Denver metro-area counties likely headed for stay-at home orders, health chief says

Tri-County Health director hopes governor's clout will yield public buy-in for orders

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With most of the Denver metro area operating one step short of a stay-at-home order in the system of Colorado's coronavirus-related restrictions, a local public health chief says it's likely only a matter of time before the type of lockdowns seen this spring return.

Denver, Adams, Arapahoe, Jefferson, Elbert and Broomfield counties were in safer-at-home level orange, one step below a stay-at-home, as of Nov. 11. Douglas County was set to move to safer-at-home level orange on Nov. 13, according to the state's COVID-19 website. The levels of restrictions affect capacity levels at restaurants, places of worship, businesses, events and other settings.

The safer-at-home policy is the set of rules that came after the statewide stay-at-home order this spring and allowed numerous types of businesses to reopen.

In mid-September, Colorado broke the safer-at-home policy into three levels that counties are placed under based on the severity of local COVID-19 spread. The state recently switched to color identifiers — levels blue, yellow and orange rather than 1, 2 and 3 — to avoid confusion. Red is a stay-at-home order.

“Most counties in the orange level actually have case rates that are way above the threshold for being classified in the red level, and unless we can reduce rates by our residents dramatically limiting their personal get-togethers, I'm afraid that many or most of these counties will end up in a stay-at-home status," said John Douglas, executive director of Tri-County Health Department, the local health agency for Adams, Arapahoe and Douglas counties.

Douglas was one of several public-health agency directors who signed a Nov. 5 letter to the Colorado Department of Public Health and Environment, urging the state to speed up the process of moving counties to tighter restrictions.

At least some counties in the past couple months have not been moved to a stricter level as soon as local data on the virus' spread exceed the standards for remaining in a current level. For example, Arapahoe County exceeded the threshold for safer-at-home level 1, now known as level blue, on Sept. 18, but it did not move to safer-at-home level 2, now known as level yellow, until Oct. 28.

The state has generally allowed counties time to attempt to reverse their trends before being forced to move to a stricter level.

“We are concerned that with the steep acceleration of cases and hospitalizations, these delays will reduce the value of the additional restrictions provided in the higher level, essentially rendering them `too little, too late,' ” the letter says.

The letter includes signatures from health agency leaders from Denver, Jefferson, Broomfield, Boulder, Lincoln, Prowers and Kiowa counties, along with Douglas of Tri-County Health.

“Paradoxically, the ultimate outcome of these delays could be a greater likelihood of moving to the stay-at-home level that we all want to avoid and/or a greater length of time required in stay-at-home to reverse the dramatic rates of growth,” the letter adds.

Hoping for state help

At the time of the letter's date, Denver and Adams County were in safer-at-home level orange, and Jefferson County's move to level orange was already announced.

“Moving up in level (so far) hasn't been effective in Denver or really any of our counties,” Douglas told Colorado Community Media. “I think we all know that the community is tired of doing more restrictions, nobody wants to do them, and we know the governor is a big believer in local control, but we're a big believer in the bully pulpit of his office.”

“Public health directors don't seem to have as much gravitas,” Douglas added, worrying that only the clout of state officials could ensure enough public buy-in for a stay-at-home order to be effective.

The clock is ticking: Adams County's “incidence rate,” or the rate of new cases per 100,000 people over the course of two weeks, recently broke 1,000, Douglas said — nearly three times the upper limit for remaining in level orange, which is 350.

The number of Coloradans hospitalized with COVID-19 began hitting its highest marks ever recorded during the pandemic in early November. Colorado's previous record, or “peak,” of COVID-19 patients was 888 in April. As of Nov. 9, more than 1,000 people were in the hospital statewide for COVID-19.

Adams County was recently put under a curfew — essentially a nighttime stay-at-home order — to keep people in their homes from 10 p.m. until 5 a.m., with an exception for those working “critical” jobs or people with an urgent reason to be out.

That public health order for Adams, which took effect Nov. 7, includes language akin to the statewide stay-at-home order Colorado saw this spring. Denver issued a similar nighttime order in recent days.

Stay-at-home could last weeks

Douglas said it's hard to predict whether Adams and Arapahoe counties would move to stay-at-home orders by Thanksgiving. But those counties have seen increases in their restrictions roughly every couple of weeks since mid-October. Tri-County Health issued a public health order for Arapahoe on Oct. 16 that moved up the last call for alcohol and tightened limits on personal gatherings, and Arapahoe moved to safer-at-home level yellow on Oct. 28. It moved to level orange Nov. 11.

Asked if he'd expect Douglas County to move to a stay-at-home order by early December, the health chief said: “Hard to predict. Very much depends on county case trends and regional (and) state hospital capacity over next few weeks.”

Douglas also said he and neighboring local health directors are talking among themselves and with the state public-health department to figure out what level of virus spread warrants taking “the draconian step of a stay-at-home and how long it needs to go on.”

“The longer we wait, the longer it'll need to be,” Douglas said. “I think at the very least, it looks like it'll probably be several weeks. It needs to be (at least) one incubation period of the virus, 14 days. And maybe it needs to be two,” depending on how quickly metro residents change their behavior, he continued.

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