An Update Snapshot of Colorado's COVID-19 Response - Colorado Academy of Family Physicians

The office of Governor Polis has provided some updates and information about the state’s pandemic response. We have lightly edited this information for the benefit of our members.

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Topline Update

As of 4/1/20, Colorado has 3,342 cases and 620 hospitalizations out of 18,645 completed tests. Tragically, there have been 80 deaths to date.

Yesterday, the Governor provided an overview of what the state must do to return to economic and societal normalcy:

Reduce the rate of infections to a level where each Coloradan is infecting fewer than one other Coloradan. At this point, the virus begins to die out.
Build out capacity in our medical system so that we can treat everyone who gets sick and save lives.
Resolve supply chain issues so that we can establish a mass testing and containment program so that we can quarantine and isolate on a case-by-case basis instead of these onerous distancing measures that amount to quarantining our entire society

The Governor also provided a critical update on the state’s ability to obtain Personal Protective Equipment as well as an overview of how the state is building out medical capacity to meet the coming surge of cases. A link to the presentation that the Governor presented during yesterday’s press conference can be found here.

Personal Protective Equipment Update

Not only is COVID-19 a health care crisis, it is a supply chain crisis that has hampered our abilities to effectively respond to the health care needs.

The Governor submitted an official request to Vice President Pence requesting what we need from the Strategic National Stockpile in terms of equipment.

Here is what Colorado has received from the federal government so far:

N95 Masks: We have gotten 220k out of 2M requested
Surgical masks: We have gotten 517k out of 4.6M requested
Face Shields: We have gotten 350k out of 880k requested
Surgical Gowns: 100k out of 720k requested
Gloves: 504k out of 4.3M requested
Ventilators: 0 out of 10k requested

One of the biggest challenges is that personal protective equipment (PPE) and ventilators are in demand across the country and around the world, so everyone is competing against each other to get it. What Colorado has received from the national stockpile won’t last beyond a few days of need.

The state has asked every relevant sector of the economy to do an inventory, and offer up to the health care system any PPE or DME (Durable Medical Equipment) they have to spare.

They are working to build entirely new supplier relationships with global companies to acquire PPE.

They are also working with manufacturers within Colorado and all over the world who are repurposing their operations to make these needed supplies.

To date, the state has placed a series of orders with various suppliers, and will continue to place orders as they identify reputable manufacturers both in Colorado and across the globe.

Once the state physically obtains this equipment, it needs to test it to make sure that it is safe for doctors, nurses and patients alike. At this point of this crisis, PPE equals lives. Ventilators equals lives. It’s the difference between healthcare workers being able to treat the sick, and falling ill themselves.

The governor’s office promises to work with anyone and everyone who can provide this equipment until Colorado’s needs are met.

Medical Surge Capacity

Healthcare institutions across the state have been preparing for COVID-19 for many months and have taken steps to increase internal capacity to prepare for a surge of patients.

The role of the state is to:

Support healthcare systems with coordinated access to private sector resources to acquire PPE, ventilators, and other equipment
Coordinate the recruitment and utilization of volunteer medical professionals to provide surge capacity within the healthcare system
Provide information on the status of the healthcare system
Create systems that overlay the normal healthcare system to provide coordination and response when the healthcare system becomes overwhelmed

Based on epidemiological models, and depending on the effectiveness of social distancing measures like school closures and stay-at-home orders, Colorado can expect to see a surge of patients that will overwhelm hospitals between April and July 2020. Their objective is to delay the peak so it is not as severe, and so it buys the state time to build more capacity, get more PPE, and save lives.

Based on clinical evidence from areas previously hit with the COVID-19 outbreaks, patients who are severely ill will require intensive care and will be ventilator dependent for an average of 11 to 20 days.

Just like in normal life, some cases are more critical than others. So the state has developed a four-tier system to classify patients, and has matched the appropriate class of patient with the type of facility that will best meet their needs.

This chart details the four-tier plan, and when they expect to have the additional capacity built.

In addition to the bed construction, the state is working to establish a patient transport unit so that patients can be transported to the appropriate facility as their symptoms progress. They believe that this plan — along with the drastic physical distancing measures that everyone is taking — will allow them to deal with the surge of patients without overwhelming our public health capacity here in Colorado.

Stay in Primary Residence

The state has gotten reports of an alarming increase in people who own a second home in the mountains traveling there. As a reminder, this is not a vacation. The mountain communities have a much higher rate of infection than the rest of the state and anyone traveling there now is putting themselves and others at additional risk.

Furthermore, from the beginning, there is extreme concern about overwhelming the public health systems in isolated mountain communities that do not have the capacity to handle a surge in positive cases. No one can afford to put extra pressure on small mountain health care systems, as EMS, Law Enforcement, hospitals are already strained, and grocery stores are already struggling to keep up with demand just from local residents, much less an influx of second homeowners who think this is an opportunity for a vacation.

To Coloradans and out-of-state home owners: Please stay in your primary residence. It is much more likely that your primary residence has better access to necessities and health care resources than our mountain communities that are having a much more difficult time dealing with this crisis.

Evictions and Utility Bill Notices

During this unprecedented time, Coloradans should not have stress over rent, mortgage payments, or utility bills adding to the other anxieties caused by COVID-19. That’s why on March 20, 2020, Governor Jared Polis issued Executive Order D 2020 012, ordering Colorado state agencies to work with property owners, mortgage companies, and utilities providers to limit evictions, foreclosures, and public utility disconnections while Colorado is in a state of emergency.

Furthermore, the federal government has passed legislation that will give individuals making under $99,000 per year up to $1,200 in cash assistance, including $500 for each dependent.

Finally, Colorado is encouraging those who have lost wages or lost their job because of this crisis to apply for unemployment insurance at https://www.colorado.gov/pacific/cdle/unemployment

If you know you won’t be able to pay for these vital needs, or are concerned about your ability to pay in the coming months, please review the steps that have been taken by both government and private industries, to see how they may impact you. You can also find resources for assistance with payment of rent, mortgage, and utility bills by visiting www.211colorado.org or by dialing 211 on a phone.

The teams at the Department of Local Affairs (DOLA) and at the Department of Regulatory Affairs (DORA) have pulled together the attached document that shares resources with consumers to help with these issues during this time of crisis.

Extension of School Closure E.O. to April 30

Yesterday, the Governor announced the extension of the closure of all schools through April 30. This is consistent with the President’s views that restrictions on in-person gatherings should go on for at least the month of April. The practice of announcing executive orders for 30 days is something that typically happens during times of crises. The state expects that many districts will make the decision to stay closed for the remainder of the school year; for now the Governor believes that the best statewide policy is to remain closed until April 30th.

Across the state, superintendents, school leaders, and educators are stepping up to build remote learning plans so students don’t lose out on valuable instruction because of this crisis. The state acknowledged that the extension of closures will be tough news for parents, including those who are juggling working from home and helping their children with schoolwork. But this is the best way to keep everyone safe, prevent the spread of coronavirus, and prevent unnecessary death.

UPDATE: Special Enrollment Period Extended to April 30th

The special enrollment period for the state’s health care exchange has been extended to April 30th. If you are or someone you know is currently uninsured or if you have temporarily lost your job due to COVID-19, please take advantage of this special enrollment period to get affordable health coverage. Visit connectforhealthco.com and enroll today.

DACA

The Governor is calling on the federal government to extend protections for DREAMers through 2020. They want to be 100% focused on the crisis at hand, and many DACA recipients work in critical services including healthcare and law enforcement. The state does not believe they should be expending resources to throw people out of the country who were brought here as children through no choice of their own, and many of whom know no other home than America.