Some El Paso County residents refuse to cooperate on COVID-19 contact tracing


Data on COVID-19 infections in the county can be found on the Public Health dashboard. - EL PASO COUNTY PUBLIC HEALTH
  • El Paso County Public Health
  • Data on COVID-19 infections in the county can be found on the Public Health dashboard.
Since businesses began to reopen after the state's month-long stay-at-home order imposed in March, angry messages from citizens have prompted El Paso County to beef up security of its offices, though no outright threats have been received, according to an advisory memo to Colorado Springs City Council obtained by the Indy.

In addition, more outbreaks of the deadly coronavirus have emerged, and it's rate of spread has more than doubled from 2.5 persons per infected person to nearly 7. Meantime, contact tracing experts at the county have encountered resistance from people who refuse to cooperate.

Moreover, COVID-19, the disease caused by the virus, is causing spread in the Spanish-speaking community at a rate that has overtaken El Paso County Public Health's capacity to deal with those cases, and more bilingual investigators are being hired.

El Paso County Coroner Dr. Leon Kelly says this county's officials haven't had threats of violence against individuals. "However, there have been direct threats on other public health directors in the state," he says. "In Teller County, that public health director has had significantly aggressive threats." Her critics have even set up a website, smearing her and demanding she be fired, he says.

At Tri-County Department of Health, vandalism has occurred, he says, adding, "Almost every public health department is under siege."

"The temperament of a small vocal minority has grown more aggressive to public health," he says. "Instead of waiting for something bad to happen, we're working with the sheriff to provide security for Board of County Commissioner meetings and Public Health."

As troublesome, Kelly says, "We have had increasing resistance from individual who tested positive to cooperate with contact tracing.

"Businesses have been fully cooperative," he notes. "But we've had multiple individuals who have refused to answer questions — where they could have gotten it from and who else could be at risk. This, unfortunately, has been turned into a political issue."

Kelly notes that contact tracing is voluntary, and the identity of those infected aren't shared with others. "The part people don't get is the people you spend time around are people you care about, so those are the people we need to reach out to. I can't comprehend how someone would refuse to cooperate with voluntary questions that could save the lives of the people they care about most. It's hard. You're doing everything you can to get everybody where they want to go. It's like somebody's house is burning down and they want us to save it and they're throwing rotten tomatoes at us."

As for the spread to more people by each infected person, Kelly that's to be expected as people return to their jobs and get out and about.

"It's an important number to monitor. It's driven by number of people gathering in those interactions," he says. "Parties of 30 or more [elsewhere, not in El Paso County] has resulted in rapid, out of control spread, more than health departments and hospitals can handle."

Kelly called the lack of contact trace investigators for the Spanish speaking community "a big one."

The county started with one such investigator and has already added three. "But this week, it's clear that's not adequate. That's an area of focus for hiring immediately. We need to get to capacity and we need to do it yesterday."

The memo, sent May 20 to Council by Deputy Council Administrator Michael Montgomery, responded to questions posed by Councilor David Geislinger on May 16.

It said that threats and vandalism have led to increased security of county buildings as such activity has increased across the state. "In EPC [El Paso County] we have received expressions of anger and frustration but have not received direct threats to date," the memo said. "Watching what is happening in other jurisdictions, we are not waiting to engage in conversations regarding safety and security for our staff, facilities and clients. We have worked closely with EPSO [El Paso County Sheriff's Office] to increase security/monitoring of EPCPH [Public Health] facilities and we coordinate in advance when our Leadership are reporting out at public venues."

County commissioners have entertained dozens of citizens at recent commission meetings who demand businesses reopen to satisfy their right to assemble and move about as they please.

When non-essential business were forced to shutter between late March and May 1, outbreaks were largely confined to long-term care facilities. But Public Health has seen outbreaks emerge in construction and manufacturing, the memo said.

"Other counties throughout the state have also reported outbreaks in construction so our communicable disease epidemiology team is raising this as a potential area for increased activity," the memo said. "Our team tries to identify and interview cases early so that we can stop transmission and prevent large community-wide outbreaks. As we work with different business sectors we also engage our environmental health team so that we can make recommendations to reduce transmission in these settings."

In recent days, Public Health identified outbreaks, defined as two or more cases, at a Goodwill thrift store, McDonald's, Safeway, Walmart, Schommer Construction and Springs Fabrication.

The spread pre-reopening was determined to be from 2.5 to 2.8 people per infected person. After reopening began, the spread has grown to 6.8 contacts per case. Still, that's still substantially lower than the trigger point at which the county is willing to rethink the waiver's provisions. From the waiver application: "A median of 11 contacts per confirmed case will be considered as a threshold for review of this variance."

Public Health has bolstered its workforce with Medical Reserve Corps volunteers, University of Colorado at Colorado Springs BethEl student nurses and faculty, county coroner staff and additional staffing to be hired with money from the CARES Act.

Equally troubling is more cases emerging from the Spanish speaking community. While Public Health dealt with those cases early on with one specialist who spoke Spanish and interviewed Spanish-speaking infected persons, "Currently we have 4 investigators assigned to Spanish speaking clients and that capacity is being exceeded," the memo said. It added the agency plans to contract for more investigators who can reach out to Spanish speakers.

Regardless, county commissioners are seeking a waiver to allow re-opening of the hard-hit restaurant industry. They noted in the waiver application, "At this time El Paso county has adequate resources and surge capacity to contain and treat additional cases that may arise from limited on-premise dining in restaurants."

Although the application states that hospitals support the waiver, officials with UCHealth Memorial Hospital and Children's Hospital wrote that they relied on numbers provided by the county and that their facilities currently have hospital capacity to care for patients based on the "current infection data."

Centura Health gave a more broad approval, saying its hospitals are "prepared to serve COVID-19 patients in El Paso County."

County commissioners unanimously approved applying for a waiver from the state's safer-at-home order, imposed in late April under which some restrictions of the stay-home order have been eased, though restaurants and bars are to remain closed to dine-in customers.

Review the county's application here:
See related PDF Submitted_Restaurant_Variance.pdf


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