The coronavirus outbreak is expected to significantly hit Southwest Colorado in coming weeks, but health officials say the severity of the surge will be determined by how well residents have followed social-distancing guidelines.

While some parts of the country, like New York City and along the Front Range near Denver, have experienced a spike in positive coronavirus cases and deaths, Southwest Colorado, for the most part, has been behind the curve – a result of a lack of testing and relative geographic isolation.

As of Tuesday night, La Plata County had 35 positive cases and Archuleta County had six positive cases, with no reported deaths. However, local health officials say the number of confirmed cases and the absence of fatalities are likely low because of a shortage in test kits.

Still, hospitals in the region are bracing for a peak in confirmed cases, and resulting hospitalizations, expected to surge around April 24, said Mercy Regional Medical Center interim CEO Mike Murphy.

Pinpointing when a surge in coronavirus cases might happen is an extremely difficult task, Murphy said, with many moving parts. Have people stayed at home? How much is the virus being transmitted in the community?

All these hard-to-answer questions factor in to when a surge will hit, and how severe it will be, Murphy said.

Health experts say the curve should have started to flatten after social-distancing measures were put in place, such as closing ski resorts, schools and some businesses, and asking people to leave the house only for essential needs.

But there is a 14-day lag between when those measures were put in place and when coronavirus symptoms typically surface. It will take some time to know if those social-distancing measures are able to flatten the curve and spread out the cases to lessen any “peak,” Murphy said.

“Statewide and on the Front Range, we’re starting to see some positive indications the curve is flattening,” Murphy said. “But locally, we should see in the next week whether we are flattening the curve.”

Health officials and hospitals in the region, however, are preparing for worst-case scenarios.

In the most extreme outbreak, models have predicted as much as 70% of the population would catch the virus, with 20% of those infected requiring hospitalization, said Liane Jollon, director of San Juan Basin Public Health, which serves Archuleta and La Plata counties.

In the two-county region, with a population of about 115,000 residents, that would mean 10,000 to 15,000 people would require hospitalization in a one- to two-week timespan.

Hospitals, preparing for this kind of outbreak, have added more beds where possible. In the two-county region, which typically has about 100 available beds, health care providers have been able to double that number.

Murphy, for instance, said Mercy has the capability to jump from 82 beds to about 160 beds. And, he said the hospital has enough supplies to handle a surge, though he would not say how many ventilators Mercy has despite repeated inquiries.

“I can’t confirm the actual number, but we have an adequate supply today and can increase that supply if needed to meet a potential surge, through Centura Health,” he said.

Jollon said throughout the three main health care facilities – Mercy, Animas Surgical Hospital and Pagosa Springs Medical Center – and other local care facilities, there are fewer than 20 ventilators in the two-county region. But, she said that number could increase to about 45 ventilators in an emergency situation.

Calls to Joe Theine, CEO of Animas Surgical Hospital, were not returned Tuesday.

Even with preparations in place, the region’s health care facilities would be vastly overwhelmed beyond capacity if those worst-case predictions manifest, Jollon said.

And that, Jollon said, would kick off an emergency response, much like a wildfire, that would bring in outside resources, such as volunteer medical workers and alternate care sites, from the state and federal government to help with the crisis.

“It would be a staged effort,” she said.

However, if people properly practice social distancing, Jollon said the infection rate would fall to 30% to 40% of residents, with only 5% requiring hospitalization, or about 1,750 people.

And, the disease would spread over a longer period of time, which would ease the strain on hospitals.

“And that’s why we’re all pushing for people to stay at home and only going out for essential activities,” Jollon said.

But there’s also another factor to consider: whether residents from northern New Mexico would come to Colorado for care, or vice versa.

“We have to factor in New Mexico,” Murphy said. “But that’s even more challenging.”

Brad Greenberg, an emergency physician and medical director for San Juan Regional Medical Center in Farmington, said the facility has been preparing since January for a possible coronavirus outbreak.

San Juan Regional Medical Center is already the Four Corners’ largest hospital, Greenberg said, with a capacity for 194 beds. But, he said the facility is looking to increase that number to more than 250 beds, and possibly open a temporary medical station if need be.

Greenberg could not immediately provide estimates of what an expected surge could bring in the coming weeks for San Juan County, including parts of the Navajo Nation, citing unreliable prediction models.

“There’s a lot of uncertainty,” he said. “But we keep hearing get ready, and we keep hearing it’s going to be very challenging.”

Greenberg believes there is fluidity between Southwest Colorado and northern New Mexico residents seeking care in the other state. He said SJRMC has been in constant talks with health officials to the north.

“We’re clearly all in the same boat,” he said.

At this point, Jollon said, health experts are working off models with a dizzying array of variables about a new virus that has been studied for only about 90 days.

“I want to stress that we can’t point to a model and think this is going to tell us exactly what will happen,” she said.

One major data gap is that SJBPH doesn’t know the total number of tests that have been conducted in the two-county region.

Hospitals are required to report only positive cases, and despite requests of SJBPH to report total number of tests completed, local health care facilities have not disclosed those numbers.

Mercy, for instance, has repeatedly declined The Durango Herald’s requests for those numbers. Murphy also did not answer questions about total number of COVID-19 tests performed, despite repeated attempts.

“Our models don’t have enough data to unequivocally say which model is the right model,” Jollon said. “Models are reliant on accurate diagnostic data, and we don’t have it. Therefore, we’re doing the best we can with the information we have.”

The local health department announced Monday it launched an online “COVID-19 symptom tracking survey,” in which residents can report if they are experiencing fever, dry cough or shortness of breath. The survey can be found at: www.sjbpublichealth.org/coronavirus.

But, with widespread community testing, health officials would be able to find out what populations the virus is most affecting. Jollon said the health department is constantly advocating for more tests, and looking at ways to collaborate with partners.

“Until we get wider numbers of tests, it’s hard to extrapolate the burden of the disease on our community,” she said. “We’re in such a holding pattern.”

This story was updated to correct the number of ventilators in the region. Incorrect information was given to The Durango Herald.

jromeo@durangoherald.com