In one of the most vaccinated places in the country, masks were still the key to slow Covid-19

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If vaccines were the singular armor against the spread of covid, then on paper San Juan County, with its roughly 730 registered residents, would be one of the most bulletproof places in the country.

Yet the past few months have shown the complexity of this phase of the pandemic. Even in a highly vaccinated location, injections alone are not enough because geographic boundaries are porous, the vaccine’s effectiveness may decrease over time, and the delta variant is highly contagious. Infectious disease experts say masks are still needed to control the spread of the virus.

The county recorded its first hospitalizations from the pandemic in early August – this year, not 2020. Five summer residents have been hospitalized. Three ended up on ventilators: two recovered and the third, a 53-year-old woman, died in late August. It was believed that not all were vaccinated. It was believed that not all were vaccinated.

These cases and even those that did not require hospitalization have sounded the alarm for the county with one incorporated city: Silverton. It’s a tight-knit former mining community nestled in the mountains of southwest Colorado, where snowstorms and avalanches often block the isolated road through it.

“The pandemic is still ongoing,” said DeAnne Gallegos, county public information officer and director of the local chamber of commerce. “We kept thinking that this was going to end until this summer. Then we thought in November. Now we’re like, ‘No, we don’t know when. “”

So the county decided to backtrack: “We went back to the tools we knew we had,” Gallegos said. “Hide warrant indoors and then discourage indoor events.” Outdoor events continued, such as a marching band concert on the steps of the courthouse and the area’s iconic mining competition, Hardrockers Holidays, with its pneumatic mucking and spiked drive.
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In total, once the under 12 category is taken into account, 85% of the total population of the department is fully vaccinated. But in the summer, the population nearly doubles as seasonal residents roost in second homes and RV parks, some on vacation while others take on seasonal jobs. Then there’s what Gallegos has described as “the tourism tsunami” – the daily influx of people arriving via Durango’s historic railway and dusty jeep trails through the mountains. Many of these visitors have unknown immunization status.

The two-week incidence in the county skyrocketed in August to the state’s highest rate and remained there for most of the month. Even though that peak stood at a total of around 40 known cases, it was almost as many as the county had recorded throughout the pandemic – and cases have also spread among those vaccinated.

Any number of cases would be a big deal in a small place without its own hospital. “We’re all one-man bands just trying to make it happen,” Gallegos said. County Public Health Director Becky Joyce, for example, does everything from contact tracing and covid testing to firing. And when the county restarted its mask tenure, it was Gallegos who designed the signs and spent his weekend attaching them in town.

The greatest concentration of covid cases has occurred at an RV park and music festival driven indoors by the rain.

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“It makes sense that after three or four weeks of scrambling tourism, people start to get sick working in restaurants, in RV parks,” Gallegos said. “And then you get all the condensed premises together for a few nights of concerts and it was just the winning trifecta.”

Dana Chambers, who runs the hardware store in Silverton, was vaccinated as soon as possible. She said the return to a mask warrant looked like “a step backwards” in some ways. But, she said, businesses like hers need the summer tourism rush to survive the calm winter, when only a few hundred tourists come, largely to jump from helicopters over terrain. ski. “If we have to wear the mask, that’s what we’ll do.”

Julia Raifman, a Boston University School of Public Health epidemiologist who tracks state pandemic policies, is not surprised that the virus could attack a place like San Juan County despite high vaccination rates.

Data shows that vaccines protect against death and hospitalization from covid. But even effective vaccines are no match for the transmissibility of the delta. “Even in the best-case scenario – if vaccines reduce transmission by 80% – you’re actually twice as likely to be a victim of covid now than in July,” Raifman said, due to the recent proliferation. virus. “It is statistically impossible to obtain collective immunity with the delta variant.”

Meanwhile, many local and national leaders, including in Colorado, continue to focus almost exclusively on vaccines as the way forward.

Talia Quandelacy, an epidemiologist at the University of Colorado-Denver and the Colorado School of Public Health, said the concept of herd immunity in this pandemic has been oversimplified and overused. “It’s a useful guide to having some sort of target to aim for,” she said. “But generally, if we hit a certain metric, it doesn’t mean the transmission or the pandemic is just going to go away.”
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Many scientists agree that, especially since most countries around the world are still unvaccinated, covid is likely to stick around, eventually turning into something more like the common cold. “It will probably be a matter of a few years,” Quandelacy said. “But that seems to be the trajectory we’re on.”

For this reason, the “finish line” language used by many politicians has frustrated Anne Sosin, a policy researcher at Dartmouth College’s Nelson A. Rockefeller Center for Public Policy, who studies covid and rural health. Vaccines do what they’re supposed to do – keep people from getting really sick, not keeping them from getting infected – but it hasn’t been communicated well. “The message on this has not been very nuanced,” she said.
She pointed to the experience of an epidemiologist who wrote last month in The Baltimore Sun that he caught lust at a house party where all 14 guests and the host were vaccinated. The host had infected him and nine others. “As miraculous as they are in keeping people out of the hospital and alive, we cannot rely on them alone to prevent infection,” Sosin said of the vaccines.
And public health experts said San Juan County is showing measures like masks, ventilation and distancing are also needed. They’re circulating the “Swiss cheese” covid defense model, in which every preventative measure (or layer of cheese) has holes in it, but when stacked together they create an effective defense. Sosin said rural areas, in particular, may need these layers of defense because residents are often closely linked and the disease spreads quickly through social media.
Joyce, the director of public health, who declined a request for an interview, wrote on Facebook in August that the county’s recent experience has proven that “the vaccine creates a line of defense but does not make us invincible against it. disease or its variants “.

Raifman views this achievement – coupled with San Juan’s ensuing indoor mask requirement – as a success at a pivotal moment. The one-month term was then lifted on September 10 as the county fell back to a low rate of covid transmission. At the time, it was the only county in Colorado with such low transmission.

“This is the point where we sort of define: how do we deal with the virus in the longer term?” Raifman said. “So far, we define that we don’t manage it; we let it manage us.”

Even after lifting his mask mandate, the county public health department’s Facebook page urges residents to wear masks and “watch out for the covid-19 situation just like you watch the weather.”

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism on health issues. Together with Policy Analysis and Polling, KHN is one of the three main operational programs of KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization that provides information on health issues to the nation.

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