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Montezuma County has moved to the more severe Level Orange on the Colorado Department of Public Health and Environment COVID-19 risk assessment dial.

The decision is the result of a steady increase in new cases in recent weeks, and triggers additional guidelines from the state to reduce the rate.

Level Orange indicates more action is needed to prevent the spread of the virus, but a Stay at Home order may not be needed.

Under Orange, personal gatherings are limited to 10 people and personal services, retail and restaurants are capped at 25% capacity, as are houses of worship.

Outdoor events are capped at 75 people, indoor events are capped at 50. Gyms are allowed to operate in person, with a 25-person maximum. Under Orange, no new variances are granted by CDPHE.

Under the previous Level Yellow status, personal services and retail stores could go to 50% capacity, and restaurants and houses of worship could host up to 100 people. Also under Yellow, outdoor events are capped at 175 people; indoor events, at 100.

As of Nov. 16, Montezuma County reported a total of 449 cases and four deaths due to COVID-19, up from 318 cases on Nov. 9, a 41% increase. There were 231 active cases and 212 recovered cases. Total negative tests have grown to 8,364.

The positivity rate for COVID-19 testing in Montezuma County was at 10.5% Monday, and the total positive cases per 100,000 people was at 745, an increase that put Montezuma County at Level Orange. On the brighter side, COVID hospitalizations have been low on the risk scale, Level Green, with no more than two new hospitalizations per day reported in the last two weeks in Montezuma County.

The Cortez City Council passed a resolution last week strongly encouraging mask wearing in public places after the Montezuma County Health Department and Southwest Memorial Hospital expressed concern about the rapid spread of COVID-19.

Officials worry that a rise in the number of cases could put the county at Level Red, which includes a “stay at home” restriction.

“All of the above numbers indicate a very concerning trend for the county and Southwest Health System,” Tony Sudduth, chief executive officer of Southwest Memorial Hospital, said in an email.

Level Red includes a positivity rate greater than 15%, more than two COVID-19 admissions in a single day over the past two weeks, and 350-plus cases per 100,000 people, Sudduth said.

Before the jump to Level Orange, Bobbi Lock, director of the Montezuma County Public Health department, warned that, based on rising numbers, the CDPHE would likely enact stricter health regulations for the county during a meeting with the Mancos School Board Nov. 9.

Wearing a mask in public is a “small sacrifice to keep the economy going, keep our kids in school and reduce the number of outbreaks,” Mayor Pro-tem Rachel Medina said during the council meeting.

Southwest Health Systems pharmacist and infection control manager Marc Meyer said the hospital was concerned about employees contracting COVID-19.

If the hospital has four or five employees forced to quarantine, a department within the health care system in the county could be nonoperational, he said.

Wearing a mask to slow the spread of the COVID-19 pandemic is a “small thing you can do” to help limited local health care resources, Councilor Arlina Yazzie said.

Southwest Memorial is set up to treat mild cases of COVID-19, but patients who need long-term care are flown to Grand Junction or the Front Range.

If beds at the hospital are taken up by COVID-19 patients, the hospital is less able to provide medical services to someone in a car crash or with broken bones in the emergency room. Those patients are then flown to other hospitals, said Kerri White-Singleton, chief operating officer of the Southwest Medical Group.

Southwest Memorial was at 50% capacity on Nov. 10, but “this changes rapidly, and we could very easily be full by the end of the day and we move patients in and out,” Sudduth said.

“For most of last week we were completely full in all areas of the hospital,” Sudduth said. Over the week of Nov. 2 to Nov. 9, the hospital averaged four to five COVID-19 inpatients per day.

Despite the rapidly rising numbers, there is still pushback within the community on wearing masks.

Allen Maez, chair of the Montezuma County Republicans, said during the comment section of the council meeting that a mask mandate was “not necessary.”

City attorney Mike Green said the council’s strong recommendation to wear masks was not mandatory, and there was not a punishable enforcement of the resolution. But wearing masks will help reduce the spread of COVID-19 in the community and avoid another stay-at-home order, he said.

Also on Nov. 9, more than 120 people used the drive-thru testing site at Southwest Memorial Hospital – the most people the hospital has tested in a day.

For the week of Nov. 2 to Nov. 9, health officials reported 70 new positive cases, representing a positive-test rate of 16%, said Kent Aiken, Southwest Memorial Hospital’s chief of medicine and a physician with the county health department.

Kerri White-Singleton, chief operating officer of the Southwest Medical Group, said Monday that the hospital has seen an increase in the number of COVID-19 patients that show up in the emergency room and require hospitalization.

Aiken and White-Singleton spoke at the Mancos school board meeting. The board decided to keep in-person learning instead of moving online, like Montezuma-Cortez schools.

White-Singleton also warned about the possible loss of hospital services during a coronavirus surge.

If hospital beds are taken up by COVID-19 patients, the hospital is less able to provide medical services to someone in a car crash or with broken bones. Those patients are then flown to other hospitals, she said.

Lindsay Roth of the Montezuma County Public Health Department Public said 90% of the new cases are now “very symptomatic.”

“It’s hitting people hard,” she said.

Journal reporter Jim Mimiaga contributed to this article.ehayes@the-journal.com