{"id":807396,"date":"2020-05-13T09:42:42","date_gmt":"2020-05-13T15:42:42","guid":{"rendered":"https:\/\/www.summitdaily.com\/?p=383157"},"modified":"2020-05-13T09:42:42","modified_gmt":"2020-05-13T15:42:42","slug":"how-colorado-caught-covid-19-a-cpr-news-investigation","status":"publish","type":"post","link":"https:\/\/alwaysmountaintime.com\/ksmt\/local-news\/how-colorado-caught-covid-19-a-cpr-news-investigation\/","title":{"rendered":"How Colorado caught COVID-19: A CPR News investigation"},"content":{"rendered":"<div id=\"primary\" readability=\"532.00388120149\">\n<div id=\"layout-single\" readability=\"60.960772901874\">\n<div class=\"d-lg-flex\" readability=\"28.639780631354\">\n<article class=\"flex-fill\" readability=\"62.133761369716\">\n<h4>Colorado can learn from this pandemic, so it is better prepared for the next<\/h4>\n<div id=\"article-byline\">\n<div class=\"row\">\n<div class=\"col\">\n<address><strong>By Ben Markus<br \/>CPR News<\/strong><\/address>\n<\/div><\/div>\n<\/div>\n<div class=\"p402_premium\" readability=\"34.012301013025\">\n<p>The March 5&nbsp;<a href=\"https:\/\/www.facebook.com\/jaredpolis\/videos\/210933673609903\/\" target=\"_blank\" rel=\"noopener noreferrer\">news conference<\/a>&nbsp;announcing Colorado\u2019s first confirmed case of COVID-19 was over.<\/p>\n<p>The governor and the director of the Colorado Department of Public Health and Environment returned to work. Colorado\u2019s first positive coronavirus patient left Summit County with a friend under orders to quarantine himself as he recovered in the lower elevation of Jefferson County.<\/p>\n<p>But back in Silverthorne, the crisis was just beginning.<\/p>\n<p>\u201cI am wondering if you can help me,\u201d the director of Summit County\u2019s Health Department, Amy Wineland, wrote to her counterpart in JeffCo just before 6 a.m., the morning after the&nbsp;<a href=\"https:\/\/www.cpr.org\/2020\/03\/05\/colorado-coronavirus-case-is-states-first-positive-health-officials-say\/\" target=\"_blank\" rel=\"noopener noreferrer\">first case was announced<\/a>. \u201cWe are trying to confirm that the unit number of the condo complex they stayed in was 2800. Can you please help confirm this?<\/p>\n<div class=\"row\">\n<div class=\"col\" readability=\"6\">\n<div class=\"row sd-donation sd-donation-mobile p-0\" readability=\"7\">\n<div class=\"col-xl-4 p-2\">\n<div data-bg=\"url(https:\/\/cdn.summitdaily.com\/wp-content\/uploads\/sites\/2\/2020\/03\/SDN-logo-white-1.png)\" class=\"p-0 mt-2 mb-2 h-75 text-center rocket-lazyload\">\n<p><img decoding=\"async\" src=\"https:\/\/cdn.summitdaily.com\/wp-content\/uploads\/sites\/2\/2020\/03\/SDN-logo-white-1.png\" class=\"logo m-0 p-0 invisible\"><\/p>\n<\/div>\n<\/div>\n<p><h3 class=\"d-inline mr-3\">Support Local Journalism<\/h3>\n<p><button class=\"btn d-inline\" type=\"button\" onclick=\"handleDonationButtonClickMidArticle()\">Donate<\/button><\/p>\n<\/div>\n<p><\/div>\n<\/div>\n<p>\u201cCDPHE is not returning our calls.\u201d<\/p>\n<p>During those lost 13 hours, thousands of cars passed through Silverthorne in either direction on I-70 as people who may have had contact with that first known patient went home from ski resorts in Summit and Eagle counties.<\/p>\n<p>All while the health director at ground zero was unable to confirm the spelling of the patient\u2019s name or where he stayed at Keystone, much less coordinate or participate in any effort to trace his contacts in the mountains.<\/p>\n<div class=\"p402_hide\">\n<figure class=\"wp-block-image size-large is-style-default\">\n<p><img decoding=\"async\" src=\"https:\/\/cdn.summitdaily.com\/wp-content\/uploads\/sites\/2\/2020\/05\/200504-KEYSTONE-SUMMIT-COUNTY-329-1024x682.jpg\" alt class=\"wp-image-383159\" srcset=\"https:\/\/cdn.summitdaily.com\/wp-content\/uploads\/sites\/2\/2020\/05\/200504-KEYSTONE-SUMMIT-COUNTY-329-1024x682.jpg 1024w, https:\/\/cdn.summitdaily.com\/wp-content\/uploads\/sites\/2\/2020\/05\/200504-KEYSTONE-SUMMIT-COUNTY-329-300x200.jpg 300w, https:\/\/cdn.summitdaily.com\/wp-content\/uploads\/sites\/2\/2020\/05\/200504-KEYSTONE-SUMMIT-COUNTY-329-768x512.jpg 768w, https:\/\/cdn.summitdaily.com\/wp-content\/uploads\/sites\/2\/2020\/05\/200504-KEYSTONE-SUMMIT-COUNTY-329-1536x1024.jpg 1536w, https:\/\/cdn.summitdaily.com\/wp-content\/uploads\/sites\/2\/2020\/05\/200504-KEYSTONE-SUMMIT-COUNTY-329-2048x1365.jpg 2048w\" sizes=\"(max-width: 1024px) 100vw, 1024px\"><\/p><figcaption><strong>Keystone\u2019s River Run Gondola is closed May 4, 2020.<\/strong><br \/><em>Hart Van Denburg \/ CPR News<\/em><\/figcaption><\/figure>\n<\/div>\n<\/div>\n<p>Colorado\u2019s state government began preparing for an expected pandemic in 2000, when the&nbsp;<a href=\"https:\/\/leg.colorado.gov\/sites\/default\/files\/images\/olls\/2000a_sl_31.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">legislature created an epidemic response committee<\/a>&nbsp;and gave the governor broad powers to fight a viral disease. And as COVID-19 approached, the state prepared CDPHE\u2019s lab to be the central hub for testing and began to coordinate among state and local agencies.<\/p>\n<p>But when COVID-19 arrived, chaos reigned and plans developed over years of tabletop exercises were almost immediately \u201coverwhelmed,\u201d according to the head of CDPHE.<\/p>\n<p>State and local public health officials acknowledge that the communications problems with county public health agencies that started that first night continued for weeks, and, though now improved, still exist today.<\/p>\n<p>\u201cThey had run through drills and we understood the concept,\u201d Gov. Jared Polis said in an interview about advance preparations by state emergency officials. \u201cAnd I had been through drills on what a contagion event might look like. We didn\u2019t know what this particular pandemic would look like.\u201d<\/p>\n<p>A CPR News review of more than 2,000 pages of emails, text messages and memoranda from the weeks before the coronavirus reached Colorado through the first days of the state\u2019s response found numerous instances of confusion, complacency and a lack of preparation.<\/p>\n<p>In interviews with more than a dozen disease and disaster experts, all agreed that the rapid transmission of the disease contributed to early missteps, whether local, state or federal. Many applauded the state\u2019s public response to the crisis after the virus arrived.<\/p>\n<p>\u201cHonestly, as an infectious disease epidemiologist living through the pandemic of our lifetimes, I\u2019m glad I live in Colorado,\u201d said&nbsp;<a href=\"http:\/\/www.ucdenver.edu\/academics\/colleges\/PublicHealth\/Academics\/departments\/Epidemiology\/About\/Faculty\/Pages\/LambM.aspx\" target=\"_blank\" rel=\"noopener noreferrer\">Molly Lamb<\/a>, with the Colorado School of Public Health. She was referring to Polis\u2019 science-based approach, including the symbolism of regularly wearing a mask in public.<\/p>\n<div class=\"p402_hide\">\n<figure class=\"wp-block-image size-large is-style-default\">\n<p><img decoding=\"async\" src=\"https:\/\/cdn.summitdaily.com\/wp-content\/uploads\/sites\/2\/2020\/05\/AP_20094844899851-scaled-1-1024x621.jpg\" alt class=\"wp-image-383160\" srcset=\"https:\/\/cdn.summitdaily.com\/wp-content\/uploads\/sites\/2\/2020\/05\/AP_20094844899851-scaled-1-1024x621.jpg 1024w, https:\/\/cdn.summitdaily.com\/wp-content\/uploads\/sites\/2\/2020\/05\/AP_20094844899851-scaled-1-300x182.jpg 300w, https:\/\/cdn.summitdaily.com\/wp-content\/uploads\/sites\/2\/2020\/05\/AP_20094844899851-scaled-1-768x466.jpg 768w, https:\/\/cdn.summitdaily.com\/wp-content\/uploads\/sites\/2\/2020\/05\/AP_20094844899851-scaled-1-1536x931.jpg 1536w, https:\/\/cdn.summitdaily.com\/wp-content\/uploads\/sites\/2\/2020\/05\/AP_20094844899851-scaled-1-2048x1242.jpg 2048w\" sizes=\"(max-width: 1024px) 100vw, 1024px\"><\/p><figcaption><strong>Colorado Gov. Jared Polis dons a mask to encourage state residents to wear them while in public as a statewide stay-at-home order remains in effect in an effort to reduce the spread of the new coronavirus Friday, April 3, 2020, in Centennial, Colo. (AP Photo\/David Zalubowski)<\/strong><br \/><em>David Zalubowski \/ AP<\/em><\/figcaption><\/figure>\n<\/div>\n<\/article>\n<\/div>\n<p>\u201cNew guidelines come up from [Centers for Disease Control and Prevention] and the next day Governor Polis is standing at the podium wearing a face mask saying, \u2018CDC says we should do this, we should do this.\u2019 That\u2019s impressive,\u201d Lamb said.<\/p>\n<p>Colorado, however, has emerged as the only state in the nation ranked in the bottom 15 for both population density \u2014 which should make it easier to control the spread of the virus \u2014 and in the top 15 for COVID-19 deaths per 100,000 residents.<\/p>\n<p>That could be because of the state\u2019s popularity as a winter destination. Or because visitors passed through both densely populated Denver and widespread ski resorts, said Glen Mays, chair of the Colorado School of Public Health.<\/p>\n<p>\u201cStates like Colorado where we had multiple points of entry, multiple places where the disease was seeded, resort areas and population centers, and then mixing between those areas that can also kind of accelerate the spread,\u201d Mays said.<\/p>\n<p>Whether caused by circumstance or ineffective planning, the result is seen in the statistics. Louisiana is the only state west of the Mississippi with a higher rate of COVID-19 deaths per 100,000 residents than Colorado, and Colorado has more than 400 more deaths than even Arizona, a state with a larger and older population.<\/p>\n<p>As Colorado now moves well beyond the peak of coronavirus round one, the lessons learned in the early days of Colorado\u2019s response serve as a guide to what went wrong and how those mistakes can be avoided as the state prepares for a feared second round of the virus, possibly during the next flu season.<\/p>\n<p>Among CPR\u2019s findings:<\/p>\n<ul>\n<li>While signs of trouble were growing from Washington state to Washington, D.C., Colorado\u2019s governor\u2019s office said little publicly about the pandemic in February, and preparations were largely confined to increasing the number of meetings and preparing the state lab. Staffers only began to inquire about the possibility of conducting a drill for the response to COVID-19 in the waning days of the month, just a week before the virus was confirmed here.<\/li>\n<li>Colorado\u2019s fragmented public health system, with a state agency and 53 independent county or multi-county departments, created confusion and animosity among government entities as they chafed over big elements of the response including testing capacity, communications plans and press releases.<\/li>\n<li>Like others across the country, Colorado\u2019s state lab was quickly overwhelmed, taking up to 10 days to turn around results in early March \u2014 a delay that frustrated even Polis. Still, it wasn\u2019t until private labs came online that results got to doctors, patients and state and local health departments more quickly. In text messages on March 5, county officials mocked Polis\u2019 claimed testing capacity of 160 tests a day as CDPHE struggled to handle half that many in a day.<\/li>\n<li>CDPHE was in the midst of an overhaul of its disaster response operations, and the agency\u2019s director of emergency preparedness and response announced he was leaving the agency just days before the first case was announced.<\/li>\n<li>As the virus approached, the state made no effort to secure additional protective equipment for first responders, health care workers, hospitals or nursing homes. The lack of masks, gloves and gowns, and the competition for supplies with other states and the federal government would become an important issue as the number of cases grew.<\/li>\n<li>When the CDPHE director called an emergency meeting of the epidemic response committee, four of the emails sent to committee members bounced back because they were sent using outdated contact information.<\/li>\n<li>Contact tracing of positive patients, at least in some counties, was abandoned early as hours were lost to poor communication and the virus got out of control. That essentially ended efforts at containment before they began, despite the emphasis placed on tracing by state health officials. Instead, slowing the virus through extreme social distancing orders became the focus.<\/li>\n<\/ul>\n<p>On March 3, Polis called his first news conference to discuss COVID-19 and the state\u2019s preparations.<\/p>\n<p>\u201cWe are prepared to protect the health and safety of Coloradans if and when Coronavirus comes to Colorado,\u201d Polis said in&nbsp;<a href=\"https:\/\/www.colorado.gov\/governor\/news\/gov-polis-public-health-safety-officials-provide-update-covid-19\" target=\"_blank\" rel=\"noopener noreferrer\">the accompanying released statement<\/a>.<\/p>\n<p>But in the critical weeks before the governor made that confident statement, no state purchases were made for protective equipment for health care workers. Accurate and consistent testing remained limited. No warnings were given to the public about the broad sweep of the impacts to come.<\/p>\n<div class=\"p402_hide\">\n<figure class=\"wp-block-image size-large is-style-default\">\n<p><img decoding=\"async\" src=\"https:\/\/cdn.summitdaily.com\/wp-content\/uploads\/sites\/2\/2020\/05\/200303-POLIS-CORONOVIRUS-009-seqnA-1024x683.jpg\" alt class=\"wp-image-383162\" srcset=\"https:\/\/cdn.summitdaily.com\/wp-content\/uploads\/sites\/2\/2020\/05\/200303-POLIS-CORONOVIRUS-009-seqnA-1024x683.jpg 1024w, https:\/\/cdn.summitdaily.com\/wp-content\/uploads\/sites\/2\/2020\/05\/200303-POLIS-CORONOVIRUS-009-seqnA-300x200.jpg 300w, https:\/\/cdn.summitdaily.com\/wp-content\/uploads\/sites\/2\/2020\/05\/200303-POLIS-CORONOVIRUS-009-seqnA-768x512.jpg 768w, https:\/\/cdn.summitdaily.com\/wp-content\/uploads\/sites\/2\/2020\/05\/200303-POLIS-CORONOVIRUS-009-seqnA.jpg 1504w\" sizes=\"(max-width: 1024px) 100vw, 1024px\"><\/p><figcaption><strong>Jill Hunsaker Ryan, the4 executive director of the Colorado Department of Public Health and Environment, speaks during a press conference with Gov. Jared Polis Tuesday, March 3 at the governor\u2019s office about state preparedness regarding the COVID-19 coronavirus.<\/strong><br \/><em>Hart Van Denburg \/ CPR News<\/em><\/figcaption><\/figure>\n<\/div>\n<\/div>\n<p>In terms of concrete actions, including supply purchases, it amounted to a lost February at the federal, state and most local levels. That set the stage for a chaotic March and the institution of draconian social distancing measures that would wreak havoc on Colorado and the nation\u2019s economy.<\/p>\n<p>While Polis acknowledges that the state\u2019s response, particularly the search for needed equipment, really didn\u2019t ramp up until after that first person who tested positive was identified, his office disputes the characterization of February as a lost month. They point to the opening of an emergency operations center, coordination among state agencies and a series of meetings as signs that the state was taking the approach of the virus with the seriousness it deserved.<\/p>\n<p>Even those closest to the state\u2019s response say they did not anticipate how the virus would lay waste to plans created over years.<\/p>\n<p>\u201cI think everybody was just quickly overwhelmed,\u201d said&nbsp;<a href=\"https:\/\/www.colorado.gov\/pacific\/cdphe\/jill-hunsaker-ryan\" target=\"_blank\" rel=\"noopener noreferrer\">Jill Hunsaker Ryan<\/a>, executive director of CDPHE. \u201cI mean, it was just sort of overwhelming and all-consuming.\u201d<\/p>\n<h2>Early Warnings<\/h2>\n<p>There have been outbreaks in the past that spooked the state into preparation mode. Anthrax in 2001. SARS in 2002. H1N1 in 2009. Ebola in 2014. Pandemic response plans were written and supplies of masks and gloves stockpiled.<\/p>\n<p>The impact of those diseases pales in comparison to COVID-19, but with each event, experts continued to warn that coronaviruses could spark a global pandemic.<\/p>\n<p>The state\u2019s pandemic response plan calls for the CDPHE, with a $616 million annual budget to monitor everything from air and water pollution to personal prevention and wellness, to run point on the response to protect the public.<\/p>\n<p>CDPHE\u2019s Office of Emergency Preparedness and Response is where the disaster experts were housed. For years, they ran regular tabletop exercises and maintained two supply caches for gloves, gowns, masks and other supplies, one in the Denver area, known as the Kaiser Cache, and one in Grand Junction.<\/p>\n<p>As COVID-19 drew closer to Colorado, CDPHE was in a state of transition. The chief medical officer,&nbsp;<a href=\"https:\/\/www.colorado.gov\/pacific\/cdphe\/dr-eric-france\" target=\"_blank\" rel=\"noopener noreferrer\">Eric France<\/a>, the highest ranking medical doctor at the agency, was hired just four weeks before the first case was identified. CDPHE\u2019s director of the Emergency Preparedness and Response office, Dane Matthew, was already looking for a career plan B after the department had altered his job duties.<\/p>\n<p>Just before that, the \u201cKaiser Cache\u201d of supplies close to Denver had been dismantled and consolidated on the Western Slope in Grand Junction, after a loss of federal funding.<\/p>\n<p>Matthew said in an interview the supplies in that cache were so old that they wouldn\u2019t have been much good anyway. A lack of basic supplies became a crisis in Colorado and across the globe as the coronavirus spread rapidly.<\/p>\n<p>On Jan. 27, CDPHE put out its&nbsp;<a href=\"https:\/\/www.colorado.gov\/pacific\/cdphe\/news\/corona-virus-low-risk\" target=\"_blank\" rel=\"noopener noreferrer\">first news release<\/a>&nbsp;about the coronavirus, emphasizing that it was nothing to worry about. By then, the state had tested three people with symptoms who had recently traveled from China. All were deemed negative for the coronavirus.<\/p>\n<p>\u201cState public health officials from the Colorado Department of Public Health and Environment say the risk to the general public is low for novel coronavirus in Colorado,\u201d the release began.<\/p>\n<p>It continued, quoting the state\u2019s leading epidemiologist, Dr. Rachel Herlihy, saying, \u201cIt\u2019s understandable that people may be worried about the appearance of a new virus, but the health risk to the general public in Colorado remains low.\u201d<\/p>\n<p>Not all experts agreed.<\/p>\n<p>At the same time CDPHE was downplaying the threat, numerous groups that monitor global health conditions, including the&nbsp;<a href=\"https:\/\/promedmail.org\/about-promed\/\" target=\"_blank\" rel=\"noopener noreferrer\">Program for Monitoring Emerging Diseases<\/a>, and the&nbsp;<a href=\"https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa2001316\" target=\"_blank\" rel=\"noopener noreferrer\">New England Journal of Medicine<\/a>, issued increasingly dire warnings about the spreading virus from China.<\/p>\n<p>\u201cConsiderable efforts to reduce transmission will be required to control outbreaks if similar dynamics apply elsewhere (as the virus spreads),\u201d the New England Journal reported on Jan. 29. \u201cMeasures to prevent or reduce transmission should be implemented in populations at risk.\u201d<\/p>\n<p>In Eagle County, the experts didn\u2019t wait for the state or federal government. By January, preparations for the coronavirus were well underway. Officials at Vail Health had started to pay attention to the virus in late December as warning signs began emanating from Wuhan, China, where the disease originated.<\/p>\n<p>One flash point was when China shut down Wuhan, a city of 11 million people, on Jan. 23.<\/p>\n<p>\u201cIt was very clear this was a major issue,\u201d said Chris Lindley with Vail Health. \u201cThere was never a thought in our mind that this was not a serious thing.\u201d<\/p>\n<p>As the news from China in January grew more dire, Vail Health began to make large personal protective equipment orders, for \u201ctens of thousands of&nbsp;<a href=\"https:\/\/www.fda.gov\/medical-devices\/personal-protective-equipment-infection-control\/n95-respirators-and-surgical-masks-face-masks\" target=\"_blank\" rel=\"noopener noreferrer\">N95 masks<\/a>,\u201d according to a spokesperson for the health network.<\/p>\n<p>In hindsight, Lindley said the early work turned out to be necessary, given that&nbsp;<a href=\"https:\/\/www.cpr.org\/2020\/04\/01\/how-mexico-is-coping-with-a-coronavirus-outbreak-partially-imported-from-vail-colorado\/\" target=\"_blank\" rel=\"noopener noreferrer\">Vail is a destination for international tourists<\/a>&nbsp;and the spread of COVID-19 coincided with peak ski season. \u201cSo, I think we got seeded with the virus very early. I\u2019m certain that the virus was in this community early January. And started slowly spreading.\u201d<\/p>\n<p>Other hospitals were also preparing. Experts at UCHealth were spooked enough that they added a question to intakes, asking if the patient had traveled to Wuhan. If they answered \u2018yes,\u2019 the patient was put in a room for further questions and testing.<\/p>\n<p>\u201cAnd so probably late December or early January, we first started seeing reports of this pneumonia of unclear origin that was happening in Wuhan, in China. And the severity of the illness certainly made you wonder what was going on and certainly caught my attention,\u201d said&nbsp;<a href=\"https:\/\/www.uchealth.org\/provider\/michelle-barron-md-infectious-disease\/\" target=\"_blank\" rel=\"noopener noreferrer\">Dr. Michelle Barron<\/a>, an infectious disease expert at UCHealth.<\/p>\n<p>The fact that the information coming out of China was murky only added to concerns that the disease could be worse than official reports were letting on.<\/p>\n<p>It turns out Barron was not just being paranoid, but she admits she had no idea what COVID-19 would become.<\/p>\n<p>\u201cThis escalated to beyond anything any of us anticipated.\u201d<\/p>\n<p>Neither Barron nor Lindley expressed their concerns to state officials about the lack of protective equipment or the need to treat the coronavirus as more than a \u201cbad seasonal flu.\u201d Both said they were focused primarily on getting their own organizations ready.<\/p>\n<p>The Colorado School of Public Health and the state now agree with Lindley that the virus was likely already spreading in Colorado in January. The latest state data shows more than 120 cases already in the state by March 1, days before the first confirmed case.<\/p>\n<p>It may have arrived here along with international travelers, who continued to pour into Vail and Aspen, long popular with wealthy skiers from all over the world. More than 270,000 international travelers passed through Denver International Airport in January alone.<\/p>\n<p>By the end of January, the state said it began monitoring COVID-19. CDPHE activated its emergency operations center, held regular meetings, and sent a basic health warning out to medical providers and local public health agencies. And the state lab began purchasing testing supplies they believed they would need should the disease enter Colorado.<\/p>\n<p>The amount they purchased \u2014 supplies for 1,000 tests \u2014 would not have been enough to get through a single morning once the virus took hold here.<\/p>\n<h2>Pivotal Weeks<\/h2>\n<p>It was difficult for state experts to see the magnitude, because of testing problems not of their making that started almost immediately. On Feb. 7, the state lab received test kits from CDC, but the kits did not give consistent results because of technical problems. It wasn\u2019t until Feb. 27, almost three weeks later, that the CDC and the Food and Drug Administration made the necessary adjustments to the tests, according to CDPHE.<\/p>\n<p>The governor\u2019s office argues that the federal government impeded the state\u2019s testing response by providing testing materials only to state labs, in effect making them the sole conduit for testing. It wasn\u2019t until several days after the first case that those regulations were loosened to allow private labs to begin testing.<\/p>\n<p>On Feb. 13 there were 60,000 confirmed cases worldwide, 13 confirmed U.S. cases. That same day the&nbsp;<a href=\"https:\/\/www.colorado.gov\/pacific\/cdphe\/GEEERC\" target=\"_blank\" rel=\"noopener noreferrer\">Governor\u2019s Expert Emergency Epidemic Response Committee<\/a>&nbsp;met. On the agenda: \u201cHot Topics in Infectious Disease \u2026 Novel Coronavirus.\u201d The allotted time: 10 minutes.<\/p>\n<p>Meeting minutes show Herlihy, the state epidemiologist, gave an overview presentation that was short on what the risk to Colorado turned out to be. The mantra passed along both publicly and privately by Colorado\u2019s public health experts remained, you are at low risk, wash your hands regularly.<\/p>\n<p>\u201cThe data was unclear,\u201d said Herlihy in an interview. \u201cWe were working on preparing for a pandemic and transmission in the U.S. and we were taking those steps, but we weren\u2019t exactly sure at that point what exactly we were preparing for because we didn\u2019t have the data on severity and transmissibility.\u201d<\/p>\n<p>By that time, China had shared considerable data, including the genome of the coronavirus. The CDC was still weeks away from providing data on the virus\u2019s transmissibility, but authorities in much of the world were watching with alarm as the virus swept through a cruise ship off Japan, with the number of cases growing from 10 to 176 in eight days. On Jan. 30, researchers in Germany had&nbsp;<a href=\"https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMc2001468\" target=\"_blank\" rel=\"noopener noreferrer\">begun to raise concerns about asymptomatic transmission<\/a>&nbsp;\u2014 spreading of the virus by a person not showing symptoms \u2014 though it was speculative at that point.<\/p>\n<p>Herlihy said that in mid-February, behind the scenes, the state was working to prepare. The department was \u201cdeveloping procedures and protocols\u201d for investigating cases, should the virus hit Colorado. She said the state was also working on infection control strategies, particularly with health care providers.<\/p>\n<p>On Feb. 19, Ryan&nbsp;<a href=\"https:\/\/drive.google.com\/file\/d\/12QksBeS4OtFnwqnA3R1WaiEVPCq2yCWR\/view\" target=\"_blank\" rel=\"noopener noreferrer\">told the state Board of Health<\/a>, \u201cCurrently, the novel coronavirus is looking like a bad seasonal flu with its fatality rate and severity.\u201d<\/p>\n<p>While there\u2019s still a lack of good data because of limited testing, the best information shows the coronavirus is orders of magnitude more deadly than seasonal flu.<\/p>\n<figure><\/figure>\n<p>\u201cWell, I wasn\u2019t at that meeting, of course, and this is considerably worse than the flu,\u201d said Polis in a recent interview.<\/p>\n<p>In an interview with CPR News on April 21, Ryan said when she appeared before the Board of Health she went with the best information they had at that point.<\/p>\n<p>\u201cWe\u2019ve just never seen a novel disease like this,\u201d she explained. \u201cWe didn\u2019t realize the asymptomatic nature of transmission until recently. I think we didn\u2019t realize how severely ill some people can get from it, where they\u2019re hospitalized much longer than someone would be hospitalized with the flu.\u201d<\/p>\n<p>At the same time in February, Polis was seeing and hearing little that would have prompted a more aggressive response. On Feb. 9, while at the National Governors Association winter meetings in Washington, D.C., he attended a private session with federal health officials, including&nbsp;<a href=\"https:\/\/www.niaid.nih.gov\/about\/director\" target=\"_blank\" rel=\"noopener noreferrer\">Anthony Fauci<\/a>, director of the National Institute of Allergy and Infectious Diseases.<\/p>\n<p>\u201cWhile this is a serious public health matter, the risk to the American public remains low at this time,\u201d read a&nbsp;<a href=\"https:\/\/www.hhs.gov\/about\/news\/2020\/02\/09\/representatives-of-coronavirus-task-force-brief-governors-at-nga.html\" target=\"_blank\" rel=\"noopener noreferrer\">news release after the briefing<\/a>. \u201cThe federal government will continue working in close coordination with state and local governments to keep it that way.\u201d<\/p>\n<p>On Feb. 20, a day after Ryan told the State Board of Health coronavirus was looking like a bad seasonal flu, Gov. Polis met with President Donald Trump in Colorado Springs. Polis&nbsp;<a href=\"https:\/\/www.cpr.org\/2020\/02\/28\/gov-jared-polis-colorado-is-ready-if-coronavirus-comes\/\" target=\"_blank\" rel=\"noopener noreferrer\">told Colorado Matters<\/a>&nbsp;the only thing he discussed, other than small talk, was potentially locating Space Command in Colorado.<\/p>\n<p>Another nine days passed, the first confirmed U.S. death occurred, and the global warnings grew louder. By the end of the month there were more cases outside of China than inside. Italy alone had more than 1,500 cases. Researchers examining the genetics of the virus&nbsp;<a href=\"https:\/\/www.nytimes.com\/2020\/03\/01\/health\/coronavirus-washington-spread.html\" target=\"_blank\" rel=\"noopener noreferrer\">reported that Washington state cases appeared related<\/a>, pointing to possible community spread.<\/p>\n<p>CPR News asked Ryan if the state had made any purchases, whether for PPE or testing supplies or additional capacity, in January and February to prepare. She spoke about the presence of state and national stockpiles. In a follow up to CPR, CDPHE provided a timeline that shows in late January the state lab made some supply purchases for testing. But it wasn\u2019t until March 19 that the department made its first request to the federal government for personal protective equipment.<\/p>\n<p>The state said it worked through its state cache located in Grand Junction first. Additionally, the governor\u2019s office said they didn\u2019t have budget authority to make large purchases of equipment. The general assembly was in session, but the governor\u2019s office sought no emergency funding in advance of the arrival of the virus.<\/p>\n<p>And there were already reports of shortages, almost a month before the request for federal supplies. A Feb. 28 situation report from CDPHE includes a bullet point that reads: \u201cIn response to ongoing reports of PPE shortages and requests for guidance, we are forming a health care mitigation branch within our response to engage stakeholder workgroups and develop these resources.\u201d<\/p>\n<p>The lack of protective equipment had a cascading effect throughout the system. It\u2019s needed for health care workers in order to obtain nasal swabs for testing. Limited PPE equals limited testing. It\u2019s needed in emergency rooms where everyone showing symptoms needs to be treated as a possible coronavirus case. It\u2019s needed for elective surgeries and routine treatments of immunocompromised patients. It\u2019s needed in nursing homes, where re-using protective equipment can spread infection throughout the facility.<\/p>\n<p>And as late as March 4 local public health agencies were confused about what equipment was needed to gather samples.<\/p>\n<p>That lack of basic supplies would become a crisis in Colorado, and across the globe as the coronavirus spread. The state was&nbsp;<a href=\"https:\/\/www.cpr.org\/2020\/04\/08\/colorado-coronavirus-ventilators-trump-polis-gardner-fema\/\" target=\"_blank\" rel=\"noopener noreferrer\">forced onto the open market<\/a>&nbsp;to compete with the rest of the world, dozens of other states and the federal government for masks, gloves, gowns and swabs. And any hope of relying on the national stockpile evaporated as it was quickly depleted.<\/p>\n<p>\u201cI can say that we put in requests from the Strategic National Stockpile, and we did go through that pretty quickly,\u201d said Susan Wheelan, director of El Paso County Public Health. There were just \u201cnot enough supplies to meet all of the different requests.\u201d<\/p>\n<p>As all that was looming, the public was largely uninformed by official channels about state preparations for the coronavirus.<\/p>\n<p>Throughout the month of February, the governor, who\u2019s prolific on social media, mentioned the coronavirus once, commenting on a tweet from someone else about the need for humane treatment of animals.<\/p>\n<figure class=\"wp-block-embed-twitter wp-block-embed is-type-rich is-provider-twitter\">\n<div class=\"wp-block-embed__wrapper\" readability=\"5.9705882352941\">\n<blockquote class=\"twitter-tweet\" data-width=\"500\" data-dnt=\"true\" readability=\"5.9705882352941\">\n<p lang=\"en\" dir=\"ltr\" xml:lang=\"en\">Absolutely true. Humane husbandry and reduced prophylactic use of antibiotics in farmed animals (not related to Coronavirus but related to antibiotic resistant bacteria) is a public health imperative. <a href=\"https:\/\/t.co\/ucA6TFp2g2\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/t.co\/ucA6TFp2g2<\/a><\/p>\n<p>\u2014 Jared Polis (@jaredpolis) <a href=\"https:\/\/twitter.com\/jaredpolis\/status\/1233835891954610177?ref_src=twsrc%5Etfw\" target=\"_blank\" rel=\"noopener noreferrer\">February 29, 2020<\/a><\/p><\/blockquote>\n<\/div>\n<\/figure>\n<p>Two weeks after Trump restricted travel from China and as the virus took hold in Washington state, Polis\u2019 personal Twitter feed remained its usual mix of science retweets, dad jokes and observations about life. His feed from the governor\u2019s office was largely focused on legislative initiatives.<\/p>\n<p>All of the epidemiologists that CPR News contacted for this article gave Gov. Polis high marks for his response to the outbreak throughout March. COVID-19 has been described as the perfect disease in terms of asymptomatic transmissibility, and many experts said delays in response are understandable given the speed with which it spread.<\/p>\n<p>\u201cThat\u2019s certainly a major part of it,\u201d said Glen Mays, with the Colorado School of Public Health. \u201cThis is a highly infectious disease. It\u2019s got high reproduction rates, significantly higher than what we see in influenza and other kinds of infectious diseases.\u201d<\/p>\n<p>\u201cCertainly the direction that we were [getting] from public comments of the president, from others, is that there was no cause for alarm at the state level yet,\u201d Polis said in an interview. \u201cAnd we didn\u2019t have any cases. We knew we might see cases, but we always hope for the best.\u201d<\/p>\n<p>Emails from the governor\u2019s office in late February, reviewed by CPR News, show scant mention of COVID-19, and no emails apparently to or from Polis.<\/p>\n<p>One email string on Feb. 25 from Colorado\u2019s congressional delegation urges a conference call because of \u201cthe shifting (more alarmist) tone CDC has adopted, thought it might be useful to check in w you all.\u201d<\/p>\n<p>The next day, Feb. 26, a staffer for the lieutenant governor, Kacey Wulff, sent an email to the National Governors Association asking for pandemic simulations to address COVID-19.<\/p>\n<p>A representative from NGA responded that they didn\u2019t have any to offer, and instead pointed the governor\u2019s office staffer to the Colorado Division of Homeland Security and Emergency Management.<\/p>\n<p>Wulff would eventually be shifted to chief of staff of the governor\u2019s COVID-19 Innovation Response Team.<\/p>\n<p>The next day, on Feb. 27, Polis posted on Facebook, looking for dining recommendations in Aurora. Within three weeks, he would order every restaurant in the state to close their dining rooms.<\/p>\n<figure><\/figure>\n<p>On Feb. 28, a budget staffer with a Master of Public Health degree wrote an email asking about potential safety training for Capitol workers given the potential for COVID-19 to reach the U.S.<\/p>\n<p>\u201cI know this sounds a bit doomsday preparations, but \u2026 it is better to be prepared and informed for a situation that hopefully never happens.\u201d<\/p>\n<p>As February gave way to March, Colorado\u2019s health officials got a warning that the coronavirus could alter life as we know it. It came not from a scientist at the CDC, an epidemiologist at CDPHE, a university professor tracking the disease or a local public health official, but from a software consultant and venture capitalist, who is also a photographer, in Boulder.<\/p>\n<p>She had family in Wuhan, some who had died from COVID-19, and so had a unique perspective to share.<\/p>\n<p>\u201cI think Colorado needs to take Corona Virus more seriously,\u201d wrote Ning Mosberger-Tang on March 2, after receiving an email introduction to Ryan from the head of the Colorado Department of Human Services, a friend. \u201cWe need to inform people, test more aggressively, reduce large gatherings, take preventative measures in health facilities, and pay special attention to places where older people or people with existing conditions congregate, etc.\u201d<\/p>\n<p>Ryan wrote back later that night: \u201cThe public health system in Colorado is prepared to respond when we see our first case \u2026 CDPHE has an entire division devoted to emergency preparedness and responding to disease outbreaks with our federal and local partners is something we do on a regular basis.\u201d<\/p>\n<p>Mosberger-Tang\u2019s email was the only clear warning contained in thousands of pages of records reviewed by CPR News from the governor\u2019s office, CDPHE, and local health departments in the weeks leading up to Colorado\u2019s first case.<\/p>\n<p>\u201cI\u2019m really shocked to hear that. Yeah, that is actually a little scary,\u201d said Mosberger-Tang in an interview. \u201cI was worried, and I would like people to act. I\u2019m a doer. I don\u2019t complain. I want to make things happen. So when I see that the state is not doing enough, I should make sure that I reach out and do my part as a citizen.\u201d<\/p>\n<p>The same day Mosberger-Tang\u2019s email was received, Ryan wrote an urgent email to the members of the Governor\u2019s Expert Emergency Epidemic Response Committee. \u201cI cannot overstress the importance of the advice and guidance \u2026 to help Governor Polis make the best possible decision to protect the health of Coloradans.\u201d<\/p>\n<p>The message, which included scheduling information for an emergency meeting to be held in two days, bounced back from multiple emails that were supposed to belong to committee members. Ryan forwarded the email bouncebacks to Dane Matthew to fix. Matthew never responded, and later couldn\u2019t recall that, and said he was out of the loop by then.<\/p>\n<p>\u201cOn the books I was still there, but I was largely out of all circulation of things going on,\u201d he said.<\/p>\n<p>March 2 was also a busy day for Polis. He was on a call with White House officials about COVID-19.<\/p>\n<p>But the next day, March 3, CDPHE\u2019s \u201ctop-line messaging\u201d to local public health directors remained: \u201cCurrent risk is still low for Coloradans.\u201d At that point, more than a dozen U.S. citizens had died.<\/p>\n<div class=\"p402_hide\">\n<figure class=\"wp-block-image size-large is-style-default\">\n<p><img decoding=\"async\" src=\"https:\/\/cdn.summitdaily.com\/wp-content\/uploads\/sites\/2\/2020\/05\/200303-POLIS-CORONOVIRUS-011-seqn-1024x682.jpg\" alt class=\"wp-image-383220\" srcset=\"https:\/\/cdn.summitdaily.com\/wp-content\/uploads\/sites\/2\/2020\/05\/200303-POLIS-CORONOVIRUS-011-seqn-1024x682.jpg 1024w, https:\/\/cdn.summitdaily.com\/wp-content\/uploads\/sites\/2\/2020\/05\/200303-POLIS-CORONOVIRUS-011-seqn-300x200.jpg 300w, https:\/\/cdn.summitdaily.com\/wp-content\/uploads\/sites\/2\/2020\/05\/200303-POLIS-CORONOVIRUS-011-seqn-768x512.jpg 768w, https:\/\/cdn.summitdaily.com\/wp-content\/uploads\/sites\/2\/2020\/05\/200303-POLIS-CORONOVIRUS-011-seqn.jpg 1318w\" sizes=\"(max-width: 1024px) 100vw, 1024px\"><\/p><figcaption><strong>Rachel Herlihy, communicable disease epidemiologist, speaks at a press conference with Gov. Jared Polis Tuesday, March 3 at the governor\u2019s office about state preparedness regarding the COVID-19 coronavirus.<\/strong><br \/><em>Hart Van Denburg \/ CPR News<\/em><\/figcaption><\/figure>\n<\/div>\n<\/div>\n<p>Though there were no confirmed Colorado cases, Polis decided to call a press conference on March 3 to discuss the state\u2019s preparations and reassure the public that Colorado was ready. He also&nbsp;<a href=\"https:\/\/www.cpr.org\/2020\/03\/03\/gov-jared-polis-raises-emergency-preparedness-level-to-fight-coronavirus\/\" target=\"_blank\" rel=\"noopener noreferrer\">raised the state\u2019s threat level<\/a>&nbsp;to its second highest category.<\/p>\n<p>Herlihy, the epidemiologist, joined Polis at the press conference because Ryan asked to have a medical doctor present, according to the emails. Herlihy emphasized the need to quickly test and thoroughly trace all the whereabouts of positive cases.<\/p>\n<p>\u201cOur goal after getting a confirmed case is the same as always \u2014 to minimize the spread,\u201d Herlihy said at the time.<\/p>\n<p>On the same day of the press conference, Matthew, CDPHE\u2019s director of Emergency Preparedness and Response, announced on Twitter that he was leaving the agency.<\/p>\n<p>Matthew had led CDPHE\u2019s emergency preparedness since 2016. But, he said, CDPHE had reorganized the leadership structure in 2019, and when the incident command structure was launched to respond to COVID-19, \u201cthat marginalized my position and I felt it was best to leave,\u201d he said.<\/p>\n<p>For Matthew, state and local authorities were well positioned to handle what he called \u201cnormal emergencies.\u201d He worried, though, with focus and money directed to local agencies and local response, that if something bigger happened the state wouldn\u2019t be prepared.<\/p>\n<p>\u201cSo it wasn\u2019t until about two years ago that we really started to realize that we need to build a stronger regional as well as state capability,\u201d said Matthew. When asked if the state had achieved that before COVID-19, he responded: \u201cNot at all \u2026 a work in progress.\u201d<\/p>\n<p>The state was not alone in a delay in recognizing the true threat. A day after the news conference, the head of Pueblo\u2019s health department wrote to Ryan after she reached out to see how he was handling what she called the \u201cCOVID-19 response surge.\u201d<\/p>\n<p>\u201cYes, we are surviving,\u201d wrote Randy Evetts. \u201cI call it the fear epidemic that we are dealing with currently. I am learning a lot!\u201d He included a smiley-face emoji for emphasis.<\/p>\n<p>When asked in a recent interview what he meant in that email, Evetts said: \u201cThere was a lot of fear of the unknown in our community. There was a lot of news stories but there wasn\u2019t much guidance at that point. We did not have testing.\u201d<\/p>\n<p>On March 5, Polis announced that a man who came to Colorado to ski in Summit and Eagle counties had tested positive for COVID-19. The floodgates of the crisis had opened.<\/p>\n<p>The governor said Coloradans should not panic. The state would work closely with local public health agencies to test, trace contacts and quarantine as needed.<\/p>\n<p>\u201cOnce we got the first diagnosed case, March 5, is really when we sprung rapidly into action around containment in Colorado and around the social distancing,\u201d Polis said in the interview.<\/p>\n<p>By then, there were likely already more than 100 cases in the state, it\u2019s now believed, and the speed and scope of the spread of COVID-19 revealed fault lines in Colorado\u2019s distributed public health system.<\/p>\n<p>There are more than 50 local public health agencies in Colorado, with varying resources. Local public health offices farther from Denver complain that they have fewer contacts and relationships with CDPHE leadership and that they face inconsistent funding compared to the state.<\/p>\n<p>The system led to confusion.<\/p>\n<p>In the hours after Polis announced the first confirmed case, two different county health departments were trying to trace back the patient\u2019s previous whereabouts, while the state appears to have taken over, complicating the tracing.<\/p>\n<p>The man had skied in Summit and Eagle counties, he fell ill in Summit and moved himself to Jefferson County to recover at a lower altitude.<\/p>\n<p>On March 5, the Summit County Public Health director, Amy Wineland, wrote to CDPHE: \u201cHow soon will we hear back from you on the interview?\u201d<\/p>\n<p>Early the next morning, she reached out to Jefferson County, because she heard they were also doing contact tracing.<\/p>\n<p><a href=\"https:\/\/www.summitdaily.com\/news\/how-colorado-caught-covid-19-a-cpr-news-investigation\/\" target=\"_blank\" rel=\"noopener noreferrer\">via:: Summit Daily<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Colorado can learn from this pandemic, so it is better prepared for the next By Ben MarkusCPR News The March 5&nbsp;news conference&nbsp;announcing Colorado\u2019s first confirmed case of COVID-19 was over. The governor and the director of the Colorado Department of Public Health and Environment returned to work. Colorado\u2019s first positive coronavirus patient left Summit County [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[99],"tags":[],"class_list":{"0":"post-807396","1":"post","2":"type-post","3":"status-publish","4":"format-standard","6":"category-local-news"},"acf":[],"publishpress_future_action":{"enabled":false,"date":"2026-07-11 06:10:38","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"category","extraData":[]},"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"distributor_meta":false,"distributor_terms":false,"distributor_media":false,"distributor_original_site_name":"KSMT The Mountain","distributor_original_site_url":"https:\/\/alwaysmountaintime.com\/ksmt","push-errors":false,"_links":{"self":[{"href":"https:\/\/alwaysmountaintime.com\/ksmt\/wp-json\/wp\/v2\/posts\/807396","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/alwaysmountaintime.com\/ksmt\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/alwaysmountaintime.com\/ksmt\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/alwaysmountaintime.com\/ksmt\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/alwaysmountaintime.com\/ksmt\/wp-json\/wp\/v2\/comments?post=807396"}],"version-history":[{"count":0,"href":"https:\/\/alwaysmountaintime.com\/ksmt\/wp-json\/wp\/v2\/posts\/807396\/revisions"}],"wp:attachment":[{"href":"https:\/\/alwaysmountaintime.com\/ksmt\/wp-json\/wp\/v2\/media?parent=807396"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/alwaysmountaintime.com\/ksmt\/wp-json\/wp\/v2\/categories?post=807396"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/alwaysmountaintime.com\/ksmt\/wp-json\/wp\/v2\/tags?post=807396"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}