More than 35 people have been referred for rabies post-exposure treatment following last week’s announcement about a rabid puppy at a rescue adoption event. But Colorado has so far identified no human cases as a result of the event, as state health officials continue to plead with those who were at the event to come forward for screening.

Rabies is almost universally fatal once symptoms appear, making this perhaps the most urgent public health response in Colorado since the early days of the COVID pandemic. The disease can be prevented after exposure if those exposed are treated before symptoms occur.

A spokeswoman for the Colorado Department of Public Health and Environment said Wednesday that the state has assessed more than 115 people to determine if they had contact with the puppy that could have spread the rabies virus to them. The more than 35 people referred for what is known as post-exposure prophylaxis came from that group.

More are expected to be screened as public health workers continue to interview people.

“I don’t want people to either minimize the risk or say ‘I didn’t have that much contact’ or ‘I probably wasn’t exposed,’” said Dr. Michelle Barron, the senior medical director of infection prevention and control for UCHealth and an expert in infectious diseases. “We want the public to get a formal assessment so (public health officials) can ask those questions.”

The head of the rescue group that organized the adoption event posted on Facebook this week, and told 9News in an interview, that another dog from the infected puppy’s litter subsequently tested positive for rabies after being euthanized. State health officials confirmed the second positive test Wednesday evening but also said the negative tests for the remaining 10 puppies in the litter did not rule out the possibility that they, too, were infected.

This is because the test is conducted only on brain tissue, which, if positive, indicates the animal was both infected and infectious. Because rabies develops slowly, it is possible other puppies were also infected but that the infection hadn’t yet reached the brain — meaning they weren’t able to spread the virus when they were euthanized but they could have later become infectious.

“CDPHE is doing everything possible to protect people and other animals from rabies,” agency spokeswoman Kristin Richmann wrote in an email.

People who attended the adoption event should contact CDPHE for screening. They can call the agency’s hotline at 303-692-2700 during business hours or 303-370-9395 after hours and on weekends and holidays. Or they can email cdphe_zoonoses@state.co.us.

A 20-day delay

The puppy, a shepherd mix, was part of a litter brought from Texas to Colorado and made available for adoption at an event July 20 at Moms and Mutts Colorado Rescue for Pregnant and Nursing Dogs on West Oxford Avenue in Sheridan. The puppy was one of 12 in the litter, which was called the “July Shepherd Mix” litter or the “Celebrity Kids” litter at the event.

CDPHE spokeswoman Gabi Johnston said the puppy arrived in Colorado on July 16. It began showing symptoms of rabies July 29, became seriously ill and was euthanized. A veterinarian submitted a sample for rabies testing, which came back positive Aug. 7. CDPHE notified the public Aug. 9.

That delay between when people were potentially exposed at the adoption event and when they were notified is not ideal because the post-exposure treatment should be started as soon as possible.

But it is crucial people receive the prophylaxis treatment any time before they begin showing symptoms of infection. Once people begin exhibiting symptoms, especially ones related to the virus’ attack on the brain, then rabies almost always kills — save for a handful of cases worldwide.

A wait of week — or years 

Rabies has an irregular incubation period, depending on the type of exposure and the location of infection. A scratch on the hand from an infected animal, for instance, may take longer to show symptoms than a bite on the neck. The typical incubation period in humans is anywhere from three to 10 weeks, but it can be as short as a week or as long as several years.

Post-exposure treatment consists of a large dose of rabies-fighting antibodies as well as a four-shot course of rabies vaccination given over a period of two weeks. The idea is to amass an immune-system army to fight the virus before it can gain a foothold.

On Facebook, the rescue that ran the adoption event said it has worked closely with the state on the response but also said the state “created a panic” that has caused families to back out of other adoptions and has severely damaged the rescue’s finances.

Barron, the UCHealth doctor, said the state is being appropriately cautious.

She said it’s possible the puppy had a lower level of infectiousness at the adoption event, since it wasn’t showing symptoms there. But she said that’s not certain, which is why public health officials are urging people to be screened and, if appropriate, start treatment.

“If this was not a uniformly fatal disease, we would play by different rules,” Barron said. “But it’s so high-risk that if we’re wrong about what information you’re giving us, you could die.”

“Devastated” adopters

Johnston, the CDPHE spokeswoman, said the puppy — and likely the rest of its litter — is believed to have had contact with a rabid skunk in Texas. CDPHE said last week that the owners of the puppy and the veterinarian who examined the dog were both bitten. They are among those referred for treatment.

Meanwhile, all of the other puppies from the litter have been surrendered to animal control, where they were euthanized because they had contact with the infected dog and, possibly, the rabid skunk. The puppies were unvaccinated against rabies at the time of the exposure in Texas.

In most states, puppies receive their first rabies vaccination after they are 3 months old, followed by booster shots in subsequent years. Colorado requires dogs 3 months and older that are being imported into the state to have a proof of up-to-date vaccination. 

“The people who adopted the other puppies were understandably devastated when they learned their puppies were exposed to rabies for a prolonged period of time,” Johnston wrote in an email.

The state has also requested immediate vaccination and quarantine of additional animals from the rescue, saying they had potential exposure to the infected puppy. Because their possible exposure was significantly less than that of the puppy’s littermates, though, the state has not ordered the animals be euthanized.

A puppy at an adoption event in the south Denver metro area last month has tested positive for rabies, and now state health officials are racing to find anyone who attended the event so that they can be screened for the almost-always fatal disease.

The puppy was part of a litter of 12 at a July 20 event hosted by Moms and Mutts Colorado Rescue for Pregnant and Nursing Dogs, also known as MAMCO. The event took place at the rescue’s shelter at 2721 W. Oxford Ave. in Sheridan. The address is sometimes also listed as in Englewood.

The puppy, along with its littermates, came from Texas and was unvaccinated for rabies at the time of exposure. At the event, the puppy’s litter was known as the “July Shepherd Mix” litter and may have also been referred to as the “Celebrity Kids” litter.

The puppy subsequently tested positive for rabies and was euthanized — there is no approved treatment for rabies in animals and euthanization is required to confirm the disease’s presence. The puppy’s littermates will likely also have to be euthanized because they, too, were unvaccinated and placing them in a strict, secure quarantine away from people and other animals is not possible.

Officials with the Colorado Department of Public Health and Environment are working to track down 17 people who had close contact with the rabies-positive puppy, including shelter pup foster families, shelter staff and veterinarian staff, to provide them with what is known as post-exposure prophylaxis for rabies.

But public health officials are concerned people who attended the adoption event may have also been exposed to rabies and are trying to reach them.

Rabies is spread most often through the saliva of an infected animal — bites, commonly, but also through licking or scratches. It can lie dormant in the body for weeks or even months before symptoms begin to show. Once symptoms appear, rabies is almost universally fatal. This makes early screening and treatment, which can stop the disease after exposure, critical.

What to do if you attended the event

People who attended the adoption event should contact CDPHE for screening. They can call the agency’s hotline at 303-692-2700 during business hours or 303-370-9395 after hours and on weekends and holidays. Or they can email cdphe_zoonoses@state.co.us.

CDPHE staff will determine whether attendees need post-exposure treatment.

How rabies is treated

Rabies post-exposure treatment consists of two components to try to kill the rabies virus before it can gain a foothold and cause damage.

The first is a shot of what is known as immunoglobulin or immune globulin — readymade antibodies that immediately go to work fighting the virus in the body. The second is a course of rabies vaccination, which can boost your immune system to carry on the fight. A full course of vaccination consists of four shots, given immediately and then three, seven and 14 days later.

While it is commonly believed that rabies vaccination shots are given in the stomach and are painful, shots today are given in the arm and are no more painful than any other vaccination.

When started as soon as possible, rabies post-exposure treatment is almost always effective at preventing the disease.

Local governments commonly require pets such as dogs and cats to be vaccinated against rabies in Colorado. Animals that came into contact with the infected puppy’s litter may need a booster dose of vaccine, though.

No human cases in nine decades

The rabies virus attacks the brain and early symptoms can be flu-like. As the disease progresses, though, it can cause anxiety, agitation, hallucinations, fear of water and over-salivation, among other nightmarish symptoms.

Nationwide, about 60,000 people each year receive treatment for potential exposure. In Colorado, the state typically finds around 50 cases of rabies in wild animals each year — skunks and bats are common carriers. The state hasn’t had a rabies case in a dog since 2020.

There hasn’t been a human case of rabies in Colorado since 1931.

Happy Wednesday, Colorado, and welcome to another edition of The Temperature, where today we are serving up an absolute feast of health and climate news.

But, first, we need to talk about heart health — specifically the kind of heart health you might have during, say, the closing moments of an extra-time win by the U.S. women’s soccer team over Germany in the semifinals of the Olympics.

You know, just minutes after Colorado’s own Mallory Swanson threaded a pass through the tiniest of needles to Colorado’s own Sophia Smith for what was apparently the game-winning goal, only for Germany to come back with a free header that almost certainly was going to tie the score, except that U.S. goalkeeper Alyssa Naeher (connections to Colorado unclear) somehow miraculously got her left heel on the ball while leaping in the air to keep it out and preserve the U.S.’s unlikely quest for gold and send my blood pressure to roughly 1,000,000/80. That kind of heart health.

(We joke, of course, but there is some evidence of cardiac events tied to watching sports.)

There’s really only one cure for stress like that, and it’s rest. So, go ahead and show this newsletter to your boss as proof that you need to take today off to give your heart a break ahead of Saturday’s gold medal match. The Temp says so.

Now, let’s make like we’re in the last 100 meters of a 1,500 and kick it into gear.

John Ingold

Reporter

TEMP CHECK

HEALTH

The health system is stressing Coloradans the heck out

If you are freaked out about the cost of health care and worried about whether you’ll be able to afford it when you need it, then you have good company. According to a new study, nearly everyone else in Colorado feels the same.

In a survey of more than 1,400 Coloradans, 83% said they worry about affording health care in the future. The survey also found that 68% of people said they delayed needed health care or went without in the prior year due to cost concerns.

The survey was conducted by the Altarum Healthcare Value Hub, a national nonprofit that studies health care policy around costs and affordability. Among its other findings: Large, bipartisan majorities support the idea that the health care system needs to change to improve affordability and also support the government doing more to help control costs.

“Health care may be one of the very few things we can all agree on that needs to be worked on,” said Beth Beaudin-Seiler, the director of the Healthcare Value Hub.

The organization worked on the Colorado survey with the Colorado Consumer Health Initiative, a group that advocates for consumers and works on policies at the state Capitol that are often aligned with approaches favored by Democrats. But the survey is part of Altarum’s broader Consumer Healthcare Experience State Survey, which runs in numerous other states.

Beaudin-Seiler said Colorado’s results are similar to those seen across the country, highlighting how health care affordability is a nationwide problem that people are eager to see addressed. But Colorado has also been a leader in doing some of the things the survey suggests have broad public support — such as capping the out-of-pocket price of insulin.

Adam Fox, the Colorado Consumer Health Initiative’s deputy director, said that shows how one-off policy changes aren’t enough to fix the bigger problem.

“Colorado has made some important steps in the right direction, but the reality is health care costs continue to rise,” Fox said. “… It means that folks are continually challenged by health care affordability.”

Fox said CCHI has not yet decided on its policy priorities for next year’s legislative session — much, he said, hinges on the outcome of the presidential election and what that might mean for, say, the policies in the Affordable Care Act. But Priya Telang, CCHI’s communications manager, said the organization will use the information from the survey in helping to guide its policy proposals.

You can read the full Altarum brief on the study, as well as companion briefs on hospital prices and prescription drug costs, on CCHI’s website.

Section by John Ingold | Reporter

BIRD FLU

Searching for silent spread of bird flu

Colorado hasn’t reported any new human cases of bird flu for a couple of weeks now, but that doesn’t mean the state isn’t looking.

The Colorado Department of Public Health and Environment has launched a new study to analyze blood samples from dairy workers who were exposed to sick cattle. The research, known as a seroprevalence study, is looking for antibodies against bird flu in the blood of workers who had not been known to have been infected.

If researchers find the antibodies, it would suggest that some workers had been infected without developing symptoms. And that would mean that bird flu could be silently spreading from animals to people.

According to an update from the federal Centers for Disease Control and Prevention, the Colorado study launched last week. It is unclear when initial results from the study will be available, and CDPHE did not respond with answers as of newsletter emailing time.

Just to provide some reassurance here: The existence of this study doesn’t mean health leaders think there is silent spread. A previous study looking at the blood of dairy workers in Michigan found no bird flu antibodies in workers who hadn’t been known to be infected. And, even if the Colorado study does find evidence of silent spread, there is still no evidence that the virus is spreading person-to-person.

Meanwhile, Colorado’s efforts to better track bird flu on commercial dairies is delivering results. The state has reported nine new cases of bird flu on dairies after discovering them through “bulk tank surveillance.” This is part of the state’s new order for mandatory testing of milk at commercial dairies to identify bird flu cases that weren’t being picked up by just watching for sick cows.

Colorado is now up to 63 dairies affected by bird flu, more than double that of any other state (though, of course, no other state has issued an order for testing at all dairies).

Section by John Ingold | Reporter

MORE HEALTH NEWS

• A Denver pediatrician helped make some of the biggest pandemic vaccine decisions. Here’s what he thinks now. We gave you the preview last week of this Q&A with Kaiser Permanente Dr. Matthew Daley, whose term on the powerful Advisory Committee on Immunization Practices ended this summer. Now here’s the full version — with a good discussion about why he thinks the committee’s votes on RSV treatment have been overlooked.
  — The Colorado Sun
• Six rural hospitals in Colorado are in immediate risk of closure, according to a new study. Colorado hasn’t had a hospital closure in decades, but a new analysis says that track record could be in jeopardy. The study, from the Center for Healthcare Quality and Payment Reform, says there are 10 rural hospitals in the state at risk of closing (out of 43 total rural hospitals), with six of those at risk of immediate closure. That’s not great, but it’s better than neighboring states like Kansas and Oklahoma, where the study found about a third of rural hospitals are at risk of immediate closure. The main reason the hospitals are at financial risk is because they’re not seeing enough privately insured patients to boost their bottom line.
  — CHQPR, Becker’s
• The CU School of Medicine has a new dean, and he has his eyes on the Top 10. Dr. John Sampson, a neurosurgeon, took over this summer as the head of the University of Colorado School of Medicine, replacing dean Dr. John J. Reilly Jr. His goal? To make CU one of the nation’s top 10 medical schools by listening to his staff and faculty.
  — CPR
• A new Colorado hospital opened this weekend. It’s built with the lessons of COVID in mind. About a month ago, we told you about the imminent move of Intermountain Health’s Lutheran Medical Center from its longtime campus in Wheat Ridge to a new campus a few miles to the west. This weekend, the move finally happened. And, in addition to moving 159 patients from the old facility, the new hospital has already seen a bit of a baby boom.
  — The Colorado Sun, Intermountain Health

CLIMATE

Colorado’s biggest new battery pack is soaking up a lot of sun

The Brighton-based United Power electric cooperative accelerated its innovative push into renewable and “hyper-local” energy supplies late last month, announcing the hookup of backup battery arrays across three counties.

The batteries at eight substations in Weld, Adams and Broomfield counties will store excess power from solar farms and other United Power transmission sources, then disperse the stored energy at peak times like summer’s late-afternoon air conditioning surge when families get home from work and school.

The batteries, which are aimed at providing about four hours of electricity at peak demand or during emergencies, are a key to United Power’s exit from the umbrella Tri-State Generation Association. The goal for United Power, which serves about 300,000 people from 112,000 meters on the northern Front Range, is to add more renewable generation to its grid and control smaller, local sources of power rather than rely on distant coal-fired plants.

The Tri-State exit, the growth in solar and other renewable contracts, and the far-flung battery array follow other United Power moves, including teaming up with Fort Lupton to seek a federal grant for a floating solar array at a containment pond. Fort Lupton wants better backup power sources for a water treatment plant, and tests have shown floating solar farms can block summer sun that produces harmful algae blooms.

Five of the new battery arrays were turned on in July, and the remaining three will be linked by the end of the summer, United Power said. One battery site takes down power sent by Xcel Energy transmission lines from a Whetstone Power solar farm in the San Luis Valley.

“We’re excited to be moving ahead with one of the most aggressive plans for such systems,” said United Power CEO Mark Gabriel. The 78.3MW of batteries are owned by United Power’s partner in the storage project, for-profit renewable energy developer Ameresco.

United Power says it is one of the fastest-growing co-ops in the nation, drawing on the rapid home and business growth from Broomfield to Weld County. It serves communities from Coal Creek and Golden Gate Canyons to Brighton, Hudson and Keenesburg on the plains.

Tri-State and United Power battled over how much the smaller co-op needed to pay to exit long-term power contracts with the parent utility. United Power is still contesting Tri-State’s latest requirement of $627 million, but has set aside enough to cover a final agreement, the co-op has said.

Section by Michael Booth | Reporter

MORE CLIMATE NEWS

• The water harvest resumes: How much can the Lower Arkansas afford to give up to big cities? If we’re going to dive back into farm to city water transfers in a big way, shouldn’t we have a big, open debate about it? Michael Booth and Jerd Smith spent time with angry and disappointed Lower Arkansas farmers and leaders who thought they had protections in place for communities that could dry up literally and economically with more purchases by Aurora, Denver and Pueblo. What’s the highest and best use of Colorado’s precious water? We don’t claim the answers, but we know people asking the right questions.
• Another unexpected source for greenhouse gases: Farm irrigation. Colorado State University researchers are counting greenhouse gases released from irrigation for the first time, making top-emitting counties more visible alongside ways to help cut emissions, Shannon Mullane reports. Agriculture relies on irrigation, the CSU researchers said. It’s a vital tool for farmers and ranchers to water crops when the rain just isn’t there — an increasingly common problem with over two decades of drought and a changing climate in Colorado. But the process of pushing water through pumps, canals and center-pivot sprinklers into soils can add to greenhouse gases in the atmosphere.
• Missing. But probably not too worried about it. Two experienced backpackers went missing recently from 12,000 feet on a ridge in the San Juans. But losing your way is just an all-day grass buffet, if you’re a llama. Vio and Rones took off from their owners after an angry sheepdog thought they were a threat to a nearby flock. Llama packer Lisa Balcomb is back up in the high country around Lake City and Ouray hoping other hikers have spotted her woolly buddies.
• Suncor takes another air pollution hit in a new federal lawsuit. Environmental groups not impressed by state or EPA victories in holding the Suncor refinery to account are now suing on behalf of residents in federal district court. They say Suncor’s continual air pollution violations should be countered with potentially hundreds of millions in fines to stop them from happening again.
  

CHART OF THE WEEK

So, you may have heard that COVID infections are rising in Colorado due to new variants known as the FLiRTs.

The variants are descendants of the paterfamilias of most COVID viruses circling the world today, the omicron strain. They take their name from their pattern of mutations and for their ability to cozy up to you and then leave you devastated, heartbroken and lying in bed for several days. (Maybe, we don’t really know, we’re not virus-namers.)

Here’s the thing, though: No shade to the dirty FLiRTies, but we’ve seen this game before.

While a summer COVID wave is often seen as novel, the chart above shows that it’s not — at least not in Colorado. There were also small summer bumps in COVID hospitalizations in 2020, 2021 and 2022.

It’s also not uncommon in Colorado for infections to start their big annual surge in August before peaking consistently — at least so far — in late November, typically well before much of the rest of the nation sees a peak. It’s all part of the mysterious seasonal patterns for the virus that we still don’t really understand.

Anyway, just a reminder to be virus-aware out there and make sure that the FLiRTs’ love for you is unrequited.

Section by John Ingold | Reporter

Hey, here we are at the finish line. Only one thing to do now — dance like we’re Simone and Elmo.

You’re all gold medalists in our books, Temp family. Thanks for hanging with us.

— John & Michael

The Colorado Sun is part of The Trust Project. Read our policies.

Corrections & Clarifications

Notice something wrong? The Colorado Sun has an ethical responsibility to fix all factual errors. Request a correction by emailing corrections@coloradosun.com.

When Dr. Matthew Daley began his term on a previously little-known advisory committee with the U.S. Centers for Disease Control and Prevention, he knew he had a bigger task before him than he had expected.

Daley is a pediatrician with Kaiser Permanente in Denver, but he also does research through KP’s Institute for Health Research. Daley’s work primarily focuses on vaccines — their safety and patients’ hesitancy to get them — and it had long been a goal of his to serve on that obscure committee, known as the Advisory Committee on Immunization Practices, or ACIP.

But while Daley waited for his chance, the COVID-19 pandemic swept into the nation. By the time Daley took his seat in January 2021, ACIP had become one of the most closely watched medical bodies in the country, responsible for reviewing safety and efficacy data on COVID vaccines and making recommendations about whether and how they should be given.

Daley’s term ended in June, and we recently caught up with him to talk about his experience. The following conversation has been condensed and lightly edited for clarity.

The Colorado Sun: How are you feeling now that your term has ended? Happy? Relieved?

Matthew Daley: I’m really going to miss it, so I’m kind of sad, frankly. It was such an incredible experience. It was so much more work than anybody anticipated, so now I can put back all that energy into my day job, which is being a pediatric health services researcher and a pediatrician. Certainly I’m excited to get back to the rest of my day job, but I’m going to miss it because it was such an interesting experience.

Sun: You joined the committee at such a tumultuous time for the nation’s health systems. Why did this volunteer job appeal to you?

Daley: I was really grateful to have an opportunity to serve. Often, we have the energy, we have the expertise, but we don’t always have the opportunity. If you remember early in the pandemic, we were under lockdown, everything was shut down. And kids could get quite sick from COVID, but it was just a whole lot less common versus adults. So as a practicing pediatrician, the first couple months of the pandemic were pretty quiet for us. It felt so odd to be a doctor in a public health crisis who was not very busy. So I really was grateful for the opportunity to serve in this very unusual and unprecedented circumstance.

Sun: There was, of course, a lot of public attention on your work, and there was also speculation about political pressure on institutions like ACIP. How did that feel from the inside?

Daley: The ACIP was allowed to independently follow its process for decision-making. We were aware of these different power centers, but I was never getting late-night calls from any of those groups saying, “This is what we need you to do,” or, “This is the decision we need you to make.” We adhered to our process, the process served us well, and we had independence to make vaccine policy decision-making. And so that was very encouraging to find because I think there was always suspicion out there that somebody had their finger on the scale. But really, the ACIP had a process, followed it and was independent.

Sun: But there was still some pretty intense criticism from parts of the public. Did that ever become uncomfortable?

Daley: Our emails are up on the ACIP website, and people could easily find our emails. So we would get emails from the public. And some of those were pretty negative. Some of those were pretty positive, you know, just thanks for the work that you’re doing. And sometimes it was a high volume, but what was interesting there was that it was sort of copied and pasted. So you get a bunch of emails, but it was verbatim from another email that you’d get. So it seemed like a small number of people who had an organized campaign. But, given the circumstances, it was totally understandable and just fine.

Sun: How did you incorporate that feedback?

Daley: I think it was helpful to hear what people were worried about. And to the extent I could, I would try to address that in the public meetings. I remember a meeting where there were some public commenters who were really worried about COVID vaccine side effects. And I remember saying, “We hear how great your concerns are about COVID vaccine side effects. We do factor that into our decision-making.” We know that no vaccine is 100% safe or effective. And then here’s what data we have about safety. We have good safety surveillance systems in the U.S. The safety monitoring was some of the most intensive — probably the most intensive — safety monitoring ever in the history of modern science in terms of how many eyes were on safety. And so I was reassured by that.

Sun: There were so many consequential decisions during your time on ACIP, in terms of recommending use of COVID vaccines and really being one of the final checks before vaccines started going into arms. Are there any decisions you regret now?

Daley: I don’t have decisions that I wish I could have had back. But I think one thing that I as a pediatrician would have appreciated is if there had been vaccines available for kids sooner. That’s out of our hands because we can’t approve something until the vaccine manufacturer has submitted their data to the FDA (Food and Drug Administration), and the FDA has made a decision about it. And I think the burden (of disease) was so great in older adults that we lost sight of the fact that there were still, in absolute terms, some significant burden in pediatrics. More kids were dying from COVID than were dying from flu. It’s because the relative burden on kids was so much less than the burden on adults that there was so much more focus on adults and getting those individuals vaccinated.

Sun: COVID, obviously, drew the most attention during your time on the committee, but was there anything else that happened that didn’t receive as much public attention as you thought it deserved?

Daley: There’s a product called nirsevimab, and what nirsevimab is is it’s a long-acting monoclonal antibody that prevents RSV (respiratory syncytial virus) in infants. So that is not technically a vaccine because it’s an antibody and a vaccine is different. But it was being used in a very vaccine kind of way. And and so there was this debate about whether the ACIP should consider it and should vote on its use. As a practicing pediatrician, I’ve admitted more babies with RSV to the hospital than anything else I’ve seen in my 25 years of practice. It’s really common, and it can be really severe. And then here we’re given this opportunity to prevent a lot of that illness including hospitalizations and ICU admissions and deaths from RSV. I remember at a meeting where I sort of realized that if we handled it very differently, we’re probably not going to achieve the public health goals that we wanted and not achieve the disease prevention that we wanted.

Sun: So this is an injection that provides protection against RSV, but it doesn’t do it in the same way as a vaccine would by creating an immune response within your body to produce your own antibodies — it takes a shortcut by just giving you the antibodies to start. And the debate was whether to treat it like a vaccine?

Daley:  It’s being used very vaccine-like, meaning it’s being given to everyone for prevention. And so I just remember saying we’ve achieved a lot in the national immunization program. And we have all of these systems in place to achieve high coverage for routine childhood vaccination. And because of that, we have prevented a tremendous amount of disease. And we have the same opportunity with nirsevimab, but we need to use all of our processes, all of our systems, to achieve the same thing with nirsevimab that we’ve achieved with infant vaccines. And after that, ACIP considered it.

Sun: What happened as a result?

Daley: Coverage was really high in the fall. This product is incredibly successful at preventing RSV hospitalizations in kids. There’s also an RSV vaccine for pregnant women that prevents their babies from getting RSV. And the combination of the two prevented just a huge amount of disease this last season. It sort of goes against the argument that there’s so much hesitancy out there that any new product is viewed with great skepticism because probably as many as 50% of infants in the U.S. in this past respiratory season, either they got nirsevimab or their mom got the RSV vaccine during pregnancy.

Sun: You mentioned hesitancy, which is a research specialty of yours. How do you view vaccine hesitancy, post-pandemic, and how do you address it now that vaccines have become a much more polarizing topic?

Daley: It’s a challenge that’s going to stay with us, I think, forever. I think we’ll always have some degree of hesitancy. When I look at hesitancy in pediatrics, I start with the principle that parents want what’s best for their kid. So I try as hard as I can not to get judgmental when parents make a different decision than what I recommend. They want what’s best for their kid. Then in the context of COVID vaccines, that’s a little different because people are making decisions for themselves and not for their kids. But it’s the same thing they want. They don’t want to get COVID, but they’re worried about the safety of COVID vaccines and they’re worried about maybe there’s some things that we don’t know about vaccines. So I understand that. But I think if we have transparency, integrity, public airing of the data, that helps. And then I think what also helps is to continue to study vaccine safety and study what people are really worried about.

Sun: When your term ended on ACIP did you get a parting gift?

Daley: No, I mean not really. What happened is that we had a three-day meeting, and on that Friday, they took a few moments to make comments about each of us and then they gave us a few minutes to make a comment. There were four of us who started right around Jan. 1, 2021. We had the most meetings that anybody ever had in the history of the ACIP. So they said thank you for your service. And that meant a lot.

Sun: OK, but not even a cake?

Daley: We didn’t have a cake. We had a lot of work to do.

The art is hung. The toilets flush. The X-ray machines are (finally) assembled.

On Saturday, barring any last-minute hiccups, Intermountain Health’s Lutheran Medical Center in Wheat Ridge will shut down its current location and move 3 miles west to a brand new, $680 million campus. It’s the first major hospital relocation in Colorado in years, and the new facility showcases how the COVID-19 pandemic has forced health systems to rethink what a hospital must be able to do.

Take, for instance, the patient rooms. There’s 226 of them, and each one comes with a nifty sliding supply cabinet that nurses can pull out to restock from the hallway.

This means nurses won’t need to disturb patients as often. But the feature serves another purpose. If the patient inside the room has a contagious bug, it keeps staff from having to load up on protective gear just to refill the tissue boxes.

Here’s another COVID-inspired design choice, taken from a pandemic when hospitals often worried about running out of capacity: Every patient room can be converted into a critical care room if needed.

“An outcome of the pandemic is we need the flexibility to take care of really sick patients everywhere,” said Casey Bogenschutz, the executive who is overseeing Saturday’s move.

Orchestrating the move

Bogenschutz is Lutheran Medical Center’s director of strategic initiatives, but that title severely undersells both the strategy and initiative the job requires.

At 6 a.m. on Saturday, the current location — at West 38th Avenue and Wadsworth Boulevard, where it has stood in some form since 1905 — will stop accepting new patients. The new hospital, which is just off Interstate 70 near the interchange with Colorado 58 in a development known as Clear Creek Crossing, will begin accepting patients.

Then the dance begins.

Starting at 8 a.m., a fleet of about 20 ambulances will begin running loops transporting patients already in the hospital to the new campus. The hospital is expecting to move about 180 patients, in a precisely timed choreography, one patient moving every eight to 10 minutes.

“We will have a down-to-the-minute plan for each patient,” Bogenschutz said.

On a recent day, Bogenschutz led The Sun on a tour of the new hospital, weaving through a maze of corridors and rooms, some with signage still TBD. Outside each room hung a list, attached with blue painter’s tape, of all the items needing to be placed inside. Bed, check. Toilet paper, check.

There were large televisions and “digital whiteboards” — screens with information for both patients and staff — to be connected. Bathrooms in the patient rooms were built as prefabricated pods at a factory in Phoenix, then shipped to Colorado on a truck and lifted by crane into place.

The operating rooms were just days away from intensive cleaning to render them sterile and ready for surgery.

Why build a new hospital?

In addition to COVID, the facility has been designed with other modern afflictions in mind. Doors connect all the rooms for trauma patients, allowing a doctor treating people from a mass-casualty incident such as a mass shooting to move quickly from patient to patient.

Bogenschutz said the new hospital has been organized for efficiency. MRI and CT scanners are positioned nearby the patients who will need them. The room numbering is orderly and intuitive, allowing a nurse to know exactly where they are in the hospital at any time. There’s an organized flow as patients move from one treatment area to the next — no more long walks or elevator rides to connect commonly used areas.

This, Bogenschutz said, is the best argument for building a new hospital, instead of simply renovating the old one.

“It doesn’t have the adjacencies that are required in the industry,” she said of the current hospital. “You make it work, but when you upgrade you can build things the way you want them.”

Colorado is a wildfire state.

There are the notable ones — the Cameron Peak fire, a 208,000-acre inferno, and the Marshall fire, which burned about 6,000 acres and destroyed hundreds of houses and businesses. And there are the smaller ones, such as the Devil’s Thumb fire that burned 81 acres in 2023. 

As fires explode around the Front Range, we wanted to map out where they were in relation to each other. But taking it further, we stepped away from the minute-by-minute updates to take a historical view of fires and where they burn. 

We looked through the National Interagency Fire Center’s records on fires since 2009 and plotted them on a map — all 10,849 of them. What resulted was a galaxy of blazes, but one with a clear message: Reported fires tend to happen most often where people live. 

Take a look for yourself. You can search this map by fire name or by year. Fires from this year are shown in red.

On the Front Range, summer has two sub-seasons: June and The Season of Looking Over Your Shoulder. We’re deep into that second half now, as scary wildfires send up new plumes seemingly on an hourly basis, from Jeffco this morning and from above Loveland and Lyons earlier this week.

Denver hit 100 degrees Tuesday and it’s turtles and 97s all the way down. Plus, after a promising spring, the entire West is way behind on precipitation to dampen fire threats. Here’s a look at the current drought monitor:

Watch out, Montana. Keep looking over your shoulders, and, as they say in “Fargo,” call it in.

The good news is that the satellites might have called it in first. Finally, an undeniably beneficial use of artificial intelligence beyond stealing everyone’s intellectual property. Not that we’re bitter. But if a NOAA satellite can call in an air tanker hours earlier for future fires, we’re all for it.

We’re packed with news of this and other climate and health news, so thanks for joining us and away we go.

Michael Booth

Reporter

TEMP CHECK

CLIMATE

How to keep up on air quality (Spoiler alert: It’s awful)

“Where am I going to live?”

We were struck by that plaintive quote from patients treated by Colorado’s top pulmonary doctors in reporting a Q&A for today on how to handle the blast of ozone and wildfire smoke we’re feeling. Patients with chronic respiratory problems are telling their doctors they feel physically and mentally suffocated by more frequent bad air days and a relentless string of 90 degree-plus weather warnings.

Sometimes it helps to fight despair with information. So let’s review how to use a couple of places where you and your family can plan your smoky day.

The first is the EPA’s AirNow.gov, where you can plug in your ZIP code and get an easy-to-read gauge with the current air quality and a forecast of how bad things might get. The gauge combines several factors, not just ozone, to come up with the Air Quality Index number; above 100 is the orange zone considered unhealthy for vulnerable people, and above 150 is the red zone considered unhealthy for everybody.

Colorado’s public health air quality page goes into more detail about regional variances, gives an almanac of what happened the day before and provides longer text descriptions of their daily advisories.

Yes, we’ve got another bad air advisory for today through the afternoon at least.

And for the love of all coughing relatives and the safety of all hardworking firefighters, please, please avoid any potential fire-starting behavior. We watched a guy in our neighborhood yesterday take one last deep drag from a cigarette, drop it on the sidewalk with barely a touch of his foot and leave it smoldering near a dry garden.

Remember one of our phrases to live by here at Temperature headquarters: Don’t be that guy!

Section by Michael Booth | Reporter

CLIMATE

Did AI help detect Front Range wildfires? Not yet, but NOAA’s new system is ready

It didn’t take artificial intelligence to spot the dangerous Alexander Mountain fire challenging Colorado’s firefighting resources west of Loveland this week. Commuters, hikers, open space rangers and TV traffic helicopters can be early detectors for newly sparked wildfires over the heavily populated Front Range.

But the National Oceanic and Atmospheric Administration is now armed and ready with AI-empowered, real-time satellite detection for the next, more remote wildfire. The Next Generation Fire System autonomously scans the observations of NOAA geostationary satellites and from a height of 22,000 miles can spot a fire as small as an acre.

A sophisticated communication system then warns land managers and fire forecasters about the hot spot.

The satellites update scans every few seconds and can detect sudden changes in heat on the ground.

The AI scans and communication tools perfected at NOAA’s Boulder test bed in June turn NOAA meteorologists into “scientific first responders,” said Todd Lindley, the National Weather Service science and operations officer for Norman, Oklahoma. “These tools will help us provide timely and life-saving warnings of particularly dangerous wildfires.”

Satellites manage to illustrate the very big alongside the very small.

We were astonished by videos and stills like the one above showing how California’s enormous Park fire is creating its own “pyrocumulonimbus” clouds of smoke and weather after blowing up last week. Started when a burning car was pushed into a ditch on July 24, the wildfire north of Sacramento exploded from 120,000 acres on the 25th to 239,000 acres a day later. It’s up to 386,000 acres as of this morning.

Section by Michael Booth | Reporter

MORE CLIMATE NEWS

• Some Steamboat residents see ruin in development of an exclusive land club. An Arizona-based operator with 35 private resorts worldwide is moving ahead with a proposal to turn a large portion of a modest, beloved community into Stagecoach Mountain Ranch, a lavish members-only ski and golf resort similar to the Yellowstone Club in Big Sky, Montana. Kari Dequine Harden reports one resident summed it up this way: “The whole thing is so overwhelming it keeps me up at night.”
  — The Colorado Sun
• Could an old idea reviled by green voters be revived for affordable housing? Under the Sagebrush Rebellion, Democrats and progressive Westerners blanched at the idea of conservatives turning over federal lands to state governments for sale to the highest bidder. Now, some old enemies may join forces to find developable land to address desperate needs for middle and lower-income housing.
  — High Country News
• Last stand for “affected persons” against an oil drilling plan. Neighbors of Aurora Reservoir and the proposed Lowry Ranch oil drilling plan have one more late-hours idea: Getting named “affected persons,” even if they don’t live technically within the boundary of that defined category. Mark Jaffe reports that a determined community effort to block the new wells has wrested some major concessions from the oil company, Civitas, but not enough to satisfy opponents. And it turns out, they were granted the status and can move forward.
  — The Colorado Sun
• Colorado water managers can “dream big” for water-saving projects. The ceiling for daydreaming about water conservation ideas in Colorado has been $300,000, Shannon Mullane reports. Now that’s the floor. Enormous new grants from the Biden administration to Western water resource managers promise to fund their biggest and best concepts for combating drought and climate change.
  — The Colorado Sun 

HEALTH

Five questions with a Colorado doctor who shaped vaccine policy through the pandemic

When Dr. Matthew Daley began his term on a previously little-known advisory committee with the U.S. Centers for Disease Control and Prevention, he knew he had a bigger task before him than he had expected.

Daley is a pediatrician with Kaiser Permanente in Denver, but he also does research through KP’s Institute for Health Research. Daley’s work primarily focuses on vaccines — their safety and patients’ hesitancy to get them — and that had long made it a goal of his to serve on that obscure committee, known as the Advisory Committee on Immunization Practices, or ACIP.

But while Daley waited for his chance, the COVID-19 pandemic swept into the nation. By the time Daley took his seat in January 2021, ACIP had become one of the most closely watched medical bodies in the country, responsible for reviewing safety and efficacy data on COVID vaccines and making recommendations about whether and how they should be given.

Daley’s term ended in June, and we recently caught up with him to talk about his experience. The following conversation has been condensed and lightly edited for clarity.

The Temperature: How are you feeling now that your term has ended? Happy? Relieved?

Matthew Daley: I’m really going to miss it, so I’m kind of sad, frankly. It was such an incredible experience. It was so much more work than anybody anticipated, so now I can put back all that energy into my day job, which is being a pediatric health services researcher and a pediatrician. Certainly I’m excited to get back to the rest of my day job, but I’m going to miss it because it was such an interesting experience.

Temp: You joined the committee at such a tumultuous time for the nation’s health systems. Why did this volunteer job appeal to you?

Daley: I was really grateful to have an opportunity to serve. Often, we have the energy, we have the expertise, but we don’t always have the opportunity. If you remember early in the pandemic, we were under lockdown, everything was shut down. And kids could get quite sick from COVID, but it was just a whole lot less common versus adults. So as a practicing pediatrician, the first couple months of the pandemic were pretty quiet for us. It felt so odd to be a doctor in a public health crisis who was not very busy. So I really was grateful for the opportunity to serve in this very unusual and unprecedented circumstance.

Temp: There was, of course, a lot of public attention on your work, and there was also speculation about political pressure on institutions like ACIP. How did that feel from the inside?

Daley: The ACIP was allowed to independently follow its process for decision-making. We were aware of these different power centers, but I was never getting late-night calls from any of those groups saying, “This is what we need you to do,” or, “This is the decision we need you to make.” We adhered to our process, the process served us well, and we had independence to make vaccine policy decision-making. And so that was very encouraging to find because I think there was always suspicion out there that somebody had their finger on the scale. But really, the ACIP had a process, followed it and was independent.

Temp: But there was still some pretty intense criticism from parts of the public. Did that ever become uncomfortable?

Daley: Our emails are up on the ACIP website, and people could easily find our emails. So we would get emails from the public. And some of those were pretty negative. Some of those were pretty positive, you know, just thanks for the work that you’re doing. And sometimes it was a high volume, but what was interesting there was that it was sort of copied and pasted. So you get a bunch of emails, but it was verbatim from another email that you’d get. So it seemed like a small number of people who had an organized campaign. But, given the circumstances, it was totally understandable and just fine.

Temp: How did you incorporate that feedback?

Daley: I think it was helpful to hear what people were worried about. And to the extent I could, I would try to address that in the public meetings. I remember a meeting where there were some public commenters who were really worried about COVID vaccine side effects. And I remember saying, “We hear how great your concerns are about COVID vaccine side effects. We do factor that into our decision-making.” We know that no vaccine is 100% safe or effective. And then here’s what data we have about safety. We have good safety surveillance systems in the U.S. The safety monitoring was some of the most intensive — probably the most intensive — safety monitoring ever in the history of modern science in terms of how many eyes were on safety. And so I was reassured by that.

Watch ColoradoSun.com in the coming days for an expanded Q&A with Daley, including what non-COVID breakthrough he is most proud of.

Section by John Ingold | Reporter

MORE HEALTH NEWS

• Colorado expands testing for bird flu at dairy farms as state hits new peaks. It seems like we write this every week, but Colorado’s worst-in-the-nation outbreak of bird flu has gotten … worst-er. The state last week identified more human cases related to an outbreak at a poultry facility — a different one than the farm where six workers were infected earlier. Genetic analyses of viral samples from the workers continue to show encouraging results, though. Meanwhile, the state is up to 51 dairy herds affected by bird flu — nearly half the herds in the state — and agricultural officials have ordered mandatory testing at dairies to try to stop the virus there.
  — The Colorado Sun
• Phil Weiser is the only person in Colorado who has succeeded lately in selling a house, high interest rates be damned. We exaggerate, of course. It was actually the Attorney General’s Office that sold a house — well, a bank auctioned it and gave the proceeds to the state — and it was related to a lien the AG’s office placed on a woman wanted in an alleged Medicaid fraud scheme. An arrest warrant for the woman, Muluemebet Tasew, remains active. The house, which is in southeast Aurora, fetched $455,381.
  — Colorado AG’s Office
• The CU Med School is asking some students to go long with patients. A new educational model at the University of Colorado School of Medicine has doctors-in-training eschewing the typical rotation schedule to instead track patients as they move through their health journeys. The goal is to get new doctors thinking less about their own silos and more about patients as a whole.
  — The Denver Post🔑
• Kansas hospital sued for not providing abortion care. A woman has sued the University of Kansas Health System for failing to provide what she says was a medically necessary abortion. She contends that violates a federal law governing emergency treatment.
  — Reuters

CHART OF THE WEEK

Millions of extra summer travelers in, around and above Denver International Airport get an unusual sight, by car or plane: The ever-growing monument to Colorado consumption known as Republic Services’ Tower Landfill.

Is the garbage tomb a little taller since the last time you flew? Definitely. But what goes on behind the carefully placed caps of soil and methane venting? What could possibly stop all that refuse from causing chaos through leaks?

We’re not guaranteeing that won’t ever happen, but there is a careful design. First we looked for graphics of how the EPA would build the ideal landfill containment. Then we asked Republic Services for their version of how things work at Tower Road, and the concepts were all the same.

On the bottom, the liner gets layers of clay, sand, plastic and more sand. Each finished section of disposed garbage is capped as they go, a process that could last at least 20 more years. The final caps include more sand and clay, to keep rain and snow from penetrating and adding to the contaminated leachate developing inside the garbage mound.

Rotting garbage produces methane, which under modern methods is systematically collected by piping and sent to a gathering plant; the methane can be used in vehicle fueling or electrical turbine fuel. Leachate is also gathered, and pumped to tanks for treatment — 500,000 gallons a year at Tower, from 6,000 tons of waste added every day, Republic Services says.

It’s all designed to keep this decade’s landfill from becoming next decade’s Superfund site, as happened to the long-dormant Lowry Landfill. Will we find out otherwise in our lifetime? Hard to say. But there is a plan.

Section by Michael Booth | Reporter

Stay hydrated, wear a mask even before you smell smoke, take an indoor movie break in the afternoon with the kids, and kiss a firefighter. Or hand them a cool drink. Or whatever form of thanks and encouragement they prefer. We appreciate them, and you. It could be a looooong August.

— Michael & John

The Colorado Sun is part of The Trust Project. Read our policies.

Corrections & Clarifications

Notice something wrong? The Colorado Sun has an ethical responsibility to fix all factual errors. Request a correction by emailing corrections@coloradosun.com.

The Colorado Department of Agriculture this week stepped up efforts to stop a runaway outbreak of bird flu cases on dairy farms by issuing an order requiring testing for the virus on all commercial cow dairies licensed by the state.

But, separately, new information about the bird flu virus that infected a Colorado farmworker provides reassuring evidence that the virus remains a low risk to human health.

The state has seen at least 51 cases of bird flu on dairy farms since April, meaning nearly half of all commercial dairies in Colorado have been affected. Of those cases, 30 have happened in the past 30 days.

Colorado’s outbreak continues to surge even as others have dwindled nationwide — no other state has seen more than four cases in the past 30 days, and some major dairy-producing states like Wisconsin and California have never reported any cases.

In issuing the order, state veterinarian Dr. Maggie Baldwin said the virus, while not causing deaths of many cattle, has still been a devastating disruption to Colorado’s dairy industry — resulting in quarantines and loss of milk production.

“We have been navigating this challenging, novel outbreak of HPAI in dairy operations for nearly three months in Colorado and have not been able to curb the spread of disease at this point,” Baldwin said in a statement, using a shorthand term for the virus, which is also known as highly pathogenic avian influenza.

The order does not apply to farms that produce raw milk, which are not regulated by the state. Pasteurization kills the virus in milk sold in stores, but raw milk is unpasteurized, meaning there is the potential for it to contain live virus.

Spillover cases

Baldwin noted that, as the dairy outbreaks rage on, they are also generating spillover cases in other animals. Most notably, Colorado has begun seeing infections again in commercial poultry operations. 

There have been two major, confirmed outbreaks at egg-laying operations in Weld County, while a third, suspected outbreak is also under investigation. Those outbreaks have resulted in the culling of more than 3.2 million chickens just in July, according to the Department of Agriculture.

Colorado has now seen 33 commercial poultry flocks affected since 2022, with more than 6.3 million domestic birds culled.

Then there’s the human toll. One of those poultry outbreaks led to an unprecedented cluster of cases among workers who were doing the culling. Six workers were confirmed positive for bird flu, though their symptoms were relatively mild and none required hospitalization.

Meanwhile, the Colorado Department of Public Health and Environment announced Thursday that it has identified three new human cases of bird flu — these tied to culling operations at a different poultry farm. The workers, likewise, have mild symptoms and have been offered antiviral drugs for treatment.

Searching for genetic changes

Including the new cases, the state has now identified 11 out of the 14 human cases nationwide since 2022, placing Colorado at the center of the nation’s bird flu epidemic. And the burst of human infections in Colorado has raised questions about whether the flu virus has mutated to make it more capable of infecting people.

But a new CDC analysis eases those concerns. The CDC took a virus sample from one of the Colorado poultry workers and sequenced its genome.

Among the findings:

• The sample’s genetics are closely related to those of viruses found in animals from other recent outbreaks at poultry and dairy facilities. Among human cases, the Colorado worker’s virus is most similar to the virus that infected a dairy worker in Michigan earlier this year.
• The Colorado virus “maintains primarily avian genetic characteristics,” according to the CDC, meaning it isn’t especially adapted to infect people or spread person-to-person. It does, however, have one mutation that makes it better at infecting mammals. That mutation has been found in more than 99% of infections among cattle.
• There were no mutations found that indicate the virus is developing resistance to existing antiviral drugs.
• There are also no changes to the virus suggesting it is more capable of causing harm to humans.
• The virus is closely related to a couple bird flu samples available to vaccine manufacturers, meaning companies could start producing a bird flu vaccine quickly if needed.

So, to recap: Nothing about the Colorado case suggests the bird flu virus has become better able to infect people, hurt people or spread to other people. The CDC said the analysis “supports CDC’s conclusion that the human health risk currently remains low.”

No evidence of silent spread

The CDC also reported some more good news last week: Blood tests of Michigan dairy workers were boring.

Michigan’s public health department conducted what is known as a seroprevalence study of workers with known exposures to infected cows. The goal was to see if workers who showed no symptoms of bird flu actually had antibodies against the virus. If they did, it would suggest that they had been silently infected and that human cases might be more common than known.

Instead, the results from every nonsymptomatic worker tested came back clean — no antibodies against bird flu.

“This is an important finding,” the CDC wrote in a weekly update, “because it suggests that asymptomatic infections in people are not occurring.”

That means the risk remains primarily to farmworkers who have direct contact with infected animals. And that puts the focus on efforts to provide information to farms and to ensure workers have access to — and are able to wear — protective equipment.

“Ongoing cooperation is key to supporting workers’ health and safety, protecting animal health and welfare, and minimizing the spread of the virus,” Kate Greenberg, Colorado’s commissioner of agriculture, said in a statement.

Hey there, Colorado, and welcome to another edition of The Temperature, where we again have viruses on the brain.

Well, not ON the brain. Or in the brain — hopefully. Just, there’s a lot of news that involves viruses, which is always wild, how these rogue, nonsentient bits of genetic scraps, basically dice in nucleic acid form, can have such a profound impact on human life, both for the negative and, as Shannon Mullane reports below, potentially for the positive.

If this stuff tickles your imagination as it does mine, be sure to join us this fall for SunFest, where I will be moderating a panel on how to identify and stop the next pandemic. We have an ace researcher from Colorado State University lined up, plus more experts to help us understand whether we are better prepared now, post-COVID, to do battle with pathogens.

The event is Sept. 27 at the University of Denver. We’ll take questions from the audience, and I’ll also be hanging around after, so we can confess our infection anxieties to one another.

Get your tickets now at ColoradoSun.com/SunFest.

Now onto the news.

John Ingold

Reporter

TEMP CHECK

ENVIRONMENT

Is a killer virus the answer to cleaning up one of the biggest messes left by fracking?

Viruses in general have been getting a lot of bad publicity lately. But what if a specific kind of virus could actually help by — hear us out — cleaning up wastewater left by fracking?

That wastewater, called produced water, is the major waste stream generated by oil and gas production.

The water can include a cocktail of naturally occurring carcinogenic compounds and radioactive materials. Bacteria in the water can cause costly corrosion. It’s so salty that, if used for irrigation, it could kill plants. When fresh water is used to drill for oil and gas, that water should never re-enter the irrigation and drinking water supply.

In Colorado, fresh water used for fracking averaged about 26,000 acre-feet per year from 2011 to 2020, or about 0.17% of the water used in the state, according to the Colorado Division of Water Resources. One acre-foot roughly equals the annual water used by two to three households.

Increasingly, officials are looking at ways to clean and reuse produced water instead of re-injecting it below drinking water aquifers, letting it sit in ponds to evaporate or releasing it into streams.

With water quality in mind, one group of University of Texas researchers looked to the medical industry and its use of a renewable technology: bacteriophages.

Bacteriophages are viruses that infect specific bacteria. They look a bit like the spiders in the “Starship Troopers” movie, said Zacariah Hildenbrand, part of the six-person University of Texas research team.

Once the phage finds its host bacteria, it hooks into the surface of the cell, injects its DNA into the center of the bacteria, and hijacks the bacteria’s replication mechanisms.

Then it reproduces until the bacteria explodes.

“Under the microscope, at the atomic scale, it’s scary. It’s an all-out civil war between bacteria and viruses,” Hildebrand said. “But from the human perspective, it’s totally innocuous.”

And the researchers showed that phages can take out bacteria in produced water in their study published in the peer-reviewed journal Water in April.

The virus, however, won’t be enough — and the researchers will have to jump big hurdles to take their tech to the industrial scale.

Stay tuned for more in an upcoming article from water reporter Shannon Mullane on ColoradoSun.com.

Section by Shannon Mullane | Water Reporter

MORE ENVIRONMENT NEWS

• A very sick mountain lion helps advance disease science. The video is terribly sad: A Douglas County homeowner in 2023 captured a partially paralyzed mountain lion dragging herself across the ground on her unstable front paws, clearly distressed. Colorado Parks and Wildlife officers had to euthanize the 1-year-old female cat. But Colorado State University has helped turn the awful moment into great science, establishing the first known case of “staggering disease” in North American mountain lions and pinpointing more dangers of the rustrela virus, Michael Booth writes.
  — The Colorado Sun
• EPA grants $328 million to Colorado climate projects. Two major grants from the Biden administration could trim greenhouse gases and other pollutants from big buildings, and from methane leaks at landfills and coal mines, Mark Jaffe reports. DRCOG will get one grant to retrofit buildings for mandatory greenhouse gas reductions. The Colorado Energy Office will disburse the other big grant to attack methane, a far more potent greenhouse gas even than carbon dioxide.
  — The Colorado Sun
• Voracious zebra mussels have eaten their way to the Colorado River. Western Colorado is starting to sound like the Midwest, subject to decades of intense warnings about keeping the fast-multiplying mussels out of new waters. Too late, the state announced. Signs of the mussels are now in the Colorado River and associated irrigation canals, and may be headed downstream to other basin states. The mussels can damage everything from boats to water intakes to canals and headgates, while stealing all the food supply of native wildlife species.
  — The Colorado Sun
• Xcel claims price of clean energy conversion is rising fast. The big energy utility has the right to pass on some of the costs of meeting Colorado clean energy mandates to its paying customers, but is now facing some pushback after saying inflation is raising the potential bill. Mark Jaffe reports on consumer advocates questioning what Xcel is asking for, and how state officials will determine what’s fair in meeting a key state greenhouse gas goal.
  — The Colorado Sun

HEALTH

State expands testing for bird flu at dairy farms

The Colorado Department of Agriculture this week stepped up efforts to stop a runaway outbreak of bird flu cases on dairy farms by issuing an order requiring testing for the virus on all commercial cow dairies licensed by the state.

The state has seen at least 48 cases of bird flu on dairy farms since April, meaning close to half of all commercial dairies in Colorado have been affected. Around 30 of those cases have happened in the past 30 days.

Colorado’s outbreak continues to surge even as others have dwindled nationwide — no other state has seen more than four cases in the past 30 days, and some major dairy-producing states like Wisconsin and California have never reported any cases.

In issuing the order, state veterinarian Dr. Maggie Baldwin said the virus, while not causing deaths of many cattle, has still been a devastating disruption to Colorado’s dairy industry.

“We have been navigating this challenging, novel outbreak of HPAI in dairy operations for nearly three months in Colorado and have not been able to curb the spread of disease at this point,” Baldwin said in a statement, using a shorthand term for the virus, which is also known as highly pathogenic avian influenza.

Baldwin noted that, as the dairy outbreaks rage on, they are also generating spillover cases in other animals. Most notably, Colorado has begun seeing infections again in commercial poultry operations.

There have been two major, confirmed outbreaks at egg-laying operations in Weld County, while a third, suspected outbreak is also under investigation. Those outbreaks have resulted in the culling of more than 3.2 million chickens just in July, according to the Department of Agriculture.

Colorado has now seen 33 commercial poultry flocks affected since 2022, with more than 6.3 million domestic birds culled.

Then there’s the human toll. One of those poultry outbreaks led to an unprecedented cluster of cases among workers who were doing the culling. Six workers were confirmed positive for bird flu, though their symptoms were relatively mild and none required hospitalization.

Section by John Ingold | Reporter

VIROLOGY

The good news in the RNA of the bird flu virus that infected a Colorado worker

We just mentioned that the recent human infections in Colorado were acquired at a poultry farm but connected to the outbreaks at dairy farms. But how do we actually know that?

Genetics, baby.

The federal Centers for Disease Control and Prevention took a virus sample from one of the Colorado workers and sequenced its genome. (While some viruses are made up of DNA, flu viruses are made up of RNA, the single-stranded cousin to DNA.)

The analysis produced some interesting findings:

• The virus’ genetics are closely related to those of viruses found in animals from other recent outbreaks at poultry and dairy facilities. Among human cases, the Colorado worker’s virus is most similar to the virus that infected a dairy worker in Michigan earlier this year.
• The Colorado virus “maintains primarily avian genetic characteristics,” according to the CDC, meaning it isn’t especially adapted to infect people or spread person-to-person. It does, however, have one mutation that makes it better at infecting mammals. That mutation has been found in more than 99% of infections among cattle.
• There were no mutations found that indicate the virus is evolving resistance to existing antiviral drugs.
• There are also no changes to the virus suggesting it is more capable of causing harm to humans.
• The virus is closely related to a couple bird flu samples available to vaccine manufacturers, meaning companies could start producing a bird flu vaccine quickly if needed.

So, to recap: Nothing about the Colorado case suggests the bird flu virus has become better able to infect people, hurt people or spread to other people. The CDC said the analysis “supports CDC’s conclusion that the human health risk currently remains low.”

The CDC also reported some more good news last week: Blood tests of Michigan dairy workers were boring.

Michigan’s public health department conducted what is known as a seroprevalence study of workers with known exposures to infected cows. The goal was to see if workers who showed no symptoms of bird flu actually had antibodies against the virus. If they did, it would suggest that they had been silently infected and that human cases might be more common than known.

Instead, the results from every nonsymptomatic worker tested came back clean — no antibodies against bird flu.

“This is an important finding,” the CDC wrote in a weekly update, “because it suggests that asymptomatic infections in people are not occurring.”

Section by John Ingold | Reporter

COLORADO OPTION

The Colorado insurance commissioner makes a bold claim

In talking about proposed prices for health insurance plans next year, Colorado’s insurance commissioner made a bold claim about the Colorado Option, one of the Polis administration’s policy babies.

Michael Conway said the proposed rates were, essentially, proof the controversial insurance product is working — despite the fact that prices for Colorado Option plans, as with other insurance plans, look set to rise next year.

“We’re reducing costs,” he said. “We’re bending the cost curve with the Colorado Option. That was something people used to say couldn’t be done.”

The Colorado Option is a government-designed health insurance plan that private companies are required to offer. Its goal is to deliver richer benefits at lower prices, and Conway has some ability to reduce hospital contract prices with insurers if the Colorado Option plans don’t hit rate targets.

He hasn’t done that yet, but Conway says that’s because hospitals have been lowering prices on their own. As to why Colorado Option plans are going up in price next year — though less than what other plans are — Conway pointed to other components of a health insurance plan’s price, including pharmaceutical costs.

“What has happened is hospitals have reduced contractual costs,” he said. “We’ve reduced the contractual costs between insurance companies and hospitals by 20% every year the program has been up and running.”

That’s a pretty bold claim, so we asked the Colorado Hospital Association what it thought. And the association’s response didn’t exactly refute Conway’s argument.

“Colorado’s hospitals have been working proactively to improve affordability for ALL consumers,” the statement read. “That includes negotiating with health insurers and investing significant resources to reach agreements on Colorado Option plans that have resulted in reduced costs.”

About a third of people shopping on the state’s insurance exchange last year bought a Colorado Option plan. We’ll keep an eye on whether that increases this year.

Section by John Ingold | Reporter

MORE HEALTH NEWS

• Extreme heat in Colorado may have contributed to an extraordinary outbreak of bird flu in people. One last bird flu story today for the infectious disease fans: Since we now know that the virus didn’t change significantly to better infect people, what caused that big cluster of cases in Colorado workers? It was likely a failure of personal protective equipment. And extreme temperatures may have been to blame for that.
  — The Colorado Sun
• Two Coloradans join first-ever commercial spacewalk to research ways for people to live on Mars. So, two people with Colorado ties are among the four astronauts working for a billionaire’s space-tourism company who will strap into a capsule sitting atop a rocket from a different billionaire’s space company and will blast off toward the highest Earth orbit ever achieved, all with the goal of studying how we can build colonies on the moon and Mars, perhaps in as little as two decades, according to that second billionaire. “It’s going to be quite a thrill,” one astronaut said.
  — The Colorado Sun
• Some Colorado insurers next year will have to cover abortion services. Carriers selling plans in the individual and small-group markets — for people buying coverage on their own or for small employers buying plans for their workers — will have to cover abortion services, according to a new bulletin from the Colorado Division of Insurance. The rule stems from a bill state lawmakers passed in 2023.
  — DOI

CHART OF THE WEEK

One big reason why the Front Range is choking under dangerous levels of drifting wildfire smoke and PM2.5 pollution is explained by a glance at the world map above, with sirens going off in bright red. June set another worldwide average temperature record — on the high side, yes — another in a series of monthly average records in recent years.

All that heat, which we experienced in late June moving into July throughout Colorado, dried out the West and southwestern Canada, creating prime conditions for another bad season of wildfires.

“The June global surface temperature was 2.2 degrees Fahrenheit above the 20th-century average of 59.9F, making it the warmest June on record and the 13th consecutive month of record-high global temperatures,” NOAA said. The agency’s global outlook says “there is almost a 60% chance that 2024 will rank as the warmest year on record and a 100% chance that it will rank in the top five.”

Section by Michael Booth | Reporter

Hey, fancy meeting you here down at the bottom. Your brain has now been thoroughly inoculated with knowledge, so go forth with immunity from misinformation.

We say it often here, but we can never say it often enough: We really appreciate you, you beautiful, precious, sparkling human. Take care of yourself, so we can spend more time together, will you?

Until next time.

— John & Michael

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The outdoor temperature flirted with 100 degrees and heat advisories blanketed the region earlier this month as workers arrived at a commercial poultry operation in Weld County to start killing chickens.

Of the 1.8 million egg-laying hens inside the operation’s barns, at least some were infected with highly pathogenic avian influenza — bird flu. The strain of the virus that is now circling the globe has shown a remarkable ability to infect all kinds of animals, from seals to skunks to mountain lions. But it spreads most rapidly and lethally in wild birds and domestic poultry.

When a commercial flock is infected, standard practice is grim but efficient: Kill all the birds at the farm, devastating one operation in the hopes of stopping the virus and sparing the rest of the industry. By the time the workers in Weld County were done, though, some discovered that the virus had survived at least for one infection longer. It had found a new host: Their own bodies.

The unprecedented cluster of six cases of bird flu reported this month in Colorado is the largest outbreak of human cases in the United States from the current strain — in fact, it is the only time in this country that more than one person has been confirmed to be infected from a single incident. And there is a possibility the outbreak may be worse than the headlines.

Colorado health officials tested at least 69 workers who showed flu-like symptoms, out of more than 150 workers who were at the farm. Of those, only six have tested positive — three of those cases were confirmed initially by the federal Centers for Disease Control and Prevention, while three others were confirmed later, most recently on Friday.

Combined with another human case reported in the state this month — a dairy worker who had contact with infected cattle — as well as the state’s worst-in-the-nation outbreak of bird flu cases on dairy farms, Colorado has become the epicenter of bird flu in the U.S.

A state health official last week said public health agencies are monitoring more than 700 people who may have been exposed to bird flu, looking for signs to see if they were infected. A team from the federal Centers for Disease Control and Prevention arrived in Colorado to help track the epidemiological evidence.

But the outbreak has also shined a light on a much more mundane factor in the infections: Those soaring temperatures.

Why extreme heat contributed to the outbreak

The CDC says that workers who have contact with infected animals should wear a thick suit of personal protective equipment, or PPE.

Head covering, goggles, mask, water-resistant coveralls, apron, gloves and boots. In a drawing of the outfit on the CDC website, only slivers of a worker’s forehead and cheekbones are uncovered.

But there are no requirements for workers to wear PPE. The U.S. Department of Agriculture has issued only recommendations. The state has no requirements, either.

The result is that workers may not be wearing PPE in bird flu hot zones.

“My understanding is that PPE is available to workers, but there’s not been 100% uptake in the use of PPE,” Dr. Rachel Herlihy, the state epidemiologist, said in an interview last week. “We’ve been working very closely with the producer to ensure improvements are made in uptake of PPE in workers. There’s been significant work to train workers on the use of PPE.”

This is where the weather comes in. All that PPE — designed to be fairly un-breathable, in order to keep pathogens out — is hot.

While temperatures outside were scorching, it was likely even hotter inside the barns where the workers were culling birds. Workers may have chosen to forego PPE or taken it off. Sweat running down faces made goggles fog up and masks slip. Large fans pushed around air, likely laden with virus, and ruffled PPE.

Every crack in the protective armor provided an opportunity for the virus to slip through.

“It’s really difficult to try and control the weather right now,” Herlihy said.

Criticisms of the response

While the difficulties of working in extreme heat might explain the outbreak, they don’t offer an excuse for not better protecting workers, some experts said.

“That’s absolutely crazy to me,” said Jennifer Nuzzo, a nationally recognized epidemiologist who is the director of the Pandemic Center at Brown University School of Public Health in Rhode Island. “Putting people into a situation where they are culling birds that are known to be infected without sufficient protection is just gambling with their lives.”

Nuzzo said officials could have considered waiting to do the culling until temperatures subsided. Or they could have sent workers in for shorter shifts.

Bird flu has not resulted in any serious infections in humans in the United States — so far. The workers in Colorado who tested positive had symptoms ranging from eye redness all the way up to classic flu symptoms of fever, chills and cough. All were offered the antiviral drug Tamiflu and told to isolate themselves. None required hospital treatment.

Herlihy, the state epidemiologist, said her agency takes seriously the health of workers who have contact with infected animals.

“I’m certainly concerned about workers that have exposures,” she said.

There is no evidence of the virus spreading person-to-person. Wastewater testing and data from hospital emergency department visits do not indicate that the virus is silently spreading. This means the risk to the general public remains low and mostly confined to contact with infected animals.

Nuzzo said this is all important for the public to keep in mind.

“My concern for a potential pandemic is growing,” she said. “I wouldn’t call it high yet.”

But, despite the mild illnesses, Nuzzo said flu viruses should not be taken lightly. In the wrong circumstances, they do have the ability to cause severe illness — as this bird flu virus has in other parts of the world. And every infection of a person is a chance for the virus to evolve and crack the code on more efficiently spreading to other people.

Nuzzo said that makes it vitally important to better protect farm workers, for their own health and for the health of others. She pointed to the example of Finland, which is offering bird flu vaccinations to farmworkers as a precaution.

“I think we’re maybe a little bit naive about the potential of this virus,” she said. “There’s a thought that it’s going to whip through and be gone. But I’m here to tell you, flu viruses don’t disappear.”