The rumors were swirling in early February that the Department of Defense had tapped the Colorado Army National Guard's facility on Fort Carson to potentially quarantine Americans fleeing Huebi province in China, the center of an outbreak of a wild new virus.
Globally, more than 30,000 had been infected. The bulk of cases had occurred in China, but several hundred additional cases had been reported in two dozen other countries.
A timeline of COVID-19 in Colorado. Since the pandemic began, Gov. Jared Polis has issued 190 “D” executive orders, with all but a handful rel…
The virus, believed to be in the same family of diseases as the Middle East respiratory syndrome, or MERS, and severe acute respiratory syndrome, or SARS — was spreading.
Colorado's U.S. Sen. Cory Gardner reassured residents that those possibly exposed to the sometimes deadly pathogen wreaking havoc overseas would likely not be housed on Fort Carson.
"That could change, but (Fort Carson officials) feel they are a very low-potential site at this point," Gardner told The Gazette on Feb. 7 after touring the facility, which had been tapped to house as many as 250 evacuees.
The evacuees never came to Colorado, routed instead to military installations in Texas, Nebraska and California.
But no bullet was dodged: The virus was almost certainly lurking in Colorado, according to top officials involved with the state's pandemic response.
While the state's first positive COVID-19 tests wouldn't be reported to the state until March 5, an individual in Colorado became symptomatic Feb. 1 and later tested positive, meaning that the virus was "quite likely" circulating the state in January, according to Rachel Herlihy, an epidemiologist with the state health department.
The virus was first reported in China in December, and the first U.S. case was identified Jan. 21. The virus was likely spreading in the U.S. by late January, but incidences were too low to be detected for weeks, according to the U.S. Centers for Disease Control and Prevention.
"We knew it was simply a matter of time before it hit," Colorado Gov. Jared Polis told The Gazette on Thursday. "We knew that with an enormous amount of visitation to the ski areas, it would very likely be in ski country."
While Herlihy didn't know the location of the patient who fell ill with the virus Feb. 1, the virus likely made its entry — or entries — to Colorado in the Denver metro and/or ski areas, she said.
"Once we began to understand what was happening globally, the inevitable happened in Colorado — this highly infectious virus arrived," echoed Jon Samet, dean of the School of Public Health at the University of Colorado. He called the virus "tricky" because it spreads before its victims fall ill, if they even do.
"We did what we had to do, but people had not experienced this sort of infection in the U.S."
September is a month full of six-month coronavirus anniversaries in Colorado, from the first reported cases March 5, to the temporary shuttering of bars, restaurants, theaters, gyms, and casinos March 16, to the closure of schools for the year March 23, to the stay-at-home order March 26.
What have Coloradans on the front line of the biggest public health crisis in a generation learned about fighting this invisible, sometimes deadly foe that spares so many, but has dealt lonely, agonizing deaths to nearly 2,000 of the state's residents? How well has the state performed when compared to others? And what might the next six months look like here? Is there an end in sight to this bizarre "new normal"?
In a bid for answers, The Gazette spoke to some of the top players in the state's fight against COVID-19. Their collective message, spoken by Polis this week at a news conference announcing a "very substantial" uptick in the virus among college-age individuals: "We are all tired of the virus, but the virus is not tired of us."
'It could have been worse'
When it comes to the cumulative number of COVID-19 cases, Colorado ranks 30th among U.S. states, with 61,667 diagnoses, according to Kaiser Family Foundation data. It ranks closer to the bottom — 42nd — when it comes to cases per 1 million residents, with 10,708.
There are multiple ways to look at the data, but, "in general, Colorado has fared well and we've done a fantastic job suppressing the virus in the last two weeks in the state," Herlihy said Thursday, pointing out that this summer's "second wave" of the virus was relatively small, especially when compared to that of other states like Texas, Arizona and Florida.
Polis called the state's relative success the sum of "responsible decisions" made by Coloradans throughout the state.
"It's the decision not to have a large barbecue, not to have a big birthday for your kid," he said. "My daughter just turned 6 and would have loved a traditional big birthday. She had two friends over, instead.
"Families across Colorado are making those decisions that lead to the state's success."
Colorado's performance isn't as favorable, however, when it comes to fatalities. With a death rate of 3% of those infected, Colorado ranks 10th in the nation — near the top.
The state is among 14 states that also have 3% fatality rates, including Indiana, Illinois, New Mexico, Maine, Arizona and Washington. (Connecticut tops the list, at 8%; Alaska, at 1%, is at the bottomNationally, the U.S. has an average 3% fatality rate.
"The virus does have a fatality rate of about 3%," Polis said. "If it's in younger people, it's about 1%. If it's in older people, you see a higher fatality rate. We're no exception. It's going to be pretty close to 3% wherever you are — that's just the nature of the virus."
When looking at the state's cumulative fatality data, "I think we were probably close to the middle of the pack" among states, Herlihy said, adding that the "early wave of illness" hit hard the elderly and long-term care facilities, boosting what otherwise might have been a lower fatality rate.
However, more recent data that spans anywhere from seven to 30 days shows that Colorado is among states with the lowest fatality rates in the U.S.. Said Herlihy: "We've been quite successful in protecting our seniors, older adults and vulnerable populations this summer, since the spring wave of the illness."
Colorado's experience of a large number of outbreaks at residential health care facilities — which comprised the vast majority of outbreaks during April and May and represent the largest category of outbreaks in the state to date — was not unique, according to Samet.
"We had the same sort of experience so many other places did: deaths among older persons and at long-term care facilities," he said. "Certainly our older population was far more seriously hit here, as with everywhere," he said.
Though results appear to be a mixed bag, overall, "I think we've done well," he added.
"When you're nearing 2,000 deaths and you use the world 'well,' it seems like a bit of a mixed message," he said. "But it could have been worse."
In Colorado, deaths among those 80 and older comprise a whopping 53% of fatalities, with deaths among those ages 70-79 coming in second, at 23%, and deaths among those 60-69 coming in third, at 13%.
Colorado ranks among the bottom of U.S. states when it comes to percent of population 65 and older, with around 14% of its population classified as elderly, according to 2018 census data. Utah ranks the lowest, at 11%; Florida ranks the highest, at 20%.
But states' fatality rates vary based on the demographics of outbreaks, Polis pointed out.
"When it tears through a nursing home or long-term care facility," there's likely to be a "much higher fatality rate," he said, adding that current outbreaks at colleges throughout the state will likely result in a much lower fatality rate.
Herlihy attributes the state's accomplishment of "flattening the curve" this spring — and from so far experiencing another equal or greater curve — to "Coloradans practicing social-distancing, wearing masks and following public health recommendations."
She also credits a state response that has used data "to drive and inform decision-making and policy."
"The governor talks frequently about the use of data to guide decision-making — and not just case count, but looking at who was being impacted and targeting interventions to specific populations," she said, citing the state's response to outbreaks at long-term care facilities, which involved "aggressively implementing infection-prevention and testing strategies," as well as the governor's "last call" public health order in July that bumped up last call to 10 p.m., then 11 p.m. — a response to a spike in transmission among those in their 20s.
Polis credits the state's innovative response for accomplishments like securing personal protective equipment from international supply chains — enough that the state has been able to issue 1 million medical-grade masks to Colorado teachers, one per teacher per week — as well as for pioneering new testing protocols, allowing for free access to coronavirus tests with a relatively quick turnaround time to anyone in the state, no doctor's order necessary.
"We hear in some states of huge lines, people can't get tested," he said. "That was the case here, of course, in the early days, in the entire country. But now, you can just go to The Citadel mall in Colorado Springs, the Pepsi Center or Water World in Denver, and you're in and out in 15 minutes."
A return to 'some degree of normalcy'
Looking toward the winter, when flu season is expected to collide with a virus that's been relentless for months, there's a potential piece of good news, according to Samet: In the Southern Hemisphere, the flu hasn't posed a major problem.
A bad flu year, combined with COVID, could strain hospital capacity, Samet said. But so far, looking at models, the flu shouldn't be so severe that the flu, combined with the pandemic, would be catastrophic.
Longer term, Samet wishes he had a crystal ball to forecast the future — better yet, one that could make a vaccine appear, he said.
"The course to having a vaccine — to go through licensing, production, scale-up, delivery — means I think most of us won't have received one at the one-year anniversary" of the virus' entry into Colorado, he said.
"That's a guess. Hopefully we're well on our way to planning to deliver one."
As for how often one might have to get the vaccine — recent reports say immunity to the virus may only last a handful of months — "we'll have to wait and see," he said.
"The immunity to the common coronavirus that causes colds is not long-lasting, so that tells us something, perhaps."
Polis said it's likely that at least one vaccine will be demonstrated safe and effective by November or December, and that some quantities will be available in the state — most likely for hospital workers and front-line employees — with greater public availability early next year.
When asked if he would ever lock down the state again, and under what conditions, Polis touted a "sophisticated local approach" to virus control, advocating for empowering local authorities to act quickly and quarantine those involved "rather than the whole community or county."
This week the state unveiled a virus "dial dashboard" that tracks the progress of counties by color, similar to a fire-danger sign. Counties can move "up" in color if they achieve certain benchmarks for two weeks, and will have two weeks to regain compliance if they fall out before being demoted. The framework will replace variances in most cases, Polis said.
So far, four counties — Moffat, Rio Blanco, Mesa and Gunnison, all in western Colorado — have qualified for the state's Protect Our Neighbors, or green, status, which involves the most light-handed restrictions in pandemic-era Colorado.
The state has achieved much in half a year, from flattening the curve to juggling the resumption of out-of-state tourism and the risks it entails, Samet said: "The bars are still closed, and the restaurants are still not fully opened indoors, but we've returned to some degree of normalcy."
Until there's a cure, wearing masks, social distancing and handwashing are the way forward, Samet, Polis and Herlihy contend.
"One of the big lessons we've learned is that we have measures that work," Samet said. "If we're on that steep epidemic curve again, we're not adhering to what we need to do. If there's an uptick, we should give careful consideration to what the policies are that might start to flatten the curve. But the costs of shutdown again are huge in so many ways. We should be able to hopefully avoid it by carefully watching and acting soon enough."
While interventions might seem simple, the riddle of the novel coronavirus is far from solved, Polis contends. There's still much left to learn about the nature of the enemy.
"It's just mind-boggling how easily this spreads," he said. "It just shows the importance of mask-wearing, of being outdoors when you can, but it's still an extremely contagious virus. It continues to surprise us just how contagious it is and continues to show us why we need people to stay cautious."