Editor’s note: This story, a collaboration between Aspen Public Radio and Aspen Journalism, is the first in a two-part series looking at the impacts of COVID-19 across six Western Slope counties. Read part two, which looks at data outcomes across the six counties, here.

https://aspenjournalism.org/wp-content/uploads/2022/09/COVID-Western-Slope-Part-1-FEATURE.mp3

Most people can remember how their lives changed when the COVID-19 pandemic reached their corner of the world.

“I still have a sticky note on my computer,” Gunnison County Public Health director Joni Reynolds said. “It just simply has the date and positive test. It was March 9, the first positive test we had in Gunnison County. And it changed my world. It changed the whole world.” 

About two and a half years after the first COVID-19 case was reported in the United States and in Colorado, responses to the pandemic have varied widely across the state — and on the Western Slope. 

Gunnison County Public Health Director Joni Reynolds, pictured on Sept. 19, 2022. Gunnison County had one of the state’s first reported COVID-19 cases in early March 2020. “And it changed my world. It changed the whole world,” she said. Credit: Luna Anna Archey/Aspen Journalism and Aspen Public Radio

Gunnison County is among those mountain communities — which also include Pitkin and Eagle counties — that recorded one of the first COVID-19 cases in Colorado. 

Those first cases came from both domestic and international travelers visiting highly popular mountain resort communities such as Aspen, Vail and Crested Butte. 

Despite these towns being destinations for international and domestic travel, in the weeks leading up to March 2020, not all local officials were convinced that the virus would cause a problem if it arrived in the U.S. — until those first cases were detected.

Dr. Kim Levin, medical officer for the Pitkin County Board of Health, remembered a board meeting in late 2019 at which she made a presentation about COVID-19.  

“I think I presented … [that] this is this illness that’s overseas and it’ll never come here,” she said, based on previous experiences with Ebola and other global infectious diseases that did not significantly impact the U.S. “And so I think we had that mentality.” 

But she was proved wrong in March 2020, when the first COVID-19 cases reported in Pitkin County were detected in a group of visitors from Australia. “And then when it arrived, I was honestly — I was absolutely terrified,” Levin said.

At the time, Gov. Jared Polis took matters into his own hands and signed an executive order on March 14 shutting down ski resorts across the state. These high-altitude, tourism-focused counties faced specific challenges, including the altitude. 

“There’s so many people coming from sea level or lower elevations with complex medical issues and with a history of lung and heart disease and diseases that put people at higher risk to progress to more moderate and severe COVID,” Levin said. “There was a sudden increase in demand for home oxygen use.”

This led to patients getting transferred to hospitals along the Front Range, where elevations were lower and resources were greater.

Dr. Kim Levin, an emergency medicine physician at Aspen Valley Hospital, also serves on the Pitkin County Board of Health, which guided public health policy throughout the COVID-19 pandemic. Credit: Caroline Llanes/Aspen Public Radio

From state to county-level decision making

In the summer of 2020,  Polis signed a new executive order — Protect Our Neighbors — that tailored restrictions to each county.

This was largely based on a few key metrics — case rates, test-positivity rates and hospitalizations. It allowed each county to adopt stricter measures than state guidance if its leaders so wanted. 

From September 2020 to April 2021, the state health department’s COVID-19 Dial indicated the status of each county based on those metrics and the restrictions they had to put in place. 

But starting in mid-April 2021, the mandatory restrictions ended and the dial became advisory. Since then, local governments have had the final say on most public health restrictions. 

“When the state response really then puts a lot of that control back to the local officials, it’s when you really saw a dramatic shift in terms of what one county was doing compared to another county,” said Eagle County Public Health Director Heath Harmon. 

In the Roaring Fork Valley, which is made up of three counties, those differences were immediately apparent. In Basalt, a town that sits in Eagle and Pitkin counties, masking ordinances varied at some point from one side of town to the other.

Resort communities’ transient population made it more difficult to track virus’ spread

But for resort communities such as those in Pitkin and Eagle counties, the state’s metrics weren’t adapted to those counties’ unique characteristics. 

“We have 18,000 residents that, on any given day, we can have three or four times that number in the county,” said Pitkin County Public Health Director Jordana Sabella. The census number doesn’t count visitors and commuters coming from neighboring counties to work in Pitkin County.

Sabella said this situation made it difficult to understand how the virus was spreading, how they could measure it and how they could set up an effective communication strategy. 

“If you’re coming into the county and you don’t live here, you might not be reading the paper or know about our website,” she said. “So how are we getting the message out to those folks?”

Diners wait outside the White House Tavern in Aspen in late 2020. Despite mask mandates and in-person dining restrictions during the first year of the pandemic, Aspen saw high levels of tourism. Credit: Dan Bayer/Aspen Journalism

Sabella said collaboration with local partners up and down the Roaring Fork Valley and Pitkin’s neighboring counties of Eagle and Garfield was key during the pandemic. 

This transient community created another obstacle to overcome for public health officials and hospital systems in Western Slope counties. Often rural in nature, or catering to populations that expand and contract seasonally, health systems weren’t always equipped to handle COVID-19 cases when they came in waves.

Garfield County Public Health Director Josh Williams recalled that this led to major stress on local health departments and health care systems as they dealt with the impacts of COVID-19 with fast-changing information.

“The volume of information is probably one of the biggest stressors that was coming in constantly throughout the day, as well as into the evenings and early mornings — 3,000-plus emails, thousands of calls that were coming in and out of our operations center,” Williams said. “We also had staff whose family was impacted by COVID. … Our friends were affected and we lost friends and loved ones. … I think that [made] it even more stressful when there’s maybe public angst about the situation.”

Staffing issues were already a problem for rural health departments, often located in areas where housing is scarce and expensive.  

“We’re having a hard time recruiting,” Williams said. The cost of living is difficult, especially with nursing. We definitely have a hard time on some of those because of the competitive wages with that licensing.”

And those weren’t the only stressors local public health departments faced. Pushback toward public health measures — from masks to social distancing — was a constant across the Western Slope. Officials at nearly every public health department said they had trouble finding solutions that made everyone happy.

“It was hard for especially a rural community. We’re cowboys out here in Mesa County,” said Allison Howe, a communications specialist with Mesa County Public Health. “I was just so heartened to see these staff members continue to give the services — and even though they knew that there’s a lot of ugly being thrown at them for the work they are doing.” 

This ugly rhetoric is also something that Pat Sullivan, nurse manager for the Delta County Public Health Department, observed in her community. 

“What I learned is that not everybody understands what public health is,” Sullivan said. “And not everybody cares about everybody.”

This put a strain on people’s relationships within their communities. Harmon, from Eagle County, said he felt that pressure. 

“When you’re implementing a public health order or a public health decision and you have community members that are in disagreement with that decision, a lot of times, they’re our neighbors,” he said.

Looking at these past 2½ years, a lot has changed regarding what we know about the virus, variants, testing, vaccines and treatment options. Some of the public health policies put in place didn’t always make sense or they felt wrong to some people in these communities. But in those early days, they felt they were doing the best they could with the information they had.

“I can’t change the decisions I made in March of 2020 based on what I know today, nor should anybody be judged based on decisions they make, based on the information they have at that time,” Gunnison County’s Reynolds said.

A scene outside Gunnison, Colorado. Public health departments on the Western Slope serve counties that are rural in nature, home to residents often classified as “independent thinkers.” Credit: Luna Anna Archey/Aspen Journalism and Aspen Public Radio

Editor’s note: This story was edited to correct the date of a meeting during which Pitkin County Board of Health member Dr. Kim Levin gave a presentation before COVID-19 had reached the U.S. The meeting was in late 2019, not late 2021.

This project is a collaborative effort between Aspen Journalism and Aspen Public Radio. Part two, which looks at data outcomes across the six counties, can be read here.

Laurine Lassalle

Laurine Lassalle is Aspen Journalism’s data desk editor, where she works to catalogue and analyze local public data. She also heads our our “Tracking the Curve” project, documenting COVID-19 in Pitkin,...