Remember to Wear Face Coverings and Maintain Social Distancing

COVID-19 Epidemiology

At Denver Health, COVID-19 hospitalization numbers have been stable to slightly increased over the past week. We have a total of 9 patients - 5 on general medicine, 4 in the ICU (4 vented).

Source: Irving Luna, Facilities

Our laboratory positivity rate among those tested is 2%, which is stable over this past week

Source: Jenna Culp, Laboratory

Denver Cases:

As of Sep 15, there have been 11,946 confirmed cases of COVID-19 in Denver, including 437 deaths. Community case rates saw a small uptick this week. After an increase to 153 cases/day on July 27 from a low of 30 cases/day on June 11, we are at 58.3 cases/day (7 day moving average) which is higher than what I reported last week. https://storymaps.arcgis.com/stories/50dbb5e7dfb6495292b71b7d8df56d0a

Colorado Cases:

There have been 62,099 confirmed cases of COVID-19 in Colorado, including 1,996 deaths among those patients. New cases saw a small uptick over the past 3 days. Hospitalizations across the state remained stable at 139 as of Sep 15, which is near our nadir (lowest rate) of 127 on June 27. Highest activity (per 100,000 persons) in the past week is in Northeastern CO and in the Boulder area. https://covid19.colorado.gov/covid-19-data

US Cases:

There have been 6,537,627 confirmed cases of COVID-19 in the U.S., including 194,092 deaths. Over the past week, there have been an average of 38,211 cases per day, a decrease of 10 percent from the average two weeks earlier.. https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html

Worldwide:

Globally there have been 29,155,581 confirmed cases of COVID-19, including 926,544 deaths reported to the World Health Organization (WHO). In the week from September 7 through 13, there were over 1.8 million new cases of COVID-19, comparable to the previous seven days; while deaths increased slightly as compared to the previous week, with over 40 600 deaths reported. The Americas continue to record the greatest number of reported cases for many weeks, accounting for nearly half of the global total of cases even as cases have declined in the reporting week. https://covid19.who.int/

PPE Supply Updates

Nitrile gloves continue to be in balance where our weekly use is just below to our purchases. Disposable isolation gown usage has dropped in the last week to under 300 per day. Our current stock on hand equates to almost 6 months of current usage. Almost all our usage is now on the reusable Image First laundered gowns. All N95 respirators continue show good stock levels and we are receiving products at our allocation level or have equivalents on site. We also have significant quantities of approved alternates on most. We received a delivery of the 3M 9205+, the U.S. manufactured equivalent to the 3M 1870+ mask. On Friday we sent a quantity to COSH and we’ll announce on the safety call when people can start fit testing to the new one. We continue to see an increase in issues of the regular duckbill, this is the only mask where our usage is outstripping our regular weekly purchase allocation, and has been for the last few weeks. However, that usage over allocation has dropped significantly in the last week. We have another 6,000 masks above and beyond our regular order delivered late last week. That extra amount is around two months of stock at current usage and will show on our on-hand numbers early next week. We have been able to maintain a supply of our regular Halyard procedure mask and now have over 225,000 on hand and have been stockpiling alternate, approved masks. We are currently using just over 75% of our weekly allocation of the Halyard mask, which allowed us to add about 15,000 to our back up stock last week. Stock on hand today is about 80 days’ worth. Last week we were able to negotiate an increase in our weekly allowance of purple top wipes in anticipation of using more as we roll out the recommendation for patient-facing staff to wear face shield and clean them with these wipes. Usage has increased slightly over the last two weeks, but only to a level where we are using less than a third of our new weekly allocation. With the additional supply of 1,000 cases from two weeks ago we now have eleven weeks of stock on hand.

Source: Stuart Layhe, Materials Management

Source: Michael Moore, Administrative Director

Stay Vigilant with Social Distancing During Meals & Breaks

COVID-19 is still present – and so are public health mandates that require social distancing in the cafeteria, break rooms, and off campus. Please continue to keep six feet of distance from others and limit the size of groups.

· Do not slide tables together or pull additional chairs close together around a table or booth.

· Sit at least six feet apart from others

· Masks must always be worn when not eating or drinking and when moving through the dining area.

· Food should be packaged and wrapped for an individual. Avoid shared items and family style orders

Get Vaccinated: Flu Clinics Have Begun
Denver Health's employee flu clinics began Monday. Clinics are being held around the main campus through October 23. Click here for the schedule. This year, pre-registration is required. Flu vaccination is mandatory for all Denver Health personnel, even those who work from home. The deadline is Monday, November 2.

If you prefer to receive your vaccination somewhere else, first pre-register and then submit an off-site documentation form by Friday, October 16.

Staff members declining vaccination due to medical reasons are required to first pre-register and then submit a medical exemption form by Friday, October 16. Employees opting out for religious reasons must also pre-register and then submit a religious exemption form by Friday, October 16.

Find clinic schedules, guidelines, deadlines, contact information, answers to frequently asked questions, and more on the Employee Flu Subsite.

COVID-19 Treatment Guidance and Clinical Trial Availability

Denver Health COVID-19 Treatment Guidance has been updated.

Denver Health also is participating in numerous clinical trials for COVID-19. If patients are not eligible for clinical trials or decline to participate, the guidance includes treatment options for consideration based on clinical criteria.

Treatment guidance can also be found on the Antimicrobial Stewardship app (antibiotics.dhha.org).

Other Policy Reminders

Universal Masking

Remember that the universal masking policy applies to all staff, patients and visitors across all Denver Health locations. This includes while in hallways and transporting patients.

· Clinical staff members are required to wear at all times a mask or a respirator that is appropriate to their environment of care. See the details here.

· Non-clinical staff members are required to wear a face covering when within entering or moving around indoor spaces and when within 6 feet of another person. Learn more here.

· Patients and visitors are also required to wear a mask or a face covering. Supplies are available at hospital entrances.

Hand Hygiene

· All employees and contractors who have direct patient contact must follow the Hand Hygiene Policy.

· Wash your hands frequently with soap and water for at least 20 seconds or use hand sanitizer provided by Denver Health.

Social Distancing

Social distancing is critical to reduce the risk of transmission. It’s also important that we lead by example. Remember to stay at least six feet away from others unless it’s required for patient care while using appropriate PPE. Staying six feet away also means skipping the handshake.

Infection Prevention Best Practice Quick Reference

COVID-19:

· N95 Mask Options and Mask Labeling

· PPE Algorithm

· Donning and Doffing Instructions

· Specialized Respiratory Isolation

· Other Personal Protective Equipment (PPE) Questions

· Centers for Disease Control (CDC) and Colorado Department of Public Health & Environment (CDPHE) Resources

Policies:

· Hand Hygiene

· Standard Precautions

· Isolation/Transmission-based Precautions

Quick Videos:

· World Health Organization (WHO): How to wash hands with soap and water

· WHO: How to wash hands with alcohol-based hand sanitizer

Denver Health Coronavirus Resources:

· Denver Health External Website for Staff

· Denver Health Pulse Subsite

· RISE Virtual Group Support

· Weekly Mindfulness WebEx

Helpful Links:

· Colorado Department of Public Health and Environment Coronavirus Information

· Denver Department of Public Health and Environment Coronavirus Information

· Centers for Disease Control and Prevention Coronavirus Information

· Denver Public Health Website

Thank you for everything you do for Denver Health!

Connie Savor Price, MD
Chief Medical Officer
Denver Health and Hospital
Professor of Medicine

Division of Infectious Diseases
University of Colorado School of Medicine

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