One Year After First Cases, Looking Back At The Pandemic In Pitkin County
There were a few days during the second week of Mar. 2020 when the coronavirus started to feel present and immediate in Aspen. Like it was no longer a distant problem. Like there was a pandemic knocking on the front door.
Catherine Bernard, Aspen Valley Hospital’s chief of medical staff, remembers how that week played out in the emergency department.
“We were frightened,” she said. “Despite our training and our systems, the frontline workers were scared.”
With precautions and adaptations, they were able to overcome that initial fear. Time and experience made the situation a bit more manageable.
“It was a jump into the very cold deep end,” Bernard said. “It felt like in March, we saw very sick patients. I specifically saw very sick patients – some of them much older than me, and some of them even colleagues. That really brings it home and makes it very frightening.”
Now, that week’s nationwide switch into emergency mode is exactly one year in the past. In the time since then, the people working on Pitkin County’s pandemic front lines have evolved how the valley responds to COVID-19.
At Aspen Valley Hospital, the situation never became critical to the point where facilities or staff were overwhelmed. But the threat that they could face a challenging patient surge, however, changed the way they operate to this day.
“Despite never becoming overrun,” Bernard said. “We learned things about utilization and preparedness, not only on the organizational level, but as physicians.”
Hospital staff firmed up plans for allocating scarce resources such as ventilators. They expanded connections with a regional network of other hospitals for transfering the sickest patients. Telemedicine became a more important part of doctors’ arsenal for treating people who need care.
Along the course of the past year, the hospital raised the alarm that things could quickly get worse. On the cusp of winter, for example, CEO Dave Ressler cautioned that facilities might get overwhelmed and the places that usually receive transfer patients might stop accepting new ones.
He does not regret putting the community on high alert. Ressler said that level of caution may have been exactly what kept the situation manageable.
“You can't prove a negative,” he said. “You don't know what you don't know. We don't know what would have happened, had the community not taken those measures.”
Aspen Valley Hospital never entered the highest level of concern in its “capacity matrix,” a chart designed to gauge if patient volume or limited staffing are threatening the hospital’s operating ability.
That is not to say that the hospital and Pitkin County made it through one year of the pandemic unscathed. More than 2,000 residents were infected with COVID-19. Four died.
Since Mar. 9, 2020, Aspen Valley Hospital admitted or transferred out a total of 43 patients who tested positive for COVID-19. The hospital typically transfers those patients when they require a higher level of care at a lower level of altitude, often in Denver or Grand Junction.
While other hospitals across the country saw their capacities pushed near the brink, Ressler said it was not an accident that dangerous surges did not end up testing his.
“To not have had that happen, is for me a combination of gratitude for the sacrifices that our community made, the leadership of our public health and the Board of Health,” he said. “And just thank god that we never had to experience that ourselves.”
The pandemic weighed heavily on hospitals financially. The onset of new coronavirus expenses combined with interruptions to normal operations proved costly for many. Valley View Hospital in Glenwood Springs was forced to lay off about 100 employees following projections of substantially reduced income.
Despite significant income reductions at Aspen Valley Hospital, Ressler said they avoided layoffs through a combination of federal aid funding, philanthropic gifts and budget tightening.
The public health department grew and evolved
Like the hospital, the Pitkin County Public Health Department also started out in emergency mode. And as the pandemic has dragged on, they have had time to build out a long-term response.
One of the biggest challenges in the beginning was a lack of information. The department’s director, Jordana Sabella, said counties had to do their own research to figure out everything from hiring contact tracers to how to safely reopen a golf course.
“Now we're really able to lean on the state dial and state guidance and CDC guidance, she said. “Which has come a long way since the early days of the response.”
When the pandemic started, Sabella said the health department only employed six people. The size of their staff has more than quadrupled since then to include new epidemiologists and a variety of specialists focused on vaccines, testing and data.
Sabella said the steady flow of new policies and scientific findings can make the job exhausting.
“We've all just had to really become very adaptable and flexible and know that each and every day we come in and we make the best decision with the information that we have,” she said, “and it might change tomorrow.”
That constantly-changing information landscape persists as vaccination efforts continue and expand. Thousands have been inoculated in Pitkin County, but inconsistent supply from the state and inequity have presented hurdles.
Sabella, who was promoted to director about eight months into the pandemic, says decision making cannot exclusively be about preventing the spread of the virus.
“It's also about protecting those social determinants of health,” she said. “Being a resort community – part of that is being able to maintain those economic drivers that allow people to have jobs and continue to work and support themselves.”
Economic troubles linger
Work has not always been in abundant supply since last March, especially with parts of the hospitality field on hold due to pandemic-related capacity limits and shutdowns. While many jobs and paychecks have slowly come back throughout the past year, the resurgence has not reached everybody.
“We've had folks who haven't been able to work for a year at this point, said Sam Landercasper, Pitkin County’s economic assistance manager. “It's not from lack of trying, it's not from lack of want. It's just how our economy was impacted by the pandemic.”
Pitkin County’s unemployment rate was 8.7% in December 2020, according to the latest federal data. By comparison, that rate was 2.8% the previous December.
Landercasper said demand for help getting food and paying rent is down sharply from the early days, but has not entirely disappeared. Many of the requests for financial needs such as housing assistance have since been redirected to other local nonprofits.
A survey of people who applied for Pitkin County’s COVID-19 relief program in the spring showed that financial needs lingered into the winter. 74% of those initial applicants said they still needed financial help meeting their household expenses in November, when the most recent survey was conducted.
That same survey showed that 28% of people who said they lost a job in the beginning of the pandemic were unemployed in November.
As part of their switch to a long-term strategy, Landercasper sees an opportunity for the department to recast itself as less of a safety net and more of a driver for economic opportunity.
For example, they could help people find remote work, so those laid off in hospitality or struggle during lulls between seasonal jobs can stay afloat.
“If that means that maybe they're not able to work for a local company,” Landercasper said. “They don't have to move away to work for a company outside of the area.”
Despite ambitions to expand the scope of the office’s economic assistance work, Landercasper said the road ahead still includes a need for the kind of immediate, direct monetary help they are used to. Especially because some residents have not yet come to the department for aid yet, instead accruing debt that could drive them to do so later.