Leaders of six Denver metro-area public health agencies have urged Gov. Jared Polis and his health department to institute a mask requirement, vaccine passports and fresh inoculation mandates to blunt a worsening pandemic surge here, joining growing calls from the broader health community for the state to intervene more forcefully.
The metro officials' delivered their broad request to Polis and Jill Hunsaker Ryan, the executive director of the state health department, on Friday, two days after the Colorado Association of Local Public Health Officials sent its own letter asking for a mask requirement. The letters come as Polis has steadfastly resisted implementing a mask order to slow the spread of COVID-19, which the state projects will help overwhelm hospital capacity by the end of the year.
The association's request is strictly for a statewide mask order. But the metro coalition — representing health departments from Denver, Boulder, Broomfield, Arapahoe, Adams and Jefferson counties' — calls for not only a face-covering requirement but for various businesses — including gyms, restaurants and bars — to require proof of vaccination before entry.
The leaders also ask the state to require vaccinations for educational and child care staff; those working in congregant-living settings; health care workers not already covered by mandates; and "state, county, municipal employees, boards and commissions, city councils, and their contractors not already subject to mandates."
Though Denver has instituted mandates to vaccinate many workers and Colorado requires inoculation of health care and state employees, the adoption of the local agencies' request would significantly expand who must be vaccinated here.
"With each passing week, it felt to us like we were losing time," said John Douglas, the executive director of the Tri-County Health Department. "The hospital capacity situation was getting worse and worse, and we were now beginning to have serious conversations at a state level about rationing care."
The metro health leaders twice met their counterparts at the state Department of Public Health and Environment in recent weeks to request state intervention, officials told the Gazette on Tuesday. No concrete answers came from those conversations, and Polis has continued to resist calls that he institute an order.
"I think we want to make it clear that we see this as a crisis," said Bill Burman, director of Denver Health Institute of Public Health. "It’s a crisis right now. And this crisis could easily worsen in the next few weeks and couple of months. The public needs to hear that at least this group of public health leaders think we’re truly in a crisis."
Over the past month, the governor has offered an array of reasons for his resistance to a mask order. He's told reporters that such decisions are best left up to local authorities; he's pointed to nearby New Mexico, which has a mask order and is the site of its own COVID-19 surge; and he's said parts of Colorado with high vaccination rates shouldn't be subject to mask orders because of unvaccinated pockets elsewhere.
But none of those explanations have assuaged the concerns of local public health officials, who have watched hospital capacity continue to dwindle.
"We all recognize and agree that this is a statewide crisis," said Bob McDonald, the executive director of the Denver Department of Public Health and Environment, "and a patchwork of public health orders and mandates is not going to get us where we need to be."
The coalition has not received a response from Polis or the state health department as of Tuesday, Burman said.
In a statement to the Gazette, Polis spokesman Conor Cahill did not address the letters or calls for a mask mandate. He noted the state's decision this weekend to require proof of vaccination for some large, indoor events in parts of the metro area and praised local health departments' efforts to work with the state to address COVID-19's spread.
Cahill did not return a follow-up email seeking specific comment on the letters or if Polis is planning to implement any changes to state policy.
Burman, McDonald and Douglas all said the metro agencies may consider implementing their own versions of the order if Polis or the state doesn't act. Burman said Mayor Michael Hancock supports them.
But all three said the hospital system is threatened statewide, and mobility in the state means a limited order in one place — even if it covers the bulk of the metro area — isn't enough to mitigate the threat to capacity. Each county has different political dimensions to consider, and uniformity is needed across the state to best address the crisis, they said.
"A localized face covering in Denver is not going to solve a statewide issue," McDonald said. "It might drive down cases in Denver, but unless something is done statewide, Denver hospitals will just take more patients external to Denver. These need to be done consistently throughout the state."
Douglas, whose agency has recently been cleaved by disagreements about mask mandates in school, said that saga was an example of what can follow when the state delegates authority in the pandemic.
"When we implemented our school mask mandates in our original three-county area, now a two-county area," he said, "we often heard ... 'The last time we went through this, it was issued by the governor. If this was really serious and if we should really be pushing this, why isn't the governor saying anything? You're not even an elected official, this is a really controversial area. We need the most high-placed voice in the state — who a year ago told us we needed masks — to tell us we need it now.'"
The metro officials who spoke to the Gazette on Tuesday praised the state's decision this weekend to require proof of vaccination at some large, indoor events in the area. But all said it didn't go far enough and that it should be expanded to many publicly accessible indoor settings.
McDonald said the letter urges Polis to adopt both short- and long-term solutions: In the short term, vaccine passports and mask mandates can help suppress spread. In the long term, requiring vaccinations of many workers will improve protection for those people and the public they interact with. He said when Denver instituted its own vaccine mandate for public employees here, less than half of a percent didn't comply.
So far, Polis has adopted strategies largely intended to stave off hospitalizations. He's pushed for increased use of boosters and monoclonal antibody treatment, which, when given to newly symptomatic, high-risk COVID-19 patients, can keep them out of the hospital. He's charged facilities with finding 500 new beds and his deputies with finding providers to man them, and he's taken regulatory steps to give hospitals leeway in staffing and transfers.
But Douglas said he didn't think boosters or monoclonal antibody uptake would be sufficient in the coming weeks to avoid overwhelming hospital capacity on their own.
"I think we've got a pretty good chance of being in a more concerning place," he said, "than in a less concerning place."
