COVID-19 Update: Senior Center Tragedy as Death Toll Nears 300

Colorado Governor Jared Polis during a previous appearance on MSNBC.
MSNBC via YouTube
Colorado Governor Jared Polis during a previous appearance on MSNBC.
The most recent developments in Colorado's ongoing battle against COVID-19 have been uniformly sobering and often shocking. They include an extended emergency disaster declaration, new standards being applied to medical crises and the use of personal protection equipment, fresh criticism of the Trump administration by much of Colorado's federal delegation, an upcoming meeting that could cause a third county to place restrictions on outsiders, and Denver-specific measures that focus on additional property tax relief and a potential call for rent cancellation, even as Civic Center Park has been closed.

Meanwhile, the loss of life is mounting, with word of at least nineteen fatalities at two nursing homes in Aurora and an overall death toll that nearly tripled in nine days and now stands just shy of 300.

Governor Jared Polis first announced that deaths from COVID-19 had exceeded 100 during an April 3 press conference. Here are the latest numbers from the Colorado Department of Public Health and Environment, updated at 4 p.m. April 12. They reflect data through April 11:
7,303 positive or presumptive positive cases
1,417 hospitalized
56 counties
37,153 people tested
290 deaths
68 outbreaks at residential and non-hospital health-care facilities
The last category was brought into stark relief by word of outbreaks at two senior centers in Aurora: Juniper Village, at 11901 East Mississippi Avenue, and the Cherry Creek Nursing Center, at 14699 Hampden Avenue. The CDPHE release about Juniper Village revealed that 33 of 46 residents and 16 of 25 staff members at the facility had tested positive for the novel coronavirus since a departmental investigation began on March 27. Since then, Juniper Village has reported eight deaths; COVID-19 is believed to have led to five of them, while it's considered the probable cause in the other three.

Meanwhile, 19 people have died at the Cherry Creek Nursing Center, which houses 159 residents, over the past two weeks or so, with 11 linked to COVID-19 thus far.

"We know that the populations in these facilities are among the most vulnerable and are at highest risk of severe illness from this virus," said Rachel Herlihy, state epidemiologist for the CDPHE. "The department is doing everything we can to be as transparent as possible regarding reported outbreaks to keep people safe while protecting patient privacy. We continue to be aggressive in our recommendations to ensure the appropriate infection prevention measures are in place to slow and limit the spread of COVID-19 in these facilities."

The CDPHE plans to start offering more details about cases at such facilities on Wednesday, April 15.

On April 9, Polis extended Colorado's emergency-disaster declaration another thirty days. This move "allows Colorado to access additional resources, temporarily waives procurement statutes for purchases related to COVID-19, and authorizes the implementation of the State’s Crisis Standards of Care plan (CSC Plan)," his office points out. (It does not affect the stay-at-home deadline, currently set for April 26.)

Late on April 10, the CDPHE confirmed that the disaster-declaration plan had been revised with emergency medical services and personal protective equipment with COVID-19 in mind.

"The activated crisis standards provide recommendations on the questions ambulance dispatchers should ask and the equipment first responders should wear, among other recommendations," stated Dr. Eric France, the CDPHE's chief medical officer. "They also clarify which first responders go out when, minimizing the number of people who could be exposed to COVID-19, while still providing care to people in need. The public can help preserve precious emergency resources by staying home, and only contacting 911 when it’s an emergency. We all play a role in slowing transmission of the virus and protecting the heroes on the front lines."

Especially telling is this guidance for EMS responders:
• First responders recognizing a potentially infectious patient should notify dispatch/communications center to assure that responding EMS personnel are prepared to implement appropriate infection prevention and control measures.
• Regardless of dispatch information, EMS personnel should be vigilant for travel history and signs and symptoms of communicable disease (e.g., fever, cough, gastrointestinal complaints) and use standard precautions and add appropriate transmission-based infection control precautions whenever history or exam findings warrant.
• Implement strict standard and transmission-based precautions based on the current known high-risk infection threat and the patient’s clinical information to avoid exposure to potentially infectious bodily fluids, droplets, and particles.
• Avoid direct contact with a patient who may have a serious communicable disease until appropriate PPE is donned....
  Similar precautions should be maintained around close contacts or household members of the patient.
• When not performing direct patient physical assessment, maintain a distance of at least six feet to provide protection from transmission of many diseases.
• Attempt to limit close contact with patient to as short a time as possible when performing the patient assessment and examination.
• Patients or their caregivers may find responders wearing high levels of PPE such as hood, suits, and respirators alarming. Communicating with and calming anxious patients may be more challenging due to PPE as well. Responders should be mindful of this and be prepared to reassure patients and to address their distress and fear.
• Limit the number of EMS providers making contact with a potentially infectious patient to the minimum required to perform tasks safely.
  Non-essential providers on scene should wait outside of the patient treatment area or outside of the residence or building.
• Conduct initial assessment and interview at least 6 feet away.
  Maintain this similar distance from the patient’s close contacts, household members, and bystanders.
• Confirm patient’s existing MOST form, DNR/DNI wishes, or advance directives.
The previous day, April 10, U.S. senators Michael Bennet and Cory Gardner, joined by representatives Diana DeGette, Joe Neguse, Jason Crow and Ed Perlmutter, sent a letter to Alex Azar, secretary for the Department of Health and Human Services, complaining that the first $30 billion in funding from the federal Coronavirus Aid, Relief, and Economic Security (CARES) Act provided little relief for many rural hospitals that are struggling to keep up with the demand placed on them by the rise in COVID-19 infections.

Meanwhile, public-health officials in Park County, where a 39-year-old Florida man died from the virus in recent days, have scheduled a meeting for tomorrow, April 14, at which they'll consider restricting road access for non-county residents and closing all short-term rentals. Such actions echo ones that have already taken place in Gunnison County, which has imposed a strict no-visitors policy, and Clear Creek County, where county roads were closed to non-residents starting April 11.

This past weekend, Denver closed Civic Center Park, as well as nearby Lincoln Park, the lawn of the Central Denver Public Library Building and other adjacent areas, over COVID-19 concerns. Red Rocks is also closed to all visitors for the duration.

Meanwhile, Denver has waived 100 percent of late payment interest on property taxes through April 30, ten days later than usual. And at the Denver City Council meeting tonight, April 13, members will consider asking Polis to cancel rent and mortgage payments over COVID-19 — a proposal pushed by Denver's Democratic Socialists of America chapter in conjunction with United Food and Commercial Workers Local 7 and other area unions.

The Colorado Apartment Association maintains that more than 80 percent of Coloradans paid rent for April during the first week of the month. But May 1 is fast approaching.