Public Health Weekly Updates

Good morning to all,


This week's update includes several environmental health items that may be of interest to readers. Also, ECPH debuts a "Public Health Pulse" column in this week's edition of The Ranchland News newspaper. This occasional column will focus on the role public health plays in promoting healthy lifestyles, researching disease and injury prevention, detecting, preventing and responding to infectious diseases, and much more.


Healthy Communities News


Veterans Can Now Receive Free Emergency Mental Healthcare

Last week the U.S. Department of Veterans Affairs announced that military veterans experiencing acute suicidal crises may now receive emergency mental care for free. The benefits include 30 days worth of inpatient care, 90 days of outpatient care, and help to get treatment and referrals after the emergency. This extends to both VA and non-VA health facilities. These benefits are available to veterans regardless of their VA enrollment. Veterans can also be connected to specialized help, by calling the Suicide and Crisis Lifeline by dialing 988 and then pressing 1. For more information, click here.


In a related note, the Behavioral Health Administration is offering a variety of engagement opportunities for stakeholders and the public to share insight, feedback, and recommendations as an integral part of the design and development of the Behavioral Health Administrative Service Organizations (BHASOs) Implementation Plan. Join the BHA for an online BHASO Community Forum on February 2 from 2:00 - 3:30 pm.


Health Benefits for Children and Pregnant Persons

HB22-1289, known as Health Benefits for Children and Pregnant Persons, or the "Cover All Coloradans" bill, expands health coverage to children and pregnant persons regardless of immigration status. The legislation is to improve health equity for pregnant persons and children in Colorado by making coverage more affordable, more broadly available, and investing in perinatal and postpartum care. The legislation also makes improvements to existing Health First Colorado (Colorado’s Medicaid program) and Child Health Plan Plus (CHP+) benefits for children and pregnant persons.


The following benefits went into effect on July 1, 2022:

  • An enhanced lactation benefit that provides electric breast pumps, related supplies, and lactation support from independent lactation consultants (in addition to those supervised by medical providers). 
  • Postpartum coverage is available for a full 12 months after the birth of the baby. These benefits are available for both Health First Colorado and CHP+. 
  • There is no longer a CHP+ enrollment fee for families participating in the program. This gets rid of financial barriers to enrollment and retention in CHP+ after the public health emergency ends. (Enrollment fees have been suspended during the public health emergency. The end date of the public health emergency is still unknown and will be decided by the federal government.)


Coverage expansions for children and pregnant persons eligible for Health First Colorado and CHP+ regardless of their immigration status begins January 1, 2025. For more information, please click here.



Environmental Health Updates


Colorado Passes New Water Reuse Rule – The First of its Kind Across the Nation

CDPHE has adopted updated drinking water standards to regulate water reuse. While water providers have long been able to use direct potable reuse, this rule requires water providers meet high standards for treatment, testing and community engagement. The rule is the first of its kind in the nation and will apply to all community water systems that pursue this pathway to meet their water supply needs. Directly reusing water for drinking will not be allowed without meeting these standards.


Direct potable reuse will require treatment with state-of-the-art multi-stage technologies to make treated wastewater safe for human consumption. Colorado communities have never been prohibited from implementing DPR projects, but no utilities have implemented DPR to date. Water providers across Colorado expressed their interest in being sure they could deploy reuse technology to ensure the availability of safe drinking water while facing population growth and water resource limitations. The department initiated an extensive stakeholder engagement process and established stringent standards to guide water providers if they choose to pursue this treatment method. In fall of 2022, the Water Quality Control Commission adopted the new rule into the state’s primary drinking water regulations. This new rule sets clear and protective standards to protect public health in the event that communities choose to use this treatment.


Under the rule, water systems must inform the public if they use DPR. This is the first time that a Colorado drinking water rule requires water systems to proactively notify the public about the use of a specific treatment technology and highlights the department’s commitment to transparency regarding water reuse. Across the nation, states are preparing to follow Colorado’s footsteps. Arizona, Texas, Florida, and California have published guidelines for DPR, but Colorado is the first state to implement a regulation. More information is available at Regulation 11 - Direct Potable Reuse.


Thoughts on the Controversy Over Gas Stoves 

In recent weeks, the topic of gas stoves leaking dangerous pollutants in people's homes has caught national attention. The U.S. Consumer Product Safety Commission is considering regulating gas stoves. Public health experts and environmentalists have long warned of the risks of gas ranges. One study found that indoor gas stoves were responsible for roughly 13% of childhood asthma cases in the U.S. The American Public Health Association and the American Medical Association have urged consumers to transition away from gas.


It is important to note that any type of cooking, from boiling water to frying food, will produce some amount of indoor air pollution. One of the most serious pollutants is particulate matter (fine particles), which is generated by cooking food and heating oil on all types of stoves. Cooking with gas produces harmful combustion products like nitrogen dioxide and carbon monoxide, and both gas stoves and electric stove burners generate ultrafine particles. These cooking-related pollutants are linked to health impacts, including respiratory problems and cardiovascular disease, and some people—including children, older adults, people with underlying conditions, and people who have been socially and economically disadvantaged—are at increased risk of harm from exposure.


Fortunately, addressing this widespread problem does not require people to stop cooking indoors, or even to decrease the frequency. It does, however, require attention to factors like stove type, cooking methods, and perhaps most importantly, ventilation. To some extent, all these factors are determined by individual choices and behaviors, but they also are driven by jurisdictions that adopt policies around how homes are designed, constructed, and maintained—especially when it comes to ventilation.


Kitchen exhaust systems like range hoods are key to preventing cooking-related pollutants from mixing with the rest of the indoor air and accumulating to unhealthy levels in homes, especially in smaller dwellings such as apartments, where there is less indoor air volume to dilute the pollutant concentrations. Yet, despite the importance of ventilation to public health, new houses and apartments are still being built without adequate kitchen exhaust systems installed. Reducing cooking pollutant exposure in existing homes is no less important than in new construction, and there are opportunities to improve kitchen ventilation in the existing housing stock.

In his weekly commentary, Jonathan Samet, M.D., M.S., and Dean of the Colorado School of Public Health, shared his perspectives on this topic:


Controversy continues about air pollution; now, indoor air pollution by nitrogen dioxide emitted by gas stoves. This is not a new problem. It first received attention in the 1970s and 1980s, and in 1993, I reported the findings of a large prospective study of nitrogen dioxide exposure and respiratory illness during the first 18 months of life. Last week, the American Public Health Association released a policy statement released a policy statement entitled: “Gas Stove Emissions Are a Public Health Concern: Exposure to Indoor Nitrogen Dioxide Increases Risk of Illness in Children, Older Adults, and People with Underlying Health Conditions.” The statement reviews some of the relevant scientific evidence and reports. It offers 13 recommendations. The statement calls for indoor air quality guidelines to be set by the Environmental Protection Agency, although it has no regulatory jurisdiction over indoor quality. For example, the EPA offers its action level concentration for indoor radon, but there is not a pathway for federal enforcement. Mitigation of radon levels above the action level is left to homeowners. Testing is mandated at real estate transactions in some jurisdictions. Guidelines for indoor air pollution are available from the World Health Organization, which published guidelines for selected indoor pollutants, including nitrogen dioxide, in 2010


Follow these tips to protect yourself if you use a gas stove:

  • Turn on the range hood above your stove. 
  • Open a window to improve ventilation
  • If you can't replace your stove, get an induction hot plate.


CDPHE Asks for Feedback On System to Share Concerns About Pollution

CDPHE is seeking feedback on a system designed to provide Coloradans with a centralized place to share their concerns about environmental pollution. The complaint system will be available in English and Spanish, but complaints can be submitted in any language. The department’s environmental justice ombudsman oversees the system and focuses on concerns raised by individuals living in communities that carry a heavier burden of pollution. Community members can express their concerns about air and water pollution, illegal dumping, and a wide variety of other environmental and public health issues. Individuals can fill out an online form, or email, mail, or call the ombudsman at (303) 549-9988 to voice their concerns.


The ombudsperson serves in an independent capacity, and works with the appropriate environmental and technical staff at CDPHE to find possible solutions. Because the ombudsperson receives information about a wide variety of issues, it will help identify community patterns and facilitate systemic solutions. 


This is the first prototype of the complaint system. CDPHE is in the process of soliciting public comment on the system through March 24, 2023. Comments can be emailed to The system will be fully launched in mid-April after incorporating feedback from the public and the Environmental Justice Advisory Board. Visit this webpage for more information on this new program or how to submit a complaint. 



Communicable Diseases Updates


Updates on COVID-19 Infections

U.S. Food and Drug Administration health officials want to simplify the recommended COVID-19 vaccine protocol, making it more like the process for annual flu shots. The FDA is suggesting a single annual shot. The formulation would be selected in June targeting the most threatening COVID-19 strains, and then people could get a shot in the fall when people begin spending more time indoors and exposure increases. Some people, such as those who are older or immunocompromised, may need more than one dose. A national advisory committee is expected to vote on the proposal at a meeting today.


U.S. residents have been much less likely to get an updated COVID-19 booster shot, compared to widespread uptake of the primary vaccine series. In its proposal, the FDA indicated it hoped a single annual shot would overcome challenges created by the complexity of the process — both in messaging and administration — attributed to that low booster rate. Nine in 10 people age 12 or older got the primary vaccine series in the U.S., but only 15% got the latest booster shot for COVID-19. According to CDC data, about half of children and adults in the U.S. get an annual flu shot. The FDA also wants to move to a single COVID-19 vaccine formulation that would be used for primary vaccine series and for booster shots. ECPH will continue to follow this discussion and share updated recommendations as they are available from trusted sources.


In Elbert County our two-week average positivity currently stands at 9.09%, while our one-week average positivity has jumped to 16.22%. These increases over previous weeks should be interpreted with caution, however, as the volume of tests is very low and therefore allows for significant variability in the measures. The statewide one-week positivity rate is 7.6%. There are just 6 reported cases of infection over the past week. There are three new hospitalizations to report:

  • a female in her 80s
  • a female in her 70s, and
  • a male in his 40s.


Updates on Influenza

CDC's FLUVIEW, the Weekly U.S. Influenza Surveillance Report, can be accessed by clicking here.


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Dwayne Smith, MEd, MCHES®, CPST

Director, Elbert County Public Health

75 Ute Avenue

Kiowa, CO 80117

(303) 621-3202