Gov. Jared Polis' statewide stay-at-home order had local elected leaders and health officials grappling Thursday with how to enforce the regulation as El Paso County's death toll rose to seven, the highest in the state.

Colorado Springs Mayor John Suthers said at a news conference Thursday that "voluntary compliance" will be critical in the governor's sweeping effort to control the rise of COVID-19. Violating the order will result in warnings before tickets are issued, city officials said. 

"To be clear, this stay-at-home order from the governor is not a suggestion. It's the law," Suthers said, adding: "We simply do not have the law enforcement resources to man every park, every trail, every open space, every small business in our community."

Enforcement struggles were discussed as deaths in El Paso County rose to seven Thursday, more than a quarter of the 27 deaths reported across the state by the Colorado Department of Public Health and Environment and other news outlets. The total positive cases of COVID-19 across Colorado rose to 1,430 with 137 of those in El Paso County, according to CDPHE data.

CDPHE data lags behind one day as the agency works to track reports from each county. The death total reported Thursday by CDPHE — 24 — does not reflect new deaths in Pueblo, Boulder and Pitkin counties. Pueblo County health officials announced the death of an 81-year-old woman via Twitter. The Aspen Times reported a death in Pitkin County, and the Boulder Daily Camera reported the death of a Lafayette man, each citing local health officials.   

Health officials have speculated that El Paso County's large population of elderly residents and those with underlying health issues are a factor in why the county has topped the state for coronavirus-related fatalities.

Amid severe supply shortages, the state health department announced Thursday that thousands of testing kits obtained from the federal government will be distributed to health departments in Larimer, Mesa and El Paso counties to "promote testing of first-responders and health care workers."

Meanwhile, new cases around the state continue to rise. 

Aside from the first death in Pueblo County, two other women — one 80 and the other 82 —tested positive for COVID-19 on Thursday, a Pueblo Department of Public Health and Environment statement said. One of the women was linked to the bridge games at the Colorado Springs Bridge Center, where a woman who became the state's first coronavirus death also played. Pueblo County health officials did not respond to a request for further details.

Among the new COVID-19 cases was a Sterling-area parole officer who did not work inside a prison, a Department of Corrections statement said Thursday. The officer was put on administrative leave, said the agency, which hasn't reported any positive cases among prison inmates. 

Local health officials who spoke at the Colorado Springs news conference Thursday praised Polis' stay-at-home order, saying it would help El Paso County hospitals adequately prepare during what one hospital spokesman called "the calm before the storm."

"The big question is: How big of a storm is this going to be?" said Dr. Brian Erling, CEO of Penrose St. Francis Health Services. "We believe that with all the strategies that we're putting in place as a community that we can keep that storm to an absolute minimum."

In a statement Thursday, the state health department said Colorado must act now to stanch the virus' spread — or "flatten the curve" —  to "help hospitals to prepare for the expected surge of COVID-19 patients."

"Based on global COVID-19 rates of hospitalization and death, public health experts predict that without measures like the stay-home order, Colorado hospitals will be unable to handle the surge of sick people, and many in the state could die," the statement said.

Keeping patients with mild symptoms at home and canceling elective surgeries have kept hospitals at 60% capacity, Erling said.

"If we can control the outbreak and the speed of it and the rise of it, then we're there with those resources to give them the fighting chance to get through this," said Dr. David Steinbruner, associate chief medical officer of UCHealth Memorial Hospital. 

One local hospital official saw evidence that "social distancing" and other precautions were paying dividends. 

This week, Penrose Hospital is seeing fewer patients coming in suffering from symptoms likely associated with COVID-19 compared to a five-day period beginning March 11, said Bill Plauth, chief medical officer for Penrose-St. Francis Health Services. He attributed the higher numbers earlier this month to patients who likely caught the virus at a bridge club tournament that took place between Feb. 27 and March 3.

Since then most large gatherings in town have been postponed or canceled, which helps slow the spread, Plauth said.

"The longer we are able to delay and reduce it the better," he said.

Penrose and UCHealth hospitals have suspended elective surgeries, such as shoulder replacements, to help free up space and staff to work with coronavirus patients for the surge that is coming and they are ready for higher numbers of patients.

But the hospitals have been challenged by the lack of timely coronavirus testing results, making it difficult to conserve masks, gloves and other protective gear that are in short supply, said Erling with Penrose-St. Francis. The hospital has more than 50 patients waiting for a coronavirus test results, and although it is likely not all of them have the virus, hospital staff must use protective equipment while caring for them any way, he said.

"We have taken a very conservative approach," Erling said.

Because of the equipment shortage, hospital workers are reusing N95 masks, respirators that filter airborne particles, each time they see the same patient through their shift, Plauth said. Respirators are covered with a fresh surgical mask to help protect the patient, he said. When the hospital is not facing a shortage of supplies, N95 masks are thrown away after each visit. Reuse of the masks has been approved by the Centers for Disease Control and Prevention, he said.

Despite concerns about enforcing Polis' stay-at-home order, local, regional and state agencies were taking steps to encourage compliance.

Although parks and open spaces remain open to visitors, yellow caution tape was strewn around several Colorado Springs playgrounds Thursday as part of El Paso County Public Health and Environment's prohibition of organized sports and playground use. 

School resource officers and park rangers will be sent to city and county parks to help enforce social distancing and "unsafe behavior," Suthers said at the news conference. 

Fourth Judicial District Attorney Dan May said law enforcement will not pull over residents to randomly check why they have left home.

"We are seeing too many scare tactics in this crisis," he said.

Once educated, most residents will want to do the right thing and abide by the order, May said.

Colorado Parks and Wildlife statement said Thursday that all playgrounds, campgrounds, dispersed camping and camping facilities (including yurts and cabins) at the state parks as well as camping at state wildlife areas are closed until further notice.

All state parks' non-campground outdoor areas, including trails, boat ramps, marinas and shorelines, remain open.

The Gazette's Bill Radford contributed to this report.

Contact Liz Henderson, 719-476-1623

Twitter: @GazetteLiz

Multimedia Journalist

Liz is a multimedia journalist who joined the Gazette staff in 2019.

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