Five years ago, on March 5, 2020, a man who'd come to ski in Colorado became the first confirmed case of COVID-19 in the state. Only three weeks later, Gov. Jared Polis told Coloradans he had sent a letter to the president asking him to declare the state a major disaster area.
“These numbers are continuing to grow here in Colorado,” Polis said at a press conference, noting Colorado was among the states with the most COVID cases per capita, in part because of tourism.
The disease claimed the lives of more than 15,000 Coloradans, one of the costliest death tolls for any event in the state in history.
Dr. Michelle Barron, head of Infection Prevention and Control and UCHealth, said one of her most vivid memories is when the state was awaiting shipments of the first COVID vaccines.
“I was getting FedEx updates on my phone so we could track where it was coming,” Barron recalls. “I still have all the texts, the emails associated with it, because it was just such a big deal…that we would maybe have something that was going to change the course of this disease.”
Anuj Mehta, an ICU physician at Denver Health who advised the state on vaccine distribution, remembers getting his first dose.
“It was just a moment to sit back and think, how did we do this so fast and so safely?” Mehta said. “I thought, this is an outstanding moment in science, in healthcare.”
COVID is still circulating in hospitals, according to Dr. Ken Lyn-Kew of National Jewish, but fewer are getting severely sick, and those that end up critically ill are often immunosuppressed due to other medical treatments for conditions like cancer.
Right now, the flu is a bigger concern than COVID, according to Dr. Mehta.
“We're seeing an overwhelming number of patients being hospitalized with influenza,” said Mehta. “There was a solid week in my ICU where more than 50% of patients were testing positive for the flu.”
Across the country, doctor visits from patients with flu-like symptoms are at their highest level since the 2009 H1N1 virus, also known as the swine flu.
Another worry for doctors is bird flu, which has affected large swaths of chickens and livestock as well as dozens of people in the US.
“When you take a virus that is widely circulating in agricultural animals, [and] you put a bunch of workers who really can't afford to take a day off when they're sick, they're going to give this back and forth until this virus evolves and…spreads easily amongst humans,” Dr. Lyn Kew said.
Yet another worry on the horizon, said Dr. Barron, noting the current outbreak in Texas, in an unvaccinated community.
“We haven’t seen measles in this manner or this degree of individuals that are being affected by it in decades,” said Barron, adding that many doctors are unfamiliar with the virus. “I know there's a whole crop of physicians that have never seen a measles case, myself included.”
She said because measles is among the most contagious viruses, she’s worried the US will continue to see more cases.
“If somebody has measles and is coughing and you're at the grocery store two hours later, if you are vulnerable and didn't have a vaccine or only partially vaccinated, you could potentially get infected by it because it can hang out for so long,” said Barron.
Many with measles have mild symptoms, including a rash, pink eye, sore throat or fever. However, people can also end up with pneumonia or encephalitis, and typically children and older people are hit the hardest. In Texas a child recently became the first reported death from the outbreak.
When it comes to vaccinations generally, Dr. Mehta said Colorado is at a “low point when it comes to vaccine acceptance.” Mehta said the number of Coloradans vaccinated for the flu this season is significantly lower than last season.
He said that includes adults over 65, who are at the highest risk for hospitalization and poor outcomes. He understands some of the general vaccine hesitance stems from the rapid development of COVID vaccines and initial safety fears because they were new.
But Mehta said it’s harder to understand safety concerns about vaccines for the measles and the flu, which have been around for years.
“Their safety is so well established that it’s really less of a scientific reason [for not getting vaccinated] and more of a vaccine avoidance issue.”
Mehta said he’s worried that vaccine hesitance at the federal level and the FDA’s recent decision to cancel its annual meeting to plan for next season’s flu vaccine will be a compounding problem.
“Conditions that were manageable in the past or, in the case of measles, virtually eradicated in the United States, I think are going to come back with a soaring vengeance,” Mehta said.
That, combined with recent reductions in funding for scientific research, could foretell a new era for public health, Mehta said.
“I kind of see this as the beginning of a dark age of science…of just not trusting science,” he said.
Despite the challenges of the COVID and post-COVID world, Mehta and others like Ken Lyn-Kew said they can’t imagine doing anything else.
“I want to help people, and this is the way I know how to do it best,” Dr. Lyn-Kew said.
