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By Rae Ellen Bichell, Kaiser Santé news
San Juan County, Colorado, can boast that 99.9% of its eligible population has received at least one dose of COVID-19 vaccine, placing it in the top 10 counties nationwide, according to data from the Centers for Disease Control and Prevention.
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.
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 it was going to end before 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 events indoors.” 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.
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 almost 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 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 spread among those vaccinated as well.
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 guns. 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.
“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 in some ways like “a step back”. 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 COVID can attack a place like San Juan County despite high vaccination rates.
Data shows vaccines protect against deaths and hospitalizations from COVID. But even effective vaccines fall short of the delta’s transmissibility. “Even in the best-case scenario – if vaccines reduce transmission by 80% – you’re actually twice as likely to contract COVID now as in July,” Raifman said, due to the recent spread of the 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 helpful guide to having some sort of target to aim for,” she said. “But generally, if we reach a certain extent, it doesn’t mean the transmission or the pandemic is just going to go away.”
Many scientists agree that, especially with most of the world still unvaccinated, COVID is likely to stay there, 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.”
Because of this, 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 in The Baltimore Sun in August that he caught COVID 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 such as masks, ventilation and distancing are also needed. They’re circulating the “Swiss cheese” model of COVID defense, in which every prevention 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 mandate 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 him manage us.
Even after he lifted his mask mandate, the county public health department’s Facebook page urges residents to wear masks and “pay attention to the COVID-19 situation just like you watch the weather.”
Kaiser Health News is a national health policy information service. This is an independent editorial program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.
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