In light of the state public-health department's decision to retire the state dial order, Tri-County Health Department collaborated with health agencies across the Denver metro area to discuss local orders that would extend certain virus restrictions past April 16, according to John Douglas, the head of Tri-County Health.
Counties in the Metro Denver Partnership for Health — which includes Boulder, Broomfield, Jefferson and Denver counties as well as Tri-County's jurisdiction of Adams, Arapahoe and Douglas counties — were expected to see similar public health orders to Tri-County's although they may vary in some ways, Douglas said at an April 13 news conference alongside Gov. Jared Polis.
The Tri-County Health Department's board of health voted to extend a modified version of the state's dial framework for one month during an April 8 meeting, impacting Adams, Arapahoe and Douglas counties.
The Colorado Department of Public Health and Environment plans to repeal the dial, which has set restrictions for each county based on COVID-19 data, on April 16.
After the state's dial is removed, Tri-County's order would move its counties to one level lower on the dial, loosening restrictions. The exception is Arapahoe County, which was in level blue as of April 12 but had virus metrics — such as rate of new cases — that sat above the limit for level blue based on the state's dial system. Arapahoe will remain in blue if its state dial metrics still reflect level yellow, which is one level stricter, on April 16, according to Tri-County.
Adams and Douglas counties were in level yellow as of April 12 and could move down to blue.
Those changes would continue until May 15, according to the order. At that point, as long as there isn't another surge in hospitalized cases, those counties would lose all restrictions and go into an observational period.
Dr. John Douglas, executive director for Tri-County, recommended this path forward after noting a rise in cases in the communities. He's also voiced concern about the continued spread of variant strains of COVID-19 in the state.
“If we can just get (one more month) under our belt, (we'll be in better shape),” Douglas said in an Arapahoe County town hall shortly after the measure was approved.
Tri-County isn't the only health department planning to continue use of the dial, however. During the board of health meeting, Douglas said that all the metro counties' health departments are planning to do the same. Denver may have a longer dial extension, he said.
Jefferson County Public Health announced plans on April 9 to also extend the dial until mid-May, according to social media posts from the agency.
The Tri-County plan has support from both Adams and Arapahoe county leaders, said Jennifer Ludwig, deputy director for Tri-County, during the meeting. Douglas County leaders have “clearly expressed reservations,” Douglas said.
During an April 6 meeting with Douglas County leaders, Commissioner Abe Laydon said he would not support the order being continued in the area.
“With all due respect, John, I'm remarkably disappointed that you would suggest we should continue under a public health order based upon your expertise,” Laydon said to Douglas. “The purpose of many of these orders and the dial was to protect the vulnerable but the vulnerable no longer exist.”
Douglas responded by noting that under the board of health's new policy, any of the three counties are able to opt out of the public health order. This policy was put in place after Douglas County commissioners announced a plan to leave the health agency. Negotiations in November of 2020 resulted in Douglas County remaining with the health department through at least 2022 in return for the new policy.
“I am sorry that I am putting any of you in a difficult place … as I try to carry out what i feel like are my professional and moral obligations,” Douglas said in the April 6 meeting. “I take the health of everybody, our businesses, our school children, our residents very seriously and ... we will continue to try to do the best we can as we transition back to as full a return to normal as possible.”
Douglas County announced April 9 that commissioners had directed staff to draft a resolution to opt-out of the public health order. They planned to vote on the resolution at an April 14 meeting.
“Douglas County will remain guided by accurate public health data, including high vaccination rates of vulnerable populations, coupled with low hospitalizations and deaths," according to a joint statement from the commissioners. "These science-driven metrics balanced against job losses, business closures and mental health consequences require that we exercise our local control authority on behalf of the people of Douglas County."
Cities and towns were able to opt out of Tri-County's mask-wearing order on their own — with counties able to opt out unincorporated areas, which are outside of cities and towns — but only the counties have the authority to opt out under the dial extension order, Tri-County and Douglas County spokespersons confirmed. So if a county opts out, its municipalities are opted out too, they said.
The modified dial that Tri-County plans to put in place would do away with many of the portions of the original dial, including restaurant contact tracing and extra sanitation requirements. While the state's outline for the dial is more than 70 pages, Tri-County's will be fewer than 10, Ludwig said.
The modified dial outlines guidelines including capacity restrictions, social distancing, signage and ventilation. There is a separate Tri-County mask order until June 30, which was recently altered to no longer include outdoor areas. Douglas County and all of its municipalities other than Lone Tree have opted out of that order.
The Tri-County dial is planned to include two phases: first a one-month continuation of restrictions, followed by a fully-open three-month period of observation. During the second phase, the health department will monitor hospitalizations to determine if any further restrictions are needed.
Tri-County's dial order, dated April 9, includes a chart of capacity restrictions for restaurants, other businesses, indoor and outdoor events, and other settings that is generally the same as the state's current dial chart of restrictions.
The recent seven-day rolling average of hospitalizations in Arapahoe has been about 1 per 100,000 people, Adams has been a bit over 1 and Douglas a bit under 1.
Under Tri-County's new dial order, restrictions would return after May 15 if a county reaches a hospitalization rate of 2 to 3 per 100,000, moving it from "level clear" — the fully open stage — back to level blue. That wouldn't happen unless hospitalization rates return to the numbers that were roughly seen between early November and early January, according to Tri-County.
Technically, Tri-County will use 14-day rolling averages rather than the seven-day rolling averages it has shown on its website, but the order cites seven-day averages as an example. Tri-County was to start putting each county's 14-day rolling hospitalization average on its online data tracker by April 12.
Under Tri-County's order, counties would move to dial levels based on their rate of hospitalizations, whereas under the state's dial system, the level a county qualified for on the dial generally depended on the county's rate of new cases and its percentage of COVID-19 tests that come back positive, along with its hospitalizations.
See the new Tri-County chart of restrictions and the text of the order here.
“Everybody wants this pandemic to be over, me included,” said Julie Mullica, a board of health member representing Adams county. “I think it's important to be cautious, especially with uncertainties when it comes to variants and things like that, we don't know how it's going to be affecting our communities.”
The motion passed with all but one board of health member voting in favor.
“I'm opposed, I have to support my constituency,” said Dr. Linda Fielding, a representative for Douglas County. “I still, for various reasons, do not entirely agree with this but I do think it's a valiant and well-intentioned effort.”
The 5-star certification program, which allows businesses certified for following additional COVID-19 prevention measures to open under loosened restrictions, will be allowed to continue, Douglas said.
While cases have decreased for much of the year, cases per 100,000 residents, or incidence rates, have begun to increase again, according to Tri-County data. As of April 9, Douglas County's incidence rate was higher than that of Adams and Arapahoe counties.
“While we are impressed with overall improvements in what I think are important metrics, I am concerned as a public health scientist about rising case rates (and) the rising number of variants across the state,” Douglas said.
Douglas is concerned about the possibility that the variants, some of which are more easily transmissible or causing more severe illness, could slow down progress in the area in the same way that they have for other parts of the world.
“Cautious continuation of the dial and cautious observation is probably the (smartest) way forward,” Douglas said.
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