COVID-19 statistics do not reflect the realities on the ground in rural southern Colorado
by Mark Craddock
OUR WORLD — On Monday, March 23, the Las Animas-Huerfano Counties District Health Department announced Huerfano County’s first confirmed case of COVID-19.
Director Kimberly Gonzales said the 64-year-old man had recently traveled to an area with a large number of COVID-19 cases and self-quarantined when he returned home. After developing symptoms, the man was tested Friday.
On Monday, the results came back positive. Gonzales said the patient is working with public health officials in the ongoing investigation to identify people with whom he may have had close exposure.
But the story beneath this headline is that the man is only the sixth person in the Huerfano County to have been tested for COVID-19 since the Centers for Disease Control and Prevention started testing for the virus on Jan. 18, 2020.
The other five tests are still pending, Gonzales said.
Gonzales said that, as of 10 a.m. Monday, Trinidad’s Mt. San Rafael Hospital had performed 32 tests. Twenty-four came back negative and the rest have not been processed.
And a polling of county health departments throughout rural southern Colorado shows a similar pattern of low testing and slow results, which experts say almost certainly skew the statistics downward and mask the true nature of the COVID-19 danger in rural Colorado.
“It is acknowledged as fact — we all understand that — that the number of (COVID-19) cases in a community far exceeds what we know from tests,” Mike Willis, director of the state Office of Emergency Management, said in a Tuesday press conference in response to a World Journal question. “I think absolutely it’s safe to assume that the spread is greater than the number of actual tests by quite a lot.”
Otero County Administrator Amy Tanabe, who is serving as PIO for the county’s COVID-19 response, said 19 tests had been performed there. She didn’t have a firm number, but said many of those test results are still pending.
Meanwhile, Richard Ritter, executive director of the Otero County Health Department, was in nearby Crowley County this week, assisting with the investigation of a death of a person presumed to be suffering COVID-19, who had not been tested. As of Tuesday, the CDPHE statistics listed Crowley County as having one coronavirus case.
Linda Smith of the San Luis Valley Public Health Partnership said she did not have firm testing numbers Monday, given the scope of the agency’s reach. The partnership is a consortium of the public health agencies in Conejos, Costilla, Alamosa, Rio Grande, Mineral and Saguache counties – basically the entire San Luis Valley.
But she echoed other rural county health officials in admitting testing is sparse and results are slow, and their abiding worry that the lack of positive cases may lead to an unrealistic sense of safety.
“The tests are more limited than what we would like, and that is true all over the country right now,” she said. “Rio Grande County did have a couple positives this morning. For our region, at least, some of that complacency is going to evaporate.”
The example that perhaps most vividly illustrates the frustrations facing local public health officials is a case in Westcliffe.
A man in his 50s is being considered a probable positive because he has been in close contact with a known positive patient and is experiencing symptoms that are consistent with the disease, Elisa Livengood, Custer County public health director, said late last week. That patient and his entire family have been quarantined, she said.
The problem is, the county had no tests available last week.
“We tried for 12 hours (on March 17) to get a test. But we’re not a priority right now,” she said. On Monday, Livengood said the county has two tests pending results, “the only tests we’ve been able to get. We could use more.”
In the absence of testing, Livengood said she is treating the patients as positive and proceeding with quarantine and contact investigation. The man had been working in construction on the Custer County Courthouse and, given his presumed-but-untested COVID-19 status, the courthouse was closed until April 1 and health officials are tracking down a host of possible contacts.
“It is making it difficult,” she said. “I have to put a lot of people on quarantine because people have been exposed to presumed-positive people all the way from the courthouse on down. It feels like it’s only a matter of time before everyone is in quarantine because we can’t verify people’s status.
“In a perfect world, we would have testing for everyone who needed it, and we’d get it before five days. But that’s just not a reality right now. We’re just keeping up the fight right now – jut presuming positive and quarantining people with any symptoms.”
At his Sunday, March 22, press conference, in which he ordered Colorado businesses to reduce their in-house workforce by 50 percent, Gov. Jared Polis also announced a task force to tackle the anemic level of COVID testing so far.
Polis’ Innovation Response Team is charged with “ramping up a mass testing program for the COVID-19 virus, creating a suite of services for citizens under isolation or quarantine, developing mobile and other technologies to help track the spread of the virus and support infected citizens, and developing locally sourced alternatives for constrained critical medical supplies,” according to Polis’s office.
If successful, Willis said, mass COVID testing will certainly allay concerns of rural communities. It should give a clearer snapshot of the epidemic, in order to better distribute resources and target governmental action.
“(Polis) is hopeful that down the road, and this will take some time to build this understanding of COVID in the state, but down the road instead of having to do things that we are doing now such as the stay at home orders, we can be more geographically specific and issue stay-at-home or social distancing orders to very specific areas because we thoroughly understand the degree of outbreak.”
Meantime, Willis said, aggressive “social distancing” is everyone’s responsibility.
“You cannot undervalue the need that, if you have symptoms, you must self-quarantine to prevent the spread,” he said. “If you’re sick, stay home. That applies everywhere in the state.”
Back in Custer County, with her whopping three COVID tests in tow and an infection investigation underway, Livengood was a bit more blunt.
“It feels like it’s only a matter of time before everybody in the county will be quarantined because we can’t verify their health status.”
During Polis’ Sunday press conference, he took the notion of social responsibility a step further. “It is not the threat of you being brought to prison,” he said.
“It is the threat of death.” As of Tuesday, March 24, 4:15 p.m., the CDPHE reported Colorado had tested 7,701 people. The total COVID-19 cases statewide stood at 912, with 84 people hospitalized and 11 deaths. The state has confirmed COVID-19 cases in 35 of Colorado’s 64 counties. The counties reporting no cases are almost exclusively low-population, rural areas in the San Luis Valley, southern Colorado, eastern Colorado and the far northwestern corner of the state.
