Pitkin County, other local officials frustrated over state’s communication during early stages of pandemic, review finds; problem has improved but still persists, they say | AspenTimes.com
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Pitkin County, other local officials frustrated over state’s communication during early stages of pandemic, review finds; problem has improved but still persists, they say

Aspen Ambulance District paramidic Lisa Hicks wears a powered air purifying respirator and a Tyvek suit next to an ambulance in the ambulance bay on April 3.The PAPR was used early on during the pandemic for transferring patients from Aspen Valley Hospital to a higher level of care, like Denver or Glenwood Springs.
Kelsey Brunner/The Aspen Times

The abrupt end to the mid-March conference call between state and local public health officials about the nascent COVID-19 outbreak in Colorado mountain towns carried with it a startling, frightening message.

Pandemic chaos was just beginning, and the contingent of rural resort county managers and public health officials on the phone call were eager for state help as Pitkin and Eagle counties were in the middle of battling the first coronavirus hot spots in Colorado.

“The state hung up on us,” Pitkin County Manager Jon Peacock said recently, recalling the March 15 call. “It’s just a fact. They were so pressed for time that once time was up, the meeting was over.

“Everyone felt like we were really on our own.”

And while that March 15 conference call was, perhaps, the most egregious example of poor communication between state and Pitkin County officials, it is far from the only one, according to hundreds of emails between state and local officials obtained by The Aspen Times through a Colorado Open Records Act request and subsequent interviews.

Officials from the state public health department and Gov. Jared Polis’s office issued statewide virus-related orders with little or no notice given to local officials who were listed as contacts for questions; released misleading, “stigmatizing” information encouraging people to stay away from mountain communities like Aspen; and bungled Pitkin County’s early requests for help controlling the outbreak.

“We would actually look at The Aspen Times and The Denver Post websites for information on what was happening,” Peacock said. “A lot of (state) announcements would say contact your local public health agency and we didn’t know anything about it.”

That murky communication began right from the start, and those frustrations continued into the summer.

But in the week after the first case was reported March 8 in Aspen, county officials were certain that help was on the way, that advice from the Centers for Disease Control and expertise from Colorado’s Department of Public Health and Environment would arrive postehaste to calm the situation and tame the outbreak.

“We were looking for guidance and to tell us how to manage this,” said Pitkin County Sheriff Joe DiSalvo, who also was on the March 15 call. “We thought we would get help during the first few weeks.”

The conference call hang-up by state public health department officials, however, was the first big hint that little help was coming.

“I realized the cavalry was not coming,” Karen Koenemann, Pitkin County’s public health director, said of her feelings after the call. “I felt like, ‘Wow we are charting our own course here. We are on an island out here on our own and we’re going to need strength to move forward.’

“I was really angry and frustrated and scared.”

Jill Hunsacker Ryan, executive director at Colorado Department of Public Health and Environment, said in a Oct. 14 interview with The Aspen Times that she could sympathize with local officials feeling like they’d been left alone to deal with an unknown, deadly foe during the first weeks and months of Colorado’s outbreak.

“We felt like that at the state too,” she said. “This was like nothing public health had to deal with before. No one could conceive of this type of event.”

In a Sept. 24 interview with The Times, Gov. Polis reiterated that the federal government did not help the situation by pitting states against each other for much-needed supplies, treatment and testing.

“It’s often felt like all 50 states are competing against each other and our own federal government for the supplies we need to successfully handle the crisis,” Polis said. “And that is really a failure in leadership, and we could have done better as a nation to coordinate that activity.”

The fact is, the state was simply not prepared in the spring to deal with the effects of a global pandemic, Ryan said.

Testing capability at Public Health’s state lab was not nearly adequate, so officials had no idea how widespread the infection was statewide. They knew next to nothing about what has turned out to be a highly unusual and highly infectious disease, so they weren’t sure how to treat it as they watched overwhelmed hospital systems in other states suffer.

Quarantine and isolation orders for international travelers brought an extra level of complexity. And none of that stopped the number of infections in the state from piling up quickly — at one point in those early days officials believe 4,500 were infected in one day, Ryan said.

“On March 5, our lives changed,” she said of the day the first two cases were announced in Colorado, including one in Summit County. “We just didn’t know what we were dealing with in the beginning. We didn’t understand the disease.”

Peacock and Koenemann said they were willing to cut state officials a break.

“In fairness to the state, they were in an impossible position,” Peacock said. “If you bring in everyone to make decisions, you can’t get anything done. Between the federal response, which was non-existent, I think the state made a lot of good policy calls.

“But their communication was problematic.”

Health care providers prepare for their first scheduled appointment at a coronavirus testing location at the Aspen Volunteer Fire Department’s Aspen Village Location on Thursday, March 12, 2020. (Kelsey Brunner/The Aspen Times)
Kelsey Brunner/The Aspen Times

A NEW STAFF STRUGGLES

Pitkin County’s COVID-19 outbreak began March 8, when a 21-year-old Australian visitor to Aspen tested positive for COVID-19 after returning home in early March and reported having several social contacts while here.

Eventually, 10 Australians who’d been in contact with the 21-year-old in Aspen tested positive for the virus. Three other Australians associated with the Aspen group declined to be tested but were nonetheless made to quarantine and presumed positive.

State confirmation of community transmission in Aspen and Pitkin County — when the source of COVID-19 infections cannot be traced — soon followed.

Pitkin County’s Public Health Department was unprepared to be a COVID-19 hot spot. The department had been created from scratch just three years before when health services that were previously contracted out to Garfield County became untenable.

Five people worked for Pitkin County public health at the time of the outbreak and the department’s only epidemiologist was out on maternity leave, Peacock said.

So when some of the state’s first COVID-19 cases popped up here, Pitkin County needed help.

And public health officials asked the state for it. But those requests were “misplaced” at the state level, Peacock said. When they were finally found, they were placed in a queue with 500 other similar requests and it was too late to capitalize on being one of the first to ask for help, he said.

Fortunately, Garfield County stepped up to provide a public health official to help in Pitkin County, which Peacock and Koenemann said came just in time.

“At that point we were frustrated because we were the hot spot with the worst cases,” Peacock said. “The state didn’t help with contact tracing, which was where we really needed help and didn’t get it.”

From March 14 to March 31, Pitkin County had 19 confirmed cases (residents only) and two deaths in Aspen, according to the county’s data.

As of Tuesday, Pitkin County has confirmed 262 coronavirus cases and two deaths and sits in the state’s “Safer at Home — Level 2” status with “medium” restrictions, according to the state’s data.

Ryan said the early days of the pandemic in Colorado were chaotic and with 55 separate public health agencies across the state, it was difficult to include local agencies in the decision-making process.

“We were needing to make decisions quickly,” she said. “But we very much value our relationships with our counties. We will always work to make the system better for counties so they can do their jobs more effectively.”

THE BIG HANG-UP

Communications between the state and officials in Pitkin County and neighboring rural resort counties likely hit its lowest point the weekend of the conference call hang-up, according to interviews and emails.

It began March 14, with Pitkin County officials in talks with the management of the Aspen Skiing Co. about how best to shut down ski operations, move visitors out of the community and give businesses a heads-up on what was about to happen, Peacock said. During a break in one of the conference calls, however, Polis shut down all Colorado ski mountains, his order effective immediately.

“We actually heard about the closure from the (Aspen) Ski Company,” Peacock said. “I think that was a surprise for a lot of ski areas. We didn’t even know that was being talked about at the state level.”

If Pitkin County officials had known such action was being contemplated, they would have concentrated their limited resources and energy on other problem areas, he said.

“It’s just a duplication of efforts,” Peacock said. “There was a lot of that at the beginning of this. But you can forgive some chaos at the beginning of events like this.”

The closing of the state’s ski mountains triggered the conference call March 15, the next day.

Near the end of the afternoon call, Peacock said state officials began acting like they were going to end it, prompting an official from another county on the call to speak up loudly and say something like, “Don’t you hang up the phone.” Then the connection went dead.

“Just disbelief,” Peacock said of the reaction to the hang-up.

Koenemann said the meeting was scheduled for an hour, and when that hour was up, the state cut the line.

“Someone was in mid-question when the hour ended and (state officials) were like, ‘OK, bye,’” Koenemann said. “Someone … said, ‘That’s outrageous.’ It was exactly verbalizing what all of us were thinking.”

Sheriff DiSalvo listened in on the call and said the ending was “a little heated” and the state hanging up the phone led to “an uncomfortable moment.”

“We didn’t know what that really meant,” he said. “It was like, ‘What just happened?’”

The abrupt ending to the phone call prompted a strong response from Peacock to Ryan and Colorado Public Safety Director Stan Hilkey.

“In my 18 years in Colorado local government I’ve never seen a less coordinated or cooperative response to an emergency between state and local agencies or the governor’s office,” Peacock wrote March 16 in an email to the state officials. “Frankly I feel like our local response is one to two days behind where it could be because of the lack of coordination, and confusion by the state.”

Peacock said he understood the pandemic posed a uniquely challenging and confusing situation, but said confusion usually clears up as the situation moves forward.

“That is not the case here,” he said. “I have decided to focus all of my efforts to our response … until there is clear evidence of collaboration between the state and local entities.”

An hour after he wrote the email, Ryan responded and thanked him for his feedback, according to correspondence obtained by The Aspen Times.

“Do you want to provide specifics so we can work to address them right away?” Ryan wrote in an email. “I know there were frustrations on the call yesterday, but anything else?”

Ryan also reminded Peacock that she’d been in Aspen the week before and thanked him again.

“This event is larger than all of us and we will need each other’s partnership,” she wrote. “It is in that spirit that we welcome feedback.”

Last week, Ryan said she couldn’t remember if she was on the conference call or not, though she “probably was.” At that time in March, she and other public health officials were running from call to call and sometimes when one person would hang up, it would end the call for everyone listening on the line.

“It was never our intention to hang up on our partners,” she said Wednesday. “I didn’t know they felt that way. It was certainly unintended.”

An uphill skiers heads out of the Snowmass Base Village area Sunday morning just before 8:30 a.m., which is the time the Village Express lift usually opens.
David Krause / The Aspen Times

ROAD BLOCK RUMORS AND A STATE CALL-OUT

The same day as the conference call — March 15 — another problem erupted between CDPHE and mountain resort counties, including Pitkin County. It concerned a news release the agency sent out that day titled, “CDPHE strongly advises all visitors and residents of Eagle, Summit, Pitkin and Gunnison counties to minimize social contact.”

“Due to extensive spread of COVID-19 in a number of mountain resort communities … (CDPHE) strongly recommends that anyone who lives in or has visited those communities in the past week minimize their contact with other people in order to reduce the spread of the virus,” the release stated. “Anyone who has been in Eagle, Summit, Pitkin or Gunnison counties in the past week should minimize all contact with other people, whether or not they are experiencing symptoms.”

Pitkin County and the other counties mentioned in the release bristled at the language and felt it was unjustified because COVID-19 spread was on the rise statewide, not just in the mountains, Peacock said. Officials felt the governor’s release should have emphasized the need to focus on statewide prevention and the fact that all residents needed to focus on taking precautions and not “stigmatize” certain areas, Peacock said.

Eagle County’s public health director seconded those thoughts in an email sent March 15 to Ryan and two of her staff members.

“We feel the release, as received, will absolutely jeopardize the supply chain in our communities, further impacting our residents and medical system,” Eagle County’s Heath Harmon wrote.

He went on to suggest the governor include all Coloradans in the general COVID reduction guidelines — which have since become second-nature to most residents, including minimizing social contacts, encouraging hygiene and emphasizing that everyone is at risk.

Harmon also wrote the governor’s office “must dispel rumors about closing off or locking down our mountain communities” and “prevent disruption in supply chains.”

Ryan — a former Eagle County commissioner and public health director — said last week that she sympathized with the reaction of rural resort communities to the news release.

“If I put myself in the shoes of the county, it is going to feel stigmatizing to be called out like that,” she said.

But the state was trying to contain the disease, and it happened to pop up first in international ski destinations like Aspen and Vail, which attract many travelers from Europe, Ryan said. Closing the state’s ski areas and highlighting what were hot spots at the time were successful strategies in terms of virus containment, she said.

“The advice was good advice,” Ryan said. “What we were trying to do was to get the tourists to go home.”

At about the same time, local leaders were concerned about a disturbing rumor making the rounds.

“Behind that there was the not insubstantial rumor that the governor was considering closing down our community and putting up roadblocks,” Peacock said looking back. “(There were Interstate 70) closure rumors.”

That’s when a working group, including public health officials from Garfield, Eagle and Pitkin counties, realized they needed to counter the governor’s message and get some answers.

That evening, Garfield County’s public health director sent an email about the governor’s news release to an official with the state public health department.

“In light of the governor’s press release today, there is panic in our counties regarding I-70 being shut down and we are being cut off from supply chains,” Garfield County’s Yvonne Long wrote. “We need exec assurance to our populations that this is not the fact.”

An hour and a half later, the official wrote back that there was no plan to shut Interstate 70 to control the virus. Ryan followed that up minutes later, saying that “closing I-70 was not contemplated, that is just a rumor.”

THE BAIT AND SWITCH

The next weekend — March 22 and 23 — CDPHE had agreed to send in some much-needed reinforcements and relations with the state public health department appeared to be looking up.

“I wanted to confirm that based on our conversation the other day, the CDPHE team will be conducting case investigations, contact tracing and issuing (quarantine and isolation) letters/orders for individuals in Pitkin County whose results come back positive, starting yesterday (3/21),” Pitkin County Deputy Public Health Director Suzuho Shimasaki wrote to a state epidemiologist in a March 22 email.

She also said she wanted to make sure the state public health team would be taking over the investigation into the latest case of coronavirus reported the day before, according to the email.

Unfortunately, none of it was to be.

As if to emphasize the message sent a week earlier in the abruptly ended conference call, the state soon backtracked and again made clear the cavalry wasn’t coming.

“I apologize for any confusion,” Peter Dupree, a CDPHE public health epidemiologist, wrote back minutes after Shimasaki’s March 22 email. “CDPHE is not able to take on case investigations nor contact tracing in Pitkin. As much as we want to help, as you rightly pointed out, our bandwidth is shrinking more and more each day as case counts rise …

“We’ll work with you and your team as best we can to help mitigate the impact of these two challenges, but at this point we don’t have the ability to take on those duties for Pitkin.”

Ten minutes later, Shimasaki wrote back, saying Dupree’s email was “very disappointing and frustrating since this was not what we agreed to … the other day,” according to the email chain.

“We just spent two days figuring out how to restructure our team based on what we had discussed and thought we would finally get some relief for our team, who has been working (12-plus) hour days for the last couple weeks now,” Shimasaki wrote.

Koenemann commented on the emails not long after.

“This is unreal and not what we were told two days ago,” she wrote to Peacock and other officials. “The continued lack of support is truly mind blowing.”

Pitkin County Public Health director Karen Koenemann talks with Aspen Valley Hospital CEO Dave Ressler during a meeting before the pandemic.
Mountain Family Health/courtesy photo

LINES OF COMMUNICATION OPEN, SORT OF

Communications with the state about the coronavirus would remain murky for the next 10 weeks, Peacock said.

And, while Peacock and Koenemann said communication with the state has improved, officials continue to complain that guidelines from the state — whether about restaurants, schools or face masks — have been slow in coming over the summer and fall.

Peacock said state public health officials began involving local officials more in coronavirus strategic planning and suppression in the late summer and fall. He also noted that he took part in discussions about upcoming ski season guidelines, which were issued earlier than expected last week.

“I have confidence in decisions made at the state level,” Peacock said. “It’s the administration of those decisions where we could improve upon.”

Koenemann agreed.

“Things have gotten better,” she said. “They recognize their weakness. (We recognize) our communication, my communication could have been better.”

Meanwhile, the state has been busy scaling up, Ryan said.

CDPHE has hired 800 new people, drastically increased testing capacity at the state lab and is spending hundreds of millions of dollars to fight the pandemic, Ryan said.

Through Tuesday, there have been nearly 88,850 positive cases in Colorado, 8,380 people hospitalized and 2,066 deaths due to COVID-19, according to state data.

Ryan’s staff has begun holding weekly meetings with directors of local public health agencies and are including local officials in decisions about COVID policy.

“If something’s not going right, we will do our absolute best to change it,” she said. “I hope counties now feel more supported. We’re always up for feedback on how we can improve.”

Polis said the state’s strategy is to empower county commissioners and health departments to localize COVID responses based on local conditions rather than a “one-size-fits-all” statewide solution.

“That’s really our overriding goal,” the governor told The Times in September. “Obviously in the early days of the crisis and even now, communication is key. I’m committed to doing even better in making sure those communications happen.”

Colorado Gov. Jard Polis talks about medical supplies needed in the state during a March 30 news conference as a statewide stay-at-home order remained in effect in an effort to reduce the spread of the coronavirus in the early weeks of the pandemic in Colorado.
David Zalubowski/Associated Press | AP

A LESSON IN SELF-RELIANCE

The stress, chaos and lack of reliable information caused by the wispy support of the state and federal governments at the outset of Pitkin County’s COVID-19 outbreak was not all bad, however. It prompted a reckoning and forced elected and public health officials in Pitkin County and Aspen to rely on themselves.

“This is something no one has ever seen before,” DiSalvo said. “I think we did a great job without a lot of oversight from the state. I think it says a lot about our leadership with Jon and Karen.”

Pitkin County Commissioner Kelly McNicholas Kury, who also was on the March 15 conference call hang-up, said the fact that Pitkin County would have to step up and deal with the local effects of the pandemic quickly became clear. And with access to more funds than counties without sky-high property values, a robust response was possible here, and the county handed out about $1.7 million in cash assistance payments to residents between April and July.

“We just had to keep going and making decisions and keep protecting people,” McNicholas Kury said. “We had to do things on our own and figure things out on our own.”

Pitkin, along with Eagle County, issued the first public health order in the state in March, which reduced group sizes to 50 people. The county developed the “Roadmap to Success” early on that brought the community into the discussion and outlined the steps public health officials would take to reopen sections of the local economy and society.

The county also built and paid for its own case investigation and contact tracing teams, with the Public Health Department going from five employees in March to 25 and a more than $4 million budget as of October.

Polis gave Pitkin County credit for the recently adopted state “coronameter” guide, though officials here based it on one from Gunnison County.

“We really took that idea that had been implemented in Pitkin County and established this information source statewide to help guide that local response in different areas,” Polis said.

And Pitkin County’s effort appears to have paid off, Peacock and Koenemann said.

As of Wednesday, with a population of about 18,000, the county continues to report just two deaths amid 265 positive cases since the outbreak began, and Aspen Valley Hospital has never been close to threatened with patient capacity issues.

“I’d like to believe our choices led to a low mortality rate,” Koenemann said. “Our conservative approach might have contributed to a lower rate of disease transmission.”

jauslander@aspentimes.com


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