Thread by @shayshinecastle

Happy(?) Tuesday, #Boulder. It's city council night and there's only one thing on the agenda: Finances.

OK, two things: COVID and finances.
We'll be getting our customary update and then diving into economic stuff with a forecast from CU's Rich Wobbekind and Brian Lewandowski, then modeling from the city on likely budget impacts.

There wasn't much info in the packet ahead of today's meeting. Looking through the slides, though, tons of numbers. None of them particularly good.

We're getting started soon so I'll share the COVID update presentation with you first. One thing that jumped out at me: The HUGE jump in cases at county long-term care facilities.

Last week: 86
This week: 151

Here's the presentation: www-static.bouldercolorado.gov/docs/1A_COVID_…

We're starting a bit late, as we have for most virtual meetings. We actually might start with a discussion of the rules passed last week governing virtual meetings, which include that council members keep their cameras on.

Nagle will not be following this for at least another week, as her computer's camera has been disabled for security purposes.

Change to open comment and public hearing rules: You can start signing up the Thursday before the meeting online. Open comment signs up the Monday before at 2 p.m.; public hearing sign-up will close at 5 p.m. day-of the meeting (which is new).

I'll provide links in my newsletter for weeks with hearings and/or open comment.

Oh I forgot we were doing the discussion/vote on making mask-wearing mandatory in public, indoor places.

That will happen a bit later.

BoCo Public Heath director Jeff Zayach is starting his presentation.

"I've been getting a lot of questions about why we extended the (stay-at-home) order and what that means for ppl in Boulder County," he says.

Reminder: The virus can be spread when ppl are asymptomatic and droplets can spread further than we initially thought, Zayach says. So masks are really important.

"The mask itself is not to protect yourself, as a cotton mask. It's to protect others from you. The mask stops a droplet from being spread. It needs to be everybody is wearing masks when out in public when they don't have the ability to social distance."

As to why the stay-at-home was extended through May 8: "We need to make sure we have a sustained reduction in new cases and hospitalizations." If we lift orders without those "we're only setting ourselves up for failure."

"We don't have the ability to have comprehensive testing yet," Zayach says. "We are moving in that direction."

"We do see the ability to move forward with expanded testing as we move into these next weeks."

I feel like we've heard that before, but Zayach sounds firm and positive on this.

We need to have enough staff to do contact tracing, Zayach says. "We're doing pretty well" — will be up to 26 staff in BoCo by May 8. "Worst-case" projection" is that we'll need up to 60.

With Colorado moving to safer-at-home, "we know we're going to have ppl out moving around," creating more chances for the disease to move around. Social distancing and masking — when there's no possibility for distancing — are super important, Zayach says.

"It really comes down to all of us and how well we follow those recommendations in terms of how long we can continue to move forward with a little bit more of a back-to-normal. I know it's not gonna anytime soon be normal."

We know this is hard, Zayach says. Unemployment, mental health issues, domestic violence, furloughs, etc.

"It's a no-win situation... none of that is being taken (for) granted.... This virus is going to leave scars on all of us for years to come."

The numbers:
531 cases
119 hospitalized, to date
34 deaths
203 recovering
100 investigations pending
14 avg daily new cases

Long-term care facilities:
151 cases
27 deaths

"These are awful numbers for us in Boulder County," Zayach says, referring to deaths.

Case rate is still relatively flat, Zayach says. County has moved to a different format of tracking new cases.

There was a spike on April 22 but ONLY because there was a delay in entering data... "That is not reflective of actual new cases we saw that day."

That may also explain the spike in long-term care facilities which "is what has caused us the most concern," Zayach says.

"We know if somebody in a LTCF ends up in the hospital, bc of the older population, they are much more likely to be on a ventilator and in an ICU bed for a longer period of time. They also in general have a little bit longer length of stays."

Zayach: We don't want our LTCF to have surges that then push hospitals to or over capacity.

BoCo has a team specifically working on this. "We're spending a fairly large amount of time with them," giving them PPE. Feds delivered some PPE this week.

"We're doing everything we can to help support these facilities."

"We have a slow but steady still increasing caseload," Zayach says. It will likely go up as testing capacity does.

Zayach: BoCo around 100 tests a day, and wants to aim for 500 tests per day.

Oh, something else new in this presentation: Longmont and Lafayette have passed Boulder in per-capita cases.

We want to see community spread drop, Zayach says. We do expect more one-to-one spread because of transmission within families.

We've got new racial/ethnicity data as well. The first African American case in BoCo. Latinx still contracting and being hospitalized at a rate disproportionate to their share of the population.

Zayach: "We are still unfortunately seeing .... there are disparities in terms of who is impacted by this disease. We are working diligently" with the state health dept. "to help reduce these numbers moving forward."

BoCo has lower per-capita cases than other counties in the Denver metro. Only Douglas is lower.

Perhaps unsurprising, given that I think Douglas and BoCo have the highest incomes as well.

Statewide, when it comes to hospitalizations, "we have flattening ... and that's exactly what we want to see" in these next few weeks, Zayach says.

"We know it's going to take until we have a vaccine" to go back to normal. "These will be things we'll have to continue tracking for months ahead."

Zayach: Surveillance other than hospitalizations will be key, because of the long incubation period: 14 days before ppl can start showing symptoms, and then days-weeks more before they are sick enough to go to the doctor.

"What are some of the early indications we can look for?" Zayach asks. Maybe 911 calls or doctor visits; we'll have to think of and track those.

Zayach: "What we'll need to do is be watching and be really cautious." Are safer-at-home orders going to be enough to stop the spread of the disease?

"It's going to be really important for people to take seriously."

Zayach: "So much of this comes down to how we follow these guidelines moving forward."

Young: What, specifically, are you doing to address racial disparities?

Zayach: These goals have been established at regional and state level. It's making sure data is available and transparent, and then using it in decision-making.

Zayach: Also looking at prevention strategies: How is spread occurring?
And increased access to testing and care.

Lastly, policy recommendations to address health overall in these communities. "Social determinants of health matter," Zayach says.

As previously reported, Latinx in BoCo even pre-COVID reported poorer health than white residents. Health strongly tied to income. boulderbeat.news/2020/04/25/dat…

Wallach: Are we meeting the metrics (testing, new cases, etc.) to be opening up at the state level?
Zayach: I'm not sure at the state level. They are definitely working on finding supplies, but I would not say the supply chain has "broken free" by any measure.

But they are increasing testing, Zayach says. "Even tho supply chain is shaky at this point" state has said it will keep providing tests to the county.

As to the needed 14-day sustained drop in new cases: "We are not meeting that indicator," Zayach said. We need to step up testing and contact tracing. "And then go slow."

"This is an incredibly difficult balance. .... We don't want to open so much so fast that we have another surge."

By May 8, "we will for sure" have more staff and testing. Not quite to the level we want on testing, but it will be better, Zayach says.

Friend: We're getting emails about cases in long-term care facilities. I don't want city council to get that information rather than the county health dept. How do we coordinate?

Zayach: If we can get that to Jane (Brautigam) she can get it to us. We have an entire "branch" dedicated to LTCF

Friend: Are people who are ill with COVID being isolated? We're getting emails on that.

Zayach: There are "for sure" requirements for facilities to isolate infected patients. "We are working diligently" with facilities to support them in creating response plans.

Friend asking about petitions!

Friend: Can this be done safely in person? Is it allowed to gather door-to-door or in public places?

Zayach: I don't know the answer to that; I received that question and pushed it to my legal team.

Friend: Can we get a confirmation about the data around mask-wearing? Indoor vs. outdoor?
Zayach: "Yes there is evidence that demonstrate that masks reduce the spread of the disease. ... They absolutely reduce the spread of droplets and the disease."

Studies differ on efficacy, but yes, they absolutely do, Zayach says.

RE: exercising and mask use.... Zayach is repeating the study that Dr. Robert Vissers referenced that the scientists I spoke to said was crap.

Zayach: "I know it is not intuitive, but to wear a mask when exercising on a trail where you're likely to run into some spots where you're not going to have 6 feet of distance is important to do."

Friend: Why isn't the county doing a mask order rather than Boulder City, as we're considering tonight?
Zayach: We're definitely looking at that.

Counties are working together on this, Zayach says. Which may explain why it's lagging.

"We are evaluating that and will make a decision this week at some point."

Swetlik: Are elective surgeries allowed again and how does that correspond to bed availability?
Zayach: There is guidance but I don't want to misstate it, bc I don't remember it all.

"Our hospitals are in a very good place, unless we were to see some kind of horrible spike in LTCF."

Zayach: We've agreed with hospitals that if one started getting a surge, other hospitals would "back them up" and support each other.

Also a reminder: St. Anthony's North will be open by mid-May for "decompression."

"But I'm not anticipating we'd have to get to that point."

Weaver: You said counties would be making a decision this week on masking. Yesterday you said the order would be directed at May 8 to coincide with safer-at-home. Do you still anticipate that?

Zayach: That would be my hope. I'm hesitant about "getting in front" of other counties. "I would anticipate we would have guidance out or an order out before the 8th."

We want ppl to know what that looks like before we move to lift stay-at-home May 8, "barring anything major happening."

Yates: Would you object to Boulder doing a masking order this week?

Zayach: "No. I would support that."

Weaver: "I know you're taking a lot of criticism from ppl who are impatient with the current situation, which is understandable. The current situation is difficult."

"Our council is completely behind you."

Dr. Robert Vissers from BCH is not here tonight.

Weaver to Zayach: Any reason to believe BCH would be in trouble anytime soon?
Zayach: No, not based on data we're seeing. But Vissers would need to confirm.

Friend: Any updates on antibody testing they were trial-ing?
Zayach: I have not heard what kind of results they're seeing.

But will report back, through Brautigam.

Moving onto the discussion on the possible mask ordinance in Boulder. Here's the staff presentation: www-static.bouldercolorado.gov/docs/3A_Presen…

City Attorney Tom Carr going over state mask orders. See:

Brautigam has many authorities under the state of emergency, but she doesn't have the power to require masks to be worn, apparently. Council will solve that with an ordinance tonight. (Presumably).

The way the law is written, the business OR the individual could be charged (with what I assume is a misdemeanor) for lack of masks.

Punishable by fines and/or time in jail, as are other violations of the emergency orders, though that latter is highly unlikely.

Here's what is covered by the definition of protective equipment:

Carr wrote it more broadly just in case, but this particular order being considered by council would be face coverings, specifically.

I know that might be confusing, but basically council needs to give Brautigam authority to require protective equipment and then council needs to do a mask ordinance.

"Our police dept should not be the group" who enforces this, Brautigam says. "We need to rely on the businesses."

"This is going to be an education effort. ... We simply do not have the resources" for enforcement, Brautigam says.

Oh, wait, sorry: Correx to two tweets ago. Council will empower Brautigam to require protective equipment and then SHE will issue the order for masks.

Yates asking about enforcement when a particular business receives many complaints. "Short of going to an officer ... is there an interim step you could take?" After letters/warnings have been sent.

Carr: I would arrange a meeting with the business and their lawyers. The order does give the city manager the power to shut down a business.

Friend: Why are we not looking at trails in this order?

Brautigam: We got a couple of emails today where ppl were asking us to add those. Dan Burke from OSMP is asking that we do not add trails "because of the problems that our rangers will encounter."

"Similar to the police, we do not want to put them in danger." Rangers have been experiencing "quite a bit of negative behavior," being harassed for not enforcing mask use.

Friend: I don't want to make anyone's jobs harder. But I think right now bc it "feel voluntary" there's "so much anger and vitriol" and "people policing each other."

Maybe making it mandatory would help with that.

Brautigam: The danger indoors is higher than the danger outdoors.

"I think ... the anger will increase if we make it mandatory on trails," she says.

Joseph clarifying that this is for indoor places.
Yes, Carr says.

Joseph: Do we have resources for masks on our website? Where ppl can get them for free?
Yes, Engagement Manager Sarah Huntley says.

Swetlik: What are we saying on our signage around masks and trail use?
Brautigam: Idk bc I've been staying home and have not been on the trails.

Burke pops up: Our signage for social distancing and masks are fairly similar. ... It pretty much says wear a mask, stay 6 feet apart. Not much difference between guidance and an order.

Messaging on face coverings "has become almost as ubiquitous as the social distancing," Burke says.

Young q for the new police chief, Maris Herold: What are you thinking about residents policing one another and being angry?

Herold: I've talked to the rangers, I've been out on the trails. "Some of the youth, they get very agitated and angry." To put rangers in that "conflict" is not what I want.

"Conflict with people in uniform is not what we want."

Moving to council discussion: Do we want an order for indoor mask use?

Weaver: "We want to set a culture of mask wearing now" with businesses so that "whenever" we move into safer-at-home, "people are aware of the way to behave as a customer."

Yates supports.

Wallach, too. "Strongly in favor .... I think it's appropriate to put the onus on the business."

Brockett: "The riskiest point right now is when you do need to go inside, say, a grocery store and it's impossible to maintain 6 feet of distance. ... It's a good next step for public health."

Friend: Do we need to think about exemptions? Like if you've already have it. Idk that we wouldn't want ppl to wear masks, but ....?

Carr: It gives Brautigam "flexibility."
Aspen's exempts kids under 2. So ours could be altered pretty easily as the science evolves.

Swetlik says maybe we want to exempt ppl who have a "breathing issue" where masks prevent them from breathing in a way that "keeps them alive."

Wallach brings up the point that we'll want exemptions for restaurants, once those are opened.

Yates makes a motion to adopt the emergency ordinance.

"I think this is the right thing to do," Yates says. Any exemptions can be crafted by Brautigam, with advice from health officials. "I think it's the right thing to do right now" when fewer than 100 businesses are open to having customers inside.

Weaver: I've been in touch with mayors of Longmont, Louisville, Superior, Lafayette. They're watching us and considering these orders, too.

"These are face coverings and not masks," Weaver reminds. So bandanas work. "This is a low or no-cost impact."

Weaver: Hopefully we can enforce this using the city attorney's office and then, maybe, code enforcement officers (non-armed) once in awhile.

Young: It does make going out and conducting "life like it used to be" in a safer way. "I completely support this."

Joseph asking for leniency in enforcement. Warnings first; education first. Onus on the businesses.

Brautigam agrees. "We are going to enforce it. ... I do feel if a police officer runs into a person who is egregiously" breaking the order, "they will talk to that person. We're just not going to have police marching into grocery stores" looking for people.

Police chief concurs. If it was an egregious case, there would likely be some other criminal element at play like disorderly conduct.

Unanimous vote.

So Brautigam now has that authority; expect an order soon requiring masks in indoor public places.

Council now going to discuss if the order should apply to trails or other outdoor places.

Friend in favor of this.

Zayach did say it is important to wear masks on trails, she says. "I would send that strong message."

"I would turn ppl back at busy trailheads if they don't have masks."

Friend: I'm not trying to be insensitive to rangers and conflict. But we already have that conflict; we're creating some conflict for the stores where they are going to have to enforce. "We shouldn't decline to do that for our areas as well."

Wallach: "I agree entirely. .... Nobody wants to be turned back at a trail... but this is not a requirement to shovel your walk. this is a requirement to keep other ppl safe."

I mean, shoveling your walk is about safety, too, but I get his point.

LOL Swetlik just made that point. #soulmates

Weaver: We should consider that transmission happens more inside than outside. Masks definitely aren't harmful outside; they can only help.

I have a q: Would this apply to OSMP trails? Bike/multi-use paths?

Yates: I don't disagree with having an order, but I'm worried about orders "we know we can't enforce."

Businesses can turn ppl away, so they're helping us. But on the trail, by the time we get a report, the person might be long gone. "The trails are very porous, we don't have rangers at every trailhead."

Yates: "It might dilute the order we're trying to get in place with respect to stores. If ppl know they can flaunt the open space order, they may be tempted to flaunt the store order as well."

Let's wait and see what the county recommends, he says.

Wallach: "This would not be the first statute we passed that relies on the goodwill of our citizenry to comply." References 20 is Plenty; "We're not going to have speed traps; we're relying on our residents to do the same thing."

Swetlik: "We don't enforce jaywalking on a daily basis, I don't think." He could be convinced to wait on the outdoor order but is "leaning toward doing it."

Brockett to Burke: Can the rangers turn ppl away at trailheads? Do we have capacity?

Burke: We have 4-5 rangers who could issue tickets. Most of the staff out on trails are educational and outreach staff, who can't do that. "Typically, rangers are busy getting called out constantly" not standing at trailheads.

Staff similarly doesn't have the authority to "send someone away."

Burke: 90% of system is in the county, adjoining county trails and lands. We don't have authority there.

"Whatever council comes up with, we'll do our best to do our job."

Given Burke's advice, Brockett does not support requiring masks outdoors. Wants to "up our signage game" and education efforts.

Burke: Right now, "we're enforcing egregious behaviors" not "tapping on someone's shoulder if they're not wearing a mask."

That was in response to a Weaver q.

Weaver: If we did an order requiring outdoor mask use, it would still mostly involve education staff doing outreach.
Yes, Burke says.
Weaver: Is there a reason you can't do that now?
Burke: No

Friend: How would this be different from enforcing voice and sight tag violations? (Off-leash dogs)
Burke: "Every situation is a judgement."

"It probably wouldn't be that different to how we enforce any of our rules and regulations," Burke says.

Young with Brockett and Weaver, more toward not requiring masks on trails. "With or without an outdoor order, what would happen out in the field would be the same."

I, for one, am enjoying watching council tackle these issues of education vs. enforcement and efficacy, etc. that (should) apply *every day* when it comes to policing, but they've never had to grapple with b4.

Joseph asked about staff capacity.
Burke: "We're already maxing out all of our education and outreach staff (and) repurposing several individuals" to work in those roles. We could bring back volunteers but don't want to do so while it's unsafe.

Joseph: How have things improved since we've been doing education? If there's no problem, there's nothing to solve.

Burke: Where we're seeing most success is social distancing: 80% compliance on weekdays, 60% on weekends

Starting to get "strong compliance" at neighborhood areas on social distancing and face coverings, but compliance goes down at places like Chautauqua, Burke says.

Nagle: "It's a hard call" but is going to follow staff advice and not support an order for mask use on trails.

I *think* that's a majority against requiring masks on trails

But council may revisit next week or after, once county issues guidelines.

In the meantime, more signs.
Young: Is it expensive?
Burke: It's a small number. "We've already busted our yearly budget for signage this year." But we wouldn't let it not happen bc of expense. It's having a good effect.

Spoken like the best-funded department in the city....

Friend: Governor has asked ppl to only recreate within 10 miles of home. Is that likely to have an impact or not?
Burke: Based on weekend numbers, we are still likely getting people from farther away but it's hard to know.

Weaver referencing the Google project to find where ppl are congregating. Apparently the state is releasing a platform for this data in a week or so.

Brockett: We're not monitoring anyone's cell phones; this is aggregated, anonymized data that shows where ppl are going. Ppl have raised concerns.

True, at least per Google. It's data they're already collecting and using, to track peak times at businesses and other places. You can find links and more in my story: boulderbeat.news/2020/04/25/bou…

Weaver: It would be great to work with the Chamber and come up with a short, simple checklist for biz to allow public in for after May 8, when stay-at-home will likely expire.

That's a wrap on this one. Not even a short break before budget stuff.

@threadreaderapp please unroll. Thank you!