Public health director predicts months of overall continued coronavirus response

The Hammer and the Dance

By Katherine Nettles

Gunnison County public health director Joni Reynolds predicted on Thursday that the Gunnison Valley is still very likely in the early stages of a COVID-19 response and overall progression through the various stages of response and recovery. She also predicted there may be a second wave of the virus in the fall and that officials should prepare to manage the situation using a longer timeline.

In a county work session on April 2 to update community leaders on the county’s COVID-19 response, Reynolds said, “I think we are 10 percent along on this journey.” She explained that this doesn’t mean the journey as limited to the ‘drop the hammer phase,’ in which patient numbers are peaking and there are strict public health orders in place. “But overall, including the stage where we get vaccines….I think we have many weeks ahead.”

Reynolds discussed research cited in a recent article, Coronavirus: The Hammer and the Dance published by Thomas Pueyo, which public health officials internationally have widely approved. The idea is that the Hammer phase requires acting quickly and aggressively—much like Gunnison County has done—to suppress the virus from spreading further. After this initial suppression phase will be a months-long period until a vaccine or an effective treatment emerges, called the Dance. During the Dance phase, Pueyo predicts varying measures of public health restrictions and scattered outbreaks.

There will be times to tighten up social distancing measures or to loosen them, depending on how cases and transmission rates evolve. “That is the dance of R (rate of transmission): a dance of measures between getting our lives back on track and spreading the disease, one of economy vs. healthcare,” writes Pueyo.

Reynolds said according to this philosophy there is a long way to go, and getting a handle on the R factor, or rate of transmission, can be key. “We could definitely see it happen in the fall where cases are manageable, maybe we have 50 or 60 percent of our population is immune, and then we get another wave. That’s what happened with H1N1, but with H1N1 at the second wave, we had a vaccine for it.”

She said that H1N1 timeline is not the same for a COVID-19 vaccine. But one benefit is that as a global issue, scientists the world over are working on it.

“I’m just not confident we will have [the vaccine] this fall. I’m not even confident that we will have it next fall,” she said. “It is just a tremendous endeavor, even with such collaboration and billions of dollars going into the research.”

Validation studies

Meanwhile, Gunnison Valley Hospital is doing a validation testing to help it do the Dance and allow some aspects of life to return to a more normal pattern. Validation testing compares the results of different experimental COVID-19 tests to confirm which prove fast, accurate and attainable to make available within the Gunnison Valley. Reynolds said this would help get a better sense of how many locals have come into contact with the virus. A larger scale testing capacity would enable the county to conduct a study and get a representative sample of the county’s population to test immunity to COVID-19. These efforts to find a reliable test are happening across the country, as authorized under the Federal Drug Administration (FDA).

“We are actively looking for the right combination of testing and viability and verification. So, this is forefront on our minds, this is what we’re looking at,” said county commissioner John Messner. “And once we find it, we’re going to do what we can to chase it.”

“Absolutely,” agreed Reynolds. “I want us to be first in the queue to get that testing. We’ve been first on a lot of things, and I’d like us to be first there too to get those validated tests and do that on a population level. And there’s going to be some companies that want to do that. They are going to want to do a distinct population like this…that is relatively isolated and defined and easier to capture.” There is group at the University of Colorado already doing that research and Reynolds said she is working with them. “I expect they are going to be helpful in getting us to the front of that line, she said. The state health department is also working on this, she confirmed.