Face coverings must be worn at all times when indoors, except in the following circumstances

· When eating or drinking, and then only when appropriate distancing can be maintained (see above)

· When alone in a private office with the door closed

Face coverings are also to be worn outdoors on the campus unless six feet distancing can be assured (new City Public Health Order)

COVID-19 Epidemiology

At Denver Health, hospitalized COVID-19 patients in isolation have been stable to slightly increased over the past week. We have a total of 22 patients in isolation - 16 on general medicine, 7 in the ICU (7 vented).

Our laboratory positivity rate among those tested is 9%, which is increased over this past week

Denver Cases:

As of today, there have been 16,111 confirmed cases of COVID-19 in Denver, including 450 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 exceeded our previous peak, now seeing 145.3 cases/day (7 day moving average) which stable versus what I reported last week. 25% of Denver’s cases are in the 20-29 year old age group. https://storymaps.arcgis.com/stories/50dbb5e7dfb6495292b71b7d8df56d0a

Colorado Cases:

There have been 86,374 confirmed cases of COVID-19 in Colorado, including 2,180 deaths among those patients. Cases among all age groups continue to increase and the number of community outbreaks remains at an all-time high. While increased testing has detected more cases, hospitalizations also have reached highest point since May 31, exceeding last week’s numbers, increasing from 126 low point in late June to 381 as of Oct 19—even though still well below our peak of 888. Much of the state is seeing high or very high rates of COVID-19. https://covid19.colorado.gov/covid-19-data

US Cases:

There have been 8,128,524 confirmed cases of COVID-19 in the U.S., including 218,986 deaths. Over the past week, there have been an average of 59,261 cases per day, an increase of 34 percent from the average two weeks earlier. Case numbers are rising nationally as outbreaks continue to spread in the Upper Midwest and Rocky Mountains. Wisconsin has opened a field hospital. North Dakota now has the most per capita in the country. Alaska, Wyoming and Montana have seen case numbers soar to new record highs. https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html

Worldwide:

Globally there have been 39,944,882 confirmed cases of COVID-19, including 1,111,998 deaths reported to the World Health Organization (WHO) with over 2.4 million new cases and 36 000 new deaths reported over the past week. Europe has continued to report a rapid increase in cases and deaths, with a 25% weekly increase in cases compared to the previous week. India, the United States, France, Brazil and the United Kingdom are reporting the highest number of cases. 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. We’ve seen a small weekly tick up in usage so went out to market and bought extra small, medium and large gloves to add to emergency stock. Disposable isolation gown usage continues to creep up but we have plenty stock and can buy more from our primary distributor if needed. We continue to investigate where 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 COVID-19, our weekly usage average usage also increased. There has been a marked increase in the use of 3M 1860 and 1860S in a couple of specific departments which we’re investigating to understand if this is a one-off or a change in usage. Stock of our regular Halyard procedure mask continues to be stable around 230,000 masks and we were offered an extra pallet of product from our distributor this week, which we took, and will be reflected in next week’s numbers. Purple top wipe usage is stable, we are receiving our full allocation and have no concern on the supply.

The Public Health Order Issued on Friday Limiting In-Person Meetings in Denver to Five People Does Not Apply to Denver Health

On Friday, October 16, Mayor Hancock issued updated public health orders for the City of Denver, including a provision to limit in-person meetings in workplaces to no more than five people. Denver Health is defined as a Critical Business, and the public health order does not apply to our organization. With that said, we encourage you to be sensible, and wherever possible, set up a conference call or WebEx option for attendees to participate remotely. Always wear a face covering if you attend an in-person meeting and maintain at least six feet social distance from others.

For specific details, the information is summarized in the links below:

  • The October 16 Public Health Order states that “Nothing in this Order otherwise modifies the requirements and operating capacities established in CDPHE PHO 20-35.”
  • Public Health Order 20-35 states in its Appendix A on page 24, that “Critical Business means health care operations including hospitals, clinics, and walk-in health facilities, medical and dental care, including ambulatory providers, Research and laboratory services… [and] Pharmacies”.

…But We Still MUST Adhere to Public Health Guidance to Limit In-person Meeting Size!

The Biggest Risk Of Acquiring COVID-19 Is Not From Patient Care – It Is From Coworkers And Interactions In The Community.

· Be mindful of social distancing rules. The number of people allowed in a room relates to its size. 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.

· When possible, hold meetings virtually, by phone or via WebEx, unless the topic is of sensitive nature and requires face to face discussion

· No food for group consumption (potluck style, pizza, etc) at Denver Health sites. Food should be ordered and packaged for an individual, and should be consumed in a space that allows at least six feet of distance from others. Encourage staff to eat outdoors whenever weather permits

What to Do If You Have Symptoms and/or Test Positive

Do not come to work if you are experiencing symptoms of fever, cough, shortness of breath, or other respiratory symptoms. Contact your supervisor and stay home. If you are displaying symptoms of COVID-19, you should fill out the Denver Health COVID-19 Staff Health Survey, notify your supervisor, stay at home in a separate area from family members, drink plenty of fluids and call your primary care provider if your symptoms worsen. A provider will contact you if your risk is high enough to warrant COVID-19 testing. Call the Nurse Line at 303-739-1211 for further advice. A separate FAQ explains further details about the staff testing process.

Based on updated guidance from the Centers for Disease Control, Denver Health staff members who have tested positive for COVID-19 may not return to work until 10 days after the onset of COVID-19 symptoms combined with at least 24 hours without fever, along with improved symptoms. If staff members test positive without ever having symptoms, at least 10 days should have passed since the date of their first positive viral diagnostic test. COSH will provide further guidance to staff on returning to work.

If an Employee Tests Positive, Will Co-Workers Be Informed?

The identity of any employee who tests positive should be kept confidential. Co-workers, however, should be informed that they might have been exposed and are advised to monitor for symptoms.

Healthy Families and Workplaces Act
In July, the Colorado legislature passed the Healthy Families and Workplaces Act (HFWA). The new law provides employees with up to two weeks of paid time off for a COVID-related absence between July 15, 2020 and December 31, 2020. Click here to learn about the benefits. Here's the application. If you have questions after reviewing this information, send an email to the Leave of Absence Office at LOAFMLprocess@dhha.org.

Denver Health Providing Free COVID-19 Testing to Symptomatic Denver Public School Students

Denver Health's School-based Health Centers and Denver Public Schools (DPS) is providing free COVID-19 testing for Denver Public School students who are symptomatic and have been screened and recommended for a test. The move is the latest effort by DPS and Denver Public Health to keep staff, students and families safe. The same-day testing will be available by appointment Monday through Saturday. Results come back within 24 hours. Denver Health currently has three testing sites, which are located at Peña Southwest Family Health Center, Montbello Family Health Center and the Rita Bass Trauma and EMS Education Institute. A fourth testing site, at Lowry Family Health Center, is expected to open soon.

Final Employee Flu Vaccination Clinic Location Moved

The final employee flu vaccination clinic scheduled for this Friday, October 23rd has been moved from 601 Broadway to Pav C Osler/Nightingale. The time is still the same: 1200-1600. We have vaccinated almost 7000 people with just under 2 weeks to go until the deadline. If you haven’t gotten your shot yet, please take advantage of this opportunity!

Policy Reminders

Where can I find more information about testing for staff?

Click here for the Staff Screening and Testing FAQ.

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 indoors, even while sitting in physically distanced cubicles AND also outdoors on the campus unless six feet distancing can be assured. 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. Social distancing is even more critical when your mask is removed (for example, when eating and drinking). Keep your distance in the cafeteria and at off-campus restaurants. Skip the Break Room in your work area and instead bring your lunch outside.

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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