Remember to Wear Face Coverings and Maintain Social Distancing

COVID-19 Epidemiology

At Denver Health, hospitalized COVID-19 patients in isolation have been stable over the past week. We have a total of 19 patients - 12 on general medicine, 7 in the ICU (5 vented).

Denver Cases:

As of today, there have been 15,102 confirmed cases of COVID-19 in Denver, including 449 deaths. Community case rates have increased this past week. After an increase to 112.7 cases/day on July 27 from a low of 31.1 cases/day on June 15, we have increased again to a new peak of 143.0 cases/day (7 day moving average) which is higher than what I reported last week. Largest increase has been in ages 18-24 year olds https://storymaps.arcgis.com/stories/50dbb5e7dfb6495292b71b7d8df56d0a

Colorado Cases:

There have been 80,085 confirmed cases of COVID-19 in Colorado, including 2,153 deaths among those patients. Cases among all age groups have been steadily increasing and the number of community outbreaks is at an all-time high. While increased testing has detected more cases, hospitalizations also have reached highest point since May 31, increasing from 126 low point in late June to 290 as of Oct 13-- though still well below our peak of 888. Highest activity (per 100,000 persons) in the past week is in central and northeastern CO (Logan, Yuma, greater Denver metro, Clear Creek, Summit, Lake, Pueblo, Fremont). https://covid19.colorado.gov/covid-19-data

US Cases:

There have been 7,787,548 confirmed cases of COVID-19 in the U.S., including 214,446 deaths. Over the past week, there have been an average of 52,141 cases per day, an increase of 21 percent from the average two weeks earlier. Case numbers are rising nationally as outbreaks continue to spread in the Upper Midwest and Rocky Mountains.

https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html

Worldwide:

Globally there have been 37,704,153 confirmed cases of COVID-19, including 1,079,029 deaths reported to the World Health Organization (WHO). From October 5 through 11, over 2.2 million new cases were reported, the highest number of cases so far in a single week. Europe reported the greatest increase (34%) in cases while the Africa reported a substantial rise in deaths https://covid19.who.int/

PPE Supply Updates

Nitrile gloves continue to be in balance where our weekly use is just above or equal to our weekly purchases. Disposable isolation gown usage had a small increase in usage but we have plenty stock. We’re investigating if we can source a reusable gown with longer sleeves for those who need it. All N95 respirators continue show good stock levels and we are receiving products at our allocation level. We also have significant quantities of approved alternates. Predictably with last week’s increase in cases, our weekly usage average usage also increased, but not to any level where we are concerned about supply. Stock of our regular Halyard procedure mask continues to be stable around 230,000 masks. Purple top wipe usage is stable. On top of the increase in COVID-19 patients, we issued a one-off large quantity to the Paramedics, which significantly changed our days on hand calculation, but we are receiving our full allocation and have no concern on the supply.

COVID-19 Testing at Webb Moving to Rita Bass

Starting on Thursday, the COVID-19 drive-through testing site outside of the Webb Center for Primary Care will move to Rita Bass. The move will allow us to open the south entrance of the Webb building to improve patient flow to the pharmacy and clinics and to promote social distancing. It will also allow us to reopen the circle drive off of 6th Avenue for patient drop offs. The new, drive-through COVID-19 testing site at Rita Bass will accommodate patients and employees. A big thanks to the teams at Webb for their flexibility and patience as we utilized the south entrance for testing.

COVID-19 Health Care Worker Study

Denver Health, alongside five other local health care organizations, is participating in a nationwide COVID-19 surveillance project sponsored by the Centers for Disease Control and the Colorado Department of Public Health and Environment. The goal of this project is to better understand the risks posed by COVID-19 to health care workers. All data, which are collected via personal interview of individuals who test positive and negative, are anonymized prior to sharing with the CDC. Feel free to reach out to Dr. Alisa Koval at the Center for Occupational Safety & Health with any questions – alisa.koval@dhha.org.

Limit Size of In-person Meetings

Staff also often ask how many people are permitted to attend in-person meetings at work. The number of people allowed relates to the size of the room. Meeting attendees should stay at least six feet apart, allowing for 25-30 square feet of space per person; or up to no more than 50% of the room's previous capacity, whichever is least. In clinic work areas, where space may be limited, only essential staff should be in the space.

Inpatient Personal Protective Equipment (PPE) Drop-In Clinic

Learn from our High Risk Infection Team (HITeam) who serve a key role in our designation as one of 10 Regional Ebola & Special Pathogens Treatment Centers (RESPTCs) in the United States. Their inpatient PPE drop-in clinic is a great opportunity for nursing, physicians, EVS, lab, radiology, and other health care partners to brush up on PPE best practices. Ask our experts about:

ü mask storage

ü tips for donning/doffing

ü cleaning practices

ü addressing peers or visitors regarding proper PPE

ü new trends/updates on COVID-19

ü …and more!

The clinics will be held October 20 2200-0100 and October 22 0700-1330 in Sabin. For questions contact Jesseca.Fuller@dhha.org

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 a mask or a respirator that is appropriate to their environment of care at all times. See the details here.

· Non-clinical staff members are required to wear a face covering in any shared, indoor space – even while sitting in physically distanced cubicles. 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

· Isolation Clearance Recommendations

· 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 – Peer Support for Caregivers in Distress

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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