Cases and Outbreaks in Schools
THIS IS A RAPIDLY EVOLVING AND FLUID SITUATION. INFORMATION AND ACTION ARE SUBJECT TO CHANGE AT ANY TIME. BE PREPARED TO BE FLEXIBLE AND PATIENT.
PLEASE DISTRIBUTE THIS WIDELY
8/7/2020 Crowley/Otero COVID-19 Update #1
Please take the time to read and understand this entire message.
Internet links: Before I send out each update, I check the links to make sure they are active. However, links do change from time to time, so the links I sent out today may not be the same tomorrow. You may have to search around a bit.
Hello to all, here are a number of COVID-19 updates for you:
Local Increase in Cases: Recently Otero County has seen an appreciable increase in COVID-19 cases. During the time period beginning on 7/23/2020 and ending on 8/6/2020, OCHD received positive test results on 38 people from Otero County, and none from Crowley County. The Otero County number includes both residents of Pioneer Nursing Home and non-residents. Should we be surprised to see an increase in cases? Not at all, as both the nation and state have seen increases. Our epidemiology team has identified possible sources of infection for the majority of cases. These sources include instances where people are not complying with public health orders, so please wear your mask and socially distance yourselves. While OCHD still does not have evidence of widespread, sustained community transmission, we have seen possible evidence of limited community transmission. What is the difference between widespread, sustained community transmission and limited community transmission? Simply put, picture a large wildfire blazing that is not yet fully controlled nor contained, that would be widespread, sustained community transmission. For limited community transmission envision small, separate pockets of fire burning, and quickly being contained. Literal fire containment can be helped by physical separation (i.e. fire breaks) of the flaming vegetation from vegetation not yet on fire. Likewise, diseases are contained by physical separation (i.e. isolation) of sick people from those that are not yet infected.
2. Situation Right Now: I just finished meeting with our Director of Nursing, and I asked her to characterize our current situation (as of 8/7/2020). She said it appears that we have stabilized and we are also seeing evidence of declining cases. Beginning on August 5th, 2020 and through today at 1:00 pm we have not received any positive test results. While it is just too early to say with certainty that we have actually stabilized or are declining, the preliminary evidence we have to date is encouraging. Keep doing your part (see #6 below)!
3. Reporting of COVID-19 Deaths: On death certificates, the medical professional certifying the death can list the immediate cause of death as COVID-19, or it can be listed in the chain of events that directly caused the death, or it can be listed as other significant conditions based upon their medical judgement. As of the time of this writing (8/7/2020 at 1:00 pm), CDPHE COVID-19 statewide death data breaks deaths down into 2 categories:
ü Deaths among cases
i. This represents the total number of deaths reported among people who have COVID-19, but COVID-19 may not have been the cause of death listed on the death certificate. This information is required by the CDC and is crucial for public health surveillance, as it provides more information about disease transmission and can help identify risk factors among all deaths across populations.
ü Deaths due to COVID-19
i. The number of deaths among people who died from COVID-19: This represents the total number of people whose death was attributed to COVID-19 as indicated on a death certificate. This number is determined by the CDC and is updated daily for dates through the previous Saturday.
ü Please note that for individual county level data, CDPHE does not distinguish between “deaths among cases” and “deaths due to COVID-19”, they simply list deaths (https://covid19.colorado.gov/covid-19-data).
ü View explanations regarding death reporting data: https://covid19.colorado.gov/cdc-death-counts
Mask Exemption: Colorado currently does allow a health/medical exemption to wearing a mask. What does it mean, though, to be unable to medically tolerate a mask (face covering)? A guidance document from the Colorado Department of Public Health and Environment (CDPHE) dated 7/17/2020 states the following: “Essentially, this means a person who has trouble breathing or anyone who is unconscious, incapacitated, or otherwise unable to remove the cloth face-covering without assistance, according to the Centers for Disease Control and Prevention. Read more from the CDC about other reasons face coverings may not be possible in every situation or for some people.” There are no exemptions for ideological/political/philosophical reasons. Please do not look for loopholes. If you can medically tolerate it, please, please, please wear a mask when appropriate. Remember, the wearing of a mask not only reduces your risk, but it reduces the risk of those around you. Others are depending upon you to express this kindness to them.
5. Back To School: Both on 7/20/2020 & 7/24/2020 I sent out information on school reopening. Even though we have had increases recently, at this point school reopening plans are going forward. What are some of the factors involved in deciding to go forward with reopening? Please see the checklist directly below. Parents, please start planning now on securing supplies such as cloth masks (for appropriate ages) and thermometers (to screen your kids BEFORE they go to school). Remember, planning for COVID is not just the schools’ responsibility, it is also our as parents. Yes, I said “ours”, because I will have 4 kids going back to school this fall, and they will be wearing masks and they will have a symptom check each day before going to school. We all have to do our part to keep our schools as safe as possible and keep them open. It is up to us.
Here are some of the current, local factors that support reopening:
ü The schools have the information they need to reduce risk and respond to potential positive cases.
i. The schools have current, specific guidelines for reopening from the Colorado Department of Public Health and Environment (CDPHE) and the Colorado Department of Education (CDE). I know they have this guidance because I sent it to the superintendents. This guidance has both requirements and recommendations based upon the specific phase (Safer At Home) that we are in, so it can be customized to our situation.
ii. The schools have access to a guidance document entitled “Cases and Outbreaks in Schools”. If you want to check this information out, here is the website: https://drive.google.com/file/d/1j_QAPmw8Fw0llI_vILLbFrEAu__d5oS_/view
ü While we have evidence of limited community transmission, we do not currently have evidence of sustained, widespread community transmission. See #1 above that addresses this.
ü Even though Otero County has had a recent increase in cases, on a CDPHE graph entitled “Case Rates Per 100,000 People in Colorado by County” (displaying information current as of 8/7/2020 at 1:00 pm), Otero County was 19th from the lowest rate out of 60 counties represented on the graph. You can see the graph here: https://covid19.colorado.gov/data/case-data While there are certainly data nuances regarding facility case counts that are not addressed by this graph, it does help to somewhat put things in perspective. Be aware that this graph is updated regularly, and when you look at the graph it might be different than what it was on 8/7/2020 at 1:00 pm.
ü CDPHE has a status indicator of viral spread, and it is ranked low, medium, and high. Otero County’s rank is currently “medium”. You can read this information here: https://covid19.colorado.gov/safer-at-home-in-the-vast-great-outdoors/guidance-for-everyone/local-orders-variances
ü Currently, we may be seeing evidence of stabilizing or declining case rates (see # 2 above).
Conversely, you might ask “what factors would be considered in the local closing of a school or schools?” I have listed some of those general factors below, and the closing of a school(s) might be the intense presentation of just 1 factor, or a combination of other/all factors. Please remember, these decision will be situation specific based upon current data. I was on a conference call with CDPHE this morning regarding school reopening, and the facilitator said that these are complex, complicated matters and situations.
ü Our community (ies) are experiencing documented widespread, community transmission in the absence of evidence suggesting leveling off or going down.
ü A school (s) has a COVID-19 situation (i.e., positive cases) that dictates closure due CDE/CDPHE guidance.
ü Our community (ies) are not experiencing stable or declining case rates, but are experiencing increasing case rates in the absence of evidence suggesting leveling off or going down.
ü Our viral status spread indicator has moved to high, with no sign of moving back to medium. https://covid19.colorado.gov/safer-at-home-in-the-vast-great-outdoors/guidance-for-everyone/local-orders-variances
ü An increasing average test positivity rate in the absence of evidence suggesting leveling off or going down.
Make no mistake, going back to school poses a risk. The measures put in place by the schools, parents, and students do not eliminate the risk of COVID-19 exposure, but it does reduce it. This is why we must all work together (parents, students, schools, OCHD) to reduce that risk as much as possible. It is not just the schools’ responsibility, “not by a long shot”. It is up to all of us, so let’s be determined to do our part!
Do Our Part: Now is the time to be united in reducing the risk of COVID-19 transmission. Please don’t let all of the misinformation, false reasoning, insensibility, indifference, politics, anger, and frustration that is so very rampant cloud your good judgement. Please wear your face covering when appropriate, socially distance yourselves, avoid large groups, delay travel if possible, stay home if you are sick, and wash your hands a lot. Take this seriously, because it is. This is a collective responsibility of us all to protect each other and keep our local businesses and schools open. It’s up to us.
Protect Our Neighbor Certification (PON) Status: I reported to you last week that because of the recent increase in cases, Otero County became ineligible under PON case transmission rate metrics. As of the time of this writing, that is still true.
Variance Status: As of the time of this writing, our variance is still in place.
Thank You: A HUGE thank you to my staff, our partners, our healthcare workers, CDPHE, and those of you that are doing your part to stop the spread of COVID-19!
Summaries: The data below was taken directly from the Colorado Department of Public Health and Environment’s (CDPHE) website on 8/7/2020 at approximately 1:00pm. Remember, this data will change after the website is updated. For Colorado (including Crowley/Otero Counties), this summary only includes data through August 5 and does not reflect cases since then. Additionally, the number of deaths due to COVID-19 includes data through Saturday, July 31, and does not reflect cases since then.
a. Crowley County
ü Total Cases: 72
ü Total COVID Related Deaths: 1
ü Facility Outbreaks (Data available on the following website as of 8/7/2020 at 1:00pm: https://covid19.colorado.gov/data/outbreak-data)
o Crowley County Correctional Facility
§ Status: Resolved
§ Number of prisoners positive for COVID (lab confirmed): 66
§ Number of staff positive for COVID (lab confirmed): 4
b. Otero County
ü Total Cases: 70
ü Total COVID Related Deaths: 6
ü Facility Outbreaks (Data available on the following website as of 7/31/2020 at 9:12 am: https://covid19.colorado.gov/data/outbreak-data)
§ Pioneer Healthcare Center
· Status: Active
· Number of residents positive for COVID (lab confirmed): 17
· Number of staff positive for COVID-19 (lab confirmed): 11
· Number of COVID related deaths (lab confirmed): 5
§ Lewis Bolt and Nut
· Status: Active
· Number of staff positive for COVID (lab confirmed): 3
· Number of staff with probable COVID (NOT lab confirmed): 2
ü CDPHE case count website: https://covid19.colorado.gov/data/case-data)
o Scroll down until you see the Colorado map, and then select “Case Counts” from the dropdown box on the upper right side of the map.
c. State of Colorado (https://covid19.colorado.gov/covid-19-data)
ü 49,436 cases
ü 203 patients currently hospitalized for confirmed COVID-19 (view hospital data: https://covid19.colorado.gov/hospital-data)
ü 63 counties (view incidence and epidemic curve data: https://covid19.colorado.gov/data/incidence-epidemic-curve)
ü 568,127 people tested
ü 1,852 deaths among cases
ü 1,729 deaths due to COVID-19
ü 509 outbreaks (view outbreak data: https://covid19.colorado.gov/outbreak-data)
d. United States (as of the time of this writing on Friday, 8/7/2020 at 1:00 pm)
ü Cases: 4,802,491
ü Deaths: 157,631
ü Website: https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html
What can you do RIGHT NOW?
ü Read, understand, and comply with public health orders! Public health orders can be found here: https://covid19.colorado.gov/prepare-protect-yourself/prevent-the-spread/public-health-executive-orders
ü Stay home if you are sick and, if needed, call your medical provider.
ü Wear an appropriate mask if you must go out for an essential activity.
ü If you are in a high risk group, take extra precautions.
ü Cover your cough and/or sneeze.
ü Keep your fingers and hands away from your face.
ü Wash your hands a lot.
ü Stay informed by trusted and reliable sources. Be careful about believing what you read on social media sites. Trusted sources/websites:
o OCHD: https://www.oterogov.com
o Centers for Disease Control: https://www.cdc.gov
o Colorado State Health Department: https://www.colorado.gov/cdphe
ü Do these things so you will be prepared, and not scared.
ü And remember, “This too shall pass.”
It is up to us.
Richard Ritter, Executive Director
Otero County Health Department
13 West 3rd Street, Room 111
La Junta, Colorado 81050
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