Aspen City Council’s Q&A with the Pitkin County COVID-19 incident command team
The local incident command team for the COVID-19 spread fielded questions from Aspen City Council members during their regular meeting Tuesday night. The team includes Pitkin County Public Health Director Karen Koenemann, Sheriff’s Deputy Alex Burchetta and Gabe Muething, director of the Aspen Ambulance District. Here are some excerpts from the Q&A session:
Councilman Skippy Mesirow: If we do a really good job of containing this spread within our community, we’re a one-entrance valley at this point of the year, we’re a relatively small population versus other communities. We acted early. And so it stands to reason that we may be in a situation where we have curtailed this spread before others, and yet we’re a resort community. So how do we think about that long-term avoiding a second or third spike?
Karen Koenemann: What we have seen in the research and the modeling right now and looking at other countries and what happens is that if you take for this active suppression pretty restrictive, and that it can, it can help with really tamping down the spread of the virus. What we also know is that if you release those restrictions, what’s going to happen is you’re going to see that peak again.
What we also know is that the most effective strategies work when it’s like a whole country doing it, or a whole state doing it, or a region doing it. I think it’s really hard if we are this little piece of the state of Colorado that has a more and more restrictive kind of strategy. We’re still going to have some sort of movement within our community and if we lift some of the restrictions, more people will probably come back to the community. So really the kinds of strategies are most effective when they’re done over large geographic areas. If there is a way to advocate at the state level this would be much more effective if we were doing it across the state with more restrictive strategies.
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We would hope that the suppression strategies would allow us to flatten the curve and with this locally, maybe a little bit in a shorter amount of time. But because we’re not isolated, I would guess that the suppression strategy will have to last certainly longer than the current public health order, which goes through April 17. We are using that as the timeline for right now; we will be revisiting that.
I will put money on it, but we will be extending it at some point, we really need to make sure that we’re suppressing for a significant amount of time and we’re asking for some epidemiological modeling right now from the state health department and the School of Public Health to really get a sense of what’s happening here. And with the symptom tracker, we may be able to model that out a little bit.
And if we did, if we did more broad-based testing, we can do more modeling out around that, as well. But I’m not an expert of that out there. But we’re trying to tap into experts to have a better sense of what’s happening in our community.
Skippy Mesirow: As we’re thinking about appropriations and the duration of financial or economic support, and hoping that we can still have a relatively successful summer but it remains to be seen if we are able to control the contagion here and stop the spread, but it is still going out elsewhere, from our current understanding of the virus. Are there screening mechanisms we could implement at our two or three entrances with the airport to reduce the reintroduction or is our belief that the asymptomatic spread is as such that those would be irrelevant?
Gabe Muething: We can have the tightest restrictions in the world, but if those around us and other parts of the country still don’t have those restrictions, and it still flourishes in those communities, we would always have the chance of inviting that back into our community. So what we’re hoping for collectively around our table is a national solution to this, a state solution to this, where everybody really realizes that we’re all part of a community — local, state, nationwide — and we work hard to control this. Are there places we can stop people and put up barriers to not allow the virus back in? It would just be a very difficult prospect to do. I don’t know if it’s possible.
Mayor Torre: Why is there testing in San Miguel County and Telluride?
Gabe Muething: As you can imagine, as soon as we heard about it we immediately reached out and said we’re looking for rapid testing, we’re looking at anything that can help our community. We reached out to San Miguel and had a fantastic conversation with their public health officials to understand exactly what it is they’re doing. And it’s really important to understand that what they’re doing is essentially research on a new way to test. They are actually having to draw blood from an IV site on patients, on people in their community.
There are three different types of testing, with the first being taking a swab and putting it up the nose, grabbing some virus. The second one, which is what we’re going for, is a pinprick on a fingertip. And then the third is what San Miguel is doing, which is actually drawing blood. And as you can imagine, drawing blood is the one procedure out of the three that takes the most (personal protective equipment), takes the most effort, it’s very labor intensive.
They are doing research. Their goal is to test the test and to see if it’s even valuable to do. They are working with a biotech company, or the owner lives in their community and trying to get as much data as they can. It is important to note that it is not an FDA-approved test. The data that comes from it will be used to determine if the test works, but it will not go into the database of the (Colorado Department of Public Health and Environment) as of right now. It may eventually when the test is proven. They have not started testing yet. They had hoped to start testing later on this week in a mass fashion.
Mayor Torre: How are we collecting data?
Karen Koenemann: We just launched that symptom tracker survey (Tuesday) morning. If you go to the http://www.pitkincounty.com website and the hyperlink on the COVID-19 banner there, it takes you to a new website that has different hyperlinks, but you can do at the very top different buttons. One of the buttons says “community engagement.” When you click on that it will take you to two different surveys. One is the symptoms tracker survey. It’s a subjective survey that we’re using to have people self report around COVID-like symptoms.
It is an interesting kind of strategy to see how symptoms might be moving through the community.
We also have a survey on there that I want to alert people to which is like, “How are you doing around social distancing and this whole new world that we’re all in?” Two weeks ago I couldn’t even imagine that we would be in this world right now. I’m really wanting to touch base with people around their mental health, how they’re dealing with social distancing, any amazing creative things that they’re doing that they can share with others, because we really want to get a pulse on the mental health of our community, as well.
Skippy Mesirow: Who should be filling this out? Do you want all 6,000 residents? Do you want only sick people? What does that person looks like?
Karen Koenemann: We want everyone to fill this out. We really want to have a true representation of what is happening in our community. Having a little bit of basic demographic information. I think age is really an important component right now, as we’re starting to see some shifting thought around high-risk populations, and having a better understanding of what symptoms people are experiencing and a geographic understanding of where COVID-19 symptoms are in our community, and all allow us to better understand if we started to see a rise of symptoms in certain community.
Alex Burchetta: We want everyone in the county to use that symptom tracker from Redstone to Thomasville, Meredith, all the way up to Aspen, Snowmass and Basalt. It’s a tool that we want to use and gather data countywide.
Rachel Richards: I work in City Market. I see dozens and dozens and dozens of community members every day. I’m just not seeing it by a lot of people taking it as seriously as they could.
I have tried to explain that a negative test would only be a snapshot in time and you might be exposed the very next day, and that we’re not really going to return to normal just by identifying and tracking some individuals and quarantine them. But it doesn’t help that people are really wondering what the magnitude of the term “community spread” is. So people are like, “Are we really overreacting horrendously?” Because we have no idea what the magnitude of the community spread is.
So the decision when you made it or the statement “we have community spread” and we’re moving away from testing and into containment. We just have had this counter-repeating message between the federal government, Nancy Pelosi, the World Health Organization, all saying testing, testing, testing. And yet, we’re trying to tell people it’s at least at this point in time, a little too late for testing to be effective use of resources, shelter in place, and we’ll move on from there. But do you have any idea of the magnitude? How much should people take it seriously? I think half the community thinks we’re overreacting. The other half thinks we’re underreacting.
Karen Koenemann: What we’re going to say to you is stay at home and to really isolate yourself. I think from it from that bigger, epidemlogical standpoint of understanding that the spread of the disease, the subjective symptom tracker is one way for us to better understand what’s happening in our community.
We also have some data points with the hospital, what their ER doctors are experiencing. The hospital is kind of a canary in the coal mine as far as the most severe cases. I don’t want to say that there’s not value in testing from an epidemiological standpoint. There’s great value in that as we move forward through that testing cycle to the point where we can get to the rapid testing we can make this an easier, less rigorous or less resource intensive process.
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