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Chris Lindley Q&A: Vail Health task force leader calls COVID-19 ‘the big war of our lifetime’

It’s understandable, when looking at a map of COVID-19 cases in Colorado, to wonder why Eagle County is the hottest hot spot outside of major metropolitan areas like Denver and El Paso counties.

As of noon Wednesday, Vail Health and Colorado Mountain Medical reported 172 positive cases and 307 tests pending out of 856 total tests. While that information might sound alarming, Chris Lindley said Vail Health Hospital, with no spring break crowds in the valley, is the slowest it has been in decades. As of Tuesday, it was using only one of 29 available ventilators.

“We are in great shape,” Lindley said.

He should know better than anyone. Lindley, who has a doctorate in epidemiology and who previously served as the director of Eagle County Public Health and Environment, has been putting in 17-hour days leading Vail Health’s COVID-19 task force while also continuing to maintain his role as the executive director of Eagle Valley Behavioral Health.

An Iraq War veteran who received a Bronze Star for saving multiple lives during a suicide bomber attack, Lindley said he has told his children that the challenge of COVID-19 is similar to the challenge faced by Americans during the two world wars.

“I’m telling them that this is the one event in their life they’ll always remember,” he said. “And none of them, nor myself, obviously lived through the world wars. But I refer to it as this is our big war of our lifetime.”

Lindley, who also holds advanced degrees in public health and business administration, managed to squeeze in a half-hour Tuesday to answer questions from the Vail Daily about preparing for the onset of COVID-19 and the weeks and months ahead.

The following interview has been edited for length and clarity.

I work out at your gym in Eagle and you told me in January that the coronavirus was going to be a story to watch when most people weren’t paying much attention to it locally. When did you know that this was going to dramatically impact lives?
We started talking about it seriously in mid-January at the same time I kind of mentioned to you in the gym that this was definitely going to roll into a pandemic and something that was going to, at some point, get here to this valley and we were going to have to be prepared for it. Some of the things that we did that really have saved us, to be honest, was we ordered personal protective equipment months before anyone else did in anticipation for this. And that’s what has allowed us to get the PPE on-site, because the other hospitals and other health care systems waited until it was too late and there was a backlog. We started testing early. We set up our incident command system early. We started doing three times a day conference calls. We’ve been doing that for well over a month now. I think we’re on Week 6. Preparing our facility. Converting rooms from regular rooms to non-pressure rooms.

This is kind of our 30,000-foot strategy. At the top, we knew we had to identify it early. We started testing respiratory patients through our health care system. And what’s unique about us, it’s just not the hospital, but we also have Colorado Mountain Medical. Through all the acute care, urgent care, emergency department, primary care visits in the valley between Vail Health and CMM, we were able to test early and identify early. That’s why our case count is so much higher than anywhere else on a rate basis in the state. It’s not necessarily that we have more COVID; it’s just that we’ve done a much better job at identifying it.

And why we want to identify it is for the following reasons: One, we know it increases isolation compliance by patients. If they know they have it, they’re much more likely to stay at home and not infect our friends, not go see grandma. Really take care of themselves, because they know they’re infectious with something that could potentially harm others. Two, we’ve had the PPE, the testing media and the infrastructure to do this. Most places haven’t had that, but because we ordered supplies early … we had this all in place, so we haven’t run out of all those things like you’ve seen in other communities.

We also know, looking at China, which is really the only country to really address this well, that this was their No. 1 thing. That this was to test as frequently as possible, identify the cases, isolate the cases and track down all their contacts. So we’ve been following the World Health Organization model that we’ve seen in other countries. We’ve been trying to emulate that here on a small level in our community.

In your estimation, what’s our trajectory right now as a country, as a state, and as a county?
As a country, it’s really bad. Yeah. What we’re seeing in New York City, I think we’re going to see in all the major cities across the United States in the coming weeks. We were the latest of all the developed countries to test. Our infrastructure is just now starting to come online. And one of the reasons you’re seeing the explosion of cases across the country is not necessarily that it’s just now spreading, it’s just that now we’re starting to identify it. We’re starting to test it, those test results are coming back, and so that’s why the cases are jumping up. COVID has been in the United States for well over six weeks or longer. We’re late to the game as a country. There’s no question about that. Everybody identifies that.

As a state, I think we’re doing a great job. I think Gov. Polis’ leadership on this has been extraordinary. He has reached out to us many times to provide support and has done that, which we greatly appreciate. And he’s calling it as it is, and that’s why they’re ramping up to prepare for what could be coming. And I think the areas that will be the biggest challenge in the state are certainly those areas that have the densest population. So definitely the Front Range areas where there might be a limit of hospital bed capacity.

Here in the mountains, I think we’re in a great spot. A couple of things that have really changed up here. One is, by closing the resorts, even though it has had a horrible financial impact on all of us, and none of us are happy about that, it has emptied this valley. And that move, which was a very hard move by Rob Katz and Gov. Polis, has been an absolute saving grace for us. The valley has emptied. We don’t have the tourism here, the population’s not here. We also have an amazing health care system in this valley that most rural communities don’t have. A valley of our size with 44,000 people to have a 56-bed hospital integrated with Colorado Mountain Medical, which serves 90 percent of primary care across the valley all working together, it’s very unique. And it puts us in a spot where we not only know what’s happening in the hospital and the emergency department, but we have much better surveillance because we know what’s happening out in the urgent care and the primary care. So we know if the community is getting sicker and presenting a week or so or more before they’d come to our hospital. So it gives us great visibility of how things are going.

And what I can say is, as of right now, things are going really well. We’re very optimistic. We feel positive about everything. We have an unbelievable amount of surge in our health care system right now. We’ve canceled elective procedures and ambulatory procedures in the hospital. By doing that, we’ve been able to cross-train many staff. We’ve converted multiple rooms to negative pressure rooms. We’ve identified potential COVID wards if we need them. We have alternative care sites identified and ready to be staffed if we need them. But, I don’t think we’re going to need them. As a community here, we are handling it great. There is no stress today on our health care system. And we are doing everything we can to keep it just like that.

We’ve set up three respiratory clinics in this valley. We have one in Vail, one in Avon and one in Eagle. We’re sending anybody that has respiratory symptoms in this valley, not to our ED, that’s the worst spot they can go. We’re sending them to a clinic. Not only are they getting tested at these clinics, they’re being seen by a provider. And if their symptoms or their conditions worsen, then we bring them to a higher-level care.

But the majority of these people, they’re fine. They’re sick. They’re worried. They’re uncomfortable. And we’re providing the care they need, which is going home, staying away from folks and getting healthy. That has been an unbelievable benefit for a hospital to have this ability to keep people out of the hospital by doing care at Colorado Mountain Medical and Vail Health urgent care clinics.

The other thing we did, we had the first drive-through testing facility in the country. Even though the governor said that they did it at CDPHE, we actually had it an entire week before they did, up and running. That has been a great resource for our community.

The question so many people want to know is how long this way of life will last? What’s your best guess?
Well, I can tell you, I think more people are going to get poorer than are going to get sick. Which is very sad. But how do you put a price on a life? How do you put a price on grandma’s life? Or someone that has diabetes or is immune-compromised? I have no idea how long it is going to last. But I’m confident, here in this valley, because we’ve been able to show clearly that we’ve had community spread in this valley for quite some time, that we’ll be one of the first communities to start recovering. One of the first communities to be able to say, we’re out of this situation. But I can’t give you a time frame on that. I don’t think anybody can.

You’re a parent. What kind of conversations are you having with your kids?
Man, it’s hard. They’re scared. They’re anxious. They’re bored out of their minds. I’m telling them that this is the one event in their life they’ll always remember. And none of them, nor myself, obviously lived through the world wars. But I refer to it as this is our big war of our lifetime. And while we might not like staying at home and we might not like being able to go see our friends or go to the gym and do all the things that we’ve become accustomed to, we have to do this for the greater good.

I just keep reminding them that not everybody is in this situation, and while it’s a little uncomfortable now, this too will pass. Whether it’s a couple of months or longer. We will look back on it and we will recover. It won’t happen immediately, but I’m certain a year from now, two years from now, everybody’s going to look back at this and say, that was a hard time. I don’t ever want to do it again.

But I think as a family and as a community, and as a state, we’re going to be better for it. We’re going to be more loving. We’re going to be more compassionate. Even though we’re all practicing social distancing, I feel like a lot of us are getting closer together by other means.

In your expert opinion, why so many cases in Eagle County? What has made us the hottest hot spot in the state outside of metro Denver?
We are testing much more than anywhere in the state and will continue to do that. Again, it’s not our hospital alone that’s testing, we have six clinics across the valley that are testing. Three respiratory clinics, then a Vail, Avon and Eagle clinic. So our surveillance is really, really great. If other communities were doing the same, I’d hope they’d be finding the same level of cases as we would.

How close are we to a tipping point like the one in Northern Italy where Colorado hospitals could soon be overrun with more patients than they can treat becomes a reality and the state is forced to do something it has never had to do before: activating the state’s crisis standards of care plan.

Here in this valley, we’re nowhere close to that. Our hospital is the slowest it has been in decades. We are in great shape. As it relates to other communities in the state, I don’t know. I just don’t know where they’re at.

What about our local hospital? How close are we to a tipping point where it’s full? Or we’re out of ventilators or ICU rooms?
Currently, today, we’re using one of 29 ventilators. We are in great shape.

Gov. Polis hasn’t issued a statewide stay-at-home order and even said it’s all but unenforceable. Do you think that’s the right decision? Do you think it’s an inevitability he will?
What I do know is in this valley people are abiding by the local public health orders and are taking this very seriously and I feel like everybody is doing their part to limit the transition of this virus. I feel great with the decisions we’ve made here locally by our local public health department and the county and they’ve been very early on a lot of this and we’ve been extremely supportive of everything they’ve done. And we’ll continue to do so. We feel collectively, as a big system, county government and everyone working in the health care system, everybody’s working well together. We talk every single day and compare notes.

What are those calls like? How would you describe the level of cooperation?
The cooperation is extraordinary. We’re coming together better in ways than we ever have. I think there’s complete transparency. There’s confidence in one another. There’s strong leadership. There’s creative, innovative thinking going on. We really get into looking at the data, we talk about strategies. It’s fantastic. Everybody is focused on making sure this community is going to get through this with the least amount of impact, both economically and health-wise as possible. That’s one thing we’re all doing. And I really feel like everybody is doing a great job in doing that.

You’re also in charge of Eagle Valley Behavioral Health. What have you seen on that front? Has the need increased there as well?
I’m really glad that we have the behavioral health infrastructure in this valley that we have today that we maybe didn’t have a couple of years ago. Prior to COVID, before it got identified here, we started saying, OK, what are we going to have to do on the behavioral health side because this is going to be one of the secondary effects that’s going to be very, very hard on everybody. Because you’re talking unemployment or taking away people’s daily routines. And, so, in anticipation of this, we’ve trained local providers to use telehealth services before COVID was even identified in this community and continued to train in-need providers them to use that system and we provide it to them free of charge. We’ve added capacity with CMM and their behavioral health providers. We’ve been producing weekly stories to the community about how to get through this. And we’ve reached out to all of our partners that are funded through Eagle Valley Behavioral Health and we’ve said, whatever your contract was on before, we want you to pivot and focus on doing anything you think is appropriate to help mitigate the impact on the community for this event.

Will Cook’s letter to the community was a wake-up call for many people, but are too many people still not taking this seriously enough? 
I feel like, in this community, I have not seen examples of that. I feel like everybody’s taking it very seriously in this community. Certainly, across the country, yes, there could be arguments around that, no doubt about it. But in this community, I have not seen it.

Should Gov. Polis have shut the ski resorts down earlier?
I don’t know. I feel like when he did was absolutely appropriate timing. We’ve seen a huge effect because of it, on the positive. And we were not in a bad situation before he did it, so I think the timing was appropriate.

President Trump suggested that the shutdown to halt the spread of the virus would not be extended. What has been your take on the national response to this? Is there any level of frustration there?
There’s certainly frustration. As a country, the United States of America, it’s hard to believe that, in January, we didn’t, as the federal government, start taking preparations for this. We should have the best testing system in the world in place. We should have the most rapid testing system in the world in place, and we don’t.

To my first point, as one of the developed countries, we might have the worst. We’re getting there quickly, but we’re starting behind everybody else. So that is alarming. I’d also like to see the Centers for Disease Control out front more. They’re not in the media more, they’re not standing up there on stage. They are our premier public health agency, one of the premier groups in the world. We look forward to their continual leadership as we move forward.