Pandemic Interval

Phase 4 is characterized by verified human to human transmission of the virus able to cause “community- level outbreaks.” The ability to cause sustained disease outbreaks in a community marks a significant upward shift in the risk for a pandemic. Phase 4 involves community-wide outbreaks as the virus continues to mutate and become more easily transmitted between people (for example, transmission through the air)

Phase 5 is characterized by verified human to human spread of the virus into at least two countries in one World Health Organization (WHO) region. While most countries will not be affected at this stage, the declaration of Phase 5 is a strong signal that a pandemic is imminent and that the time to finalize the organization, communication, and implementation of the planned mitigation measures is short. Phase 5 represents human-to-human transmission of the virus in at least two countries.

Phase 6, the pandemic phase, is characterized by community-level outbreaks in at least one other country in a different WHO region in addition to the criteria defined in Phase 5. Designation of this phase will indicate that a global pandemic is underway. Phase 6 is the pandemic phase, characterized by community-level influenza outbreaks.

Climate Change Considerations

According to the best available data, the changing climate is expected to exacerbate future pandemics. Climate change will influence vector-borne disease prevalence, although the direction of the effects (increased or decreased incidence) will be location- and disease specific. The intensity and extent of certain diseases is projected to increase. Climate induced hazards threatens to increase the spread of infectious diseases because changing heat, rain, and humidity levels allow disease carrying vectors and pathogens to come into closer contact with humans. If Colorado’s climate becomes warmer, mosquito populations could swell, making the region more favorable for disease transmission. Warmer weather could also play a role in elevated seasonal deer mouse populations. Disadvantaged populations such as people with compromised health and the economically disadvantaged are expected to bear a greater burden as a result of their current reduced access to medical care and limited resources for adaptation strategies.

Additional research is needed to determine the effects of climate change on the frequency and duration of epidemics and pandemics. Ongoing efforts to reduce Colorado’s greenhouse gas emissions and adapt to a changing climate, such as the Colorado Climate Plan, may help to reduce the impacts of climate induced on pandemics.

Vulnerability Assessment

Preparing for, responding to, and recovering from a pandemic requires a strategy that includes a holistic suite of public health activities designed to lessen the impact on morbidity and mortality. These activities include education, vaccination, prophylaxis, isolation/quarantine, a robust contact tracing program, and the closure of public facilities. In addition, clear, concise communication with the public and with other agencies remains a critical component, as does the ability of the involved agencies to achieve collaboration and coordination. By their very nature, most pandemics, once started, will not be stopped until they have run their course. This course can be shortened and weakened by a number of factors, with vaccination being the most effective method for protecting the population. Pandemic plans describe strategies of preparedness, response, and recovery to attempt to decrease illnesses and deaths during the pandemic period to manageable levels (i.e., that do not overwhelm the critical infrastructures of the State), and to promote community resiliency and rapid recovery.

People

Pandemics have the ability to affect large segments of the population for long periods of time. The number of hospitalizations and deaths will depend on the virulence of the virus. Risk groups cannot be predicted with certainty; the elderly, people with underlying medical conditions, and young children are usually at higher risk, but as discussed above this is not always true for all influenza strains. People without health coverage or access to good medical care are also likely to be more adversely affected. Mental health of the public could also be impacted depending on the length of the event and public health guidance on prevention. Medications may be limited to help prevent or treat the disease. Vaccines typically take several months to years to manufacture and would likely become available in small quantities at first. It may become necessary to ration limited amounts of medications, vaccinations, and other health care supplies.

As noted under Previous Occurrences, the COVID-19 pandemic has resulted in 99.4 million cases worldwide with over 2 million deaths as of January 25, 2021. The U.S. has seen 25 million cases with 420,000 deaths, and Jefferson County specifically has seen 33,961 cases resulting in 1, 882 hospitalizations and 707 deaths. In addition to the direct impacts, the pandemic has completely disrupted life for many people. Most large gatherings have had to be cancelled, and many schools have closed.

Sheltering in place and social distancing have been highly encouraged and, in some places, mandated, leaving some individuals isolated for months.

Medical staff can become overburdened with hundreds of additional cases on top of their normal workload. All other responders will be impacted in similar proportions to the general public, thereby reducing available responders. Adverse impacts are expected to be severe for unprotected personnel and uncertain for trained and protected personnel, depending on the nature of the incident.

The COVID-19 pandemic has had severe impacts on healthcare workers and other responders. The difficulty of trying to protect themselves and their families while still doing their jobs was exacerbated initially by shortages of personal protective equipment (PPE). The mental health impacts on responders and healthcare workers have not been fully quantified but are likely to have impacts for months if not years to come.

General Property

For the most part, property itself is not generally impacted by a human disease epidemic or pandemic. However, as concerns about contamination increase, property may be quarantined or destroyed as a precaution against spreading illness. Additionally, traditional sheltering facilities including homeless shelters or facilities stood up to support displaced persons due to an evacuation or other reason due to a simultaneous disaster occurring cannot be done in a congregate setting. This requires additional planning considerations or use of facilities that allow for non-congregate shelter settings which may require an approval of a request to FEMA for non-congregate sheltering, and may have an increased cost (such as the use of individual hotel rooms) as opposed to traditional congregate sheltering facilities.

Critical Facilities and Infrastructure

Hospitals and morgues will be heavily affected and may be overwhelmed. Other critical facilities and infrastructure are not directly affected by a pandemic but may have difficulty maintaining operations and maintenance activities due to a significantly decreased workforce. Schools may be forced to close.

Medical staff can become overburdened with hundreds of additional cases on top of their normal workload. All other responders will be impacted in similar proportions to the general public, thereby reducing available responders. Adverse impacts are expected to be severe for unprotected personnel and uncertain for trained and protected personnel, depending on the nature of the incident.

The COVID-19 pandemic has had severe impacts on healthcare workers and other responders. The difficulty of trying to protect themselves and their families while still doing their jobs was exacerbated initially by shortages of personal protective equipment (PPE). The mental health impacts on responders and healthcare workers have not been fully quantified but are likely to have impacts for months if not years to come.

Other responders will be impacted similarly to the general public, although the nature of their jobs may make social distancing more difficult which could potentially lead to higher infection rates, thereby reducing available responders.

Unscheduled sick leave from a large portion of the workforce could result in loss of productivity and delivery of services. Even without large numbers of infected workers, social distancing requirements and workplace closures can have a major impact on the government’s ability to deliver services, as seen during the COVID-19 pandemic. As residents are quarantined due to the pandemic, as seen during the COVID-19 pandemic the demand for deliveries of essential goods will also increase.

Ability to respond and recover may be questioned and challenged if planning, response, and recovery are not timely and effective. Help from the federal government and from other states would likely be limited, as all personnel would be deployed throughout the country already. While the federal government would do what they can, communities would have to rely on their own resources for a much longer period of time as compared to other disasters. It is expected that the government will work towards a solution that will end the pandemic, typically by helping to distribute vaccines and antiviral agents. Continual public messaging and outreach is vital.

Economy

In a normal year, lost productivity due to illness costs U.S. employers an estimated $530 billion. During a pandemic, that figure would likely be considerably high and could trigger a recession or even a depression. Local economy and finances may be adversely affected, possibly for an extended period of time. Unscheduled sick leave from a large portion of the workforce could result in millions, even billions, of dollars lost in productivity. Business restrictions due to social distancing requirements can also be significant. In a normal year, lost productivity due to illness costs U.S. employers an estimated $530 billion. During a pandemic, that figure would likely be considerably high and could trigger a reception or even a depression.

The economic impact of the COVID-19 pandemic and associated closures has been significant, triggering a recession and high unemployment; the unemployment rate jumped for 4.4% in March of 2020 to 14.7% in April and stayed in the double-digits through most of the summer. Some studies estimate that 1 in 5 renters are at risk of eviction. The stock market suffered major losses in the early days of the pandemic. The restaurant, retail, and oil and gas industries have been particularly hard hit, with numerous businesses closing or filing for bankruptcy. And among household with children, food insecurity – defined as when a household does not have sufficient food for its members to maintain healthy and active lives and lacks the resources to obtain more food – has more than doubled from 14% in 2018 to 32% in July 2020.

Historical, Cultural, and Natural Resources

Impacts to these resources are typically minimal. However, reduced tourism during outbreaks could lead to additional economic impacts.

Future Development

Population growth and development contribute to pandemic exposure. Future development in and around Jefferson County has the potential to change how infectious diseases spread through the community and impact human health in both the short and long term. New development may increase the number of people and facilities exposed to public health hazards and greater population concentrations (often found in special needs facilities and businesses) put more people at risk. During a disease outbreak those in the immediate isolation area would have little to no warning, whereas the population further away in the dispersion path may have some time to prepare and mitigate against disease depending on the hazard, its transmission, and public notification.

Overall Hazard Significance

The geographic extent of the hazard is considered extensive. The probability of future occurrences is occasional, and the magnitude/severity for the event of record is critical. The HMPC considers the hazard to have an overall impact rating of high for Jefferson County.