THIS IS A FLUID SITUATION.  INFORMATION AND ACTION ARE SUBJECT TO CHANGE AT ANY TIME.  BE PREPARED TO BE FLEXIBLE AND PATIENT.

The situations, numbers, website links, data, and etc. described below were current as of Thursday 9/2/2021 at 1:07 p.m.

PLEASE DISTRIBUTE THIS WIDELY

9/2/2021 Crowley/Otero COVID-19 Update #1:  Weekly Update

Please take the time to read and understand this entire message.

Internet links:  Before I send out each update, I check the links to make sure they are active.  However, links do change from time to time, so the links I sent out today may not be the same tomorrow.  You may have to search around a bit.

Please find this week’s COVID-19 updates below.

1. Current Crowley/Otero COVID-19 Rate Status

ü  One Week Cumulative Incidence Rate (per 100,000) Ranges

§ Green Level:  0-35

§ Blue Level:  36-100

§ Yellow Level:  101-300

§ Orange Level:  301-500

§ Red Level:  501+

ü  COVID-19 Dashboard:  COVID-19 dial dashboard | Colorado COVID-19 Updates

ü  Crowley County:  Our rate in Crowley just increased to Blue Level with a 1 week cumulative incidence rate of 66.3 (for the data period 8/25/2021-8/31/2021).  Crowley maintained Green Level status for an impressive 54 consecutive days!

ü  Otero County:  Our rate in Otero very recently entered Yellow Level again with a current 1 week cumulative incidence rate of 103.9 (for the data period of 8/25/2021-8/31/2021), just above the Blue Level Threshold. 

2. Potential Local Public Health Orders:  Every day I watch data and the epi curves very closely (yes, even on the weekend).  Crowley and Otero Counties have spent an amazing, commendable amount of time in the lower levels of the COVID-19 Dial, namely Green and Blue.  Now I am seeing and hearing indications that our rates might continue to climb.  Notice my deliberate use of the phrase “might continue to climb”.  If (notice my deliberate use of the word “if”) these rates continue their climb unabated and the data dictates, I am fully prepared to issue local Public Health Orders (PHOs) and enforce them using the legal public health framework described in #3 below.  As a courtesy “heads up” to local officials, yesterday (Wednesday, 9/1/2021) I emailed them details regarding this issue.  I have attached that email, please take time to review it completely and carefully.  If I have to do this (again, notice my deliberate use of the word “if”) because rates continue to climb unabated (thus increasing the risk of transmission to others), here is my endgame, what I am hoping to achieve through a local PHO(s):

ü  Increase the chances of keeping our schools open to in person learning and not have to close schools.  I am firmly committed to this, I believe it is in the absolute best interest of our students for them to physically be at school if at all possible (mine included, I have kids at the junior high and senior high);

ü  Reduce the risk to those little ones that are too young yet to receive a COVID-19 vaccination;

ü  Reduce the risk of exposure to and transmission of the emerging COVID-19 Delta Variant; &

ü  Since the Pfizer vaccine (now marketed under the brand name Comirnaty) has been fully approved, reduce the risk as much as possible while those previously hesitant about being vaccinated (because of the prior Emergency Use Authorization designation) now seek vaccination.

So that this will come as no surprise, if (notice my deliberate se of the word “if”) we get there, I giving you a heads up now as to what might (notice my deliberate use of the word “might”) be coming.  As I said in my email to local officials that was sent yesterday, “We are not there yet, and I hope we don’t not get there.”  Let’s work together so that we don’t get there. 

DON’T STOP READING NOW.  Please read the next section entitled Public Health Law.

3. Public Health Law:  Dr. William Foege was a former director of the Centers for Disease Control and Prevention.  In a career that has spanned decades, he has been instrumental in numerous public health achievements.  He is quoted as saying, “the first tool of public health is epidemiology… The second public health tool might well be the law”.  And I can attest through my professional experience that this is very true. 

In the tear-jerking end scene of the movie, Star Trek 2, The Wrath of Khan, as Mr. Spock is dying from the ultimate self-sacrifice, the phrase is uttered “The needs of the many outweigh the needs of the few, or the one.”  This phrase completely and totally describes public health law.  Another way of summing up public health law, a little more formally, is by saying “public health law is the balance between an individual’s right to freedom from unnecessary governmental control versus the rights of the public.”  Or in other words, “The needs of the many outweigh the needs of the few, or the one.”

Very interestingly, this view has a Supreme Court precedent as its backing.  Dating back all the way to 1905, in the landmark public health law case of Jacobson V. Massachusetts, the Supreme Court of the United States (SCOTUS) found that the police powers of a state must be held to embrace at least such reasonable regulations established directly by legislative enactment to protect public health and safety.  The court’s decision articulated the view that the freedom of the individual must sometimes be subordinated to the common welfare and is subject to the police powers of the state.  Chief Justice Harlan ruled that personal liberties could be suspended when “the safety of the general public may demand”.  This whole situation was about a smallpox outbreak.  He compared the smallpox outbreak to the American Civil War (in which 3 out of those 9 Justices served) by saying that a community has the right to protect itself from both disease and military invasion.  The way that the community, or public, protects itself from communicable diseases is through Local Public Health Agencies (LPHA) and the state department of health.

In my public health practice over the last 21 years, I have used public health law and the court system to protect the needs of the many.  One significant example of this is an issue that arose in the year 2006.  I was at home eating dinner with my family when I received a call from Otero County Sheriff’s Dispatch.  A truck driver had been sent to the E.R. because he drove through a caustic vapor cloud.  That night I discovered that copious amounts of Red Fuming Nitric Acid was lying unsecured and unprotected on the plains in Otero County.  I immediately requested assistance from the Colorado Department of Public Health and Environment (CDPHE).  The next day a team from CDPHE and my team were at the site, and the senior chemist said something to me that chilled my bones:  “This situation is very dangerous and is beyond the capacity of CDPHE to address alone.”  Then began an odyssey that involved the U.S. Department of Defense, The Army Corps of Engineers, the U.S. Environmental Protection Agency (EPA), and numerous local agencies.  How was public health law employed during this event?  Public health law was used to quarantine the property and control the owner’s activity on said property so that the risk to the public was greatly reduced.  This all culminated in a district court case where the judge ruled with CDPHE and OCHD and ordered the owner to relinquish this dangerous material to the federal government.  Now a person may argue, “that was a really dangerous event, and should not be compared to COVID-19”.  Yes it was a dangerous event, (I know, I was at ground zero) but thanks to the quick actions of many local, state, and federal agencies there were no deaths nor injuries.  The Centers for Disease Control and Prevention (CDC) most current COVID-19 related death count stands at 641,725 (CDC COVID Data Tracker).  You can see the COVID-19 related deaths for Crowley and Otero Counties further below. 

It has become painfully apparent to me that over the last 17 months there are those who do not subscribe to the simple, selfless truism “the needs of the many outweigh the needs of the few, or the one”.  Some of these seemed to be more concerned with what they perceive as government overreach resulting in affronts their own personal liberties, freedoms, and constitutional rights.  I have heard the argument that wearing a mask is a personal choice that should be left up to an individual or to parents.  What this argument fails to include or remotely address is that, in a communicable disease scenario,  this decision to not wear a mask can harm others.  The constitution does not guarantee any of us the right to harm others.  In fact, the Tenth Amendment to the U.S Constitution gives police powers to the states to enact legislation to protect the public, so yes, the government does have latitude, afforded to it by the U.S. Constitution, to protect citizens, the public, from dangerous conditions, including communicable diseases.  It is not just about the individual, but about the community, the public.  “The needs of the many outweigh the needs of the few, or the one.” 

It seems that for some, no amount of reasoning will persuade them differently.  There is an old saying, you cannot reason with unreasonable people.  I have experienced this many, many times over the last 17 unrelenting months.  Believe me, that for all those that oppose any kind of PHO, there are also those, all the way on the other side of the spectrum, that want the exact opposite, more PHOs and more closures.  In fact, just yesterday (Wednesday, 9/1/2021) I received a threatening call from an individual that wanted me to close a school.  I tried to explain that the current data does not justify this, he would not listen to me, he kept interrupting me, and the conversation ended by him saying “I am on my way down there right now mother fu#%er!”   It simply doesn’t matter what I say or do, there will be those that will not be satisfied.  And I am very much at peace with that.  And make no mistake, my job is not to attempt to appease those at either end of the spectrum.  It is to use science and data to administer and enforce public health laws because “the needs of the many outweigh the needs of the few, or the one.” 

So, how are things going to play out if (notice my deliberate use of the word “if”)  OCHD has to issue local PHOs and enforce them.  Consider the following illustration (this is just an illustration, and if there is someone out there named “John Doe”, I am absolutely NOT referencing you).  So here goes the illustration:  Based upon the most available, current data, OCHD issues a local PHO.  John Doe does not agree with it (for whatever reason), and refuses to comply.  OCHD receives a complaint regarding John Doe’s noncompliance (and we absolutely will).  Pursuant to CRS 25-1-506, OCHD investigates the matter.  After investigation, OCHD confirms the complaint as true.  OCHD issues a Notice of Violation/Notice to Comply to John Doe.  After the issuance of the Notice, follow-up OCHD investigation finds that John Doe continues with noncompliance.  At this point, and pursuant to CRS Title 25, Article 1, and Part 5 (specifically CRS 25-1-506, 509, 514, 515, and 516) OCHD turns the matter over to our agency attorney for a legal remedy through the courts, and we let a judge decide the matter.  This is the established legal process for public health law enforcement, this is the process I have followed in the past, and this is the process I will continue to follow for COVID-19.  If you want to check out the public health statues (Title 25), you can find them here:  Colorado Legal Resources (lexis.com)

“The needs of the many outweigh the needs of the few, or the one”.

4. CDPHE Spanish Language COVID-19 Website:  Home- Español | Colorado COVID-19 Updates

5. Ayuda En Espanol (Spanish Language Assistance):  Para ayuda en Espanol, habla con Debbie Jaramillo en 719-383-3040 por favor (For help in Spanish, please call Debbie Jaramillo at 719-383-3040).

6. Delta Variant Update:  As of the time stamp noted above, we have detected the Delta Variant in 5 individuals in Otero, and 3 in Crowley.  You will notice that the CDPHE Variant website (COVID-19 data | Colorado COVID-19 Updates) now has 4 columns for the Delta Variant.  All of these are subtypes of the Delta Variant.  You can read more about variants at the CDC website here:  SARS-CoV-2 Variant Classifications and Definitions (cdc.gov)

7. Free Community Testing:  Our local testing schedule is as follows until further notice.

ü  Location:  Crowley County Nursing Center

§ Address:  401 Idaho, Ordway

§ Date:  Wednesdays

§ Time:  9am-11am

ü  Location:  Otero College

§ Address:  1802 Colorado Avenue, McDivitt Gym, La Junta

§ Date:  Wednesdays

§ Time:  12:00pm-4:00pm

ü  Please find attached more information on our local testing. 

8. VACCINATION INFORMATION

a.       Third Doses of Moderna and Pfizer Now Available:  According to CDPHE, “Third doses of Moderna and Pfizer are now available for individuals who are immunocompromised. Just as for age, residency, insurance status, etc., those attesting that their immune systems are moderately or severely compromised should not be required to show additional paperwork or proof and should be administered a third dose by providers.”  If you qualify for a third dose, you can call your medical provider, a participating pharmacy, or OCHD to arrange for the third dose.  For scheduling with OCHD, see item c. below.  However, due to vaccination clinic demand, staffing issues, and scheduling, we are still about 2 weeks out minimum for those getting on the schedule right now.  If getting your third dose is time sensitive, I would strongly suggest that you contact a local pharmacy or your medical provider.   

b.      Pfizer Vaccine Full FDA Approval:  According to CDPHE,  “… the Food and Drug Administration (FDA) gave full approval to Pfizer-BioNTech’s COVID-19 vaccine for eligible people aged 16 and up. While it’s the first to receive this designation, all available COVID-19 vaccines have been proven safe, effective, and authorized for emergency use. The state remains focused on vaccinating as many eligible Coloradans as possible.”

c.       OCHD Vaccination Appointments:  If you would like to make an appointment with OCHD for a COVID-19 vaccination (first, second, or third doses), please call Carolina Cortez at 719-468-8083.

d.      Ayuda En Espanol (Spanish Language Assistance):  Para ayuda en Espanol, habla con Debbie Jaramillo en 719-383-3040 por favor (For help in Spanish, please call Debbie Jaramillo at 719-383-3040). 

e.       OCHD Vaccines:  OCHD is using Moderna, Pfizer, and Johnson and Johnson (Janssen) vaccines.

ü  Pfizer vaccine information:  Coronavirus COVID-19 Vaccine Update: Latest Developments | Pfizer

ü  Moderna vaccine information:  Moderna’s Fully Enrolled Phase 3 COVE Study of mRNA-1273 | Moderna, Inc. (modernatx.com)

ü  Johnson and Johnson (Janssen) vaccine information:  Janssen COVID-19 Vaccine Official Website

f.       More Vaccine Information:  Colorado-specific information on COVID-19 vaccine can be found here:

ü  Colorado COVID-19 Vaccine Website:  COVID-19 vaccine | Colorado COVID-19 Updates

ü  Vaccine Frequently Asked Questions (FAQs):  COVID-19 Vaccine frequently asked questions | Colorado COVID-19 Updates

ü  Learn about COVID-19 vaccines:  Learn about COVID-19 vaccines | Colorado COVID-19 Updates

ü  Colorado Vaccine Dashboard (including county-level data):  Vaccine data | Colorado COVID-19 Updates

ü  Currently approved vaccine side-by-side comparisons:  https://astho.org/COVID-19/Vaccine-Comparison/

ü  CDPHE COVID-19 vaccine hotline:  This is a state-wide call center for the public to ask questions specifically about the COVID-19 vaccine.  The toll-free number is 1-877-CO VAX CO (1-877-268-2926).

9. COVID-19 Test Information

a.       Basic Information:  The U.S. Food and Drug Administration (FDA) has some good, general information on the different types of COVID-19 tests about which you may have heard.  To review this information, please go to the following website:  Coronavirus Disease 2019 Testing Basics (fda.gov)

b.      State Testing Sites:  Here is a website that details COVID-19 testing sites across the state of Colorado:  CDPHE Test Sites Portal (colorado.gov)

10. School Webpages:  Please visit these websites for any school-specific information and updates regarding COVID-19:

a.       Cheraw:  https://www.cheraw.k12.co.us/

b.      Crowley County:  http://www.cck12.net/

c.       Fowler:  http://www.fowler.k12.co.us/

d.      La Junta:  https://www.lajuntaschools.org/

e.       Manzanola:  https://www.manzanola.k12.co.us/

f.       Otero College:  https://www.ojc.edu/

g.      Rocky Ford:  https://www.rockyfordk12.org/ 

h.      Swink:  https://www.swinkk12.net/

11. Summaries

a.       Crowley County

ü  COVID-19 Rate Color/Level Status:  COVID-19 dial dashboard | Colorado COVID-19 Updates

ü  COVID-19 Data:  COVID-19 data | Colorado COVID-19 Updates

o   Click on “Case Summary” at the top/left

o   Then click on “Maps” on the right

ü  Facility outbreak information can be viewed here:  https://covid19.colorado.gov/outbreak-data

o   Important Note:  Facility outbreak numbers (i.e. prisoners and nursing home residents) are only updated by CDPHE once per week, on Wednesdays after 4:00pm.  Total case numbers, on the other hand, are updated daily by CDPHE.  This means that there could be facility cases reflected in the total case numbers that are not yet reflected in the facility numbers.  And remember, total case numbers are cumulative, meaning they include all cases since the outbreak began.

ü  Total COVID-19 Related Deaths:  18

o   Change from the last weekly update:  None

b.      Otero County

ü  COVID-19 Rate Color/Level Status:  COVID-19 dial dashboard | Colorado COVID-19 Updates

ü  COVID-19 Data:  COVID-19 data | Colorado COVID-19 Updates

o   Click on “Case Summary” at the top/left

o   Then click on “Maps” on the right

ü  Facility outbreak information can be viewed here:  https://covid19.colorado.gov/outbreak-data

o   Important Note:  Facility outbreak numbers (i.e. prisoners and nursing home residents) are only updated by CDPHE once per week, on Wednesdays after 4:00pm.  Total case numbers, on the other hand, are updated daily by CDPHE.  This means that there could be facility cases reflected in the total case numbers that are not yet reflected in the facility numbers.  And remember, total case numbers are cumulative, meaning they include all cases since the outbreak began.

ü  Total COVID-19 Related Deaths:  69

o   Change from the last weekly update:  One additional death

c.       Crowley/Otero COVID-19 Related Hospitalization(s):  Two new hospitalization since the last weekly update.

d.      State of Colorado Information:  https://covid19.colorado.gov/data

e.       United States Information:  Coronavirus Disease 2019 (COVID-19) | CDC

f.       Global information:  https://covid19.who.int/

12. What can you do RIGHT NOW?

ü  Please seriously consider getting vaccinated if you have not already done so.  Please.

ü  If you are not vaccinated, please wear a mask whenever in public, even if it is not required.  Please.

ü  Read, understand, and comply with public health orders.  Public health orders can be found here:  https://covid19.colorado.gov/prepare-protect-yourself/prevent-the-spread/public-health-executive-orders

ü  Prevent the spread of COVID-19: https://covid19.colorado.gov/prevention 

ü  Stay home if you are sick and, if needed, call your medical provider.

ü  Wear an appropriate mask when required to do so. 

ü  If you need to isolate (because you have tested positive and/or are symptomatic) or quarantine (because you have been exposed but are not symptomatic), here is the guidance:  Isolation & quarantine | Colorado COVID-19 Updates

a.       According to CDPHE (How to quarantine | Colorado COVID-19 Updates):  If you’re fully vaccinated, you don’t need to quarantine after being exposed to someone with COVID-19. However, we recommend that you get a COVID-19 test three to five days after exposure and wear a mask in public for 14 days after exposure or until you have a negative test result. These precautions will help protect the people around you in the rare case of a breakthrough infection. If you develop any symptoms of COVID-19  in the 14 days after exposure, you should get tested, even if you have a previous negative test.

ü  If you are in a high risk group, take extra precautions.

a.       CDPHE:  People at higher risk for severe illness | Colorado COVID-19 Updates

b.      CDC:  Do I need to Take Extra Precautions Against COVID-19 | CDC

ü  Cover your cough and/or sneeze.

ü  Keep your fingers and hands away from your face.

ü  Wash your hands frequently and thoroughly.

ü  Stay informed by trusted and reliable sources.  Be careful about believing what you read on social media sites.  Trusted sources/websites:

o   Otero County Health Department (OCHD):  Home | Otero County (colorado.gov)

o   Centers for Disease Control and Prevention (CDC):  https://www.cdc.gov

o   Colorado Department of Public Health and Environment (CDPHE):  https://covid19.colorado.gov/

Richard Ritter, Executive Director

Otero County Health Department

13 West 3rd Street, Room 111

La Junta, Colorado 81050

719-383-3045 (Office)

719-383-3060 (Fax)

rritter@oterogov.org

Hello to all.  PLEASE READ THIS EMAIL COMPLETELY AND CAREFULLY.  Throughout the 17 months of this grueling, damnable pandemic, OCHD has not had to issue any local Public Health Orders (PHO), but has administered and enforced state PHOs.  For the last several weeks both Crowley and Otero have maintained low rates.  However, now I am tracking a distinct rise in rates in Otero, which has placed us in Yellow Level (Crowley is still in Green Level).  Depending on the trajectory of the current epi curve I may have to issue local PHOs.  More than likely this will involve issuing a local PHO regarding mandatory mask wearing in schools for both students and staff (regardless of vaccination status), unless they have a written note from a medical provider excusing them from mask wearing for a medical reason(s).   We are not there yet, and I hope we don’t not get there.  If this becomes necessary, though, I will send out an email in advance of the effective date of the PHO apprising you of the situation.  The authority and OCHD’s process for issuing local  PHOs are as follows:   

1.       Authority

a.       The United States Constitution, Tenth Amendment, gives Police Powers to the states. 

                                                               i.      Police Powers can be defined as “Powers exercised by the states to enact legislation and promulgate regulations to protect the public health, welfare, and morals, and to promote the common good.” 

b.      Under the authority given to it by the United States Constitution, the State of Colorado has created and maintains the Colorado Revised Statutes (CRS), which are laws ratified by the General Assembly and signed into law by the Governor.

c.       The statutes specific to Local Public Health Agencies (LPHA, and OCHD is an LPHA), is CRS Title 25, Article 1, and Part 5.

d.      Specifically, CRS 25-1-506 and 25-1-509 gives OCHD (and me) the authority to issue and enforce local PHOs, to control people and property to control  communicable diseases

                                                               i.      Statute is very clear, this is OCHD’s and my authority and responsibility.

e.      If it becomes necessary, and pursuant to CRS 25-1-506 and 25-1-509, I will issue such local PHOs as I find necessary to protect the public’s health. 

                                                               i.      As I mentioned before, I will give you as much advance notice as I can before I issue the local PHO.

OCHD will pursue enforcement.  On 8/12/2021 I sent an overview of our enforcement process, and I have attached that email for your reference.  Basically, if a parent(s) decides not to comply, and their child(ren) does not have a medical exemption for mask wearing, then the following steps will be taken:

ü  The school will contact OCHD with the contact information of the parents

ü  OCHD will follow the protocols in the attached email.

I am firmly committed to supporting and keeping in-person learning in place (as opposed to shutting schools down and going virtual).  Depending on where things go, we may need to mask up to increase our chances of keeping kids in school (my kids included).

Any opposition that OCHD encounters pursuant to local PHOs will immediately be referred to our agency legal counsel, Nathan Shultz.  He can be reached at 719-383-0867.  Also, Mr. Shultz reviewed this email before I sent it to you. 

A little over 1 year ago, in a community update, I shared an illustration that draws parallels between prohibiting public nudity and requiring mask wearing.  I have attached this update, it is the second attachment.  Also, please check out this link about a Texas dad that did more than just talk about it: 

Texas dad strips to support masks at school board meeting (cnn.com)

Recipients to this email include the following:

ü  Crowley and Otero County Commissioners

ü  Crowley Sheriff Larry Reeves

ü  Otero Sheriff Shawn Mobley

ü  La Junta Police Chief Todd Quick

ü  Rocky Ford Police Chief Angelo Griego

ü  Local Board of Health

ü  Crowley and Otero School Superintendents

ü  Otero College

ü  OCHD Staff

ü  Judge Mark MacDonnell

ü  C.J. Montoya, 16th Judicial District Court Administrator

ü  Anne Hause, CDPHE Attorney

 

Richard Ritter, Executive Director

Otero County Health Department

13 West 3rd Street, Room 111

La Junta, Colorado 81050

719-383-3045 (Office)

719-383-3060 (Fax)

rritter@oterogov.org

Link to OCHD PHO Enforcement Email:

http://seconews.org/page/1842