Published on March 5, 2020

by Mark Craddock

The current statistics for COVID-19 (Coronavirus) in the United States from the Centers for Disease Control and Prevention (CDC) are certainly cause for concern, if not alarm – yet.

While the CDC and the Colorado Department of Public Health and Environment (CDPHE) currently consider the chances of a statewide outbreak as low, local health officials are quietly making preparations, monitoring the situation, and holding their collective breath.

Actually, at the moment, they’re breathing quite normally – and without the widespread use of now-scarce N95-compliant particulate-filtering face masks. But that could change.

What are the numbers?

As of Tuesday, the CDC reported 60 cases across 12 states, with six deaths attributed to the virus. Of those cases, 22 are travel-related, 11 are the result of person-to-person spread and 27 are still under investigation. These numbers do not include people who returned to the U.S. via State Department-chartered flights, the CDC said.

Last week, the CDC reported community spread of the virus that causes COVID-19 in two California cities, as well as Oregon and Washington.

Community spread in Washington resulted in the first U.S. death from COVID-19, as well as the first reported case in a healthcare worker and the first potential outbreak in a long-term care facility.

Local preparations

So far, no cases have been confirmed in Colorado. As of Monday night, the CDPHE had tested 37 people for the COVID-19 virus. Of those, 29 were negative and the other eight tests were still pending.

At the Las Animas-Huerfano Counties District Health Department, staff is working to ensure they are prepared in case the region sees COVID-19 cases, director Kimberly Gonzales said in a press release.

“We are utilizing our the Public Health Emergency Operations Plan, developed many years ago for situations such as this one, which includes activating our pandemic and community containment plans in the event that we have positive cases,” Gonzales said. “Our response plans contain tools and protocols to assess potential exposures and ill people and implement disease control measures.”

The CDPHE is, by state law, the lead agency in responding to disease outbreaks, so a large part of the local agency’s preparations involve meeting with the state agency, keeping abreast of the latest strategies and protocols for testing and, if needed, response, she said.

“What we do is mediate between our local healthcare organizations and the state,” said Robert Bukovac, the health department’s emergency preparedness and response coordinator.”

He said the local health department is working with the state to ensure adequate supplies in the event of an outbreak.

“A lot of supplies are being bought up,” Bukovac said, “so they’re kind of limited at this time. If we do have a situation, we have the strategic national stockpile which we could request from at any time.”

Managed by the Office of the Assistant Secretary for Preparedness and Response, the Strategic National Stockpile is the nation’s largest supply of potentially life-saving pharmaceuticals and medical supplies for use in a public health emergency severe enough to cause local supplies to run out.

On Monday, Huerfano County Emergency Manager Larry Sanders said he had just returned from a conference of the Colorado Emergency Management Association where public health played prominently in the discussions.

“I haven’t heard anything particular,” he said, “but what we are looking at locally is personal protective supplies for our people.” Many of these supplies, he said, are at shortage levels.

“(CDPHE) by state statute has its own power, so for a pandemic it has the lead role. Our role is primarily assisance to that,” Sanders said. “We will work with and support those professionals in any way we can.”

“I’ve been thinking about some of the things that we might be asked to do, including non-pharmaceutical interventions,” he said. “What are the tools available? The primary tool is to be ready for ‘social distancing.’ That involves a number of things besides quarantines such as public meetings and gatherings. It’s all about advice and guidelines and working together. But I think everybody is pretty much on board.”

SPRHC plans

At the Spanish Peaks Regional Health Center, infection prevention nurse Carrie Andreatta said the facility is basically “following CDPHE guidance, and trying to keep up with the CDC guidance.”

The facility already has infection-control protocols in place, and its response to COVID-19 involves utilizing those protocols.

“We would put a patient under investigation (a suspected COVID-19 case) into negative airflow in the emergency room and we would practice contact and airborne precautions,” she said. “We would then call the CDPHE to seek guidance on testing and for further guidance on disposition.”

SPRHC public information officer Debbie Channel said the facility is trying to be “as proactive as possible.”

“We’re pretty geared up. We have a pretty healthy stock of supplies which we may or may not need,” she said. “We’re being as proactive as possible to make sure we are prepared and ready.”

San Rafael is ready

At Trinidad’s Mt. San Rafael Hospital, infection prevention nurse Terry Combs said the hospital is ready for what comes.

“This isn’t the first virus we’ve had issues with,” she said. “We are constantly being made aware of things that could impact our community health.”

“In our basic disaster preparedness plan, we do much of this work already,” Combs sasid. “It’s already involved in all of our plans. We are already semi-prepared so when something like this happens, we can assess the situation and respond.”

At the core of the preparedness, Combs said, is ongoing training in infection prevention.

“Every year we have an educational process,” she said. “The nurses come in, all of our clinical people come in and are required to go through certain processes in different departments. Everybody has different protocols. So our respiratory protocols are covered.”

She said it takes a good deal of training just to to properly fit, put on and remove an N95 mask.

“So our people are very well trained on how to handle myriad diseases that we use respirator isolation for,” Combs siad.

With the predictions of a Colorado outbreak low, and the number of existing respiratory illnesses still high, Combs offered some tried-and-true common-sense prevention advice. “If you’re sick, stay home,” she said.

“If you’re coughing, use a tissue. A mask is not going to help you, but washing your hands can make the difference.”