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Moving to Yellow: Concern means more people will be allowed in businesses.

Battling COVID-19 on many fronts has enabled El Paso County to move down a level on the state’s dial framework.

The county, which had been at the Orange: High Risk level since November, moved to Yellow: Concern on Feb. 6. That allowed businesses to open up to more clients and customers.

Business compliance with safety guidelines has been key to the improvement, state and local officials say, and continued vigilance will help lower the county’s disease metrics and lead to easing of restrictions.

“We’re hoping to get our trends to go down a bit more so that we can become eligible for Blue, which will then further the opening up and loosening the restrictions,” says Fadi Youkhana, an epidemiologist with El Paso County Public Health.

The metrics the state uses to determine a county’s level are the incidence of COVID-19 cases, the rate of positive tests and the number of hospital admissions.

“We pay attention to trends, not just a one-day blip in time,” says El Paso County Public Health Director Susan Wheelan. “That’s the significance of having weekly averages and seeing what the trends are, in order to make informed decisions based off of the data.”

Two key factors played a role in the county’s move to the Yellow level: lower metrics and the new Dial 2.0, which changed the way some of the metrics were determined.

We asked local and state officials what these metrics mean, what’s changed with the new dial, and how businesses can keep the momentum going toward fuller reopening.

Rather than looking at just the number of newly identified COVID-19 cases, the state determines the incidence — the number of cases per 100,000 people — to determine how much disease is occurring over a certain period of time, says Stephen Goodwin, chief data scientific strategist with El Paso County Public Health.

The county’s incidence, which is updated weekly on Wednesdays, was 125.1 on Feb. 22. That translates to about 900 cases.

“Per hundred thousand is used so that you can compare multiple places while adjusting for the population size,” Goodwin says. “This leveling by population allows us to compare different places.”

Douglas County, for example, had an incidence rate of 287.9 as of Feb. 22, according to the county’s data dashboard; Teller County’s incidence was 59.2.

El Paso County also tracks the average number of new cases per day over seven-day periods, which is another way of looking at the prevalence of the disease, although it’s not one of the metrics used to determine dial position.

“That’s an easy-to-understand number,” Goodwin says. “The average is a way for us to smooth the cases. You can sort of equilibrate that to where you would have to be to move down to the next level.”

With 971 cases in El Paso County the week ending Feb. 21, the average is 129.14.

As the average goes lower, the incidence also drops, Goodwin says. To move to the Blue level, “we’d have to average below 100 cases a day.”

The second metric, test positivity rate, is the number of positive tests compared to all the tests that are done in a week, expressed as a percentage. Between Feb. 10 and 16, the county’s positivity rate was 5.41 percent.

“Of course, lower is better, and 5 percent is the golden number,” Goodwin says. The positivity rate has been trending downward over the past two weeks.

It’s important that as many people as possible get tested, he says.

“With this disease, it’s quite challenging, because you may well have the disease but not know it,” he says. “So the only way we’re really seeing it is through testing.”

The county’s dial standing also depends on COVID-19 hospitalizations. Between Feb. 9 and 16, 32 people were admitted to hospitals in El Paso County. The number of daily hospital admissions has been dropping since it peaked in late November.

El Paso County Public Health’s data dashboard reports and charts these and other statistics that provide a detailed picture of the pandemic in the county.

The state of Colorado made it a little easier for businesses by updating the COVID-19 dial, the tool that gives guidance on procedures to contain the virus at various stages of infections, deaths and hospitalizations.

“Given the level of vaccinations occurring and decreasing COVID-19 rates, the range of incidence metrics in Dial 2.0 better reflects a balance between disease suppression and economic activity,” says Brian Spencer, a spokesman for the Colorado State Joint Information Center.

Dial 2.0 went into effect Feb. 6. The biggest difference is that, before then, the state had based its evaluations of the three metrics on a 14-day scale. Dial 2.0 measures the numbers over a seven-day period.

“Dial 2.0 is designed so that counties can swiftly move into more restrictive levels when their numbers go up, and more quickly into recovery when their numbers go down,” Jill Hunsaker Ryan, executive director of the Colorado Department of Public Health and Environment, said in a statement.

Level Orange, El Paso County’s level before the change, now applies when there are 300 to 500 COVID-19 cases per 100,000 people and a test positivity rate no higher than 10 percent.

Level Yellow, where the county is now, applies when the incidence is 10 to 300 cases and a positivity rate of no more than 7.5 percent.

To get to the Blue level, the county must achieve an incidence of 15 to 100. To reach level Green, the lowest on the dial, the incidence would have to drop to no more than 15 cases per 100,000 people.

The new dial also changed the capacity limit for restaurants at the Yellow level. Restaurants may now operate indoor service at 50 percent capacity up to a maximum of 150 people using a social distancing calculator. Previously, the limit was 100 people.

The Orange level restricted restaurants to 25 percent capacity or a maximum of 50 people. If the county moved to the Blue level, restaurants would be able to serve a maximum of 175 people indoors.

Similar limits are specified for other types of businesses at each level. They haven’t changed on the new dial.

Businesses that have qualified for 5 Star certification, which indicates they have instituted enhanced measures to protect employees and customers, will be able to operate at the Blue level once 70 percent of the county’s over-70 population is vaccinated.

El Paso County’s metrics have plateaued over the past couple of weeks, but Wheelan says, “I like to be cautiously optimistic that in the seven-day metric, … we can move to level Blue. Our goal all along has been to work with businesses to have a holistic approach and to move down on the dial.”

Achieving Blue may seem to some like a mountain too high to climb, says Youkhana, but “we’ve done this before. All the decreasing trends we’ve seen since December is because of our community’s response to the high numbers.”

Public health officials at the state and local levels attribute the decrease in COVID-19 metrics to two factors: the growing number of people who have been vaccinated, and the measures taken by businesses and individuals to reduce the spread of the disease, including mask wearing, social distancing and vigilant cleaning and sanitation.

As of Feb. 22, more than 1 million doses of COVID-19 vaccines had been administered in Colorado, according to CDPHE. That includes 797,634 people who have received one dose and 379,144 people who have been immunized with two doses.

In El Paso County, more than 107,000 vaccine doses have been given. The number includes 76,886 people vaccinated with one dose, or 10.5 percent of the county’s population, and 31,218, or 4.3 percent of the population, who have received both doses. The total number excludes doses administered by Veterans Affairs and the Department of Defense.

Of residents 70 and older, 52 percent have been vaccinated.

“As the vaccinations go up, you see the disease trends going down,” Wheelan said.

During the week of Feb. 8, “the total number of cases identified was eclipsed by the total number of people who’ve had one or more vaccinations,” Goodwin said. “That’s a pretty exciting threshold.”

Colorado Springs Chamber & EDC President and CEO Dirk Draper said he is encouraged by the way local businesses are continuing to comply with the COVID-19 regulations and even to go above and beyond them.

As of Feb. 22, at least 26 businesses had met the enhanced safety guidelines and were certified under the 5 Star program according to the Chamber’s website, and more were in the process of completing their applications.

“I’m pleased to see businesses being able to open and continue to do so safely,” says Draper. “One of the keys that businesses need to do for their employees and for their customers is to continue to use those same practices.”

In addition, he says, “the best thing we can do as businesses, as consumers, is to do business with other local businesses.”

Draper says he thinks there is a “very high degree of compliance” with COVID restrictions in El Paso County. “I think that’s hastened our recovery and bodes well for our future.”

He acknowledges that “there are pockets where there is willing failure to comply. I don’t go to those businesses. I’m going to vote with my feet. I think that’s a very small minority in Colorado Springs, though.”

El Paso County Public Health is responsible for enforcement of the restrictions and responds to complaints about noncompliant businesses. But Wheelan says the agency prefers to educate businesses about the importance of compliance and how it contributes to reopening rather than using harsher measures,

if possible.

The agency has received 1,305 complaints about noncompliance since Nov. 1, Public Health Information Officer Michelle Hewitt said in an email. The top three complaint categories regarded masks, social distancing/capacity and positive cases/outbreaks.

Public Health has taken five formal enforcement actions, including Notices of Determination and, in one case, a cease-and-desist order.

In January, the Monument Town Council passed a resolution terming Gov. Jared Polis’ public health and executive orders regarding COVID-19 regulations unconstitutional and urged businesses “to determine for themselves the level to which they desire to comply.”

“As a public health director, and also others in the community, we don’t have a choice to not follow the law,” says Wheelan. “I do not have the authority to loosen restrictions, [nor do] other bodies of elected officials.

“But I’ve seen, overall in our community throughout the pandemic, business leaders want to do the right thing,” she says. “I’ve given direction to my team that we want to be helpful. I don’t believe in being heavy-handed. We do follow up with businesses, and we’re always focused on driving toward solutions.”