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COVID-19 Response Updates
10/26/22 COVID Response Update
10/26/22 COVID Response Update
Written by Denver Health
Updated over a week ago

NEW: Epidemiology Data and Notes

NEW: Employee COVID-19 Testing Process Changes Begin Nov. 1

NEW: Bivalent COVID-19 Vaccine Boosters Approved for Children Ages 5–11
REMINDER: Employee Bivalent COVID-19 Vaccine Boosters

NEW: Masking Policy and Disability Accommodation Requests Update

What You Need to Know

NEW: Epidemiology Data and Notes

As of 6:30 a.m., Denver Health has 3 COVID-19 Patients, 2 are on the Floor, 1 in the ICU, and 1 on ventilators.

NEW: Employee COVID-19 Testing Process Changes Begin Nov. 1
In March of 2020, Denver Health launched the Employee COVID-19 Testing Questionnaire in REDCap to ensure the safety of our staff, patients and greater Denver metro community via quick and timely access to COVID-19 testing. Since then, 30,364 REDCap surveys have been completed and 17,265 COVID-19 tests were recommended.

Denver Health will be retiring the COVID-19 REDCap Survey on Nov. 1, 2022. Coinciding with these changes, RAVE notifications about the REDCap survey will also stop. There are several reasons for this change. First, the widespread availability of rapid home COVID-19 tests has reduced the need for hospital-based testing. Second, there are other pathogens that are circulating at higher rates in the community, making it less helpful for staff members to diagnose the cause of their respiratory tract infection. Some of these other common viral infections include influenza and respiratory syncytial virus (RSV). Finally, federal funding available for this service has ended, and we can no longer employ staff members to respond to the survey results, schedule COVID-19 tests for employees and follow up on results.

Traditionally, the fall and winter are known to many as “Respiratory Season” due to the increase in viral infections. Currently, Colorado has relatively low levels of COVID-19, influenza and RSV. Both RSV and influenza are circulating at high levels in other parts of the country and what will happen with COVID-19 is unclear. Determine which virus is causing an individual’s respiratory tract infection cannot be done based on symptoms alone.

As we retire the COVID-19 REDCap process, Denver Health would like to provide updated guidance for those who have a symptomatic upper respiratory tract infection.

Employee Illness Procedures and Recommendations:

· Stay home from work if you have a new onset of fever, cough, runny nose, sore throat or other “cold” symptoms.

· Discuss whether or not to seek testing with your primary care physician or at a Virtual Urgent Care visit. Primary care physicians know your medical history best, and they can determine if viral testing and/or treatment is warranted.

· You may not return to work until you have been afebrile for at least 24 hours.*

· You may not return to work until your respiratory secretions can be well contained by a medical mask.* Nasal secretions or sputum production should not saturate your medical mask.

· When you return to work, you should wear a medical mask, even in non-clinical areas, until your respiratory tract infection symptoms are fully resolved.*

· Work remotely if you are able and otherwise feel well enough and are approved to do so by your manager.

· Communicate with your leader on your symptomatic upper respiratory tract infection.

* If you are diagnosed with COVID-19, you must remain out of work for a minimum of five days from symptom onset and wear a mask in all clinical and non-clinical areas at work for a minimum of 10 days after symptom onset.

Beginning Nov. 1, employees will not be able to complete the survey. We are exploring online options for employees to readily access this guidance, and more information will be forthcoming.

Instead, employees who need to seek COVID-19 testing should: 1) complete an at-home test, 2) visit a free community testing site, 3) schedule a Virtual Urgent Care visit at Denver Health (no co-pay with Denver Health Medical Plan insurance) or 4) schedule an appointment with their primary care provider.

COVID-19 Testing Options:

1. Take an at-home rapid test

a. You can self-administer an at-home COVID-19 antigen rapid test. Although the government stopped taking orders for free at-home tests as of Sept. 2, free and low-cost tests are still widely available. Many health insurance plans and Medicaid will cover the cost or reimburse you for over-the-counter COVID-19 tests as long as the test kit is authorized by the U.S. Food and Drug Administration (FDA). These can be purchased at online and in-person retailers such as Amazon, Walmart, Target and pharmacies. There also are more than 200 distribution sites throughout the state for free at-home antigen rapid tests. Learn more.

2. Visit a free community testing site

a. Visit one of 22 state-sponsored community PCR testing sites or hundreds of low- or no-cost pharmacies for a free, fast and safe COVID-19 test. View locations.

3. Schedule a Virtual Urgent Care appointment
Virtual Urgent Care (VUC) opened in October 2020 and has taken care of more than 15,000 patients for their health care needs over the last two years. It is open from 7 a.m.-7 p.m., seven days per week (closed on Denver Health holidays). VUC accepts most major insurance carriers, including Denver Health Medical Plan coverage. There is no co-pay if you are insured through a Denver Health Medical Plan. During these visits, patients can receive letters for work or school absences, review treatment options and receive prescriptions. Virtual Urgent Care cannot see patients who are out of state, pediatric patients under 18 years old, and cannot prescribe controlled substances. Patients do not need to be Denver Health employees to access VUC, although MyChart is recommended. Learn more about Virtual Urgent Care or schedule a VUC appointment.

4. Schedule an appointment with your primary care provider (PCP)

a. You can also schedule an appointment for COVID-19 testing and/or treatment with your PCP. If you receive your care at Denver Health, you can make an appointment through MyChart or by calling the Denver Health appointment line at 303-436-4949.

Please see the attached FAQs and flow chart for further information.

On Oct. 12, 2022, the FDA and CDC approved the use of updated (bivalent) COVID-19 vaccine boosters in children ages 5–11. The Pfizer-BioNTech bivalent booster has been expanded to include children ages 5–11 (previously limited to ages 12+), and the Moderna bivalent booster has been expanded to include children and adolescents ages 6–17 (previously limited to ages 18+).

The bivalent vaccines, also known as “omicron boosters'' and “omicron doses,” contain two messenger RNA (mRNA) components of SARS-CoV-2 virus: The original strain of SARS-CoV-2 and the BA.4/BA.5 omicron subvariants of SARS-CoV-2. According to the CDC, about 79% of the circulating strains are BA.5, and the rest are other omicron variants.

Children as young as 5 years old who have completed a primary COVID-19 vaccination series are eligible for a single bivalent booster two months after their last dose. Children can receive a bivalent booster with a different brand than their primary series. Denver Health has made the decision to only use Pfizer bivalent boosters in its ACS clinics. If patients and families are wanting the Moderna bivalent vaccine, it will be available at our Immunization Clinic and Travel Clinic at Denver Health by calling 303-602-3520.

**IMPORTANT: The original monovalent vaccines are no longer allowed as boosters for patients ages 5 and older now that a bivalent booster has been authorized. Children who have not received the primary vaccination series need to receive those vaccinations prior to receiving a bivalent booster. At this time, there are no changes to the COVID-19 vaccination schedules for children aged 6 months through 4 years.

Parents can schedule their children for primary series and bivalent booster vaccinations through MyChart or by calling our appointment line at 303-436-7000. Vaccinations will also be available during regularly scheduled well-child visits at pediatric clinics throughout Denver Health. COVID-19 and influenza vaccines are safe to give at the same visit at different injection sites.

Find more information about COVID-19 vaccinations for children on the CDC website.

REMINDER: Employee Bivalent COVID-19 Vaccine Boosters

Denver Health is offering adult bivalent COVID-19 booster vaccines to current Denver Health patients. Employees are encouraged, but not required to get boosters. Employees who receive their care at Denver Health can schedule vaccinations through their MyChart account. Other employees interested in receiving a booster are encouraged to look within the community to get their vaccination. Community vaccine sites hosted by the state can be found here. Local pharmacies continue to have walk-in availability. You can also contact your primary care provider for availability.

Denver Health does not plan to do a mass COVID-19 employee vaccination event surrounding boosters. The Public Health Emergency Taskforce will re-evaluate this as needed based on the future vaccine supply, staffing capacity and employee needs.

NEW: Masking Policy and Exemption/Accommodation Requests Update

You may have seen that the CDC recently announced new guidelines that removed the recommendation for universal masking in health care facilities when COVID-19 transmission is not high. Because transmission rates in Denver are still “substantial” per CDC Community Transmission tracking, Denver Health is choosing to maintain its masking policy to keep patients and staff safe through the respiratory and flu season. We will continue to monitor transmission levels and will reevaluate the masking policy after the burden of respiratory viruses ease this winter. This decision is in line with most Denver-area peer health care facilities’ policies.

The policy states that staff, patients and visitors ages 2 and older, regardless of vaccination status, must wear a mask when entering, and while inside, any area where patients and/or visitors are encountered. This includes in retail areas on the main campus, in pharmacies, in clinics and in hospitals. It excludes non-clinical buildings, charting areas, break rooms and all other areas where patients or visitors are not expected to be present.

If a patient is unable to wear a mask due to a chronic or acute medical condition and/or disability, they may request a mask exemption. They may also be allowed reasonable accommodations even without a pre-approved mask exemption. Clinical leadership must work with these individuals to ensure access to care.

Additional forms of communication are being developed, including a notation in Epic, a wallet card for patients with approved exemptions, and signage informing patients of Denver Health’s mask-wearing policy.

Examples of reasonable accommodations that may be granted by clinical leadership:

1. Offering telehealth options for visits that do not require an in-person physical examination, provided that the patient has the technology and ability to engage effectively in a virtual visit.

2. Placing patient in room and offering N95 masks to staff if aerosol-generating procedure is anticipated. A medical mask for the HCW should be sufficient for all other encounters.

3. Decreasing the time a mask needs to be worn and limiting time spent in shared waiting areas by allowing individuals to call to check in to appointments, wait in their vehicles, and be called into buildings or clinics.

4. Depending on the specialty, allowing certain services to occur via drive-through.

5. Aiding with putting on and removing face masks for individuals who cannot do so.

6. Allowing and providing access to an approved clear face mask or face shield.

7. If no alternative is workable, rescheduling the visit to the end of the same or different day when fewer patients are present and/or considering the use of alternative entrance points.

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