID-19 in the state, and the latest wave that's really hit the state and the country from Colorado's governor, Jared Polis, and a state epidemiologist, Rachel Herlihy.
Dr. Herlihy, one thing I hear people say who are wary of the numbers, who are wary of the alarmism, is that so many of the people who are hospitalized have what are called co-morbidities. These are people who entered the pandemic with serious illnesses already, and they see that, and they think that's an important detail in understanding the toll that the virus is taking. Help us understand that. Put that into some context for us.
RH: Yeah. Unfortunately, the reality is that a large proportion of adults in this country have some sort of chronic disease, whether that's heart disease and hypertension, high cholesterol, diabetes, we know that those chronic conditions are very common. So if you look at the U.S. population, about 45 percent of the U.S. population has a chronic disease. If you look at those over the age of 55, it's actually 78 percent have at least one chronic condition. And so that's really the population that's out there. That's who we are. We have these chronic diseases, and it's true that those chronic diseases can put us at greater risk of COVID severe outcomes. But the reality is, most people in this country have, especially those over the age of 55, have some sort of an underlying medical condition.
RW: Governor, before the break, we talked about a plea from local public health officials. I'm interested in what your communications are right now with the business community, their concerns about a potential shutdown, if the virus gets out of control here, and how that plays into your decision-making.
JP: At this point, it's whatever motivates people to do the right thing. I think the business community feels the right way. What is the right thing? Delaying your social plans, not seeing people outside of your household, wearing a mask, keeping six-foot distance, washing your hands when you get back home.
I think you mentioned saving Christmas, if saving Christmas motivates you, we all want to save Christmas, what that means for families, and to do that we've got to do better or it'll be simply too dangerous to spend time with loved ones during Christmas. So whatever motivates you, saving businesses, saving jobs, saving Christmas. I think the biggest motivator is saving your own life and the life of your loved ones, frankly, and hopefully that'll win the day. But if saving your own life and your loved ones isn't enough, how about saving businesses and jobs, maybe your job, saving Christmas.
RW: Of course, I think of how busy the retail period is from Thanksgiving onto Christmas. Speaking of Thanksgiving, Governor, what should Thanksgiving look like? How should it change to correspond to what you are asking of Coloradans?
JP: So, look, if you want to spend indoor time non-socially distanced with loved ones who are at high risk, aunts and uncles, grandparents, et cetera, then the best course of action will be to quarantine yourself for 10 days or two weeks prior to Thanksgiving to make sure you're not bringing something in that can kill them, or has a very high chance of having a severe health effect, if you're an asymptomatic carrier.
The other thing that many families are doing including our own is we're simply delaying when we're going to have an intergenerational Thanksgiving until things are safer, and many families are doing that as well.
RW: Lives of course are the main concern here. But to what extent is the state budget, the need for revenue, the need for tax generation and your priorities as governor — to what extent does that fit into this picture, Governor Polis?
JP: Well, there's an economic crisis, in addition to there being a health crisis. The health crisis is the immediate one that we are focused on rightly so. But yes, this is a tough time for Coloradans. Coloradans have had their hours cut back, who've lost jobs. We have the highest unemployment rates since we've had since the Great Recession. We're doing better than most other states. We've seen less of a downturn to our GDP. We have less deaths from the virus than most other states. So we're doing better on the health and the economic side, but all of that progress is very tenuous. And the better that we do at the health side, (the) better decisions informed by data and science that Coloradans make, and the better that we can do a job in getting that data to them to make informed decisions, the better we do from a health perspective, the better we'll do from an economic perspective.
RW: I want to spend just a few more minutes on the question of the Pfizer vaccine and how it complicates your message. Here is listener Acacia Fonte of Denver.
Acacia Fonte: I think the vaccine is a glimmer of hope, it's great news, but I'm a little worried about how that meets the fatigue as well, for people who are feeling like we desperately want to get out of this spot. I could see that providing a pathway to rolling back some of those safety measures.
RW: Dr. Herlihy, the governor alluded to this a little earlier in the conversation, but to what extent are you concerned that the glimmer of hope the Pfizer vaccine or any other vaccine for that matter presents, works counter to the message here of ‘keep your distance’?
RH: Yeah, absolutely. So this vaccine is certainly, I think, some hope, that we all need for seeing a light at the end of the tunnel with this virus. But I think the reality is that at this point, we have approximately 9 or 10 percent of Coloradans that have been exposed to this virus and potentially are immune to it. And then we don't even know how long that immunity lasts. So that means that most of the state is susceptible to this virus right now. And we have high levels of disease transmission.
We know that the first doses of the vaccine aren't going to arrive probably until near the first of the year. And it's going to be smaller numbers of doses than we will ultimately need. It's really not going to be until several months into 2021 that we'll have sufficient numbers of doses to start seeing an impact of the vaccine on our immunity in the state. So we have many months to go, unfortunately, until we can see real significant impact from that vaccine.
RW: There's also the question of a distribution system. I mean, when there are enough doses to reach the general populace. How do you distribute it? I think of all the shortages of PPE early on, of ventilators, of toilet paper. Is there an ample system in place, Doctor?
RH: Yeah, that is certainly something that our state is working on right now. We know that private providers are going to be a really important part of that distribution system. Pharmacies are going to be an important part of that distribution system. We really are going to need to ensure similar to what we've done with access to testing, that this vaccine is distributed widely across the state and that individuals have access to it when we have the sufficient doses.
RW: Dr. Herlihy, how concerned are you that schools are a fount of transmission?
RH: Yeah, we know that schools certainly can be an environment where this virus can be transmitted. But if you look at our data specifically, you'll see that many of the cases that have occurred, have occurred in staff. We know that adults seem to be more likely to transmit this virus to each other. We know that things are different based on the type of school environment that you're in. We know that high schools are very different from elementary schools. We know that the mitigation measures that we have in place, the recommendations that we've issued to control transmission in schools are working.
The outbreaks that we've seen in school have generally been quite small, on the number of two or three cases in those schools. So we are seeing that strategies in schools are working, but we need those strategies to stay in place and to ensure that schools are open to our students that need them. We know that schools play a really critically important role in the social and emotional wellbeing of our kids. And they're critical to our society. And we want that to be available to students, as it continues to be safe to do so.
RW: Governor, in just the last few minutes, a few questions focused on Washington. What do you need most from the current administration just over the next few months to deal with the pandemic?
JP: Well, I think the messaging and the unity of messaging is so important. I think it's so important that President Trump address his supporters, honestly, frankly, support wearing masks, support social distancing, devote his soapbox towards encouraging that. There's folks that aren't going to heed what Dr. Herlihy or I are going to say, but they might heed what President Trump says. So I think that's very important in terms of reaching people. Continuing with the support that we need from Congress around the health support that we need. For instance, a lot of the money we're using for testing, for tracing, expires in December, and they need to act to continue that. We have over 80 free testing sites. If you need to get tested, go to COVID19.colorado.gov to find a testing site near you.
RW: We have just about a minute. Have you been in touch with the Biden folks, the transition team?
JP: No, I haven't.
RW: Okay. What do you need most from them, just briefly?
JP: Well, once he becomes president, we'll continue that relationship that we've had with President Trump, with President Biden. And again, hopefully, President-elect Biden is already echoing the right themes from a communication side and embracing mask-wearing. I think he's assembled a good group of experts. I think whoever the president is, Trump or President Biden, at any given time, they should heed the advice of the experts in terms of how they use the most powerful soapbox in the land to promote the health and safety and the economic recovery of the American people.
RW: Well, thank you to both, Governor, Doctor, I appreciate your time.
JP: Thank you.
RH: Thank you.
JP: Gov. Jared Polis speaking with us and the state's epidemiologist, Rachel Herlihy, and Colorado Matters continues in the next half hour. What are the next steps for wolf reintroduction? I'm Ryan Warner and this is CPR News.
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