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Where are Colorado’s COVID-19 hotspots? The answer is more complicated than it seems.

State’s latest modeling report and color-coded dial show different areas of concern

David Parker gets tested for COVID-19 ...
Kelsey Brunner, The Aspen Times
David Parker gets tested for COVID-19 at the MIRA bus in El Jebel on Thursday, April 16, 2020.
DENVER, CO - MARCH 7:  Meg Wingerter - Staff portraits at the Denver Post studio.  (Photo by Eric Lutzens/The Denver Post)

Mountain ski communities still look like hotspots for COVID-19 in Colorado, but you might want to be just as cautious if you’re traveling to the Eastern Plains.

The Colorado School of Public Health’s current model shows new infections are starting to decrease in the mountains, but are picking up in much of the state’s eastern half.

The state’s dial framework still shows hotspots in ski communities, however, with only a few warning signs on the Eastern Plains.

Which one is right? That’s difficult to say — and both regions could be relatively risky.

The school’s model has a two-week delay built in, so it’s possible that it missed recent changes. The Colorado Department of Public Health and Environment’s dial dashboard provides closer to a real-time view of how the virus is spreading, but counties that do less testing could skew the results.

“Both of these frameworks are useful in determining risk levels. The lowest-risk activities include staying at home or in your own community, especially until you and the majority of other Coloradans are vaccinated,” a state health department spokesman said.

Hospitalizations for the coronavirus have been essentially flat in Colorado since mid-March, though new cases have begun to trend up again. On Thursday, the state averaged 1,179 cases each of the last seven days, up from about 961 per day two weeks earlier.

That obscures wide variation, though: More than half of Colorado counties had no more than 10 people test positive last week, while some of the state’s most-popular tourist destinations approached levels that would shut down indoor dining.

Hospitalizations rise in the east

The latest COVID-19 modeling report estimates about one in every 44 people is infected and potentially contagious in Colorado’s east central region, which includes Elbert, Cheyenne, Kit Carson and Lincoln counties. That’s about four times the risk any given person you ran into in the Denver area would be infected, and nearly 15 times the risk you’d find in southwestern Colorado.

According to the model, the odds that any particular person is infectious are decreasing in the western and southern parts of the state, and in the Denver area. They’re increasing in the central region, which includes Chaffee, El Paso, Lake, Park and Teller counties; and the northeast, which includes Larimer, Logan, Morgan, Phillips, Sedgwick, Washington, Weld and Yuma counties.

The School of Public Health’s model relies on coronavirus hospitalizations and mobility data from cell phone tracking to try to determine how many people could be contagious.

Using hospitalizations does introduce a delay, because most people aren’t sick enough to need that level of care until about two weeks after they’re infected, said Dr. Jon Samet, dean of the Colorado School of Public Health. Unlike case data, however, it doesn’t vary based on how much testing a community is doing — if you’re sick enough, you’ll probably end up in the hospital regardless.

It’s possible that the eastern counties might be starting to improve, and the model didn’t catch it because of the delay, or that those areas didn’t have enough testing to get at the scale of the problem, and look better on the state’s dashboard.

There are some areas of overlap between the school’s model and the state’s dashboard. Some of the counties in the regions the model identified as hotspots are in yellow for hospitalizations on the dashboard, meaning their hospitalizations increased three to six days of the last two weeks. The two don’t line up exactly, though, with the dashboard also putting some Western Slope counties in yellow.

The dashboard also noted high positivity rates in Lake, Teller and Elbert counties, which are in regions the school’s model flagged. Karen Mutzert, deputy public information officer for Teller County Public Health and Environment, said they’re still trying to sort out why 9.3% of COVID-19 tests were positive this week.

Dwayne Smith, director of Elbert County Public Health, was more certain about that county’s 8% positivity rate. Elbert County is dealing with outbreaks in a school and a church, and he thinks people may be loosening their precautions because of “pandemic fatigue.”

Cases sky-high in ski country

The state’s dial framework for deciding on COVID-19 restrictions paints a different picture. It found the highest case rates in Colorado’s ski communities, with Pitkin County recording 461.8 cases for every 100,000 people as of Friday morning.

That means roughly one out of every 215 people in Pitkin County tested positive in the last week. While high, it’s an improvement over earlier in the week, when about one in 200 people was newly diagnosed. At that level, the county could have been pushed into level red, which would close indoor dining.

Summit and Eagle counties weren’t far behind, in the dial data. Roughly one in 265 people in Summit County tested positive, as did about one in 430 in Eagle County. Both had high percentages of tests coming back positive, as did Pitkin County. When more than 5% of tests are positive, it’s a sign that public health agencies may not be catching significant numbers of infections.

The state’s dial looks at average cases and the percentage of COVID-19 tests coming back positive over the previous week, as well as whether hospitalizations increased, decreased or held steady over two weeks. People typically develop symptoms around five days after infection, so they’re likely to get tested well before they would end up in a hospital, providing closer to a real-time view of the virus’ spread.

The numbers can be skewed if a community isn’t doing much testing, though the positivity rate can help flag if that’s what’s going on.

Last week, Pitkin County moved into Level Orange, which limits most businesses to 25% of capacity. Restaurants and other businesses that have completed the state’s 5 Star certification process can be up to half-full, though. Summit County also had raised alarms about tightening restrictions, but hadn’t done so as of Friday afternoon.

Five other counties also had positivity rates that fell into Level Orange or Level Red: Teller, Elbert, Lake, Clear Creek and Custer.

Reggie Foster, spokeswoman for Custer County, said the 8.6% positivity rate reflects their small population, and new cases have been in the single digits. The county had dropped all COVID-19 restrictions in early March, and Custer’s three county commissioners tested positive soon after, according to the Wet Mountain Tribune.

“Our county is so tiny, and we only have a few tests,” Foster said.