COLORADO CASES ● 14,735 positive cases ● 2,610 total hospitalized ○ 784 currently hospitalized ○ 72 discharged in last 24 hours ● 56 counties ● 69,449 people tested ● 760 deaths ● 149 outbreaks
DAILY CASE GROWTH RATE GROWTH RATE: 4/28=2.8%
DAILY HOSPITALIZATION GROWTH RATE GROWTH RATE: 4/25=0.3% GROWTH RATE: 4/28=.4%
WE NEED YOU TO DO YOUR PART
SAFER AT HOME Chronically ill and over 65 yrs old stay home. All people still stay at home as much as possible and wear a face covering when you leave home Bars, Restaurants, gyms and K-12 schools remain closed for in-person activities General population continue to limit social interaction to only your household- avoid unnecessary travel - wear masks in public No group gatherings of over 10 people Friday May 1st- Retail and Personal Service resume with strict social distancing and hygiene practices in place Monday May 4th - In office work can resume at 50% reduction of census- telecommuting should continue to the maximum amount possible.
Safer-at-Home for Stay-at-Home for General Vulnerable Population & more protections at senior facilities Wearing Facial Enhance Testing, Coverings Isolation, and Monitoring
COLORADO’S ALL-OF-THE-ABOVE STRATEGY Scenario F tests these assumptions with social distancing levels of 65%, 55%, and 45% 1 All critical businesses continue to operate as presently doing based on Safe at Home protocols
SCENARIO F: ALL INTERVENTIONS
Projected timing and magnitude of the peak number of ICU hospitalizations for interventions (Scenario F) Relax social distancing to 45% Relax social distancing to 55% Relax social distancing to 65% Est. peak ICU Est. date of Est. peak ICU Est. date of Est. peak ICU Est date of ICU need* ICU peak need* ICU peak need* peak Mask wearing, improved case 4,100 09/10/2020 1,420 09/24/2020 355 04/21/2020 detection and containment, and older adults maintain current high levels of social distancing Colorado is currently identifying and isolating 33% of symptomatic cases within 48 hours, model assumes this will increase by 5% per week. Note: this doesn’t not include contact tracing which will increase suppression impacts
COLORADO TESTING ● To date we have completed 69,449 tests We are running about 3,000 tests/day ● 58 days ago we could only do 160/day ○ Through lean processes and added staffing, lab capacity has ○ improved 20-fold ● We have the private and state lab lab capacity to do over 10K (but face supply constraints) Goal between public and private partners: 5,000 tests/day early May and up to 8,500+ tests/day if needed by end of May)
EPIDEMIOLOGY UPDATE: STATE LAB TURN AROUND TIME
HOW DO WE GET THERE? Increase testing supplies Increase availability of testing statewide Increase epidemiological capacity
ROLE OF TESTING Identify people Identify hot Protect people who who are sick spots are vulnerable Must be accompanied by compliance with isolation/quarantine and follow-up contact tracing to get maximum suppression impact
KINDS OF TESTING Swab Sampling Blood Test
SWAB TESTS VS. BLOOD TESTS for illustrative purposes only
SEROLOGICAL A.K.A BLOOD TESTING FOR ANTIBODIES While we don’t yet know enough about what antibody tests mean for individual patients, they can help us build the science base to understand the disease. Colorado is spearheading critical research to use antibody ● testing to understand the disease. CU and CSU are developing their own ELISA tests and ● developing use cases for clinical work and fine-tuned techniques that can help us scale faster and cheaper. Laboratories across the state are working to validate the tests ● on the market so we can make sure they are accurate.
SEROLOGICAL A.K.A BLOOD TESTING Important efforts are being made to build the science base to increase our knowledge and surveillance: A longitudinal study looking at the rate of infection across Colorado over time A study seeking to understand the role of children in transmission A study looking at infection rates in different communities A study looking at exposure among frontline healthcare workers And a study looking at exposure among senior care workers
SUPPLIES NEEDED FOR TESTING PPE: Gloves, masks, eye gear and gown Lab: Extraction prep and detection reagents (test) Test: Collection kit (test tube and swab) Equipment and staff to do testing
SUPPLIES NEEDED FOR TESTING ABI 7500 Fast Dx Real-Time PCR instrument
TESTING FOR THE MONTH OF MAY Needed Materials Current Supplies Supplies Secured Supplies Secured Secured by May 11 by May 31st Swabs/ Viral Media 15,000 147,000 195,000 Extraction Reagent 20,000 117,000 195,000 Detection Reagent 100,000 147,000 195,000 (tests)
FOUR TYPES OF TESTING SITES IN COLORADO Private sector hospitals and Local community based testing sites health care facilities Targeted testing for outbreaks and The state collaborates with private-sector partners at-risk populations
HOW TESTING IS DONE Healthcare setting: Children’s Hospital ● National Jewish ● Denver Health ● UCHealth ● Centura ● Stride, Clinica, and other Community Health Centers ● Kaiser Permanente, expanding healthcare workers and first responder ● testing outside their network
HOW TESTING IS DONE Local community-based testing sites: State distributed a playbook to local public health agencies to support them in ● their testing efforts ● 51 counties requested a site. The state lab has completed readiness assessments and approved the plans for 34 of the requests, and has sent testing supplies to support 26 of the community testing sites. ● Mobile, site-specific testing: Example: Island Grove Park in Greeley
HOW TESTING IS DONE Private Sector Partners: ● King Soopers: 4-28 ○ Auraria campus testing site: 179 tests administered on first day ○ Site in Boulder later this week State and County Public Health are Conducting testing for outbreaks and at-risk populations: 4.24-4.28 Weld county testing site: 882 Weld County residents tested ● (124 positive: 88 symptomatic, 34 asymptomatic & 1 unknown) Other sites: Pueblo (484), Mesa (482), El Paso (1769) ●
SENIOR FACILITIES UPDATE: ● Testing Update at Senior Facilities: ○ 4 facilities tested and one ongoing today ■ 1,171 total tests ■ 99 total positive (55 Symptomatic, 33 asymptomatic, 11 unknown) ● Partnership with CSU to run 45,000 tests on nursing home workers (May/June) ● PPE: Weekly supplies for nursing homes by May 1: ○ Masks: 85,521K ○ Gloves: 388,733K ○ Gowns: 7,840K ○ Eye protection: 10, 413
WHO CAN GET TESTED TODAY? ● Symptomatic healthcare and frontline workers ● Symptomatic hospital and nursing home patients ● Symptomatic workers and others in outbreaks ● Some symptomatic community members ● On a scheduled pilot basis, asymptomatic workers at senior care facilities
WHO CAN GET TESTED BEGINNING ON MAY 15TH? ● Symptomatic healthcare and frontline workers ● Symptomatic hospital and nursing home patients ● Symptomatic workers and others in outbreaks ● All symptomatic community members who desire it ● Broader outbreak testing ● On a scheduled basis, more asymptomatic workers and some residents at senior care facilities. Build a more robust program to prevent hotspots in senior, long term care, and congregate care facilities, and other vulnerable populations like people experiencing homelessness
INFRASTRUCTURE NEEDED Partnerships with private and public sector to have more testing sites Robust lab capacity to process the tests Epidemiology team to contain the spread of the virus
EPIDEMIOLOGY UPDATE We have doubled the epidemiology and contact tracing team in the past two weeks, and are rapidly growing! 31 → 56 We are building a first in the country COVID Navigator Program , to establish wrap-around supports for those who are sick
EPIDEMIOLOGY: TECHNOLOGY UPDATE Partnership with MTX & Google, launched Symptom tracker COSYMPTOMTRACKER.COM ● ID hot spots early ● Daily SMS check-in ● Direct referral to testing sites ● Easier, quicker contact tracing ● Rapid scale ● More data available more quickly
Communities of color have a history of unequal access to health care and economic opportunities
EQUITY TASK FORCE MEMBERS Congressman Joe Neguse ● Farduus Ahmed, Hope Communities ● Harry Budisidharta, Asian Pacific Development Center ● ● Lizeth Chacon, Colorado People's Alliance Eudelia Contreras, Lake County Build a Generation ● Maggie Gomez, Center for Health Progress ● Joline Dorce, Dawn Clinic ● ● Rudy Gonzales , Servicios de la Raza Amanda Henderson, Interfaith Alliance ● Deidre Johnson, Center for African American Health ● Adrianne Maddux, Denver Indian Health and Family Services ● ● Denise Maes, ACLU
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