A county's level of restrictions depends on its rate of new COVID-19 cases, percentage of tests that come back positive, and whether hospitalizations are stable or declining.
Public health officials may place a county under a more restrictive level in the state's updated safer-at-home policy if a county is out of compliance with any of those three metrics for a two-week period. If a county comes back into compliance in that time frame, no further action is needed.
If that doesn't happen, then the county must consult with state officials to determine next steps, according to Colorado's updated safer-at-home policy.
The consultation ensures that officials take local factors into consideration. For example, if cases are clustered at a university or in a part of the county that's geographically distinct, then targeted actions may be more appropriate than county-wide actions, the policy says.
At the end of the consultation, the state public-health department assesses whether local trends are improving, the risk to the community and the strength of local mitigation efforts. At that point, the state will either:
• Provide an extension for another two-week period to remain under the same level while continuing existing mitigation strategies;
• Provide an extension on the condition that additional mitigation strategies are put in place; or
• Require the county to transition to a more restrictive level.
On the heels of their first notably sustained increases in rates of new COVID-19 cases since July, Adams, Arapahoe, and Douglas counties must slow the spread or face tighter restrictions, a news release from Tri-County Health Department announced.
The three counties each stand at risk of moving to a more restrictive level on what officials call Colorado's COVID-19 “dial,” the framework that lays out which level of social distancing policy a county must operate under.
A tighter level could mean reduced capacity for businesses, places of worship and gatherings — and earlier last-call times for bars and restaurants, Tri-County's release said.
Colorado's dial framework has five levels: The stay-at-home policy is the most restrictive, and the loosest is the “protect our neighbors” phase that only a handful of counties have qualified for so far. That phase is likely months away for Denver metro counties.
The vast majority of the state operates under the updated safer-at-home policy, which the state broke into three levels in September and makes up the middle three notches in the dial. As of Oct. 8, Arapahoe and Douglas are listed under the least restrictive safer-at-home level, and Adams falls under the middle level.
Since early September, Adams, Arapahoe and Douglas counties have seen the first notably sustained increase in their rates of new cases since July, according to data from Tri-County Health, the public health agency for those counties. The change has been most pronounced in Adams, less so in Arapahoe and milder in Douglas.
Arapahoe County's rate of new cases per 100,000 over a two-week period was 121.7 as of Oct. 2. That's up from 76.2 as of Sept. 17.
Between Sept. 24 and Oct. 7, according to Tri-County, the following increases occurred:
• About 1,400 new cases and 52 new hospitalizations were reported in Adams County;
• About 890 new cases and 39 new hospitalizations were reported in Arapahoe;
• In Douglas, 400 new cases and eight new hospitalizations were reported.
If trends don't change, tighter restrictions could take effect around late October for Arapahoe and Douglas counties and early November for Adams, according to John Douglas, Tri-County's executive director.
Tri-County and the Colorado Department of Public Health and Environment are working with the three counties on individual mitigation plans to help reduce the number of new cases, the news release said.
For example, Arapahoe's mitigation plan has included steps such as producing a public information campaign to increase awareness of the county's COVID-19 statistics and conducting business roundtables with public health experts to address industry- and site-specific questions. Arapahoe's plan could see modifications, though, according to Tri-County.
“We all need to step up our prevention measures to reduce transmission and keep our counties open,” Douglas, the executive director, said in the news release. “That means we need to limit the number of activities we participate in. You're more likely to get COVID-19 from someone you know and spend time with than a stranger.”
The state public-health department monitors the rate of new cases, COVID-19 test positivity rates and hospitalization trends to determine if a county moves toward more restrictive or less restrictive levels on the state's policy dial. Such changes also affect the level of restrictions for outdoor and indoor events and personal gatherings.
The public can view the restrictions for different events, activities and types of businesses on the state's policy framework on page 6.
Tri-County's contact-tracing process shows that a large number of positive cases may be connected to public and private social gatherings, according to the news release.
“When gathering — whether it is indoors or outside, or at a private party or public event — everyone should be sure to wear face coverings, maintain at least 6 feet of social distancing from others outside of their household and wash their hands frequently,” Douglas said in the release.
The limit on personal gatherings is 25 people in the level Arapahoe and Douglas were under as of Oct. 8, while the limit is 10 people under Adams' level.
For information on how to gather safely, the public can see Tri-County's small-gathering guidance.
Asked if putting kids back in school has contributed to the rise in new cases, Douglas told Colorado Community Media that returning to school likely hasn't played a large role — but determining how much the coronavirus is transmitted in schools is still a work in progress, he added.
"The impression I have is the transmission in schools is probably not happening much and probably not contributing much to community transmission, but that could change," Douglas said.
Prevention measures are especially crucial now that weather is cooling and more gatherings and restaurant seating will be indoors where transmission can occur more readily than outdoors, the news release added.
Key prevention steps also include staying home when sick, getting tested if COVID symptoms occur, and cooperating with public health staff if a person tests positive or gets exposed to a COVID-19 case, the release said.
“We know that many of our residents have 'COVID fatigue,' but our community needs to come together to improve our transmission prevention efforts to help slow the spread and lower the numbers of COVID-19 cases so that we can continue going to work, to school and to worship, especially before we head into the holiday season,” the release added.
Tri-County also urged area residents to get a flu shot as an extra precaution to stay healthy.
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