On Monday, as he ordered residents to stay home, Denver Mayor Michael Hancock implored, “We can’t let our hospitals get overwhelmed.”
“So if you’re sick, stay home,” he said during a news conference. “If you’re not sick, you need to stay home, too.”
Denver’s stay-at-home order, along with similar ones in Boulder and San Miguel County, is among the most aggressive steps local officials have deployed to combat the spread of the new coronavirus in Colorado. These restrictions, along with statewide orders that limit crowds and shut down gathering places, are designed to keep Coloradans home.
Yet despite these strong social distancing measures, state health officials and experts say Colorado could still see hundreds of thousands of people become sick as the number of coronavirus cases is expected to grow exponentially. And it’s unclear what will happen when state and local officials start to pull back these orders — including whether there will be a spike in cases as people reenter society.
The outbreak is widespread and delays in testing for COVID-19, the respiratory disease caused by the new coronavirus, mean the number of cases confirmed by health officials is likely far lower than the actual number of people in Colorado with the illness.
“Because it takes a long time for this disease to progress, people reach that state weeks after they were infected,” said Dr. William Hanage, associate professor of epidemiology at the Harvard T.H. Chan School of Public Health. “This means that by the time you realize you have a problem, it may be too late to prevent a catastrophic outbreak that will overwhelm health care systems.”
On Tuesday, New York Gov. Andrew Cuomo warned that other states across the country could soon face the same dire situation as his state, which has become a hotspot for the national outbreak and where the number of cases is doubling about every three days.
There are more than 25,000 confirmed cases of COVID-19 in New York, more than 3,200 people hospitalized and 210 deaths, Cuomo said during a media briefing.
Hospitals in New York are facing shortages of ventilators and protective equipment as they see the number of patients increase. State officials are opening makeshift hospitals to treat the rapid surge in patients.
“You will see this in cities all across the country,” Cuomo said, adding, “Where we are today you will be in three weeks or four weeks or five weeks or six weeks. We are your future.”
But comparing state caseloads is difficult due to a lack of consistent testing. As of Monday, Colorado ranked 12th in the U.S. for the number of confirmed cases, and tied for 11th for the number of deaths, according to data compiled by Johns Hopkins University.
So far, there are more than 900 known cases of the novel coronavirus in Colorado. Of those, 84 people are hospitalized and 11 individuals have died.
But state officials cautioned against comparing Colorado and New York, given the differences in populations and testing capabilities.
Experts warned, however, that the number of new coronavirus cases in Colorado can still reach a level that strains the state’s hospitals. And the state health department is preparing for the influx of patients by examining how to increase capacity, including looking at dorms, empty buildings and large gathering places.
“People need to take this very seriously,” said Scott Bookman, who is overseeing the Colorado Department of Public Health and Environment’s response to the new coronavirus.
“This is a deadly illness that is spreading, and while cases will be mild to moderate in 80% (of people), we expect to see thousands of cases across the state before this is done, if not hundreds of thousands,” he said.
Coronavirus in Colorado
“It doesn’t stop it”
Social distancing policies, such as stay-at-home orders and crowd limits, will slow the spread of the new coronavirus in Colorado. But it will take weeks for their effects to show because the policies were implemented after the disease already was widespread.
“It’s probably going to just continue to rise exponentially for a couple of weeks,” said Ira Longini, co-director of the Center for Statistics and Quantitative Infectious Diseases at the Emerging Pathogens Institute of the University of Florida. “The main thing that it does is slow down the transmission (of the virus). It doesn’t stop it.”
Social distancing can slow the transmission of the new coronavirus by increasing the physical distance between individuals. The new coronavirus mainly spreads when an infected person coughs or sneezes, and those who are within six feet of an infected person are most at risk. Symptoms include a cough, fever, body aches, fatigue and shortness of breath, according to the U.S. Centers for Disease Control and Prevention.
Symptoms of COVID-19 can be mild and feel like a cold in the first few days, according to the state Department of Public Health and Environment.
Gov. Jared Polis has ordered measures, such as closing schools and large gathering places, since state officials first confirmed the presence of the disease in Colorado on March 5. But he has stopped short of issuing a statewide stay-at-home order.
“We just have not seen the mass levels of community transmission across the state that would make it necessary to initiate this order statewide,” Bookman said.
Community transmission occurs when a person tests positive for the new coronavirus but health officials can’t find a source for their exposure, such as travel or contact with a known infected person. State health officials have identified community spread in multiple Colorado counties, inducing Denver and Eagle.
Colorado needs to expand access to testing in the coming months so that health officials know where people are still becoming sick after the state’s social distancing policies are more effective, Bookman said.
“We’re behind where we should be,” he said. “There should have been widespread testing supported at the national level from the beginning.”
“Potential of a resurgence”
One challenge state and local officials will face is determining when to lift the shutdown orders.
The polices can work to slow the spread of the new coronavirus, and in turn, potentially soften the burden on hospitals. But they come with an economic price as businesses close and residents reduce spending.
It’s also unknown, experts said, if there will be an increase in new cases when people return to work and to public spaces. Other countries hit by the coronavirus pandemic, such as China, are just beginning to lift their shutdowns.
“There’s always a potential for a resurgence, if there’s still people out there who are still sick,” said Kathryn Colborn, research director for surgical outcomes and applied research at the University of Colorado’s Anschutz Medical Campus.
State health officials have said they are concerned about a shortage of hospital beds as more people become ill.
If about 40% of the Denver-area population became infected with the new coronavirus in the next 12 months, there would be about 195,000 patients — 6,510 of who would need beds, according to a study by Harvard Global Health Institute and ProPublica.
“One thing you have to consider really in all of this is can you suppress the transmission long enough to prepare hospitals, health care systems for the number of cases they might see,” Colborn said.
The Denver Post’s David Migoya and Kevin Hamm contributed to this report.
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