Editor’s note: This story is a collaboration between Aspen Public Radio and Aspen Journalism, and is the second in a two-part series looking at the impacts of COVID-19 across six Western Slope counties. Read part one, which looked at how different the initial responses were across the six counties, here

The impacts of the pandemic have varied widely across the Western Slope, especially between mountain communities with higher infection rates but lower death rates and counties to the west, which saw fewer cases but higher death rates.

In the beginning stages of the COVID-19 pandemic, public health professionals across the Western Slope were faced with big, unprecedented challenges as they worked to find solutions while the science was still new and information could change by the day.

In December 2020, however, there was a game changer: COVID-19 vaccines.

Now, these communities, often rural in nature, had access to a pharmaceutical tool to help fight the virus.

But there were challenges to getting those vaccines to the folks who needed them.

And that shows in different counties’ death rates.

An analysis of pandemic data from six Western Slope counties —Pitkin, Eagle, Garfield, Gunnison, Mesa and Delta — conducted by Aspen Journalism and Aspen Public Radio shows that the counties home to resort communities that played host to the first cases saw higher infection rates but lower death rates, while the lower-elevation counties saw comparatively fewer cases but higher death rates.

Delta County has reported about 6,700 cases and more than 140 COVID-19 deaths since 2020, according to the Colorado Department of Public Health and Environment (CDPHE). Its death rate is 10 times higher than Pitkin County and double the state average.

But Delta County had one of the lowest case rates in the region — nearly two times lower than Pitkin.

Mountain communities — which still saw lots of tourists, even during the pandemic — have some of the highest case rates in the state. But they counted very few deaths —some of the fewest in Colorado.

A mural in Delta, Colo. Delta County is known for its produce, particularly fruit and sweet corn. While the county had one of the region’s lowest COVID-19 case rates, its death rate was higher than most other counties. Credit: Luna Anna Archey/Aspen Journalism and Aspen Public Radio

Although the cumulative number of deaths per capita for Eagle, Pitkin and Gunnison counties steadily increased without large spikes over the past two years, Mesa and Delta counties have seen their death rates jump in fatal waves.

From Nov. 4, 2020, to Feb. 4, 2021, Delta County’s death rate multiplied by nearly 20, jumping from 9.6 per 100,000 to 189.3 per 100,000. This corresponds to 56 new deaths.

“We definitely saw fatalities in the long term care facilities, and that was before vaccines were available,” said Delta County Health Department nurse manager Pat Sullivan. “So you look at risk factors — the very old and, of course, those individuals had some chronic medical conditions and there were individuals who got exposed and didn’t realize they were being exposed and they had underlying health conditions.”

About a year later, during the Delta variant wave and after vaccines were available, the county’s death rate still increased by nearly 44% in the fall, from 272.7 per 100,000 on Oct. 15, 2021, to 391.5 per 100,000 on Dec. 15, 2021.

This means that 37 people passed away with COVID-19 between mid-October and mid-December 2021.

Vaccination helped prevent additional COVID deaths

Sullivan thinks low vaccination rates played a role in Delta County’s high death toll.

“There were some individuals who unfortunately suffered because they just didn’t think it was going to be as bad as it was,” she said. “And if they were a leader in the community, other individuals followed their lead and may have suffered as well.”

Mesa County followed the same pattern but over a longer period of time with more deaths occurring later in December 2021. From mid-October 2021 to mid-January, the county’s death rate rose by nearly 50%, which represented about 170 new deaths.

Meanwhile, in that same time frame, Pitkin County reported only two new deaths, and Eagle County’s rate remained stable. On Oct. 15, 2021, Pitkin County’s death rate was hovering at about 28.2 per 100,000 and Eagle County’s rate was at 56.3 per 100,000. On Jan. 15, they reached 40.3 and 62.9, respectively. This means that four Eagle County residents passed away with COVID-19 over this period of time.

Dr. Kim Levin, who serves on the Pitkin County Board of Health, explained that multiple variables probably contributed to this low death rate.

“We started with a healthier community than other communities,” she said. “Vaccines, all of the masking efforts, the social distancing efforts, all of the tools that were put into place effectively and how we can put them in place and at local level work towards that end.”

Nearly 90% of the population ages 5 and older in Pitkin County and 85% of that population in Eagle County are fully vaccinated.

It’s a very different picture in Delta and Mesa counties, where about 50% to 55% of people ages 5 and up is fully immunized.

Different vaccination distribution strategies across the Slope

Sullivan remembered the emotion and hope that came with the first vaccine clinics in Delta County.

“What was interesting is these were people who, for the most part, had been isolating at home because they thought they would die if they got this,” she said. “This was not a joking matter to them. Some of them cried when they got it. It was very emotional. People in wheelchairs, the very elderly who were at home, husbands and wives, children bringing in their parents.”

Many counties took an approach to vaccine distribution that involved big public information and education campaigns, actively putting materials and personnel into their communities to make people aware of the vaccines and to provide them with information.

But Delta County’s approach was very different — something Sullivan said was an attempt to embrace local culture.

“It would probably be no surprise to consider the West Slope individuals as independent thinkers,” Sullivan said. “Our approach has just kind of naturally fallen to ‘Here is what we’re offering for you today. Can I make any promises? I can’t promise anything, but I can tell you it is going to improve the risk, so you will be less likely to be hospitalized. If you’re vaccinated, you will be less likely to die, especially if you have some of these underlying risk factors.’”

Sullivan said there was even a physician in Delta County that prescribed ivermectin — a medication most commonly used as horse dewormer — as an alternative to the COVID-19 vaccine.

The medication has not proved to be an effective COVID treatment, although it gained popularity after some conservative political figures spread false claims of its effectiveness.

Combatting inaccurate information about COVID and the vaccine was a challenge for public health departments looking to get as many people vaccinated as possible.

But despite these challenges, Sullivan said health department staffers wanted to honor that independent-thinking spirit of their community.

“I’m not trying to convince anybody of anything. I’m just trying to help them,” she said.

Delta County Health Department staff outside their headquarters on Sept. 20, 2022. Credit: Luna Anna Archey/Aspen Journalism and Aspen Public Radio

Eagle County undertook a much more aggressive campaign than Delta County did, looking to meet people where they’re at.

Those efforts included live question-and-answer sessions on social media and public-information campaigns, as well as making the vaccine as easy to access as possible and offering clinics at health care centers and throughout the community.

A huge challenge for many counties was making sure that the more-vulnerable populations were able to access the vaccine and providing people who didn’t speak English with accurate, understandable information about the vaccine.

Although most of the white population in Eagle County got at least one shot of the vaccine, about 40% of the county’s Latino population did as of April 1.

“We implemented some strategies as early as we could,” said Heath Harmon, Eagle County Public Health director. “That said, if I’m being really honest, I don’t know that it always reached all of our community members with the level of intention that we had hoped.”

Gunnison County has one of the smallest vaccine disparities in the region. About three-fourths of the white population and half of the Latino population received at least one dose.

Gunnison County Public Health Director Joni Reynolds said the county was able to take advantage of existing relationships within the community, which helped them be more equitable in their distribution of the vaccine.

“We did a lot of outreach at nontraditional settings, so we didn’t just wait for folks to come into our clinic settings. … We did some clinics at recreation centers, at meetings that the immigrant community holds on a monthly basis. We did vaccinations at churches, we did vaccinations in the spring at soccer games,” Reynolds said. “My guidance really for my team was I’d like people to trip over the vaccination.”

That aggressive vaccination campaign paid off. Gunnison County has reported about 3,700 cases and 15 COVID deaths since 2020 — one of the lowest case and death rates in the region.

Deb Hornbacher, public health nurse with the Delta County Health Department, gives Doug Toney, Montrose resident, a PCR test during a weekly COVID testing drive-through at the Delta County Health Department, in Delta, Colo., on Sept. 20, 2022. Credit: Luna Anna Archey/Aspen Journalism and Aspen Public Radio

This project is a collaborative effort between Aspen Journalism and Aspen Public Radio. Part one, which looked at how different the initial responses were across the six counties, can be read here

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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,...