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Coloradans must continue social distancing to avoid COVID-19 resurgence this summer, projections say

If Colorado is going to avoid overwhelming hospitals with new COVID-19 patients this summer, the public will need to do what health officials say, rather than what they’re allowed to do under easing restrictions, according to new projections.

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Those projections, from the Colorado School of Public Health, showed the number of patients in critical condition due to the new coronavirus could exceed the number of intensive care beds available to treat them as early as August, if the public doesn’t maintain a high level of social distancing.

In several of the projected scenarios, more people would be hospitalized in Colorado during a summer peak than were at the peak of the first wave, in April.

The projections rely on mobility data, gathered from cell phones, as a proxy for how much people are social distancing. That means it’s impossible to tell if people are going out for relatively low-risk activities, like exercising alone, or if they’re going to a large party at a friend’s house. They also don’t fully account for the effects of wearing masks, which appear to be somewhat helpful in controlling the virus’ spread, said Dr. Jonathan Samet, dean of the School of Public Health.

Reported deaths from COVID-19 have fallen dramatically, and hospitalizations are down, though the rate of decrease is leveling out and hospitalizations could rise again, Samet said.

“This is what we would expect as the distancing measures are relaxed somewhat,” he said. “The important thing is it inclines in a controlled way, so intensive care capacity is not overwhelmed.”

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There are two projected scenarios that avoid overwhelming hospitals.

In the first, everyone over 65 and those with chronic conditions only leave their house for necessities and outdoor exercise, while those at lower risk from the virus keep their face-to-face contacts to about half the normal rate. That’s not a very likely scenario, since not everyone at high risk because of age or medical conditions can almost completely isolate themselves, state epidemiologist Dr. Rachel Herlihy said.

If the highest-risk people have less-than-perfect success isolating themselves, everyone else with need to reduce their interactions to about one-third of the normal number to avoid an overwhelming spike in cases, according to the projections. It’s also important that everyone wear masks in public and get tested if they develop symptoms or know they’ve been exposed to the virus, Herlihy said.

Colorado needs to stop the virus from gaining a strong footing if the state is going to meet the goals of allowing school to convene in the fall and avoid another stay-at-home order, said Jill Hunsaker Ryan, executive director of the Colorado Department of Public Health and Environment.

“While Coloradans have made tremendous sacrifices to suppress the virus… we are still not out of the woods,” she said. “We’re trying to promote economic stability while keeping virus spread at a minimum.”

Despite the emphasis on possibly severe consequences if residents don’t continue social distancing, state officials on Monday released drafts of potential guidance to reopen houses of worship, guided outdoor activities and other types of recreation with social distancing. And while the state health department recommends that people not travel outside their county for recreation, the state allowed short-term rentals to restart Monday, provided their owners follow certain cleaning rules.

Counties can still apply to reopen more businesses, if they can show they have a plan to do so safely, Ryan said. Efforts are shifting to contain the virus “at the business level rather than the societal level,” with stores and offices that have two or more cases required to close for at least 48 hours, she said.

“It’s this very difficult balance,” she said. “The more populations mix, the more likely disease transmission will pick up.”

A new study shows Coloradans have started spending more time out and about since late April, with the average number of hours at home decreasing before the state’s stay-at-home order lifted on April 27.

Jude Bayham, an assistant professor at Colorado State University who uses economic models to study wildfires and epidemics, said aggregated cell phone data showed people spent more time at home starting in early March. That changed in late April, and there was a significant increase in travel to mountain communities over Memorial Day weekend. That’s “potentially concerning,” because visitors could bring the virus back to places that have little community spread, he said.

The model doesn’t include the effect of masks, because it’s not clear if people will feel protected and therefore be less cautious — in the same way driving at high speeds increased as more people wore seatbelts, Bayham said. Masks aren’t recommended for children younger than 2, but are safe for older kids and adults, according to the American Academy of Pediatrics.

At the same time, both consumer spending and earnings by employees of small businesses fell significantly as more people stayed home, and haven’t fully rebounded, showing that social distancing has it own drawbacks, Bayham said.

“Distancing has proven to be effective, but costly,” he said.

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