COVID safety-certified businesses in Colorado try to win back leery patrons

GRAND JUNCTION, Colo. — On a sunny Saturday, Ruth Hatfield was sitting with a friend’s dog on a sidewalk bench in downtown Grand Junction.

Back home in Snowmass Village, 120 miles away through winding Rocky Mountain roadways, officials had just shut down indoor restaurant dining as the number of coronavirus cases reached some of the highest levels in Colorado.

In Grand Junction, though, restaurants were open. And Hatfield had sought out those with the health department’s “5-star certifications,” a designation meant to reassure people it is safe to patronize businesses during the pandemic. Those restaurants are part of an innovative program that allows businesses that agree to follow certain public health protocols to be open with less stringent rules than would ordinarily apply.

At a time when officials in parts of the nation are facing backlash from business owners who have been hurt by covid restrictions, Mesa County’s 5-star program encourages them to work with the health department to promote the directives.

Whether the approach ends up boosting compliance with health directives, this largely rural county of 154,000 people on the Utah border is divided about COVID-19 protocols, with many still skeptical of wearing face coverings.

Hatfield recalled a recent visit to a 5-star certified restaurant in Grand Junction where a party of four ignored a host’s request that they wear masks while waiting to be seated.

“I’m impressed with the 5-star program, but I’m not impressed with the level of mask-wearing here,” she said.

Mesa County public health director Jeff Kuhr and Diane Schwenke, president of the Grand Junction Area Chamber of Commerce, came up with the idea for the 5-star program in June.

“It is a way of encouraging [businesses] to do the right thing, that they could then use as a marketing tool,” Schwenke said.

Interested business operators fill out a form, and the health department sends them a list of program requirements, which include mask enforcement for employees and customers, regular cleaning schedules, hand-sanitizing stations and spacing of furniture.

The program was launched in July with about 100 businesses, including restaurants, gyms and bars. It has grown to include about 600.

Colorado Department of Public Health and Environment officials were so pleased with the Mesa County program that they unveiled a statewide version in December, with Douglas County the first in the Denver metro area to be approved. Officials in Utah, Michigan and Canada also have expressed interest.

“This whole event is about juggling viral suppression” while preventing economic devastation and the upheaval it brings to families and communities, said Jill Hunsaker Ryan, executive director of the state health department.

The program has helped keep restaurants open despite rising COVID numbers, but state officials are still analyzing whether it helps reduce spread of the virus, Hunsaker Ryan said.

In practice, public health isn’t just about medicine. It’s about politics, too, said Kirsten Bibbins-Domingo, professor and chair of the Department of Epidemiology and Biostatistics at the University of California-San Francisco. Though COVID health directives at time have pitted business owners against public health officials, the 5-star program aims to unite the two.

“Ultimately, you have to deal with compliance not just with the hard hand of enforcement but also with strategies that engage people in the goals of public health,” Bibbins-Domingo said.

Because participation in the program provides the opportunity to operate with looser restrictions on capacity and hours, businesses have an incentive to comply “even if they don’t think that the coronavirus exists — and we still have people here who believe that,” said Bill Hilty, medical director of the emergency department at St. Mary’s Hospital in Grand Junction.

“The program doesn’t impugn people who didn’t believe in covid or in masks,” Hilty said. “Their freedom was not infringed.”

Any business is eligible for the program, but it is especially appealing to gyms, restaurants and bars, which face restrictions on capacity and, in some cases, hours. For instance, Mesa County’s restaurant capacity limit under current COVID rules is 25%, but eating establishments in the 5-star program are allowed up to 50% capacity. Schwenke estimated that at least half of the county’s restaurants have signed on.

The program has “absolutely saved us,” said Josh Niernberg, executive chef and owner of restaurants Bin 707 Foodbar, Taco Party and Bin Burger in Grand Junction.

Even so, Niernberg has mixed feelings. The program allowed his businesses to remain open, but support in enforcing the rules has been minimal, he said.

Niernberg worries about the risk to his employees, who face “a daily struggle with anti-maskers” who visit his restaurants and demand to know why they’re being asked to wear a mask when establishments not in the program don’t require them.

Even with the 5-star program, Bin 707 is operating at about a 20% loss each week, he said. Mesa County’s 5-star restaurants are allowed 50% occupancy, but they’re also required to have six feet between tables. That spacing allows just 22% occupancy at Bin 707, Niernberg said.

In Mesa County, compliance is enforced by the honor system, reports from the public and occasional compliance checks by health department employees. About 10 establishments have been booted from the program for noncompliance.

Kuhr said his department does not release the names of businesses that have left the program.

Loosening rules imposed to slow COVID might seem like a bad idea, but, if the 5-star program can produce better compliance with public health rules, it might be a good strategy for slowing the coronavirus, Bibbins-Domingo said.

“I don’t want to dismiss the strategy because buy-in is the holy grail in public health communication,” she said.

Still, when cases and community spread reach critical levels, as they did recently in Colorado and across the United States, then at some point there’s a faulty logic to keeping businesses open, even with restricted hours, which might not do much to slow transmission. Density, on the other hand, “is very clearly related to transmission, so it’s the one thing I’d be very loath to ease up on,” Bibbins-Domingo said.

Whether the 5-star program would nudge businesses to accept health directives or would simply be used as license to open was something considered as the program was coming together.

“We discussed this early on — who’s going to use this as a loophole and then not require masks,” Schwenke said. “We were worried about that initially, but the interesting thing is that this has seemed rare.”

KHN (Kaiser Health News) is an editorially independent, nonprofit news service covering health issues.