It was 2 a.m. on Sunday, March 8th and Bill Brueck couldn’t sleep.
The 45-year-old father of two, from the snowy town of Minturn, Colorado, had a cough, body aches, chest congestion and a fever. He stayed in bed all day.
Brueck would soon become one of the first diagnosed cases of COVID-19 in Eagle County, Colorado, a region of the Rockies spotted with idyllic resort towns. Dozens of people came down with similar symptoms around the same time.
And the confirmed cases have continued to climb — so much so that Eagle County’s numbers have grown to the “hotspot” conditions found in much larger U.S. cities. As of Friday, there were 61 confirmed cases of the disease there, according to the state — nearly as many as Denver in a county of around 55,000.
While those numbers alone made Eagle County the heaviest-hit county in the state, the disease is likely much more widespread than the confirmed cases let on. Between a hundreds-deep backlog of test results and the typical gap between contracting the disease and showing symptoms, public health officials haven’t been able to track the true extent of COVID-19 spread.
“Local health officials throughout Eagle County now suspect that hundreds, if not thousands, of community members have contracted COVID-19,” the county said Wednesday.
“It is everywhere here; we just don’t have the test results to prove it, and we won’t anytime soon,” Will Cook, president and CEO of the major health care provider in the area, Vail Health, wrote in an op-ed.
Lying awake that night two weeks ago, Brueck remembered hearing about the first confirmed case of coronavirus disease in his state — a man who’d traveled to Italy and then returned to Colorado, where he went skiing at nearby Keystone Resort and Vail Mountain.
The Friday before feeling symptoms, Brueck had worked his restaurant job in the same area.
“That tipped my brain,” he told TPM Friday. “The symptoms seemed kind of consistent with what people were talking about.”
So Brueck called his doctor, who recommended he stop by a drive-up testing center a couple towns over in Gypsum.
“They came out all dressed in their space suits and did a couple swabs and sent me on my way,” Brueck recalled. “Never had to get out of my car.”
That was before the symptoms surged. Now, a county spokesperson told TPM Thursday, there are hundreds of outstanding tests without results.
Within a few days of his test it was official: Brueck was one of the first confirmed COVID-19 cases in Eagle County. He’s spent the week since watching movies, reading and walking his dog through the woods.
Thousands of people in the county are in a similar situation, keeping to themselves: Restaurants have been ordered closed except for take-out. County buses are operating fare free and riders have been instructed to board from the back door, minimizing contact with drivers.
With hundreds of tests outstanding and community spread already confirmed, “we are not relying on test results any longer to take action,” Kris Widlak, a spokesperson for the county, told TPM Thursday.
Normally around this time of year, the prime ski spots within Eagle County’s borders — Vail, Beaver Creek and Avon among them — would be flush with tourists from all over the world enjoying the Rocky Mountains and the sprawling hospitality-based economy that’s sprung up around them over the years.
Now, the slopes are closed. The Eagle County Regional Airport’s arrivals board is a red wall of cancellations. The area has emptied of international tourists and seasonal workers, whom resorts kicked out by the hundreds earlier this week.
“For a couple of weeks, I’d been like, wow, we’re going to have some problems,” Mike Heaphy, a father of three who works year-round at Beaver Creek, said. “It’s totally spooky around here, driving around. Completely spooky and weird.”
Brueck’s daughters were on their way to Heaphy’s house when their dad got the news about his test.
Now, Heaphy said, he’s spending most of his time as his kids’ “e-schooling coordinator.”
For Eagle County, whose small towns are dependent upon the tourism industry, the reality of the pandemic was a hard pill to swallow, Mayor Sarah Smith Hymes of Avon told TPM.
“But over the past few days, the reality has finally hit home,” she said.
The quiet that’s fallen over the county will likely stretch across the country in coming weeks. As emergency rooms try to clear out space for a coming spike in cases, local doctors and health authorities are essentially flying blind, relying upon epidemiological modeling rather than individual tests to map the true spread of the virus.
Over the past 10 days, the two small clinics serving the town of Eagle have seen more than 100 cases of flu-like symptoms that could match COVID-19, Dr. Corey Dobson of Eagle Valley Family Practice told TPM Thursday. He was worried that the United States is headed toward “where Italy was at” with the disease.
“The testing has been pretty difficult, so we’ve had to treat a lot of people kind of presuming they’re COVID-19 positive, without knowing 100%,” Dobson said. “Our state and county shortage on testing has been a real issue.”
“Eagle County has certainly had evidence of widespread community transmission,” Scott Bookman, the Colorado public health department’s incident commander for COVID-19 response, said in a conference call Thursday, adding: “They have a high rate of respiratory illness that is consistent with COVID-19, even if every case hasn’t been laboratory confirmed.”
For all the brewing trouble, local leaders have tried to put on a brave face.
Appearing in a video on Vail Health’s YouTube channel this week, Chris Lindley, an epidemiologist and the former director of Eagle County Public Health and Environment, was measured and purposeful.
“Things are really looking good, and we wanted to make sure — most importantly — folks remain calm,” Lindley said. “So while there’s a lot of information going around, we do know this virus will pass.”
The hospital had recently tapped a state reserve of personal protective equipment for doctors, giving it access to resources that have all but disappeared elsewhere around the country. By cancelling elective surgeries and ambulatory care, Lindley said in another video, the hospital had doubled its capacity in a matter of days.
But Cook, the hospital’s CEO struck a different tone in his op-ed Wednesday.
The 56-bed hospital could be “overflowing” in 2-4 weeks without “disciplined” social distancing, he said, and then “we will not have enough respirators to keep people alive, and locals of all ages will be dying.”
It’s not just Eagle County. Across Colorado, state health officials still don’t have a complete ventilator inventory; shortages of the crucial piece of equipment in Italy and elsewhere have forced doctors to make impossible decisions.
“The biggest problem could be strains on our rural health-care system,” Widlak, the county spokesperson, told TPM.
Smith Hymes, the Avon mayor, was more blunt.
“Once the tide hits us, no, I don’t think we’re prepared,” she said. “I don’t think anyone in this country is prepared.”
Unlike many large, urban COVID-19 hotspots, the outbreak in Eagle County is affecting small towns, some of which are home to service workers who, Avon said, sometimes don’t have internet access. On Friday, the mayor was preparing to distribute print-outs of Cook’s op-ed around a mobile home park in town. Other towns facing a surge in cases ought to get creative when it comes to informing residents, Smith Hymes said.
“Somehow, at the earliest possible opportunity, even if you have to use alarmist language, they have to get the message out any way they can about how serious the situation is,” she said.
Brueck, who was shoveling snow Friday morning when TPM reached him, was one of the lucky ones. His symptoms were gone two days before his test results came back, and he and his family’s quarantine ended Thursday, eight days after he felt healthy. He said he only knew of one other person in town with the disease, but that he assumed there was more to come.
“If I was contagious before I had symptoms, countless people would have been in contact with me,” he said. “Same with anyone else, you know? How do you know?”
“You can see how it could be an exponential bubble here, pretty soon.”