Virus cases continue to rise in Pitkin County, though hospital admissions remain low
Local health officials continue to monitor delta variant’s infection rate among vaccinated and unvaccinated residents
The state of Pitkin County’s current battle with the COVID-19 delta variant is much the same as the rest of Colorado and the nation: not good.
Local case numbers continue to rise — especially among fully vaccinated county residents — while transmission is double the number the Centers for Disease Control considers “high,” and winter is coming soon.
“In trying to rush to – quote – normalcy, we might have moved too quickly at times as a county, as a world,” Josh Vance, Pitkin County epidemiologist, said earlier this week. “Our incidence rate is back above 200 (per 100,000 residents). We haven’t had an incidence rate that high in several months. In the past two weeks, there’s been a sizable increase (in cases).”
As of Tuesday, Pitkin County had 45 new cases of COVID-19 in the past seven days, including 36 county residents and nine from outside the county, according to the county’s online case and testing data dashboard. That equated to a seven-day incidence rate of 203 per 100,000 residents, and a testing positivity rate of 7.4%.
The CDC says that any community with an incidence rate of more than 100 per 100,000 residents means a high rate of COVID-19 transmission.
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Pitkin County’s incidence rate had been hovering just below 200 between Aug. 20 and 25 before it jumped to 236 on Sunday and 214 the day after. The highest per day COVID-19 case count was also Sunday, when 42 county residents were confirmed to test positive for the virus, according to the county’s COVID-19 status dashboard.
Colorado’s cumulative two-week incidence rate Tuesday was at 358 per 100,000 residents, according to the state’s COVID-19 dashboard.
As of Monday morning, 68% of the new positive cases in Pitkin County in the preceding 28 days involved residents who had been fully vaccinated, Vance said. A total of 155 fully vaccinated residents so far have tested positive for the virus since April 1, according to the county’s testing data dashboard Tuesday.
That is just 1% of the total of 11,363 full vaccinated county residents, though it is still a high number and higher than surrounding counties, Vance said. County public health officials have consulted with state public health officials about the high breakthrough infection rate, though it is not clear why it’s happening in Pitkin County, he said.
One possible reason is that fully vaccinated Pitkin County residents are more likely to get tested for COVID-19 when they have symptoms. Beyond that, the reasons for the high rate are unclear, though it is clear that boosters are likely necessary, Vance said.
“There’s been no additional hypotheses (about the breakthrough rate) at this point,” he said. “There’s definitely something there with the amount of time since the second dose.”
Vance has previously said that county data shows that the highest percentage of fully vaccinated residents who have tested positive for the virus were vaccinated in January, followed by those vaccinated in February, followed by those vaccinated in March.
All the recent positives are almost certainly the result of the delta variant. Pitkin County sends some local positive samples to the state public health lab for analysis, which has detected nothing but delta variant cases since July 17, Vance said.
Jordana Sabella, Pitkin County’s public health director, pointed out that at the beginning of September 2020, the county’s incidence rate was below 50, and didn’t hit 100 until the beginning of October, with 200 not occurring until November.
“Compare that to now, when we are over 200,” she said Monday. “We’re starting to say it’s looking like we need to do something about this.”
However, the vaccines are the main difference between now and then, Sabella said. All three available vaccines prevent severe versions of COVID-19 that could lead to hospitalization and death. She said she also heard that a vaccine could be made available for children younger than 12 sometime this month, though she declined to say which one.
As proof of the protection provided by the vaccines, Sabella cited the fact that Aspen Valley Hospital has remained under “comfortable” status this summer, even as case counts have increased. The comfortable status takes into account COVID hospitalizations, the number of staff out with COVID symptoms and the number of possible COVID patients seen at the emergency room.
Dave Ressler, hospital CEO, also said the prevalence of vaccinated residents in Pitkin County – 84% of the county’s population have received at least one vaccine dose as of Tuesday – has kept the hospital mostly in comfortable status. It’s a “terrible mistake” for people to think they’re going to become sick anyway and avoid getting the vaccine, he said.
“A significant amount of our population is vaccinated and the major benefit of the vaccines is an extraordinarily low incidence of serious illness even if you test positive,” Ressler said Tuesday. “If you’re fully vaccinated, you might acquire the virus, but vaccines are 97% effective in preventing serious illness and hospitalization.”
He said the hospital has had days where it exceeds comfort levels — for example the emergency room might have seen more patients with COVID-like symptoms than is considered comfortable — but it has never been overwhelmed. AVH has not admitted a person with COVID-19 in more than two weeks, according to the county’s online COVID status dashboard.
On Monday, the Colorado Board of Health approved a vaccine requirement for staff at all health care facilities and hospitals in the state. The AVH Board approved a similar requirement for all medical staff at its August meeting.
“For us, it was a validation that that was the right thing to do,” Ressler said.
Pitkin County has reported just four deaths from COVID-19 since the pandemic began in March 2020.
With the delta variant raging, the future in Aspen and Pitkin County — both short and long-term — is on the minds of public health officials.
For example, both the Jazz Aspen Labor Day Weekend concerts and the Food & Wine Classic in Aspen are on deck and could cause local COVID-19 infections numbers to increase, said Sabella and Vance. However, Sabella said she’s confident that event organizers have taken precautions to lessen transmission.
“On one hand, there’s great measures to make these events as safe as possible,” she said. “But I wouldn’t be surprised if we see increases in cases from these events.”
Then there’s the upcoming winter season, when everyone heads inside and out of the cold.
As of Tuesday, there were no local efforts to re-instate an indoor mask mandate in Pitkin County, according to Sabella and Pitkin County Commissioner Greg Poschman, who also chairs the county Board of Health.
Sabella said the county Public Health Department continues to recommend wearing masks indoors whether fully vaccinated or not, and that she appreciates businesses and organizations — like the Aspen Skiing Co. and some local performing arts groups and venues — that have implemented mandatory indoor masking policies.
While more specific guidance for the winter will be released in the coming months, Sabella said public health officials will continue to work with businesses and organizations to incentivize or require vaccines or indoor masks or both for staff and patrons.
However, a future mask mandate is not off the table, said Sabella and Poschman. In fact, nothing is off the table, including a possible future stay-at-home order if the situation gets that bad, though that would be an extreme step, Sabella said.
“We don’t want to go there,” she said. “We want businesses to flourish and we want tourists to continue to come.”
“We realize what damage it did to shut down completely,” he said. “Everyone is hesitant to do that. But we might have to overcome that hesitancy in the future. All options are on the table, but I can’t tell you which way it’s going to go.”
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