Small Colorado mountain counties aren’t sure how bad their COVID situation is. So they’re testing the masses.

Gunnison, Ouray and San Miguel counties have teamed up with the state to hold mass testing events for people — with and without coronavirus symptoms — to “know what we don’t know.”

Originally published at The Colorado Sun on Dec. 24, 2020.

With the thermometer well below zero, cars full of Crested Butte residents lined up on a private air strip starting at 7 a.m. last week to stick swabs up their noses. 

While that doesn’t sound like a fun morning for anyone involved, Gunnison County residents and public health officials were eager for the chance to gauge just how much coronavirus is circulating in their community.

The Colorado Department of Public Health and Environment has been deploying teams to help small communities with limited testing resources, like Gunnison, Ouray and San Miguel counties, to run mass screening events so that public health officials can see the full picture of their coronavirus infection load. 

Having that knowledge is critical for a number of reasons, including helping to shift where the counties fall on the state’s COVID-19 dial. If mass testing results show the counties are improving, they may even be allowed to relax some restrictions on restaurants and other local businesses. 

Outside of the mass testing sites set up in Crested Butte on Dec. 17 and Gunnison on Dec. 18, Gunnison County has only been testing people who are experiencing COVID-19 symptoms or had a known exposure, and is doing so via appointments at the hospital. This is in large part due to limited resources, both in the number of tests available as well as the ability to turn around results in a timely fashion, county emergency manager Scott Morrill said.

That potentially leaves a large swath of individuals who are asymptomatic or presymptomatic — but no less contagious — unidentified, meaning they could continue to spread the virus to others without knowing it. 

“We don’t know what we don’t know, so having mass testing helps illuminate that for us,” Gunnison County Public Health Director Joni Reynolds said.

Last week’s results are in and the news is good: Of 1,624 tests, just 44 came back COVID positive, which translates to a 2.7% positivity rate. (Experts say a positivity rate over 5% indicates that a community does not have sufficient testing capacity to understand the community-wide infection rate.) Data on which of those positives were asymptomatic is still being processed. 

That 10% of the county’s population was reached during the two-day testing event is better news, yet. “It was a really good indication that the testing we’re doing is appropriate, capturing the people we need to, and we don’t have disease spreading on a high level in communities that we aren’t aware of,” Reynolds said.

She added that since the county has been able to keep up with contact tracing — even as many others around the state have abandoned it — many of the county’s positive cases had been in quarantine or isolation before they got tested and potentially got a positive result. 

Gunnison County wasn’t the only one attempting a mass-testing campaign recently; joining forces with Ouray and San Miguel counties, the counties hosted a series of pop-up testing sites last week throughout southwest Colorado. 

Ouray County has done large-scale screenings three times, Ouray County Public Health Agency director Tanner Kingery said, in August, November and on Dec. 16.

Of the 535 people tested during last week’s event, only six were positive for COVID-19. That’s a 1.1% positivity rate.

The county has been offering coronavirus tests regardless of whether someone has symptoms, but the extra support from the state to mass test has been useful. For weeks after the first two events, Kingery said the county saw cases drop off rapidly, likely because asymptomatic people were able to quarantine sooner than they would have otherwise. 

Even with the testing help from CDPHE, this has not been an easy time for rural public health agencies.

“It’s kind of tough because we’re all maxed out,” Kingery said. If it was one emergency in one place, then neighboring counties could help each other, he said, “but for COVID, everyone’s fighting their own fires.”

Ouray County may be able to relax its level orange-level restrictions soon, if their coronavirus metrics — cases, hospitalizations and positivity rates, to name a few — continue to trend down. But Kingery cautions that “we’re not there yet.” 

Meanwhile, Gunnison County — currently operating under the state’s level-yellow restrictions — has been teetering on the brink of being forced to increase restrictions. Results from the mass testing events are promising — no, they’re not missing a large swath of COVID-positive residents, according to Reynolds. 

But colder weather and COVID fatigue could tip the dial in the wrong direction in a county that fared remarkably well this summer.

“People are just tired of it,” Morrill said. “So people tend to let guard down and maybe do something they wouldn’t have done six months ago.”