As the COVID-19 pandemic moves toward a more endemic phase, resources and services relating to the virus as well as vaccines and tests continue to shift in Eagle County.

According to Heath Harmon, Eagle County’s director of public health, throughout the months of May and June, the county experienced “higher levels of transmission,” mirroring the rest of the state. However, over the past two weeks, the number of new cases as well as positivity rates have started to level out and even slightly drop.

“Fortunately, throughout the period of increased transmission in our communities, hospitalizations have remained low,” Harmon said. “This helps highlight protections within a highly vaccinated community, as well as some immunity from previous infection.”

Largely the cases being seen across Colorado are still dominated by various strains of omicron. In the spring, the dominant strain was BA.2 and now BA.4 and BA.5 account for approximately 50% of COVID-19 cases nationwide, Harmon said.

“Each of these variants have demonstrated higher transmissibility compared to the original omicron strain of December and January, which is why vaccines later this year will likely cover omicron in this newer formulation,” he added. “The good news is we have not seen evidence of increased severity during this recent period of higher transmission.”

A spokesperson for Vail Health noted that COVID-19 is still present in the community. On Wednesday, the spokesman said the hospital is experiencing one to three patients a week being admitted, and that patients coming into urgent care and the clinics are generally experiencing mild COVID-19 symptoms.

As we move toward the new endemic phase of COVID-19, however, tracking positive cases and transmission has certainly changed from even six months ago as public testing sites closed up shop and at-home testing became more prevalent. 

“With a significant amount of at-home testing available, many of these cases are not reported to state or local public health agencies,” Harmon said, adding that for this reason the practice of comparing disease rates to historic or even geographic data no longer makes sense.

That doesn’t mean that disease tracking is gone, however.

“Surveillance efforts will continue to look at positivity rates, disease rates, and hospitalizations. However, the Colorado Department of Public Health and Environment is using wastewater surveillance throughout Colorado, including Eagle County,” Harmon said. “This surveillance tool helps to identify changing trends in community virus levels earlier than just looking at case rates.”

Changes to testing

In recent months — largely following the December and January surge of omicron — one of the main changes locally has been the availability of free public testing sites.

“As COVID-19 is shifting toward being endemic, the testing resources continue to evolve to reflect changes in transmission and demand for testing. The pandemic phase required more of a crisis response, hence testing locations in parking lots throughout the county and availability five or more days each week,” Harmon said. “With a disease that is more endemic, state and local public health officials are working to shift more testing and vaccination resources back into traditional medical clinics.”

In fact, the Colorado Department of Public Health and Environment recently has opted to close test sites in the region due to decreased demand. As such, starting July 1, the state department is consolidating Eagle County test sites to one location under a new provider, Affinity/Eurofin, at the Eagle Town Park.

This location will be open three days a week for six hours a day offering free PCR testing and is acceptable for travel validation. 

At local health care providers — Colorado Mountain Medical and Vail Health — testing is still available. However, around six months ago when testing sites began to close, the providers only started offering tests to those with symptoms. As such, walk-in testing and travel testing are no longer available from these locations.

As Harmon stated earlier, this has led to an increased reliance on at-home testing. Free at-home tests are widely available for pickup throughout the county and online through the federal government. In Eagle County, these pickup locations include the Vail Library, Vail Fire, Eagle County Government offices in Avon, Eagle and El Jebel as well as mail delivery via the U.S. Postal Service.

Plus, Harmon added, “Walgreens continues to provide testing and ‘patient-pay’ testing for travel is available in El Jebel outside of the Eagle County Community Center.”

And even as many things change, once a person tests positive for COVID-19, guidelines remain the same.

“We continue to ask anyone who tests positive for COVID-19 to isolate per the CDC guidelines. This remains an important prevention measure to reduce community spread,” Harmon said.

To view the testing options, which are changing on July 1, visit EagleCountyCOVID.org

Vaccines 

The most recent change to COVID-19 vaccines was the June 18 Centers for Disease Control recommendation that all children between 6 months and 5 years old receive a COVID-19 vaccine. The Centers for Disease Control and the Federal Drug Administration authorized both Pfizer (a 3-dose series) and Moderna (a 2-dose series) for this age range. 

Several locations in the county are offering vaccines to this youngest age group including the Eagle County Public Health and Environment office locations in Eagle and Avon; the state mobile vaccination bus; and local pharmacies and healthcare providers.

According to a Vail Health spokesperson, the health care provider is currently offering Moderna for this age group, with Pfizer expected to be available soon.

As for everyone else: “Being up-to-date on your COVID-19 vaccinations is important to both protect you, as well as our community,” Harmon said.

The Colorado Department of Public Health and Environment now has a vaccination calculator available to help determine how many doses are recommended for individuals. This depends on pre-existing conditions, vaccine doses received and more. This tool is available at: Covid19.Colorado.gov/vaccine-calculator.

For information on where to get vaccines in Eagle County, visit EagleCountyCOVID.org.

Even as Eagle County pushes toward an endemic phase with COVID-19, Harmon added a reminder that testing and vaccine availability and administration is also impacted by other key challenges facing the community.

“While the U.S. health care system is plagued with staffing shortages, Eagle County also has a severe affordable housing need that contributes to the challenges we have in filling positions for physical and behavioral health care providers, as well as nearly all businesses in our mountain communities,” Harmon said. “Many actions are being taken by Eagle County Government and other local partners to increase the affordable housing stock, but it won’t alleviate some of the immediate service challenges within our communities.”

Aspen Skiing Co. gave its employees 25,000 reasons to get vaccinated against COVID-19 this season.

The company held 15 drawings for $1,000 each and a grand prize drawing of $10,000 in December.

Skico president and CEO Mike Kaplan announced the vaccination mandate in September. While the vaccination rate was already above 90% for full-time, year-round employees at the time, it was lagging in some departments, and the company had a horde of seasonal employees lined up for ski season. The company had about 4,000 workers at the peak time over the holidays, according to Jeff Hanle, vice president of communications.

“We wanted to do everything we could to have a healthy workforce” and ensure the safety of customers, Hanle said.

The company required all employees to be fully vaccinated by Nov. 15. Unvaccinated employees were not allowed to start work until they got the jab.

“We had a number of employees who decided to move on because they didn’t want to get vaccinated,” Hanle said. “It wasn’t a significant number.”

To sweeten the pot, Skico started holding the $1,000 drawings in June and continued through the fall. Employees had to submit a vaccine card anyway, so they were urged to also fill out a vaccination form and enter the drawings. Early winners ranged from ski instructors to bartenders and ski patrollers, according to a September employee newsletter.

A worker at the concierge desk at the Little Nell Hotel won the big prize and pocketed $10,000 in December. She declined a request for an interview.

Even with the vaccine mandate, Skico’s ranks were hit hard when the omicron variant swept through the valley. Skico had COVID-19 testing sites at each of its four ski areas during the holiday period and urged employees who felt symptomatic or were exposed to take time for the slopeside test.

The Roaring Fork Transportation Authority was another major employer that offered incentives for workers to get vaccinations. The bus agency did not mandate vaccines but offered $500 bonuses to employees who got their shots. RFTA decided earlier this month to offer an additional $250 bonus for boosters. As of mid-January, 77% of the nearly 400 workers had been vaccinated. The booster rate wasn’t known.

Omicron officially has arrived in Pitkin County.

The county’s Public Health Department said in a news release it was notified Monday “that a vaccinated individual tested positive for the COVID-19 omicron variant.”

“There are now six confirmed cases of the variant in the state,” according to the release. “Although the recent Garfield County (omicron) case did not have any recent travel, the individual from Pitkin County had traveled, similarly to the initial cases detected in early December.”

The Pitkin County resident recently traveled to Mexico, said Josh Vance, county epidemiologist.

Omicron was first identified in Colorado in an Arapahoe County resident who had recently traveled to South Africa and has been detected in Boulder County’s wastewater, suggesting community transmission. After Garfield County announced its first case last week, Pitkin County’s public health director said the variant was likely already here.

On Monday, Vance confirmed public health officials were ready for omicron.

“We anticipated that it was only a matter of time before we would see the omicron variant in our county,” he said in the news release. “Although the delta variant still currently accounts for most cases in Pitkin County and Colorado, research suggests that the omicron variant is more transmissible than the delta variant and will likely become the predominant variant circulating in Pitkin County in the next several weeks.”

Pitkin County and Colorado’s public health department are jointly monitoring the spread of omicron locally and statewide. Local health workers talk with everyone who tests positive for COVID-19 and conduct contact tracing in an effort to slow local transmission, Vance said.

After a post-Thanksgiving lull in COVID-19 cases, Pitkin County’s incidence rate of the virus has doubled in the past week, Vance said. Data from weekend cases was scheduled to post online Monday night and was not available earlier Monday.

“Public Health encourages everyone experiencing any symptoms to get tested, particularly before spending time with friends and family,” according to Monday’s release.

Vaccines and boosters provide the best protection against infection and against severe disease and death in the event of breakthrough cases, which have been common, according to public health officials. Preliminary research indicates that Pfizer and Moderna vaccines “work against omicron,” Vance said.

“Those who received two doses of Moderna or Pfizer should get another dose of Moderna or Pfizer,” he said. “And similarly, those who received a (Johnson & Johnson) dose should get a Moderna or Pfizer booster.”

Go to Covid19.pitkincounty.com for information on testing, vaccines and boosters, as well as local data.

Aspen’s adult hockey leagues have been put on hiatus as of Friday by city officials due to players not complying with the indoor mask mandate in its public facilities.

League games are held at both the Aspen Ice Garden and the Aspen Recreation Center, and masks are currently required inside both facilities, even while playing.

“Unfortunately, we have been seeing violations on every single team, so we have to walk where we are talking and we are having to take some action now,” Denise White, the city of Aspen’s communications director, said Friday. “We are in the business to support healthy and physical activity and we know the hockey players enjoy playing, but we can’t say we are going to do something and not do it.”

All leagues — this includes the women’s Mother Pucker league — have been suspended until at least Jan. 6, which results in two weeks of the league season when factoring in the holiday break. This suspension of play does not include youth hockey at the moment, nor will it impact the Aspen High School hockey season, although spectators will be limited at games and masks will be required for everyone in attendance.

White said there will be a public meeting at 5:30 p.m. Wednesday at City Hall and all players are invited. The hope is to create a more sustainable solution for play while the mask ordinance remains in place. Among the options brought up is to require all players be vaccinated, which would mean masks would no longer be required during games.

“We don’t like doing this either, so we are looking for more sustainable solutions that our hockey players can appreciate as well as help us provide that safe environment,” White said.

White mentioned she does not believe the players are necessarily against the mask ordinance, but that during play the masks naturally tend to drop in the heat of the moment. Intentional or not, the city is determined to make sure masks stay on faces before play can resume as long as the ordinance remains in place.

“Playing and being athletic while wearing a mask has been challenging,” White said, making note of some of the other enhanced measures the city has used to curb local COVID-19 infections around the ice rink. “We hired security personnel. We focused more staff members on mask compliance and we added signage around the facility. We did a lot of messaging right around that outbreak and canceled games at that time. This is unfortunate.”

Last month, adult and youth hockey tournaments in the Roaring Fork Valley were believed to be responsible for a COVID-19 outbreak, with more than 70 individuals testing positive for the coronavirus. Pitkin County epidemiologist Josh Vance called it the area’s largest outbreak since the beginning of the pandemic.

acolbert@aspentimes.com

The number of COVID-19 cases from an outbreak that started with adult and kids hockey games in Aspen two weekends ago rose by more than 50% on Thursday after new cases were reported from a total of six Colorado counties, an official said.

The Colorado Department of Public Health and Environment notified local public health officials Thursday that 27 more cases related to hockey games played in Aspen and Glenwood Springs the weekend of Nov. 5-7 had been detected outside the Roaring Fork Valley, Pitkin County epidemiologist Josh Vance said Thursday. That included 22 children and five adults.

Those additions Thursday brought the total number of cases linked to the hockey outbreak to 71, including 36 adults, 27 children and eight others who tested positive after being exposed by those at the hockey games, he said.

“That is a lot of cases,” Vance said. “It was already our largest outbreak (since the pandemic began) before we added 20 to 30 more cases. It’s by far now our largest outbreak.”

The counties with COVID-19 cases tied to the hockey outbreak are Pitkin, Eagle, Garfield, Routt, Summit and San Miguel, he said. None of the new cases have resulted in hospitalization.

On Wednesday, the total cases linked to the outbreak included 31 adults from 10 different hockey teams and five children from two teams, as well as the eight people exposed to the initial 36 tested positive for COVID-19, he said.

The COVID-19 exposures are all linked to games involving Aspen’s B-league and C-league city hockey adult league teams that played at the Aspen Ice Garden, the ice rink at the Aspen Recreation Center and the Glenwood Springs Ice Rink between Nov. 5-7. A junior hockey tournament the same weekend sickened players who are younger than 18.

The Aspen-area rinks — which are owned by the city of Aspen — began strictly enforcing mask use for hockey players on and off the ice this week, a city spokeswoman said.

The additional cases Thursday caused Pitkin County’s COVID-19 numbers to rise even further, according to online dashboards.

Public Health reported 72 new cases of the virus in the county in the seven-day period ending Wednesday, including 63 residents and nine out of county cases. The incidence rate of the virus per 100,000 people — which was 158 on Nov. 9 — hit 355 on Thursday.

The Centers for Disease Control considers communities with an incidence rate higher than 50 per 100,000 people as having “substantial” transmission, while anything above 100 is considered a “high” level of transmission.

“We’re really looking at Thanksgiving next week,” Vance said. “There’s definitely a lot more COVID in the community. Whatever people can do to practice precautions for the holiday (is important). Be as safe as possible when gathering with people.

“We’re definitely pretty concerned heading into December.”

jauslander@aspentimes.com

The largest outbreak of COVID-19 in Pitkin County since the pandemic began in March 2020 occurred earlier this month in connection with hockey games played by both adults and kids, an official said Wednesday.

The 44 new cases so far associated with the outbreak — more are expected — prompted a statewide alert late Tuesday night by the Colorado Department of Public Health and Environment notifying the state’s other 63 counties of what happened in Pitkin County and asking that any cases possibly connected to the Pitkin County outbreaks be reported to local public health officials here, said Josh Vance, county epidemiologist.

“We were not expecting an outbreak of this size at this point,” Vance said Wednesday. “This was a very wide exposure event, so it’s difficult to discern where it came from. We think a lack of masks was a significant factor.”

The exposures all took place the weekend of Nov. 5-7, and are linked to hockey games at the Aspen Ice Garden, the ice rink at the Aspen Recreation Center and the Glenwood Springs Ice Rink. A total of 31 men and women and five children under 18 who either played in or attended the games that weekend tested positive for the virus. Eight more people exposed later by those who were initially sickened also tested positive for COVID-19, Vance said.

Of the 36 hockey-related cases, the vast majority were hockey players, though non-players also were infected. None of the cases of COVID-19 linked to the hockey outbreaks resulted in severe symptoms or required hospitalization, he said.

Technically, public health officials consider the COVID-19 hockey outbreak two separate incidents, “but there’s definitely some crossover between the two,” Vance said.

The first occurred among two junior hockey teams during a tournament held that weekend, which sickened the five players. The second took place during regular league games involving adults and infected at least one person from 10 different teams. Most of the teams were from Pitkin, Eagle or Garfield counties, though one was one from Routt County, he said.

Public health officials were inundated with the cases in about two days.

“They all came in almost at once,” Vance said. “It’s the largest outbreak we’ve had since the beginning of the pandemic.”

The city of Aspen, which owns the recreation center and the Ice Garden, was notified Nov. 12 of 17 COVID-19 cases related to B-league and C-league hockey games, said Denise White, city communications director. A-league games were allowed to continue.

“Following guidance from Pitkin County Public Health, the adult hockey games on (Nov. 12) and (Nov. 14) were canceled,” White said Wednesday in an email to The Aspen Times.

The city was contemplating Wednesday what to do about the games this weekend, she said.

Regardless of when hockey returns, players will likely notice a difference the next time they play at the Ice Garden or the ARC. The city plans to redouble efforts to enforce the indoor mask policy among teams playing at those venues, White said.

“We’re going to zero tolerance on enforcement of the (indoor mask) policy,” she said. “I wouldn’t say there was lax enforcement (before), but we have the same challenges a lot of businesses and groups face here — and that’s being everywhere at once.”

City recreation officials are even pondering requiring each team appoint a mask monitor to enforce the rule, White said.

“It’s putting the onus on the teams playing,” she said. “If somebody slips up, game over.”

The Pitkin County Board of Health required mandatory indoor masks beginning Sept. 16 because of a high local COVID-19 transmission rate. The county issued face covering guidance for sports soon after.

“Pitkin County’s local Face Covering Order requires all individuals age 2 and older to wear a face covering over their nose and mouth whenever they are participating in indoor sports,” according to the online guidance. “Pitkin County’s Face Covering Order does not provide an exception for engaging in sports with others while indoors.”

Further, “any variance granted by the State of Colorado allowing an individual to remove their face covering while participating in certain sports such as hockey, (high school) spirit or (high school) wrestling does not apply in Pitkin County unless specifically authorized by Pitkin County Public Health,” the sports guidance states.

Keith Howie, Aspen High School hockey coach, posted a note online Wednesday informing his players — who use city hockey facilities — of the new normal when it comes to mask-wearing at the city facilities where they play.

“This includes gameplay on the ice, changing in the locker rooms and within the facilities always,” according to Howie’s note, which quotes a city employee in charge of the ice rink. “… (In) order to keep players on the ice and leagues going, we will be requiring masks always.”

The city also has ordered “hockey specific masks” that will sell for $10 each and be available in the next two weeks, according to Howie’s note.

While public health officials think mask use was lax at the hockey games — some who tested positive admitted not wearing a mask while others said they wore masks at times — the game also lends itself to transmission because it involves close-contact play, Vance said. Spread may have occurred in locker rooms, as well.

Pitkin County public health officials are working closely with the leagues, which are cooperating, to continue case investigation and help them move forward.

Pitkin County’s high vaccination rate may have had something to do with the fact that none of the cases became severe or required hospitalization, Vance said.

The vast majority of the 31 adults who tested positive in the hockey outbreak were fully vaccinated, which may be the reason none of the cases became severe. And while a few had received booster shots of the vaccines, none of them had completed the 14-day waiting period necessary before the fullest immunity takes hold, he said.

“Something we’re noticing … is that almost all who tested positive got their last dose over six months ago,” he said. “We know there is a waning over time.”

Vance compared the virus to other diseases that require a few or more vaccine doses for protection, including polio, which requires four doses.

“For COVID, we may need more,” Vance said.

He said evidence shows that a COVID-19 booster shot provides significant additional protection.

Public health officials continue to emphasize that while fully vaccinated people can still get COVID-19 — the delta variant is virulent and likely responsible for the hockey outbreak — getting the vaccine will almost certainly guarantee a milder case of the virus if infection occurs, they say.

“Even with the outbreak, we haven’t seen any resulting hospitalizations,” Pitkin County Public Health Director Jordana Sabella said. “The normal course (of the vaccine) is doing its job.”

As of Wednesday, Pitkin County public health officials had not yet officially heard anything about more cases linked to the hockey outbreaks from other counties. However, Vance said he’d heard anecdotally that more cases do exist outside Pitkin County but have not yet been officially reported.

Before Nov. 9, Pitkin County was doing fairly well managing COVID-19 cases compared with the rest of the state. The incidence rate was slowly but surely going down, while the state’s was rising.

For example, between Nov. 3 and Nov. 9, Pitkin County’s daily number of new cases bounced between 28 and 33, while the incidence rate per 100,000 people ranged between 158 and 186, which isn’t low but is lower than the state average, according to the county’s online COVID-19 dashboards.

Then the toll of the hockey outbreaks began to push both numbers up. Beginning Friday, the daily case count jumped to 44, then 49 on Sunday, 52 on Monday and 53 on Tuesday. That pushed the incidence rate to 298 per 100,000 people on Tuesday, according to the dashboards.

“I think what’s apparent is how this outbreak affects the incidence rate and transmission in the county,” Sabella said. “We are such a small county, (so) we do feel the ripple effects.”

Subtracting the cases associated with the hockey outbreaks puts Pitkin County’s incidence rate at 155 on Wednesday, Vance said, which is lower than the incidence rate has been in two weeks, according to the online dashboards. He said he expects the rate to drop in the near future because no new cases associated with the hockey outbreaks have been reported since Friday.

Still, with the upcoming holiday gatherings, increased tourist activity, winter forcing everyone inside and delta still lurking, the near future could bring more cases, Sabella said.

“The pandemic’s not over,” she said. “This winter we’re really seeing it play out how transmissible the delta variant is.”

Editor’s note: This story has been updated to reflect the city of Aspen was notified Nov. 12; and the polio vaccine takes four shots.

Proof of COVID vaccination will be required this ski season for guests in certain indoor Aspen Skiing Co. venues and to participate in some activities, Skico announced Wednesday, but not for lift access.

The policy is in response to a growing number of COVID infections in Pitkin County and across the state and the country, Skico officials said in their announcement.

“Guests vaccines are required for all ASC owned and operated hotels, full-service seated restaurants, Powder Tours and additional experiences where prolonged close contact while unmasked might occur,” Skico said in a news release. “Proof of vaccination is not required for lift access, Ski & Snowboard School lessons, market-style restaurants, rental shops or ticket offices.”

Those 12 and older will be required to show proof of vaccination either with an approved vaccine card, photograph of a vaccine card or an approved vaccine verification application along with proof of identity when entering or checking in to the restricted facilities or activities.

“We put a great deal of thought in to this decision and feel that for the health and safety of our guests and employees this is a necessary step,” Skico President and CEO Mike Kaplan said in the news release. “We want to provide the healthiest environment possible in order to give us the best shot at remaining open for the season and providing a safe work environment for our staff and the community at large.”

Last month, Vail Resorts announced proof of vaccination will be required for guests ages 12-older at all indoor, on-mountain quick-service (cafeteria-style) restaurants, but the proof of vaccination requirement does not apply to fine dining establishments.

Skico vice president of communications Jeff Hanle said Thursday there were two main reasons why the Aspen resorts’ cafeteria-style on-mountain restaurants were not included in the vaccine requirement but the fine-dining establishments were.

One is the logistics of checking the sheer amount of people going in and out of those buildings, including the Sundeck at Aspen Mountain or Elk Camp at Snowmass. The other is many of those visitors are there for a short time, whether it’s a quick bite to eat or just using the restrooms.

“In the fine-dining and sit-down establishments you have people who are in there for an extended amount of time — an hour or two hours — and in close proximity and unmasked once they sit down to eat,” he said. “The other places people typically are in and out a lot quicker.”

All of Skico’s employees will be required to be vaccinated unless they have a religious or medical exemption. Those with an exemption are required to be tested weekly.

Pitkin County is currently under an indoor mask mandate, which was enacted in September and likely will continue into the winter unless case counts drop.

Masks will not be required in lift lines, and Skico likely will keep the “ghost lanes” in place, according to Hanle.

“Per the county (mandate), gondolas will be considered indoor space and masks will be required,” he said.

The pastor of Cornerstone Christian Church in the midvalley appealed to the Eagle County Commissioners this week to let his school determine its own policy on masks for students based on its religious status.

Pastor Jim Tarr, who also is president of Cornerstone Christian School, said the parents of students at the school should determine whether masks should be required rather than the Eagle County Health Department.

“In the role of society, children are not created to be obedient to any other system of government except for the wishes of their parents,” Tarr said Tuesday during the public comment portion of the county commissioners’ meeting.

He said the school isn’t forbidding masks as a precaution against COVID-19. It is letting families choose.

“There are a lot of parents who say, ‘I do not want to cover my child’s face for eight hours a day, five days per week, 180 days per year,'” he told commissioners.

Cornerstone Christian School is located along Colorado Highway 82 between El Jebel and Basalt. It has about 100 students enrolled.

Tarr took his case directly to the commissioners after he was told by the Eagle County Health Department the private Christian school must adhere to an indoor mask mandate that was extended Sept. 16 for all schools in the county. Tarr said his school requested a religious exemption.

“We didn’t hear anything for about three weeks, and that happened when we were reported to the county health department,” Tarr said. “So in that process, we began to meet with them and just said how can we navigate through this?”

The answer from the health department was to mask up. It’s an answer Tarr didn’t like, and it led to some turmoil at Cornerstone Christian School.

Principal Emily Lambert submitted her resignation after the school determined it would defy the public health order. A meeting that was called for parents after Lambert’s resignation became “very polarizing” with “anti-maskers versus maskers,” a parent said.

At least three families withdrew children from the school after the controversy erupted, according to one such parent.

As the standoff between the Christian school and county unfolded, county officials said it was their intent to meet with Tarr and explain why masks were required as a precaution against COVID-19. They said they weren’t interested in a heavy-handed enforcement action.

The county commissioners didn’t engage in conversation with Tarr. It is policy not to respond public comment. County manager Jeff Shroll said Wednesday that no resolution had been reached between CCS and the county health department.

Tarr indicated Tuesday he took offense at the tone of emails he received from the county health department.

“I just want you to understand the nature of the emails that were coming to me,” he told the county commissioners. “They would include language such as this — that the Legislature of the state of Colorado has granted to the directors of health departments, that they can, if we’re not complicit with their mandates during a crisis, they can actually take control of what happens on our property, they can quarantine. It also included this idea, if we don’t align with a mandate, then the penalty can be a $5,000 fine and 18 months in jail.”

Tarr closed his 12-minute presentation by noting that former President Barrack Obama was able to host a birthday party and not wear a mask during the pandemic without fear of getting fined or imprisoned.

“But you know what, what do I get from Eagle County? With all due respect, I get emails that are threatening, that carry threatening messages to me,” Tarr said. “And here’s the thing, if our policy ends up with me getting arrested or paying a $5,000 fine — trust me, I only have about one and a half $5,000 fines in me — then we’re done. But the truth is this. If the county (health department) comes against me, you have to understand it will be like shooting a fish in a barrel. I’m a little church and a little school, and I’m saying, please, let us live according to our faith.”

While Tarr didn’t make the case that the COVID-19 disease passes over students in religious schools, he did note that no classrooms had to be closed last year at CCS because of the pandemic.

Face masks will be required in all indoor public settings in Pitkin County for everyone 2 years old and older regardless of vaccination status beginning Thursday, county public health authorities said Wednesday.

Businesses or facilities that choose to implement a mandatory vaccination policy for employees and guests can receive an exemption to the indoor mask order if approved as a fully vaccinated facility by the Pitkin County Public Health Department.

The order, which goes into effect at 12:01 a.m Thursday, does not apply to private homes.

“By adopting an indoor mask order now, we can preserve our health care system resources, protect the health of our community and have the best chance at preventing hugely impactful capacity and social distancing restrictions in the future,” Jordana Sabella, county public health director, said in a news release.

For those who might view the mask mandate — coming after the JAS Labor Day concerts in Snowmass and the Food & Wine Classic in Aspen — as punishing locals now that the tourists have mostly gone, Pitkin County Manager Jon Peacock pointed out that officials have been “telegraphing” the possibility of a mask mandate since mid-summer.

“Masks are not punishment,” he said in a news conference Wednesday afternoon. “They’re protection. They’re mandates in place to protect our local community. It starts with a mask.”

During its monthly meeting last week, the Pitkin County Board of Health directed Sabella to draft an indoor mask order for public spaces by this week if COVID-19 case counts didn’t decrease. They have not, and in fact have increased in the past seven days.

“We didn’t expect … anything precipitous to change,” Dave Ressler, Aspen Valley Hospital CEO, said Wednesday at the media briefing. “We haven’t seen a significant change.”

Pitkin County’s incidence rate hit 298 per 100,000 people on Monday — nearly three times the transmission rate the Centers for Disease Control considers “high” and the highest so far of the delta wave of cases, according to online Pitkin County COVID-19 statistics dashboards. The rate was back down to 276 Tuesday, though that equals the highest rate in the past two weeks.

The county has has 61 new cases of COVID-19 in the past seven days, which included 49 residents and 12 out of county cases, according to the online dashboards. The daily number of new cases in the county has hovered between about 40 and 50 for residents in the past two weeks, while the number of out of county cases has stayed roughly between 10 and 15 per day during the same time period.

The latest COVID-19-related death occurred over the weekend at Aspen Valley Hospital, when an elderly, fully vaccinated person died, sources have said. A total of five Pitkin County residents have died form the virus since the pandemic began in March 2020.

Despite the death of a fully vaccinated person, public health officials continued to urge people to get the vaccines, which they stress offer the best protection against serious illness, hospitalization and death.

The health board’s action a week ago also came on the heels of AVH deciding to move from “comfortable” to “cautious” for the first time in months. As of Wednesday, the cautious designation remained in place, with between six and 10 essential health care workers out with COVID-like symptoms, between six and 10 average daily visits by COVID patients and 25% to 50% inpatient hospital capacity and transfer capacity.

Public health and AVH officials decided to remain at the cautious level during a meeting Wednesday, Sabella and Ressler said. A main part of that decision was the fact that it’s becoming harder to transfer COVID-19 patients who need a higher level of care to hospitals in Denver and Grand Junction, Sabella said.

As of Friday, just 12% of ICU beds were available across the state, Ressler said.

“Clearly, capacity issues at a system level are significant,” he said, noting that though AVH was able to transfer a patient this weekend he remained worried about those capacity issues.

On Wednesday, one of AVH’s four ICU beds was occupied by a COVID-19 patient, while another was occupied by a non-COVID patient, Ressler said.

The CDC has recommended universal indoor masking since July 27, when it warned that the COVID-19 delta variant was twice as contagious as the alpha variant. Pitkin County Public Health officials seconded that advice, though indoor mask wearing was spotty at best in Aspen and throughout the county and state.

Pitkin County becomes the fourth county in Colorado to implement an indoor mask mandate, behind Boulder, San Juan and San Miguel counties, after Gov. Jared Polis lifted a statewide indoor mask mandate in May.

In Pitkin County, the new order will require masks indoors during periods of high and substantial transmission. Once the rate drops to moderate or low levels for 21 consecutive days, the mask requirement will automatically return to a recommendation. Should cases rise to substantial or high transmission levels again for five consecutive days, the mask requirement again would go back into effect until the transmission level drops again, according to the news release.

High transmission means an incidence rate of 100 or more cases per 100,000 population, while substantial transmission is considered to be occurring when the rate lands between 50 and 99 cases, according to CDC guidelines. Moderate transmission is defined as an incidence rate of between 10 and 49 cases, and low transmission occurs when 10 or fewer cases per 100,000 population are detected.

Masks will be required on public transportation, in public and private offices, retail stores, restaurants, bars, event centers, gyms, recreations centers and any other indoor space that allows the general public, the county said. Masks are not required anywhere outdoors.

“Public Health also recommends that businesses and facilities move activities outdoors whenever possible, or increase ventilation by opening windows and doors, running the HVAC or installing portable air filters,” the release states. “Only second to vaccination, adoption of an indoor mask order is an extremely effective tool to prevent the spread of COVID-19 and set a universal expectation for mask wearing throughout the community.”

Businesses and facilities that want to implement a mandatory vaccination policy for employees and guests or customers so indoor masks are not required can begin applying to the Pitkin County Public Health Department on Oct. 11. Further details are pending.

“This is a voluntary program that allows businesses to develop their own policies to encourage and require vaccinations while meeting their specific demographic, community and business needs,” according to the release. “All businesses must receive explicit approval as an Approved Fully Vaccinated Facility by Pitkin County Public Health.”

At Wednesday’s media briefing, Sabella said the Public Health Department would not be collecting vaccine information for employees of businesses that apply for the program. They will, however, look for a detailed policy on how that information is being communicated, collected and safely stored, she said. Sabella suggested businesses consult with legal counsel to come up with the best individual plan.

Exact criteria about the program will be posted on Pitkin County’s COVID-19 website in the coming weeks, she said. Businesses will be able to apply for the program online.

Businesses or facilities that already require guests and employees to provide proof of vaccination and plan to continue that policy can contact communityliaison@pitkincounty.com to obtain an exception to the mask order.

Further information about the mask order can be found at covid19.pitkincounty.com/mask-recommendations/#details.

Rising COVID-19 case counts along with all four of Aspen Valley Hospital’s ICU beds full Thursday, half of them with COVID-19 patients, was enough evidence for the Pitkin County board of health to unanimously agree to empower the public health director to craft a new indoor-mask mandate.

The health board issued the directive during its monthly and virtual meeting Thursday. That does not mean people in Pitkin County are required to wear face-coverings indoors Friday, Saturday, or Sunday or into early next week. What it does mean, however, is the county’s public health director, Jordana Sabella, is now charged with creating an indoor-mask mandate by next week if coronavirus case counts continue to hold steady or worsen.

The extra time also will give the community and businesses time to digest the policy, which will be modeled after a similar mandate in Boulder and under guidelines set by the Centers for Disease Control and Prevention. Local hospitalization data also will factor into the decision.

For the mandate “to be done right and communicated correctly,” Sabella said, additional days given to write the order will help the county “make sure we communicate what the policy is, to make sure it is correct and as good as we can make it the first time around, and roll this out in a responsible way.”

Board chair Greg Poschman, also a county commissioner, said: “I think the board can say ‘yes, let’s do this, and let the public health director make the call.'”

Sabella has met with Aspen Valley Hospital officials every Wednesday during the pandemic to better understand its operations. After next week’s meeting, and if trends hold, she will create the mandate that could take effect as soon as Thursday.

“This board, going even back two months now, has really been talking about using that as our primary metric for our precautions in our community,” Aspen Mayor Torre said in reference to hospital operations.

AVH was functioning at “cautious” levels in all three categories it uses to determine its operational health during the pandemic. The hospital made the switch Thursday from operating in the comfortable level in the three metrics, according to data presented at the meeting.

• Cautious means that six to 10 essential health care workers at the hospital are out with COVID-19 or its symptoms.

• The hospital’s daily visits as they relate to the coronavirus also were considered cautious — the emergency department averaged more than six COVID-19 visits a day during its last seven-day reporting period through Wednesday, its respiratory evaluation center was seeing at least 10 coronavirus patients daily, and its community testing center was giving at least 16 tests a day.

• The third metric, AVH’s hospitalization and transfer capacity, also was deemed cautious because it operated at 25% to 50% capacity during the most recent period.

The situation is compounded by what is happening elsewhere in area and state hospitals, noted David Ressler, CEO of Aspen Valley Hospital. The more full other hospitals become, the more difficult it is for AVH — a 25-bed critical-care facility — to transfer patients to larger operations.

“It doesn’t take much to stress our system,” Ressler said Thursday. “So we don’t want to wait until we’re overwhelmed. We want to be forthright with yourselves and the community on where we stand. And right now, we’re cautious.”

The board of health batted around the possibility of issuing a mask recommendation rather than requirement. They concluded that though a mandate would not be enforced, it would command more buy-in from residents and visitors than a recommendation would.

“I’m supportive of what puts the health and safety of the community first,” said Mayor Torre, who shrugged off the suggestion that the mandate would not carry much clout without enforcement.

Masks currently are required indoors at Aspen public schools and on public transportation — whether it’s on a Roaring Fork Transportation Authority bus or a United Airlines flight. Unvaccinated people who are in settings with vulnerable or at-risk populations also are required to wear masks.

The CDC’s most recent guidance is to wear a mask indoors in places with “substantial” or “high” rates of COVID-19 transmission. Pitkin County checks those boxes, officials said.

As of Tuesday, Pitkin County’s incident rate of 253 cases for every 100,000 people was nine times what it was at the same time last year, according to county epidemiologist Josh Vance.

Pitkin County’s resident case count was 45 from Sept. 1-7, up from the 40 recorded during Aug. 25-31, 41 during Aug. 18-24, and 19 from Aug. 11-17, Vance said.

Of the 145 positive cases during that period, 47 involved unvaccinated people, according to the report from Vance, who noted that approximately 90% of Pitkin County residents have received at least one vaccination shot.

Unless another municipality or county beats it to it, Pitkin County would be the second governmental entity to issue a mask ordinance since Gov. Jared Polis lifted the statewide mandate in May. The mandate doesn’t apply to indoor business that fall under the fully vaccinated status if they require patrons to show proof that they are fully vaccinated.

Belly Up Aspen, a downtown concert venue, doesn’t have social-distancing or face-covering requirements, but patrons are allowed entrance only if they show documentation that they have been fully vaccinated for at least 14 days. Businesses that follow that model would not be required to adhere to the mask mandate; business not using that model would need to put signs up about the county’s mask mandate.

Board members acknowledged that this is a busy month for events. The Food & Wine Classic starts Friday, with most of the event’s offerings held in open-air tents on public Aspen parks. It also has testing sites, and patrons must show verification of vaccination or a negative test result. Ruggerfest is also on tap this month, as well as the Golden Leaf Half Marathon, Aspen Filmfest and Aspen Autumn Words.

“We are probably a week-and-a-half late on this,” said Torre.

rcarroll@aspentimes.com