Hospitalizations at a minimum even as Garfield County COVID case numbers rise again
As the rate of new coronavirus cases and the test positivity rate have increased in recent weeks in Garfield County, one very important part of the overall equation remains in check — hospital capacity.
The county has seen its COVID-19 incidence rate per 100,000 people climb from around 80 in late September to nearly 160 as of Thursday, pushing the risk factor from “cautious” to “very high,” according to that particular metric.
Likewise, the testing positivity rate has risen during that same time period from less than 4% to 5.6%, as of the latest statistical reports from Garfield County Public Health.
That pushed the county from the “comfortable” range for risk of disease spread in that category to “cautious,” which remains the overall risk level for spread of COVID-19 in Garfield County.
Those statistics, even going back to case surges that came in July and again in early September after major holiday gatherings, have been tempered by the fact that area hospitals have not been overrun by COVID patients and have kept hospitalizations at a minimum.
In fact, hospital capacity in Garfield County has remained in the “comfortable” range for most of the duration of the pandemic.
“Hospital capacity is a very important component of those markers,” said Dr. Brett Hesse, hospitalist and Emergency Department doctor at Valley View Hospital in Glenwood Springs.
“The fact that we’ve been able to remain at the comfortable level really reflects the expanded testing capacity,” Hesse said of one of the main factors in diagnosing cases early and starting treatment before hospitalization may be necessary. “We have been able to test more people, where at the beginning (of the pandemic) we didn’t have access to that testing capability.”
Valley View has been averaging between about 470 and 515 COVID-19 tests per week for the past month. During that time, it has had 69 tests come back positive, for a positivity rate of about 3.4%.
Grand River Health in Rifle has averaged 152 tests per week during that same period of time, but with a much higher positivity rate of 13.3%.
Another of the region’s bigger testing facilities, Mountain Family Health Centers, with locations in Glenwood Springs, Rifle and Basalt, has tested an average of between 75 and 100 people per week over the last three weeks.
It’s positivity rate has gone from about 12% three weeks ago to 21% in the most-recent seven-day period, said Ross Brooks, CEO for Mountain Family.
Those who are hospitalized, which for Valley View has been just 75 people since the outbreak began, are now being treated more effectively than in the early days of the outbreak. That results in shorter hospital stays and, more importantly, fewer deaths.
Garfield County has had five COVID deaths since the outbreak began locally in March, and none since early September even as case numbers have continued to climb.
The more recent cases have also been in younger age groups, primarily those of typical working age. To date, the largest percentage of cases in Garfield County have been in the 20-29 age group (22.6%), followed by those ages 30-39 (19.5%) and 40-49 (16.4%).
“The highest incidence rate has been among younger people who are less likely to require hospitalization,” Hesse said. “And when they do contract it, they fare better than someone who is older.”
In general, even among older patients, treatment for COVID-19 has evolved substantially in the months since the outbreak began. In particular, steroidal treatments, such as the use of Dexamethasone, have proven to be effective.
“It has been a challenge for us as we adjust to COVID,” Hesse said. “But we have an amazing team of physicians here, and I would put our local team up against any in the country in bringing in the best evidence and carefully vetting every treatment.”
The latest increase in positive case numbers in Garfield County, as across Colorado, is consistent with people moving about more, Mason Hohstadt, public health specialist with Garfield County, said during the Monday public health update to county commissioners this week.
According to cell phone data tracking people’s movements that the Colorado Department of Public Health and Environment uses as one of its measures, the amount of time people are staying at home in Garfield County has gone down from about 75% of time over a week’s period during the height of stay-at-home orders in the spring, to about 25% in recent weeks.
That can be attributed to more people being out and about not only for work purposes, but also is related to schools being back in session, as well as shopping and frequenting restaurants, Hohstadt said.
“That isn’t really a judgment on anyone … and it isn’t saying that people are making unnecessary trips,” Hohstadt said. “It just shows that work and workdays are where we see the highest mobility.”
At the same time, people are still tending to stay around home on the weekends, he said.
The important thing for people to remember when they are out in public, whatever the reason, is to wear a mask, keep a safe physical distance from others and limit the number of contacts with people, Hohstadt said.
Hesse and Brooks echoed that message.
Brooks noted that Mountain Family has seen the same trends in its testing results as those countywide, with peaks in new cases after major holidays when people are more likely to have social gatherings.
But a big driver for Mountain Family clients is the fact that many of them tend to be low-income, and working service-sector, construction and hospitality jobs where social distancing is harder to accomplish.
“A lot of people carpool to work and are in places where it’s harder to maintain separation,” Brooks said. “A lot of the people we see don’t have jobs where they can work at home, and have to be on-site to work those jobs.”
Added Hesse, “We’re all getting a little COVID fatigue, and it’s easy to say we just have to live with this. But it’s still super important for people to understand that we have to keep our guard up.”
That means continuing to follow the “three W’s,” which are to wear masks when in public places and around other people, washing hands regularly, and watching your distance when interacting with others, Hesse said.
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