COVID update – changes to dial and vaccine schedule

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by Marissa Lorenz
During her most recent update to the Grand County Board of County Commissioners (BOCC)/Board of Health, Public Health Director Abbie Baker announced coming changes to Colorado’s COVID-19 dial system, which is used to determine levels of concern and restrictions within a county, such as permitted restaurant patron and event participant numbers.

Being termed Dial 2.0, Baker describes the new system as better able to assess “what’s currently happening in our communities so that we can respond accordingly.” The Colorado Department of Public Health and Environment (CDPHE) has utilized a dial system since the earliest COVID-19-related restrictions were enacted in March 2020. It began with three levels of caution and guidance and underwent one previous overhaul which expanded those categories to six.

The dial level of a community has been based primarily on that community’s two-week case rate (the number of new cases in the previous two-week period), the two-week positivity rate (the number of positive cases per 100,000 people, as determined by community testing in that previous two weeks), and the availability of hospital beds for possible COVID patients.

Certain of Grand County’s numbers, primarily case rate and positivity rate, have placed the County in the Red category of Severe Risk since early November, which would normally mean extreme restrictions, including restaurants being closed to in-person dining, no permitted indoor events, and no personal gatherings.

Grand County, however, avoided full Red-phase restrictions by proposing an “Orange-plus” period with some but not all of the state-mandated restrictions, which were in effect over the Thanksgiving holiday and following week.

The efforts seemed to help the community avert the post-Thanksgiving spike seen in much of the state, and local numbers declined, though still not dropping below the Red-phase level.

And then numbers began to rise again the first week of January. Whereas Grand County’s positivity rate had dropped below 10% for several weeks (a positive sign correlating to yellow-phase level), it is presently calculated at 11.35%, a trend taken to mean that cases are increasing. However, positivity is determined by the number of positive tests out of the total number of tests during that time period and could also indicate a decrease in residents being tested.

The newly-proposed dial would change the window of relevance from 14 days to 7 days, according to Baker, and would therefore provide a better snapshot of the current situation in a given community.

It could also mean significantly different-looking numbers.

At the time of Baker’s presentation this week, she noted the Grand County two-week case rate as 1,065/100,000 people. She acknowledged a spike in cases the week before but indicated that a 7-day snapshot would demonstrate a case rate of only 310/100,000 people, below the Red phase threshold of both the current and proposed dials.

Other changes to the dial include changing those thresholds of concern. The case rate threshold for red would change from 350/100k in two weeks to 501/100k in one week, and from 175 to 300 for phase orange. The positivity rate threshold for red would go from 15% or more in a two-week period to 10% or more in a one-week period.

A citizen noted mention of possible additional considerations for communities of less than 20,000 people, but Director Baker indicated that she would have to gather more information before confirming that. She also expressed uncertainty around how quickly communities would be expected to pivot between dial phases and restrictions but confirmed, “There would be an expectation that [the County] would be prepared to adjust quickly if we’re seeing a high incidence of disease in the community.”

Baker explained that the purpose of the proposed changes was to be ready for elimination of a dial system by the end of 2021, as herd immunity grows following widespread administration of the vaccine among the state’s population.

Vaccine report and schedule changes Reporting on Grand County’s vaccination efforts, Baker stated
that over 1,500 doses had already been administered in Grand County (including some second doses) but that vaccination supply remained too low with orders for vaccine from Public Health and other health care providers still not being fully filled.

Finally, Baker indicated that the county was readying to make changes to the vaccination schedule, in accordance with recent changes approved by the Governor’s office. She said that Public Health is preparing to expand vaccination efforts to include early childhood and preschool-12th grade educators and support staff and residents who are 65 and older as of February 8.

“The vaccine expansion to the school-based population is a huge win for Colorado,” declared Baker, “as well as expanding vaccines to 65-69 year olds in our community. It is a big step towards getting us to a place where we don’t have to refer back to the dial.”
To register for interest in vaccination, go to co.grand.co.us/vaccine. Specify Middle Park Health as your primary care provider if you would like to be vaccinated at one of their permanent or drive- thru clinics, whether you are a new or existing patient there.

For more information on COVID-19 in Colorado, go to covid19. colorado.gov. And for details about COVID-19 in Grand County, including most recent data and mitigation efforts, go to co.grand.co.us/COVID19.