Colorado is having a moment of deja vu as some of the state’s mountain communities once again have become hot spots for the novel coronavirus despite the months-long decline in new infections statewide.
Counties in the high country have staved off a significant rise in hospitalizations, but public health officials say there is concern as increasing infections in one region of the state could spark a spike in cases in another — especially given the new, more contagious variants circulating in Colorado.
A cluster of counties in southwestern Colorado is seeing high enough COVID-19 transmission that the region is approaching 1 in 30 people being infectious, leading some local authorities to implement targeted restrictions on indoor dining, lodging and gatherings.
“Colorado is a connected state, meaning that an outbreak in one region or a high level of infection in one region can spill over into another region,” said Beth Carlton, an associate professor of environmental and occupational health at the Colorado School of Public Health. “We’ve seen this again and again with the pandemic.”
It’s reminiscent of the early days of the virus — the first confirmed cases were found in mountains after visitors from other states and countries tested positive for the disease COVID-19.
And somewhat similar to a year ago, when scarce testing meant the state didn’t know exactly how widespread the virus was, it’s not yet known how widely the new variants are spreading undetected. Variants have been confirmed in at least 20 counties, including San Miguel, Garfield, Gunnison, Routt, Delta and Summit.
“We approach it from the perspective that it’s likely to be here but we have just not found it yet,” said Heath Harmon, director of Eagle County Public Health and Environment. A variant has not yet been confirmed in his county.
Public health officials said there are multiple factors that are elevating coronavirus infections in some areas of Colorado’s mountains, including winter weather, the influx of visitors into ski towns, and the fact that many essential employees live together in dense housing.
“Concerned that infections are increasing”
Infections and hospitalizations from the novel coronavirus are decreasing in most places across the state, but the opposite is happening in some of the state’s mountain communities, according to Colorado researchers tracking the trajectory of the pandemic.
In two of the regions tracked by the researchers, the Central Mountains and the West Central Partnership, the R0, or “r-naught,” value — which reflects the average number of people infected by one person — is likely higher than 1, according to the latest report from Gov. Jared Polis’s modeling team. This means that each person with the virus is potentially transmitting the disease to more people.
The Central Mountains region includes Eagle, Garfield, Grand, Pitkin and Summit counties. The West Central region covers Delta, Gunnison, Hinsdale, Mineral, Montrose, Ouray and San Miguel counties.
These communities are small, so the estimates of viral transmission for the regions in the modeling report tend to fluctuate frequently. And in some individual counties, such as Pitkin and Eagle, cases have declined since mid-January.
Public health officials are “not only concerned that the infections are increasing but that the percent of the population infected is high,” said Carlton, a member of the state’s modeling team. This means that contact with other people becomes riskier in these communities, she said.
Coronavirus cases are increasing at the highest rate in the West Central region, where it’s estimated that 1 in 33 people are infectious. In the Central Mountain region, an estimated 1 in 119 people are infectious, according to the Feb. 16 report.
By comparison, in the Denver metro area, where infections are decreasing, an estimated 1 in 172 people are infectious and the region’s reproduction number is below 1.
“The amount of tourism is a little surprising”
Mountain communities are particularly vulnerable to the spread of the novel coronavirus because they attract tourists from other parts of the state or elsewhere in the U.S. who come and mix with locals in town.
“People come to the mountains to play in the winter,” said Mike Bordogna, spokesman for the San Miguel County Department of Health and Environment. “So we have this giant mixing bowl and when you factor in bringing in people from all 50 states and different countries… it’s a potential recipe for virus exposure.”
Skiing itself is not a big spreader of the novel coronavirus, Carlton said, but the other activities that take place when people gather indoors without masks, such as going to restaurants and bars, or carpooling, can lead to transmission.
Mobility data shows that ski towns saw about 60% fewer visitors this past holiday season compared to last year and most of the visitors were coming from other states, such as Texas and Florida, said Jude Bayham, a Colorado State University faculty member and member of the School of Public Health’s COVID-19 modeling team.
“Still, the amount of tourism is a little surprising,” Bayham said.
In Pitkin County, mobility data has shown that visitors also are spending more time at restaurants — which are high-risk areas for transmission of the virus — and are coming into contact with more people than local residents, said Jordana Sabella, interim public health director for the county.
Health officials also have found that when there is an increase in the number of mobile devices pinging in the county, a rise in coronavirus cases follows seven to 10 days later, she said.
“The risk now is that tourists might introduce new variants and some are potentially more transmissible,” Bayham said. “There’s a concern that it would do a similar thing as last spring with these variants.”
Growing populations, dense housing
More people also have relocated to the mountain communities since the pandemic began. For example, San Miguel County has seen an increase of 20% in full-time residents, Bordogna said.
“We know that a lot of second-home owners relocated here to the mountains,” said Harmon, with Eagle County Public Health. “It ties into the theme that the pandemic is really driving some migration of Americans moving to different communities.”
Housing costs are expensive in the mountain communities so residents often live with one or more people. This is especially so for essential workers, who are more likely to hold multiple jobs, which can increase their exposure to the virus, Bordogna said.
At Winter Park Resort in Grand County, more than 100 employees have tested positive for the novel coronavirus. The outbreak, first declared on Jan. 23, is one of 19 current outbreaks connected to ski resorts, according to data from the Colorado Department of Public Health and Environment.
“The vast majority of the cases were tied to social gatherings outside of the workplace and shared housing,” Winter Park spokeswoman Jen Miller said.
Since the outbreak, the resort is requiring staff members who live in employee housing to wear masks in common areas and has prohibited outside guests.
Grand County public health officials also have placed restaurants based at Winter Park Resort at Level Red restrictions, meaning they can no longer offer indoor dining. The restrictions also affect at least two other businesses that were not publicly identified.
Miller said that none of the restaurants operated by the resort have offered indoor dining since it opened in December. However, independent restaurants that are based at the resort were affected by the new restrictions.
Health officials targeted Winter Park and the town of Fraser specifically rather than moving the entire county to higher restrictions because they are the areas with the highest transmission, wrote Grand County Public Health Director Abbie Baker wrote in a Feb. 15 letter published by Sky-Hi News.
“I want to see us go from second highest transmission in the state to one of the lowest as soon as possible,” she wrote.
As of Friday, Grand County had a one-week incidence rate of 419.9 infections per 100,000 people, according to the state health department’s color-coded dial.
Moving to “Level Orange Extreme”
San Miguel County public health officials also have implemented similar targeted restrictions after noticing higher transmission of the coronavirus in the east side of the county, which includes Telluride.
The new restrictions, which are being called Level Orange Extreme, reduce lodging occupancy to 50% while gatherings are limited to members of just one household. Restaurants and bars can still offer indoor dining, but only customers from the same household can sit at the same table and masks must be worn except for when people are actively eating or drinking.
San Miguel had an incidence rate of 538.3 infections per 100,000 people the week ending on Feb. 14, according to the county’s data — though Bordogna noted the rate of infections in the county has improved in recent days.
By comparison Denver, had a one-week incidence rate of 88.70 infections per 100,000 people, according to state data.
The main difference between Level Orange Extreme and Level Red restrictions would be that if the county moved to the latter, restaurants and bars would close indoor dining, Bordogna said.
He said the county is trying to avoid that because when the restaurants shut down in San Miguel County last year, health officials found that many employees traveled to visit their families or to go on vacation and then came back after potentially being exposed to the coronavirus.
“Red is also… not off the table,’ Bordogna said. “If our numbers start trending in the wrong direction we’ll revise again.”
Denver Post reporter Meg Wingerter contributed to this report.