Mesa County no longer has a single bed available in intensive-care units, as the county recorded more than 2,000 new COVID-19 cases and seven deaths affiliated with the disease caused by the novel coronavirus in the last two weeks.
Denver Health, too, has seen its intensive-care capacity met several times over the last week.
Still, Aspen Valley Hospital CEO Dave Ressler assured Friday that patients in need of care in Pitkin County will get it.
“It isn’t time to hit the panic button yet, as doing so can be disruptive,” he said. “But it is time for us to understand the implications of our behaviors, both locally and across the region and across the state. Our inability to slow the spread of this virus could very likely lead to the condition that we wouldn’t be able to have critical-care beds available to transfer patients when we need them. This is more than just reducing the spread so we can keep our community open — it literally, ultimately is about saving lives.”
Currently, two of three categories of Pitkin County’s COVID-19 metrics that pertain directly to AVH are in “cautious” rather than “comfortable” ranks. While the hospital is not concerned about its capacity at the moment, there are 15 staff members out of work, more than half of whom are in quarantine.
Ressler emphasized that, like the school district and other large employers in the area, quarantine is the primary culprit behind creating staffing shortages, not the disease itself. One ironic silver lining of large swaths of people restricted to quarantine? It means the box-it-in strategy is working.
“It isn’t just a matter of people being out ill,” he said, adding that those with symptoms include the full spectrum of ailments, not just COVID-19. “We have a lot more that are quarantined because of a contact tracing process that is working well in our county. But it has the effect of reducing your workforce if we follow the rules.”
Additionally, the contact tracing program is creating what for a short while became a backlog of people needing to receive a COVID-19 test. As more and more robust testing sites come online throughout the Roaring Fork Valley, AVH has focused more closely on ensuring those with a known exposure to the disease are tested.
In the last two weeks alone, AVH reported 30 positive test results and 348 negatives, according to data outlined on the county’s COVID-19 dashboard.
“We used the parking lot Monday at the high school to set up an emergency testing site to accommodate our large volume of contact-traced tests that we had to get caught up on, that would have clogged the system, as it were,” Ressler said. “The city provided the kiosk — it’s kind of like a tiny home on a trailer. We staffed it, and the schools provided the parking lots. It was truly a partnership that evolved over the weekend. That was really good news.”
Like has been the case with the pandemic since its arrival to the area in March, landscapes change quickly and, in turn, the plans in order to respond accordingly. For instance, in its surge plans, AVH relies on St. Mary’s Medical Center in Grand Junction as a “Tier 1 choice” for transferring patients in need of higher levels of care or lower elevations — but as of this week, that is no longer a viable option.
“It’s true that there are not any critical-care beds available at St. Mary’s as of this morning, but there are beds,” Ressler said. “We constantly monitor the availability of beds in Denver, and even … for some patients, Valley View [in Glenwood Springs] may be an option.”
To that effect, technology has streamlined communication and strategic partnerships among an already close-knit hospital network, he continued.
“All the hospitals are working together and providing real-time information about bed capacity so we’re able to make decisions, if we have to, about where to send a patient,” he said. “Also, the Colorado Hospital Association is facilitating this process and has developed a transfer center that is a centralized resource that we can contact that will assist us with locating a bed to which we can transfer the patient. They’ve done a really good job.”
Additionally, an online platform called EM Resource, which has existed for months, has emerged as an integral, twice-daily tool in the era of the pandemic, especially as hospitals find themselves confronted with having to turn to surge plans.
“It’s an immediate view into where beds are available. Before this call, I had somebody look it up: that’s how I knew St. Mary’s didn’t have a critical-care bed, but I could tell you how many beds are available at each of the hospitals in Denver, as well,” Ressler said.
Still, Ressler remains optimistic, even as the Colorado Department of Public Health and Environment warned the Pitkin County Board of Health this week that the county would likely have to move into the red level of the COVID-19 dial, bringing far more stringent restrictions that tend to hit the hospitality and restaurant industries particularly hard.
“We can do this, it’s just going to require that we shake off the fatigue of COVID and just agree there’s a light at the end of the tunnel, so let’s double down and get this done,” he said, adding that the need for mitigation strategies will continue well into next year. “The cavalry won’t get here, at least as it pertains to a vaccine, in time for ski season.”
Greg Poschman, a Pitkin County commissioner who also serves on the health board, agreed with that sentiment Friday evening.
“The big, hard challenge is going to get everyone on board. The staffs in restaurant kitchens, the crews out working on projects around town, it’s going to come down to that. When we say informal gatherings are such a large part of that, informal gatherings are happening in restaurant kitchens,” he said.
Poschman was feeling a bit of discouragement after receiving a particular photo documenting a lack of protocol being followed in an Aspen commercial kitchen.
“A photograph was sent to me last night that just showed a restaurant kitchen where nobody was following protocol,” he said with some trepidation, noting he didn’t want to cause a “panic.”
“I confess, I’m not sure we are up to this task of doing the safe thing. We all have to follow this, and I’m not seeing it,” he said. “We’ve just been given the Stanford marshmallow experiment as a community, and we’ve decided to go for the marshmallow right now — which is a week in offseason. So I’m exhausted by all of this.”
Still, Poschman finds hope in the myriad entities working together.
“We all want to solve this problem — it underscores the necessity of good, clear communication,” he said.
Ressler pins much of his optimism on the technological advances that have flooded the market and evolved testing capacities to the point that has so dramatically benefited the area recently. He pointed to Roaring Fork Neurology’s new El Jebel testing site and the hospital’s own drive-thru site in Basalt as resources that would not have been possible even a few months ago.
“What you have is a rush to the market by technology and innovation,” he said. “These capabilities that have been developed could be applicable to future pandemics. That’s heartening — I think we may be able to handle our next pandemic better, so that’s heartening.”