Nine individuals in Aspen tested “presumptive positive” for coronavirus, or COVID-19, on Wednesday, making Aspen the site of the state’s largest outbreak cluster, Colorado Department of Public Health and Environment officials said Wednesday.

Test results for one last person still in isolation were pending Wednesday afternoon.

“Pitkin County Incident Management Team is in contact with those who tested presumptively positive, as well as the local properties impacted,” according to a news release. “Systems are in place to address the needs of the affected individuals.”

All told, 13 people were in state-ordered isolation in Aspen at various locations Wednesday, including The Little Nell hotel.

In addition to the presumptive positive tests, county health officials Wednesday sent or planned to send more samples from other people in the Aspen area to the state health department lab in Denver, said Suzuho Shimasaki, Pitkin County deputy public health director.

Officials have said repeatedly that tests will be performed only on samples from people with symptoms that mirror COVID-19 because the state can only perform 160 tests per day. Two samples collected at Aspen Valley Hospital were sent to Denver on Wednesday night, while 11 more collected at an off-site testing center Wednesday will be sent in the near future, Shimasaki said.

Aspen Skiing Co. spokesman Jeff Hanle said Skico officials were informed by the CDPHE on Wednesday that a guest in The Little Nell has tested presumptive positive for the coronavirus.

Hanle said the state health department didn’t specifically notify Skico of the test result of the other person in the hotel room, but the presumption is that person was exposed to the virus, as well.

Skico will rely on officials from the Center for Disease Control and Prevention to determine how long the couple will remain in quarantine and isolation.

“The CDC was here today and were in the hotel,” Hanle said.

Meanwhile, the couple is being fed by placing food outside their room. The food is served in disposable containers.

Members of the Incident Management Team would not disclose the locations of the remaining individuals in isolation.

CDPHE officials have ordered three individuals who refused to be tested held in isolation until March 18 when they will have to pass two consecutive tests certifying they are free of the virus, according to Pitkin County Public Health Director Karen Koenemann.

The three who exhibited symptoms of COVID-19 did not give a reason why they refused the tests, officials said.

All 13 are Australians who visited Aspen recently with a 21-year-old fellow Australian woman who tested positive for COVID-19 when she returned home, according to state and local public health officials.

The samples from those who already tested “presumptive positive” will be sent to the CDC in Atlanta, where they will be tested again to confirm the diagnosis. Shimasaki said she wasn’t sure if those samples had been forwarded yet to Atlanta, and didn’t know the timeframe to expect results back once they’re received.

She also didn’t have information about the exact conditions of the nine people in Aspen who tested positive, though spokeswoman Tracy Trulove said no one has yet been hospitalized.

Koenemann said while all the cases are different, the people who have tested positive will remain in isolation through next week.

She said she did not know the Aspen travel dates of the Australian group, some of whom are family members.

CDPHE’s standard protocol is that individuals who test positive must remain in isolation 14 days past their date of exposure.

CDPHE confirmed early Wednesday afternoon that one victim is a female in her 20s, another is a male in his 50s, and a third is a female in her 60s. The press release cited “travel, close contact with individuals” as the reasons for their exposure to the disease.

A total of 18 people were traveling with the Australian woman. Five did not exhibit any symptoms and were not tested or placed in isolation.

Koenemann said the nine individuals who tested positive are cooperating, and health officials are in touch with them via phone to monitor their health and well-being.

She added that officials were not concerned about any of them leaving self-isolation because they understand the severity of what is happening worldwide; the World Health Organization classified it as a global pandemic Wednesday.

“They can self-monitor by taking their temperature and reporting on symptoms,” she said during a media briefing Wednesday. “These are folks that are right now in our community that are sick and away from home, and it’s got to be a little stressful emotionally and just in general for them, so we’re trying to take a really compassionate approach to making their stay as comfortable as possible and so we’re going to do everything we can to support them.”

Still, state and local officials can rely on a statute that mandates individuals must remain in isolation or quarantine. If they don’t, an action can be filed in district court to enforce the orders aimed at protecting public health.

In addition to being in contact with those in isolation in Aspen, authorities are in contact with local properties where they are staying, the news release states.

“The property managers have been given information on how to protect themselves and proper cleaning procedures to prevent the spread of coronavirus,” the release reads.

Isolation separates sick people who have a communicable disease from those who are healthy. It also restricts the movement of those people to help stop the spread of certain diseases.

Quarantine is used to separate and restrict the movement of healthy people who may have been exposed to a communicable disease to see if they become ill. These people may have been exposed to a disease and do not know it, or they may have the disease but do not show symptoms.

No quarantines have been issued in Aspen — only isolations.

Pitkin County Public Health has established a local hotline at 970-429-6186 to screen people who think they might meet the criteria for COVID-19 testing. It is staffed with a live human from 8 a.m. to 8 p.m. seven days a week.

A remote location to take swabs for the testing, which is done in Denver, is being employed so as to not disrupt the operations of Aspen Valley Hospital, said Gabe Muething, Aspen Ambulance director.

Trulove said the incident management team was working on getting more resources to Aspen.

CDPHE Executive Director Jill Ryan will be in Aspen on Friday to meet with elected officials and others involved in the virus response, Shimashaki said.

Koenemann said the CDPHE’s website indicates its capacity is 160 tests per day but that’s been increased, and private companies also are offering tests.

Those who are most vulnerable to the virus, which has no vaccine yet, are people over 60 years old and with health issues like compromised immune systems.

To protect local seniors, Pitkin County Senior Services will temporarily suspend all group operations beginning Thursday morning, said Pitkin County Manager Jon Peacock. The senior meal program will continue as before, he said. Seniors with questions can call 970-925-5432.

Pitkin County Sheriff Joe DiSalvo also said he is taking precautions to keep his deputies safe. That includes not sending deputies on ambulance calls, which is the standard operating procedure, and taking reports for minor crimes like theft over the phone, he said.

At a briefing Wednesday at the Pitkin County commissioners meeting, Commissioner Kelly McNicholas Kury said she’s been repeatedly asked by people why information about the Australians and their whereabouts in Aspen has not been released.

Shimasaki said the virus is easily killed through cleaning, is transmitted by droplets on surfaces or directly on people and is not airborne, so that community cleaning standards can easily take care of it. And just because someone might have been in the same building or public bus as someone with COVID-19 doesn’t mean they were exposed, she said.

For example, people within 6 feet of an infected person who sneezes or coughs could possibly be exposed to the virus, Shimasaki said. Others in the vicinity would not be exposed unless they touched a surface with virus droplets, she said.

The Australians’ names have not been released to protect their privacy, Muething said.

Commissioner George Newman asked about the H1N1 virus in 2009, the last declared pandemic, and how it compared to this outbreak.

Muething said there’s much more coordination between local, state and federal authorities this time. In addition, officials learned a few things from the last outbreak, including the fact that closing schools may not be the best course of action, Shimasaki said.

That’s because closing schools doesn’t mean students won’t congregate with each other, she said. Schools can be a safer environment because they can be thoroughly cleaned and monitored, Shimasaki said.

Department heads in the city of Aspen government met Tuesday and discussed internal plans for employees to work remotely, as well as contemplating how to handle public events locally.

Aspen City Manager Sara Ott told City Council on Tuesday that she will follow CDC guidance concerning public events.

She also said she and Mayor Torre have the ability to do a declaration of emergency if needs are more than what local resources are available, in terms of money and manpower.

That declaration is good for 48 hours, then council would have to vote to extend it, per the home rule charter.

Councilman Ward Hauenstein said he trusts the local incident management team and asks everyone to remain calm.

“I just don’t want the public to panic if we start talking emergency,” he said.

Reporter Scott Condon contributed to this report. jauslander@aspentimes.com, csackariason@aspentimes.com