Don’t reopen too quickly

It’s critical that Colorado does not open too quickly. If we reopen too quickly, while the virus is not contained, all of the sacrifices we’ve made during our temporary shutdown could be for naught and people could contract COVID-19 and lose their lives unnecessarily.

COVID-19

Drive up testing - Staff photo
Allison Conwell

Public health experts have identified two key indicators for when it’s safe to lift a shutdown:

  1. Less than 3% of people tested should have a “positive” test result. At that level, we can effectively trace new cases and contain new outbreaks.
  2. The rate of new daily cases should be less than 1 per 100,000 people in the population.

On February 7, 4.70% of people who got tested received a positive result, and the 7-day average test positivity as of that day is 4.21%. As of February 8, our state had 26.2 new daily cases per 100,000 people

While guidelines by the World Health Organization indicate that test positivity should be under 5% to indicate that enough cases are being detected, a paper from the Harvard Global Health Institute suggests a test positivity of 3% along with comprehensive contact tracking and tracing is needed to contain the spread of the virus. 

Colorado should make decisions based on the lower test positivity rate recommendation because 40-60% of the virus spread is due to people who do not show symptoms

In addition, these rates must be accompanied by enough testing and contact tracing to make sure that everyone who has been in contact with a person who has tested positive for COVID-19 knows they could have the virus and quarantines. 

The Brown University School of Public health suggests Colorado conduct 914 tests per 100,000 people, or between 52,000 and 53,000 tests, per day to make sure that everyone who has the virus knows they have it and needs to quarantine. The state hasn’t reached 50,000 tests per day since January 6. We have more work to be done on testing to be ready to suppress the spreading of the virus.

Based on where we need to be to safely reopen, we need to wait, until we see less than 3% of people getting tested receiving a positive result, less than 1 new case per 100,000 people per day and we have ramped up testing again.

Unfortunately, if you are like me, you have been confused and concerned by Governor Polis’s decision to loosen restrictions in counties that had a high rate of infection and outbreaks

Some local governments like Pitkin County have since imposed further restrictions on activities to contain the spread of the virus. I applaud counties that make the hard decision to impose restrictions to slow the spread of the virus and caution against reopening in a way that doesn’t help us contain the virus. 

Given the need to ensure the public and decision makers know the true risks around our current COVID numbers,  I’m particularly frustrated that last week, the state also proposed changes to our COVID Dial that I think could weaken our ability to suppress the virus by giving Coloradans and local decision makers a false sense of security. 

Dial changes include adjusting the time period that counties have to move between categories and increasing the number of cases per 100,000 people in a given county for many of the categories while still allowing high-risk activities like indoor dining. 

Specifically, I’m concerned the new COVID Dial 2.0 allows for indoor dining at 25% capacity when test positivity is 10%, and when there are as many as 500 cases per 100,000 people over a one-week period. Both of these metrics are above what the Harvard Global Health Institute recommends. 

Hawaii presents an example of why waiting to hit these numbers is important. 

The state rolled back its reopening and instituted another Stay at Home order in late August when 7.5% of people had positive tests and 16.6 cases per 100,000 people. 

When the state reopened two weeks later, there were 12.3 new cases per 100,000 people, but only 2.9% of people had positive test results. By starting reopening at these lower numbers, the state was able to keep test positivity and new daily cases per 100,000 people low. As of February 8, the state has 6.2 cases per 100,000 people and 2.9% of people tested receiving a positive result.

Hawaii’s success is partly attributable to meeting public health benchmarks as part of their reopening plan. 

Local governments and the Polis administration should not reopen or rollback COVID restrictions until less than 3% of people who get tested receive a positive result, there is less than 1 case per 100,000 people and we’re testing over 52,000 people a day. 

After meeting these benchmarks, Colorado needs to reopen a little at a time, one small step at a time. Those steps should be taken only at intervals long enough that there is enough time to see the effects.

This is about saving lives. Telling the hard truths and making the hard calls now will save more lives later. Reopening too early risks unnecessary, additional suffering.

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Allison Conwell

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