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A Reflection on the COVID-19 Pandemic · Healthier Together: Larimer County's Public Health Podcast

0:02
Welcome to Healthier Together, Larimer County's
0:04
public health podcast where we come together
0:05
for healthier lives, connected communities, and
0:08
real conversations. From your local public health
0:10
team, I'm your host, Tom. And I'm Joanna. This
0:12
is our monthly extended episode where we'll dive
0:15
deeper into public health topics and peek behind
0:17
the scenes of the day -to -day work at the Larimer
0:19
County Health Department. Today, we're thrilled
0:22
to bring you an extended interview with our public
0:24
health director, Tom Gonzalez. This month marks
0:28
six years since the National Emergency Declaration
0:30
for the COVID -19 pandemic. We've invited Tom
0:34
to share a bit about what that time looked like
0:36
from inside the health department, the lessons
0:38
learned, and the lasting impact the pandemic
0:41
has had in our community and the work of public
0:43
health. Tom, thank you so much for joining us.
0:46
Thanks for having me, Joanna and Tom. It's a
0:48
pleasure. To start, Tom, do you remember when
0:51
you first heard about COVID -19? Oh, I do. Yes.
0:55
It was probably middle of December of 2019 when
0:59
our colleagues at the Colorado Department of
1:02
Public Health and Environment asked us to jump
1:04
on a call. And they were talking about this coughing
1:09
virus out of China that we need to pay attention
1:12
to. So it was by that middle of December that
1:15
we heard about it. And then where it really was
1:17
ramping up was in January, probably the second
1:20
or third week in January when the first case.
1:22
was identified in the United States in Washington
1:25
State, and that's when it hit. This is real.
1:28
In those early days as COVID was spreading and
1:31
we were hearing about new cases in new countries,
1:33
but it hadn't reached Colorado yet, what was
1:37
the health department doing or thinking about
1:39
in preparation? We're lucky in Larimer County.
1:42
We have a really wonderful system called the
1:44
Office of Emergency Management, and we started
1:49
meeting early on, probably. right there before
1:52
the holidays in 2019, to talk about how would
1:56
we get into the incident command system, what
1:59
would be our resources, our objectives and goals.
2:01
And really we were dusting off our old respiratory
2:04
plans, response plans, and those were all built
2:09
around influenza. So we didn't know much about
2:12
this virus, but we knew we had plans and those
2:14
plans could be enacted. And then when did Larimer
2:17
County have its first positive case? Boy, I'll
2:19
never forget that day. It was March 5th, 2020.
2:22
In fact, we were meeting with the Larimer County
2:24
Board of County Commissioners with Office of
2:28
Emergency Management to talk about our planning
2:31
and our strategies. And the phone call came in.
2:33
And I remember we had to just stop that meeting.
2:37
And we were getting notified that we had our
2:41
first case. Folks, remember, our first case was
2:45
linked to a long -term care facility. And that
2:48
was significant because we learned early on this
2:52
virus was very deadly to especially our seniors
2:56
and seniors living in congregated settings such
2:58
as long -term care. So it was immediate concern
3:01
right off the bat, right on March 5th. I'm just
3:04
curious. I know it took a while for rapid testing
3:07
to be available. Where did that call come from,
3:09
that first call? notified you of the first case
3:12
in Larimer County it came from Colorado Department
3:14
of Public Health and Environment and you're right
3:16
it was taking us forever to get test results
3:19
back so that was a test result that probably
3:22
took four or five six days to get it through
3:25
the state lab because we didn't have that surge
3:27
capacity for laboratory testing. So the scope
3:30
of the response to COVID -19 was massive, you
3:32
know, in terms of people, equipment, resources.
3:35
Can you tell us what the process was like to
3:37
scale up the health department to meet the demands
3:39
of the COVID response? And what were some of
3:41
the challenges the department faced in the process?
3:44
Right off the bat, we were all sent home for
3:46
the most part. We were working remotely or those
3:49
that were working in the sheriff's office, which
3:51
was the, at the time, our incident command system.
3:55
through the Office of Emergency Management. So
3:57
it was the EOC or the Emergency Operations Center.
4:00
But we had laptops. We were somewhat remote,
4:04
but we didn't have all the equipment. So it was
4:06
the first piece with information technology,
4:08
getting equipment to staff, which was clunky
4:11
as ever, getting it to them so they could do
4:12
their job and understand how they were going
4:15
to do their job. And then as the pandemic progressed,
4:18
it was ramping up through our incident command
4:22
system, understanding, boy, we need help. And
4:25
early on, we got volunteers through the School
4:26
of Public Health right here at Colorado State
4:28
University. And that was a great resource to
4:31
have right in our backyard. But that was ramping
4:34
up utilizing those staff and getting some state
4:38
staff help. But as you recall, everybody was
4:40
in this crisis. So we were pretty limited. As
4:43
this went on and we did get some federal funding
4:46
support, we ramped up to adding 60 staff at one
4:50
point. On most days, we only have 100 staff,
4:55
so we increased our staffing by 60%. And I'd
4:58
say all 160 staff at some point had their hands
5:00
in this response. It was that big. Was there
5:03
one thing during the COVID response that you
5:05
found particularly daunting? That's a heck of
5:08
a good question. I look at this response because
5:10
it was such a long response. You know, most responses
5:12
we deal with in public health, it's a two -week
5:16
thing and then a recovery, whether that's a...
5:18
a measles outbreak or a flood or a fire. This
5:22
went on for years. So I've looked and thought
5:25
about this. I broke it down into four areas.
5:27
That first area or first time was really the
5:32
initial surge in hospital capacity. It was right
5:34
when we heard about the virus. And there were
5:36
so many unknowns. What is a coronavirus? All
5:39
these kind of things, trying to get information
5:40
on it. But we knew right off the bat our number
5:43
one objective. was to preserve hospital capacity,
5:47
our ICU, our intensive care units, because we
5:51
were already hearing from our hospitals they're
5:52
filling up, and many of them were with this coughing
5:55
disease. So that was the concern because we wanted
5:58
to make sure the hospital system was there to
6:01
preserve for any emergency. What if there's a
6:03
car accident? What if somebody has a heart attack?
6:04
How are they going to get basic services and
6:07
needs? So that was the big challenge early on,
6:10
ramping up, understanding the virus. Number two
6:13
was the winter surge of 2020. That, if most people
6:16
recall, December of 2020 was one of the deadliest
6:18
months that we had here in Larimer County. And
6:22
we had to go back on the Colorado dial. Now,
6:25
if you all remember, as we got from like blue,
6:29
from green, blue, yellow to red, we got more
6:32
restrictions and such as not being able to sit
6:35
in a restaurant and those kind of things. And
6:38
that was frustrating to people. It was frustrating
6:40
to our businesses, frustrating to everyone. And
6:43
I understand that. So that was a difficult time,
6:46
the winter phase. And I remember touring Poudre
6:49
Valley Hospital. It was probably early December.
6:53
And I'll tell you, folks, I can't even describe
6:55
what I saw. I saw rooms, double occupancy, just
7:00
stacked with people that were sick. I saw health
7:03
care workers just working around the clock. They
7:06
were tired. And I saw people being triaged in
7:10
break rooms because there was not enough beds
7:13
and people to help those that may have come in
7:15
for another emergency issue. So that was really
7:19
a hard time for sure. I'd say another challenge
7:23
was when the vaccine rolled out early 2021 because
7:27
the initial vaccine came in very limited supplies.
7:31
Like we were getting 200 doses every two weeks.
7:33
So we had to prioritize to EMS to... long -term
7:38
care facility folks. And that was frustrating
7:40
for many that wanted the vaccine. So as it opened
7:43
up, we were able to then open up mass vaccination
7:46
sites. At times, we were vaccinating 2 ,000,
7:49
3 ,000 people a day when it got into April. But
7:52
early on, that was a challenge. And then the
7:53
most challenging piece, Tom, was the Delta variant,
7:57
the Delta wave. If you recall, that was late
8:01
November, December of 2021. The Delta variant
8:05
changed the game because it... And it was a very
8:08
different virus in many ways, and its attack
8:11
rate was much higher, and it attacked those that
8:15
weren't vaccinated. And we had treatment at the
8:18
time for all the other variants, monoclonal antibodies,
8:20
but it didn't work on this virus. So we were
8:23
seeing lots of hospitalization and increase in
8:26
deaths. And at that time, I did issue a second
8:30
mask mandate, which really upset the community
8:33
and many of our members, not all. because of
8:36
pandemic fatigue. So I think that Delta way was
8:39
the big challenge. So bearing in mind that, you
8:42
know, the last pandemic prior to COVID was over
8:45
100 years ago, you know, what were some previous
8:48
experiences that you were able to draw on as,
8:50
you know, you kind of... crafted this and guided
8:53
this response effort? Great question. I mean,
8:55
it's hard to go back 100 years, right, and dust
8:57
off those documents. But we've had a measles
9:01
outbreak here in Larimer County that we could
9:03
go back onto and draw, at least on contact tracing,
9:05
the basic fundamental of epidemiology and how
9:08
do we slow the spread of disease. We also had
9:11
some other diseases like meningococcal. How can
9:13
we vaccinate mass quantities? I don't know. We've
9:16
done that here in Larimer County through the
9:18
years. And we have trained staff that have worked
9:20
in those situations. So we draw off that and
9:22
we utilize those plans and the lessons learned
9:27
from then. But I think the hardest part was when
9:30
you were adding so many staff was just really
9:33
doing the education and the training on the fly.
9:37
But that's what we use. We use a lot of our experiences
9:39
here. in Larimer County and even how we respond
9:43
to all of our floods and fires. How do we work
9:47
together in an incident command system and utilize
9:49
resources in a way that we're achieving our objective?
9:52
So we're good at that in Larimer County because
9:54
we've had a lot of these events. And I think
9:57
that was a real silver lining in the beginning
9:59
of this pandemic. I think we all remember that
10:03
at times the public discourse was. very contentious,
10:07
and even violent. Did you or health department
10:10
employees ever feel unsafe? And if so, how did
10:13
you handle that? Yeah, that's a good question.
10:16
And I'd say many of my colleagues around the
10:20
state had it much worse than I did. There were
10:23
threats made to public health directors around
10:25
the state and some other really serious issues.
10:28
I never really saw it to that extent. And I think
10:32
that just sings praises to the community we have
10:34
here in Larimer County. I would say in May of
10:37
2020, both the sheriff and the police chief of
10:41
Fort Collins did sit me down, and we talked about
10:44
strategies, just ways to make sure neighbors
10:46
were aware and just things to look out for and
10:48
making sure we're more security. So we did do
10:51
that, and I looked at other ways to protect my
10:55
information so it would be harder to find me.
10:59
We made sure also key staff that were on front
11:01
and center. Of the response, they were also going
11:05
through these protection strategies as well.
11:08
I would say the bigger part was in the Delta
11:11
wave. There were some times that people were
11:13
frustrated. The fatigue had hit. I think there
11:18
were some times that people, you know, they were,
11:21
it got a little more than I would have liked
11:24
to seen. But I do, you know, I talk with my kids
11:26
about it now. Now they're both in high school.
11:29
They said there were times they were a little
11:31
scared just because of all the noise. But overall,
11:35
I think safety was number one priority. At least
11:40
our law enforcement was looking out for all of
11:42
us, so I appreciated that. And we never got to
11:45
some of the discord we heard in other areas of
11:47
the state and the country. Speaking of your family,
11:51
how did you and your family handle lockdown?
11:54
Yeah, well, first it was... I was in the basement
11:59
working when I wasn't in the operations center,
12:02
and I had a fifth grader at the kitchen table
12:05
trying to do remote learning at points and a
12:09
sixth grader upstairs and my wife doing, she's
12:13
got a private practice for behavioral health,
12:15
trying to do that in the kitchen. So it was comical
12:18
at times. And I remember our broadband, I kept
12:23
stalling on us because we didn't have enough
12:25
at the time, so we had to increase that. I think
12:28
that part, it was very challenging for, as we
12:31
all know, for our youth at that time. It was
12:33
hard to actually learn remotely and then not
12:37
being able to play with friends, those kind of
12:39
things. We were able to encourage them to go
12:41
to the park outside, you know, in the distance
12:43
and still have relationships. But it did isolate
12:46
us. So that was a challenge early on. As we were
12:49
able to kind of open up a little bit that summer,
12:53
we created a bubble. Most folks have done. So
12:57
we had a couple close families with kids our
13:00
kids' age so that we stayed with just that. We
13:03
didn't expand, but that's how we kind of navigated
13:06
it early on. How did you and the health department
13:09
tackle misinformation and disinformation? Yeah,
13:13
there was a lot of that. I would say probably
13:16
more going into the summer of 22 on as frustrations
13:21
continue to rise. We early on within the operations
13:27
center put together a joint information command
13:31
center. So we had several folks working together
13:34
on all information coming in and how it was going
13:37
out. And we had a really good communications
13:40
manager that managed all of that. So we tried
13:44
to stay on top of it. Of course, it was very,
13:46
very difficult. And a team working literally
13:49
around the clock trying to. respond to texts,
13:53
to Facebook posts, to emails, to phone calls,
13:57
and trying to get the information out as correctly
14:01
and as swiftly as possible. Now, the biggest
14:03
problem and the challenge with the COVID -19
14:05
is, as we were learning, because I said early
14:07
on, we didn't know a lot about this virus. We
14:11
know a lot about influenza. We've been studying
14:13
and dealing with that for years. We haven't as
14:17
much with this. And SARS -CoV -2 is a fairly
14:20
new virus and how it transmitted and how it impacted
14:25
folks. Even hospitals were learning as they go.
14:28
The information changed. And that was difficult
14:31
for the community. And my stance from the beginning
14:35
is as soon as we learn the new information, we're
14:37
getting it out. Let's not hold back. Let's get
14:40
it out. And I think the team did a fantastic
14:42
job. But there were times we had to pivot. Right
14:45
on a Friday afternoon, and folks were like, wait
14:48
a minute, we were just doing it this way. Now
14:49
why on Saturday we're going to change? And that
14:53
was frustrating. And I think there was some caution
14:57
from our community, and I appreciated their patience,
15:00
but that's what it was. We were learning as we
15:01
went, and the information changed quite often.
15:04
So the health department was part of a larger
15:07
national and even international response effort.
15:10
Can you tell us about the work that the department
15:12
did with other community partners and what we
15:14
learned from working with them? Tom, that's fantastic.
15:17
And that's what I love about Larimer County.
15:20
I've worked with other counties and other states
15:22
doing public health. But Larimer County has a
15:25
connection piece. We work together. We don't
15:28
work in silos. We work as a team. And right off
15:31
the bat, when we got in the operations center,
15:33
we had the sheriff's office there. folks from
15:38
municipalities, police departments, EMS, our
15:41
hospitals, liaisons. We had school districts.
15:44
We had you name it. They were involved and wanted
15:47
to be part of this response. That was key early
15:50
on because we were coordinated, our information
15:53
was coordinated, and we were working as one unit.
15:55
And our information and how we went about some
15:59
of these restrictions to manage the virus was
16:02
unified. So many of our organizations, I mean,
16:07
our Chambers of Commerce, our United Way. I don't
16:11
want to miss anybody and forget them, but it
16:13
was a number of folks that we worked together.
16:15
I just remember, like, weekly meetings with our
16:17
chambers and our business community because they
16:21
wanted to know, what do they do? How does this
16:23
impact them? I think that was the key, having
16:26
organizations at the table early on and often.
16:29
Gosh, I remember having almost every other day
16:32
phone calls with our school districts and our
16:34
schools, our charters, our private schools. So
16:37
we could hear from them and we could give them
16:38
the information. But that was key. And if to
16:42
do it all over again, I would even build upon
16:44
that and keep those partnerships even stronger.
16:47
That kind of leads to my next question. In retrospect,
16:50
is there anything that you would have done differently
16:52
if you could go back in time to the start of
16:54
the response effort? Tom, that's a profound question.
16:58
I'll tell you, I'm a runner and some times on
17:00
my run, I often get kind of go. To that part
17:04
of my brain, and I'd say it's a little bit of
17:06
trauma in some aspects, but what could I and
17:11
the team have done differently? And again, looking
17:14
at, we didn't have a lot of information. This
17:16
was a new virus, and we're all learning as we
17:19
go. It's hard to be, I guess it's easy to be
17:23
a Monday quarterback, kind of assessing how the
17:28
team played. But in the middle of the game, how
17:32
do you react, I think is the big key. The one
17:36
area I've thought about that I think we could
17:38
do differently and we could do better, and that's
17:40
in -person learning. There was a profound impact
17:44
on our K -12 and even our college university
17:47
students on remote learning. And the impacts
17:51
not only just learning, but socially. And also
17:55
the impacts to our teachers and our educators
17:57
and all of those folks that are... involved in
18:00
educating our youth. I'd love to figure out the
18:04
best way where we can manage the closest to normal
18:07
in -person learning and protect those the most
18:11
vulnerable to the virus. At the time, it was
18:13
tough, and the school districts did such great
18:15
jobs, and so did CSU and Front Range. I think
18:19
we could do better, and I know there's a group
18:22
that are looking at that and ways if we have
18:24
to deal with another. situation like this, but
18:28
I think in -person learning really needs to be
18:30
looked at and we really need to make sure we
18:32
keep that as normal as possible for our youth.
18:36
Was there something that you found worked better
18:38
than you had imagined that it was going to work?
18:42
That's a great question. I would say early on
18:46
our ability to ramp up and be able to do specimen
18:51
collection. So there's two pieces of testing.
18:54
One is collecting the specimen where the nasal
18:56
swab and then going to the lab and actually testing
19:00
it for the virus. I was so impressed with our
19:04
team and all of our volunteers as well as our
19:08
temp staff that were hired. But we were being
19:10
able to collect specimens by May of 2020. We
19:15
could do these drive -through specimens of over
19:17
a thousand people. to get them to the lab. That
19:21
was impressive. Now, the hard part was then the
19:23
lab was packed. So you had all these specimens
19:26
at the lab, and it was taking six, seven days
19:28
to get results. So the next big, I think, win
19:30
was working with Colorado State University and
19:33
their vet diagnostics laboratory to turn it from
19:36
an animal lab to a human lab. By that fall, we
19:41
were running PCR, is what the test is called,
19:45
for COVID -19 through the CSU animal lab. And
19:49
we were able to knock it down from about five,
19:51
six days on the average to get a test result
19:54
back down to 24 to 48 hours. And then we could
19:57
actually do real contact tracing. If you could
19:59
imagine when you get a result six days later,
20:02
it's pretty tough to do contact tracing rather
20:04
than a day or two. So I think overall that ability
20:06
was incredible to turn early on in the pandemic.
20:12
We could maybe do 100 tests, 50 to 100 tests
20:15
a day to over 1 ,000. And that was pretty darn
20:19
remarkable. How has the Larimer County Health
20:22
Department changed since the pandemic? I'd say
20:26
the biggest change or improvement is the communications
20:30
with our hospital systems. And that's communication
20:35
to us that we get weekly on why folks are in
20:41
the ICU. So we know if... 5 % of the ICU is due
20:46
to influenza now, or if it's due to trauma, or
20:49
it's something else. We never had that data.
20:51
So we absolutely know what's going on in our
20:54
community and what's putting people in the hospital.
20:56
And then that's an early warning indicator, and
20:58
then we can respond and get the information out
21:00
to the community. Such recently, we had a fairly
21:02
significant uptick in influenza type A over the
21:07
holidays into January, and we were able to kind
21:09
of let the community know. But that was the information
21:11
we were getting. from the hospital. It's called
21:13
syndromic surveillance data. That was put together
21:17
during COVID. So we could have that data and
21:20
it's continued. So that's excellent. I'd also
21:22
say internally, how we look at data, how we're
21:26
using data and communicating the data. Myself
21:31
and much of my staff are, they're scientists,
21:34
their background is in that. And so sometimes
21:36
our communication. is difficult for the general
21:40
public to understand. So we have a communications
21:41
team, you two and more, that translate that into
21:46
how the community could understand and then what
21:48
actions they can take to protect themselves and
21:50
their family. I think that's key. So it's really
21:53
about how we communicate with our hospital systems,
21:56
gathering information, how we look at the data
21:58
and how we communicate that to the community.
22:01
I mean, I know this is a big question, but how
22:04
have you seen public health change due to the
22:07
pandemic? That's a great question. I would first
22:10
say, again, back on data and storytelling, I
22:14
would say public health's gotten a lot better
22:17
at listening. And that's myself, starts with
22:20
me. We have strong beliefs. We believe vaccines
22:24
work. We have the data that shows it. We believe
22:27
certain mitigation steps. work to keep people
22:30
safe and healthy. Not all the people maybe understand
22:35
the why and maybe have different views. And we're
22:39
doing a much better job of listening and understanding
22:41
and meeting people where they're at. Another
22:45
big piece is equity. Our health care system is
22:48
not equitable in this country. And we have to
22:52
work within that system. And I think we can do
22:55
better. Our mission is, working to provide everyone
23:00
the opportunity for a healthy life, and everyone
23:03
an opportunity and are intentional. And we've
23:06
taken a whole different approach on how we look
23:08
at those two words. For example, our back -to
23:12
-school vaccination clinics used to be, before
23:14
the pandemic, here at the health department in
23:16
Fort Collins, Loveland, or Estes Park, between
23:18
8 and 4 or 4 .30, we would do one maybe evening
23:22
clinic, and that's when you could get your shot.
23:27
Your kiddos could get their vaccines. Well, we
23:30
know people maybe have to work one or two jobs.
23:32
They don't have transportation. Maybe it's not
23:35
accessible to come to Fort Collins or Loveland
23:37
or Estes Park. We now come to community. This
23:40
year, I'm proud to say we had 26 off -site clinics
23:43
where we came to community, and if they wanted
23:46
to get their kids vaccinated, it was right there.
23:48
That increased vaccination rates significantly.
23:52
and creates more of an opportunity for everyone.
23:54
So that's just one example of what we're doing
23:56
and how we've changed. I'm proud of our staff,
23:59
and I appreciate our Board of Health, who's our
24:02
governing body, that supports this work and really
24:05
lets us do the great work so that we're getting
24:08
to everyone in the community, no matter where
24:11
they're at. What did you learn about Larimer
24:14
County through this experience? I think it comes
24:17
back to that we are relationship built. Larimer
24:22
County, it's a fantastic place to live and raise
24:27
a family. But most importantly, it's just great
24:30
people. I get a little emotional here because
24:34
I think about all my colleagues around the state
24:37
that served in my role. Folks, over 60 % of them
24:44
now, and it's about 50 public health directors.
24:47
were either pushed out of their job, resigned,
24:50
or retired. So when I get on statewide meetings,
24:56
it's many new faces. And I'm still here and proud
25:00
to be here and excited to be here because of
25:03
this community. And this community works together.
25:06
We don't work in silos. We bring everybody to
25:11
the table. And when I say we listen better, I
25:13
think we've even gotten stronger as a community.
25:16
I see us in community meetings where maybe somebody
25:20
that wasn't invited before is now, and we're
25:22
listening to them more than we ever have. So
25:25
that's what I've learned about Larimer County
25:27
is we're relationship built, we care about each
25:31
other, we listen to each other, and we agree
25:34
to disagree, and we're going to work together
25:36
to try to create a thriving community. We've
25:39
talked a lot about the lessons that you've learned
25:41
through this experience. You mentioning losing
25:44
60 % of people in your role, I'm sure that happened
25:49
at multiple levels in the public health workforce.
25:54
I guess I'm just curious about how you see that
25:57
sort of historical institutional knowledge playing
26:01
out in the future due to that loss in workforce.
26:05
Yeah, Joanne, I have to think about that. There
26:08
has been a lot of... institutional knowledge,
26:11
at least with the public health system. When
26:13
I'm talking to folks, I tell them public health
26:15
works as a system effectively. And that starts
26:19
with our federal partners, Health and Human Services,
26:22
Centers for Disease Control, the EPA, down to
26:25
the state, Colorado Department of Public Health
26:27
and Environment, to the locals. And we are a
26:29
united group called the Colorado Association
26:30
of Local Public Health Officials. When we are
26:33
working together and we're listening to each
26:36
other and we are sharing. information and resources
26:39
together, we're effective. Whenever we're not,
26:42
we're not effective. I think the biggest key
26:45
right now is making sure that system continues
26:49
to grow and expand and that we're properly training
26:53
our new public health directors and getting them
26:55
fit in. And then those that are still here, like
26:58
me, that we're involved in talking about historical
27:01
times. what we've learned from the past, what
27:06
we could do differently in the future. So I think
27:09
we've got to invest in the system. And right
27:13
now there's some forces against that system.
27:16
And I'm here to say we're going to continue to
27:18
work together to improve that system and tell
27:25
folks the why. I think one of the biggest priorities
27:29
of our new strategic plan that just rolled out.
27:32
is telling the public health story and building
27:36
trust. There's a lot of distrust out there for
27:39
many reasons, probably, as I said, because information
27:42
was changing all the time. That can build distrust.
27:45
Like, wait a minute, you just told me to do something
27:47
yesterday. Now we're doing it differently. We
27:51
want to make sure we're getting out in our community
27:53
and listening and hearing what's the challenges
27:56
for them. What's the challenges for them to not
28:00
thrive? and work together because it's different
28:03
than in Red Feathers compared to Timnath, compared
28:06
to Estes Park or Berthoud. That's what makes
28:09
this county so amazing is what we got to work
28:12
together and listen to each other and learn from
28:15
that. But I think moving forward, it's investing
28:18
in the system, public health system, with our
28:22
elected officials in our community. Is there
28:24
anything you wish more people knew about the
28:27
pandemic? Yeah. I wish folks all understood the
28:33
major objective. And that objective was during
28:37
the pandemic to make sure our hospital system
28:42
did not collapse or become overwhelmed to where
28:47
basic emergency needs could not be handled. And
28:51
there were two times along the pandemic where
28:54
we reached that. I talk about that winter phase
28:57
of 2020. I remember getting a call. from one
29:00
of our hospital systems saying, Tom, we have
29:03
no beds. I have no more health care workers.
29:07
And I'm sitting there, and it's a Friday evening,
29:10
and I'm going, I look out the window, and it's
29:12
snowing hard. And I'm just thinking, where's
29:14
all my family? We need to get them in the house
29:16
because if there's a car accident or if there's
29:19
something that happens out there, roads are slick,
29:22
there is no way to treat these folks. And so
29:25
that was our major objective. I look back at
29:28
folks, I don't like masks. I don't like having
29:31
something on my face. And all the mitigation
29:36
and the sacrifices we made, it was to make sure
29:41
our hospitals did not reach that end point where
29:45
they could not treat the basic emergency. We
29:48
got close, but I just want everyone to know that
29:52
was the major objective. And the majority of...
29:56
Larimer County residents and visitors all chipped
29:59
in and did that. And that's why. Why we did not
30:02
exceed hospital capacity like some other parts
30:05
of our country did because we did those things.
30:08
We never thought it would be zero COVID because,
30:11
wow, this thing could spread. And as we've seen,
30:13
it spreads like it's very contagious. But it
30:17
was more to just keep that curve a little flat
30:21
so we could have let the hospitals be able to.
30:24
not get over capacity. Looking out into the future,
30:28
how do you think the health department's previous
30:30
response to the COVID pandemic might prepare
30:33
us better for like a next pandemic? Tom, that's
30:37
a great question. I think first and foremost,
30:38
we did an after action report. So we documented
30:42
a lot from all of our partners. What went well?
30:47
What didn't go well? What should we have done?
30:49
What did we do? And we should continue to do.
30:51
And we documented that. And that's in... And
30:54
there were about a list of eight to nine things
30:56
that said, we need to improve on these. And we've
31:00
been working on that list and chipping it away.
31:02
And it's part of our overall emergency response
31:04
plan. I think that's important. We've got to
31:07
document it and preserve it. Because if another
31:09
event happens 20 years from now, who's going
31:12
to be here to go back to learn from our lessons
31:15
learned? But there's a lot we can build from
31:19
it. And again, I come back to our being able
31:21
to. ramp up testing, not only the swabbing piece,
31:25
but the actual laboratory piece, being able to
31:28
get results quicker, contact tracing, be able
31:31
to really look at how do we look at in -person
31:36
learning, maybe a little differently. How do
31:38
we do other mitigations to slow the virus spread
31:42
for the hospital capacity? But a lot we learned,
31:45
a lot we got out of it. That was a real life
31:48
exercise. Much of what we had done was in plans.
31:51
I mean, H1N1 was the closest thing in 2010, but
31:56
this was real. And the most important is we need
31:59
a document and keep talking about it. And it's
32:02
something we should exercise yearly so it doesn't
32:05
get forgotten. On a personal note, what was the
32:08
hardest part of the pandemic for you? I'm a coach.
32:14
I coach youth basketball. So I coach middle school
32:16
youth basketball. And really, any activity, whether
32:21
it was sports or band or art or dance or anything
32:24
like that, was that all being stopped. That was
32:29
hard because we are social creatures. And I love
32:33
coaching. I love the kiddos. And to say, hey,
32:36
we all got to go home and we can't do this, that
32:39
was really hard. It was hard on society. And
32:41
again, anything we did. So, you know, I was a
32:45
dad, a coach, a husband. And I was living that.
32:49
And I was the one saying, we got to do this.
32:51
And that was probably the biggest challenge.
32:54
Watching my, now he's a senior, he didn't get
33:01
to play seventh grade football. And he's an all
33:04
-conference football player in high school. And
33:06
I look back, those kids didn't get to play. And
33:09
in eighth grade, it was kind of awkward. They
33:11
had to wear a mask here and there. And you could
33:14
tell those stories over and over. I think that
33:16
was hard. And even on the adults when we just,
33:19
we couldn't be social. We were all doing remote.
33:22
I think that was the biggest, hardest piece.
33:25
And it was hard to be the one requiring much
33:30
of this because, again, it was coming back to
33:33
the hospital surge. But it was hard. That was
33:36
really, really difficult. And I remember when
33:38
we were able to come out and we were able to,
33:41
I coached basketball one season with a mask on.
33:44
And that was incredibly hard. I remember the
33:47
day when we lifted the mask mandate and we didn't
33:50
have to wear masks and I was coaching. I thought,
33:51
oh my gosh, this is great again. But it also
33:55
was a sign of all the struggles and sacrifices
33:58
we made. And Joanna, you and I were talking about
34:01
this yesterday. Tom, when was the last time you
34:03
found a mask in an old jacket or a pair of pants?
34:07
Recently. Tom, I pulled out and it was one of
34:10
our Larimer County ones that was branded. And
34:12
it just takes you back on memory lane. But yeah,
34:16
it was probably about a couple months ago when
34:19
with this seasonably warm weather, I think it
34:21
was raining in like January, and I pulled that
34:23
coat out. Tom, is there anything else you'd like
34:27
to add that we didn't cover? You know, in coming
34:29
back to the vaccination, we had 19 partners helping
34:34
get the vaccine rolled out. And early on, it
34:37
was in small quantities, as I said. But one of
34:41
the groups was 65 years old or plus. And we were
34:45
able to get about 500 doses. And we thought,
34:48
let's get it out this weekend. So we opened our
34:50
doors here at the Blue Spruce Campus in Fort
34:53
Collins. And, oh, my goodness, it was snowing.
34:55
It was cold. We really, this was our first time
34:58
to roll out, you know, kind of a mass vaccination.
35:03
We really didn't have a good electronic record
35:05
system. Lots to learn, lessons to learn. Individuals
35:09
waited for a long time to get their vaccine,
35:11
but everybody was in good spirits and happy and
35:14
excited to get the vaccine. So that was early
35:15
in January. And I so appreciated our staff putting
35:19
that together so quickly to get the first dose
35:21
out. And then as the vaccine supply got more
35:26
and more, we started opening up clinics at like
35:29
the Northside Autzenlawn Community Center partnership
35:31
with Fort Collins where we were. 500 to 1 ,000
35:34
vaccines. And then the big one, if everybody
35:36
remembers, out at the ranch, we had the drive
35:39
-through vaccination clinic. And that was a partnership
35:41
with FEMA through Governor Polis and the state.
35:45
It was a huge collaboration. And we took all
35:48
our lessons learned from our earlier clinics
35:50
and kind of handed it to FEMA and our team. And
35:54
there we were easily doing 2 ,000. doses a day,
35:59
and it was an incredible setup. But we knew not
36:02
everybody could drive out to the ranch. So then
36:04
our team put together kind of a mobile clinic
36:07
where we'd go to Estes Park. We'd go to Loveland,
36:10
several places in Loveland, and just do clinics.
36:14
And then another really fun clinic was at Moby
36:17
Arena at Colorado State University. So all these
36:20
clinics, we were getting shots in the arm. And
36:24
it was a real big treat. It was a huge lift,
36:27
all the staff doing that. But I think by the
36:29
time we got to the end of that, going into the
36:35
fall, we had almost 70 % of our community vaccinated.
36:39
So it was quite an effort. I think it's important
36:42
to really thank, sincerely thank, all of those
36:47
involved with the response. And that's our staff.
36:52
My goodness, like I said, at one point we had
36:54
160 or so staff and every one of them had their
37:00
hands in the pandemic, whether that was going
37:03
to retail food establishments, restaurants. If
37:06
you remember back in the winter 2020, we did
37:10
the level up program to those restaurants that
37:12
were even taking stronger measures to prevent
37:15
the spread of the virus. They could open up a
37:17
little bit more. We had a variance early on.
37:21
in 2020 where folks could open up again part
37:24
of our community because the good work our staff
37:26
going around helping everyone understand the
37:29
six -foot rule this and that that that was endless
37:31
they were they were working christmas eve uh
37:33
the staff were all you know hands on deck all
37:37
of the staff doing the contact tracing the testing
37:39
all of those things uh was tons of work whether
37:43
they were all the phone calls and text messages
37:46
it it was amount an endless amount of work So
37:50
all of our staff and all the volunteers from
37:52
the School of Public Health and all of the volunteers
37:54
from the Office of Emergency Management, our
37:57
municipalities, our law enforcement, our school
38:01
districts, for goodness sakes, all of them. And
38:04
then I want to give a big thank you to the Board
38:05
of County Commissioners who, you know, they support
38:09
us as an organization. And then ultimately our
38:14
Board of Health. I report to the Board of Health.
38:17
It's kind of unique. And that five -member board,
38:20
boy, we were having special meetings like every
38:22
other week, and we were getting feedback, and
38:24
there was disagreements, and it was good, and
38:27
it was conversation on how do we move forward.
38:30
But they went through a lot as well, and I just
38:33
appreciate their support and their wise wisdom
38:36
as we move through the pandemic. And then, ultimately,
38:39
all of our 360 ,000 residents that lived through
38:42
this. Thank you. Thank you. I think we're stronger
38:45
and better going through that. All right. Thank
38:48
you so much for joining us, Tom. Thank you again
38:51
for having me. Do you have a question about public
38:54
health in Larimer County or a topic you'd like
38:56
us to discuss? Let us know. Email us at healthiertogetheratlarimer
39:01
.org. Until next week, stay well, stay connected,
39:05
and remember, we really are healthier together.