GRE-L-JBSGreeleyCOVIDVax-AM0057

JBS employee Luis Arellano, left, receives his first dose of the Pfizer-BioNTech vaccine from Kaiser Permanente medical assistant Liz negron, right, during a two-day COVID-19 vaccination clinic inside the JBS Greeley Beef plant in Greeley March 5

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Colorado's COVID cases and hospitalizations have plateaued at what officials are calling a "concerning" high, as the state both loosens its COVID restrictions and enters the final phase of its mass vaccination campaign. 

Roughly 1.7 million Coloradans — about 30% of the population — have received at least one dose, and more than a million are fully vaccinated. The increase, particularly among the state's oldest residents, has led Gov. Jared Polis to start pulling out of running the COVID response from a state level. The state will more fully step back by mid-April.

As Polis and Colorado begin to look to the end of masks and closures, the disease continues to spread. Though case totals and hospitalizations had reliably dropped since their peaks in November and December, the decline has ended and has instead settled into a "stubborn" plateau, as Denver officials said Thursday.

Statewide, the seven-day average of new cases has stuttered upward over the past two weeks. Colorado's now averaging 1,143 cases every day, below the November peak of nearly 5,300. It's the highest seven-day average since mid-February. 

The seven-day average positivity rate has also moved back upward. It's at its highest point since early February, albeit still below 5% and significantly below fall highs. 

Hospitalizations, long the biggest metric for gauging the severity of the pandemic, have languished roughly at their current level for two weeks. They'd declined largely consistently since December. Three hundred and eighty-two residents are hospitalized with confirmed or suspect COVID. 

The backdrop of the state's vaccine push — and related loosening of restrictions — comes as variants continue to flex their presence here. Two variants constituted as many as 30% of the state's cases two weeks ago. There are now more than 1,000 confirmed cases of concerning variants, a number that is certainly an undercount of the current load.

State officials have for weeks couched the vaccine effort as a race against the variants: get as many people vaccinated as soon as possible, to stave off a fourth wave that could prove more deadly and more transmissible. 

Jon Samet, the dean of the Colorado School of Public Health and a state COVID modeler, said in an email that if the epidemic curve continues to turn upward, "then the timing of changes in policy measures might well be affected."

"Certainly, vaccination is of increasing benefit and hospitalizations among those 65+ have dropped substantially," he said. "Multiple possible contributors to the plateau/rise—variants, COVID fatigue, and consequences of policy changes."

Deaths and hospitalizations of older Coloradans have fallen off since January, and Samet said that "hopefully" vaccinations will bring the curve down.

But more than a third of employees at Colorado's long-term care facilities haven't been vaccinated -- a lower vaccination rate than that for the facilities' residents and other targeted groups.

Slightly more than 62% of staffers in nursing homes, assisted-living facilities and immediate care centers have been inoculated, according to data provided by the state Department of Public Health and Environment. 

The low vaccination rate among these staffers contrasts with that of their residents. According to state data, 87% of long-term care residents have been inoculated. The impact of that can already be measured in fewer hospitalizations, cases and deaths among residents, who have long been particularly at risk from the disease.

Glen Mays, another Colorado School of Public Health expert, said overall the cases and hospitalization situation is "concerning." He, too, praised the vaccination effort. But the question now "is now how many additional Coloradans will be harmed by the virus — deaths and long-term health consequences — before we get to population-level protection or herd immunity."

In a statement, a representative of the state Department of Public Health and Environment noted the high level of uptake among older Coloradans and said the state's goal has been "to protect hospital capacity." Now that that threat has been abated because of the vaccination push, the state can step back.

Mays warned that the state may want to be "more cautious in loosening restrictions."

"If the goal of state policy is to avoid a catastrophic overwhelming of the healthcare system, then we don’t appear to be in any real danger of this in the near term," he said. "So this may be a reason for loosening restrictions. But if the goal of state policy is to protect the public against serious adverse health consequences, then we are clearly not out of the woods yet."

General vaccine eligibility for every Coloradan over the age of 15 began Friday. How quickly those residents pick up the vaccine will define the next few months here.

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