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Answers to COVID-19 FAQs in Northern Colorado: How many patients and where are they coming from?

Rebecca Powell
Fort Collins Coloradoan

About 180 patients are currently being treated for COVID-19 in Fort Collins, Loveland and Greeley hospitals, and 50 of them — more than a quarter — are in the ICU.

Out-of-state patients aren't much of a factor in the numbers, though some Weld County patients are being treated at UCHealth's Larimer County hospitals.

The information came from UCHealth and Banner Health leaders, who on Tuesday gave Larimer County commissioners a snapshot of what they are experiencing amid the latest surge of COVID-19 cases.

In UCHealth, 110 COVID-19 patients are being treated at Poudre Valley Hospital, Medical Center of the Rockies and UCHealth Greeley Hospital, according to Kevin Unger, CEO of UCHealth Northern Colorado.

In Banner Health, there are 70 patients at McKee Medical Center, North Colorado Medical Center and Banner Fort Collins Medical Center, said Margo Karsten, president of Banner Health's Western Region.

Hospital admissions for COVID-19 patients have nearly doubled in the past two to three weeks, Karsten and Unger confirmed.

Karsten expects the surge to continue for at least 4 to 8 weeks.

COVID-19 in Colorado tracker: Larimer and state case, death and hospital data for November

For hospitals, the pinch point isn't with access to personal protective equipment or pharmaceuticals, but staffing, Unger said. Many health care workers are calling in sick, Karsten reported.

To make sure there is room for COVID-19 patients, some elective and nonemergency surgeries, such as hip replacements, are being canceled. Still, Unger said, people should not delay care for their ailments: Hospitals are seeing many critical care patients who are not sick with COVID-19 but who put off getting the care they needed earlier.

As part of their surge capacity plans, UCHealth and Banner are doubling up some patients in COVID-19 ICU care units; cross-training employees so more are able to care for COVID-19 patients; working with rural partners in case they need to transfer patients; and assessing the need to send patients to the field hospital at the Colorado Convention Center.

UCHealth is also seeing an increase in people seeking help for behavioral health issues, including their own employees, Unger said. The needs, including care for drug and alcohol abuse, are exceeding pre-pandemic levels.

Larimer County's dashboard showed 65% hospital utilization and 70% ICU utilization, down from higher percentages a few weeks ago. Larimer County Public Health Director Tom Gonzales said that can be misleading: The percentage is going down as hospitals implement their surge plans by doubling up patients within rooms and because they are delaying some surgeries to create more capacity.

"If we were to go back to where we were three months ago, we'd be well into the 85-90" percent range, Gonzales said.

Out-of-area patients' impact on Northern Colorado hospitals

Karsten said many people are asking whether out-of-state COVID-19 patients are putting a burden on Northern Colorado hospitals. The answer is no.

About 10% of total patients at UCHealth's and Banner's Northern Colorado facilities are from outside Colorado, Unger and Karsten said.

In a typical year for UCHealth, about 40% of patients come from outside the primary market area of Fort Collins, Loveland, Greeley and Estes Park, Unger said. They've been turning down many out-of-state transfers unless they require a higher level of care they can't get in their area, he said.

As for patients coming to Larimer from Weld, Unger estimated the number to be about 20%. Last week, Weld hospitals reached capacity, and the state health department moved the county to Level Red. But the Weld County commissioners signaled their refusal to comply with the state's guidelines.

Banner is not seeing an influx of patients from Weld to Larimer counties because its main hub, NCMC, is in Greeley.

Commissioner Tom Donnelly asked Unger whether it was fair for Larimer County businesses facing greater restrictions under Level Red to suffer as a result of inaction by neighboring communities.

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If 30% of the beds in Larimer County are being occupied by either out-of-state or out-of-county patients, "that's a significant amount of our ICU beds that are being filled by folks who really aren't Larimer County residents. Our board of health seems to have no problem dictating business practices for every other type of business. Have they indicated that they might dictate business practices for you, to perhaps stop you from accepting patients from out of state or across county lines?"

Unger said when accepting patients, what other communities are doing isn't part of the consideration.

"We don't discriminate as to who we take care of," Unger said. "A patient's a patient, and so for us to not take care of Greeley patients just because they have different practices isn't a decision that we're making when we're treating our patients."

Potential solutions for helping businesses

After speaking with Gov. Jared Polis, commissioner Steve Johnson urged the Larimer County health department to pursue establishing a special certification program for businesses that might allow them to operate at a higher level than what the red zone allows.

A similar program is ongoing in Mesa County despite its red-level status, Johnson said, and Polis told him the county should work with area chambers of commerce to develop a proposal.

Gonzales also noted that work during the special state legislative session beginning Monday would focus on providing relief to businesses in Level Red counties.

Feeling blue? Seeing red? Here's what the levels on Colorado's COVID-19 'dial' mean

Vaccine delivery to begin in December

On Dec. 12, Larimer County is expected to receive 1.6% of vaccine made available nationally.

Work is ongoing to determine how the vaccine will be delivered to health care workers, including those in long-term care centers. But Unger said it probably won't be enough to cover all frontline staff.

A second batch is expected later in December.

UCHealth is also taking part in an AstraZeneca vaccine trial, with the goal of enrolling more than 1,500 people. So far, 700 people have been enrolled.

Health officials plead with people to stay within household

"Immediate family means underneath your roof, and what I see is neighborhood gatherings," with many considering them in their bubble, "and that's where we're seeing infections spread," Karsten said.

Additionally, she said, with 20% to 30% of tests producing false negatives, anybody with symptoms should simply stay home.

Gonzales said during the spring stay-at-home order, cellphone data showed that in Larimer County, movement by residents was down to 85% below normal. In the past two months, it's been about 30% below normal, and now the goal is to see it go 75% below normal.

"I'm just pleading with community that we stay home as much as possible and we do not have other households within our home," Gonzales said. 

If that metric goes up, he expects to see positivity percentages and case rates go down.

Masks work to help prevent the spread, and washing hands, social distancing and not intermingling in large groups are all needed, Unger said.

"It's going to look different for Thanksgiving within the Unger family." Unger said. "It's going to be just those that I live with within the household, and I'm urging my staff to do the same."

"We're making a conscious effort to make sure that we are all staying safe and separated this Thanksgiving and holiday season," Unger said.

Why did Larimer County skip over Level Orange?

Gonzales said after weeks of negotiating with the state health department regarding the county being out of compliance for Level Yellow, the health department eventually notified him that the county would need to move to Level Orange immediately and then to Level Red in a week. 

The health board didn't want to require a new set of requirements for a short period of time, only to move to another set of requirements the next, "confusing our businesses, and frustrating the heck out of them."

Is indoor dining contributing to a surge in cases?

Johnson said he doesn't think open businesses are causing the COVID-19 surge

"This is going to get worse, we're hitting flu season, people are coming indoors. Closing businesses is going make people associate in groups more frequently in their homes where they're not protected," he said.

Gonzales said with more people moving indoors, the industry with the highest number of positive cases is restaurants, and contact tracing is showing that bar workers who report they are not socializing outside of work are still testing positive.

He also noted the inconsistency of telling people not to have anyone in their homes if they aren't within their household but then telling people it's safe to socialize in restaurants.

COVID-19 patients in Northern Colorado hospitals

UCHealth

Poudre Valley Hospital: 45 patients, nine in ICU 

Medical Center of the Rockies: 44 patients, 15 in ICU

Greeley: 21 patients, eight in ICU

Total: 110 patients, with 32 in ICU

Banner Health

North Colorado Medical Center, Greeley: 53 patients, 18 in ICU

McKee Medical Center, Loveland: 15 patients

Banner Fort Collins Medical Center: Two patients

Total: 70 patients, with 18 in ICU

Rebecca Powell is a content strategist at the Coloradoan, working to connect our community with the answers they seek. Contact her at RebeccaPowell@coloradoan.com. We can't do the important work of keeping our community informed without you. Support her work and that of other Coloradoan journalists by purchasing a digital subscription today.