August 31, 2021 (Mask Guidance)
Mask-wearing and vaccination are the two most important tools Coloradans can use to prevent the spread of COVID-19 and bring us closer to ending the pandemic. Now that all Coloradans age 12 and older have access to safe and effective COVID-19 vaccines, masks are only required in certain places for people who are not fully vaccinated. However, fully vaccinated Coloradans may choose to protect themselves by wearing masks in public indoor places. View the CDC’s current guidance for mask-wearing after vaccination.
The Sixth Amended Public Health Order 20-38 requires unvaccinated people to wear masks in specific settings, including medical facilities (including long term care facilities), homeless shelters, prisons, and jails. The state also requires universal mask use for staff, visitors, and residents in residential care facilities regardless of vaccination status. The Colorado Department of Public Health and Environment (CDPHE) encourages people who are not fully vaccinated to wear masks in all other public indoor spaces to help prevent the spread of COVID-19.
In July 2021, the state updated the practical guide for operationalizing CDC school guidance, recommending that local public health agencies and school districts consider either mask requirements for all unvaccinated individuals or a masking requirement for all individuals in schools, particularly in higher-risk environments.
Local communities and businesses may have additional mask restrictions. CDPHE encourages all Coloradans to keep masks with them in public and wear them if asked.
Everyone age 2 and older must still wear masks on planes, buses, trains, and other forms of public transportation traveling into, within, or out of the United States, and in U.S. transportation hubs such as airports and stations. This is required by federal law for both vaccinated and unvaccinated people.
August 30, 2021 (Vaccine Guidance)
STATEWIDE, (Aug. 30, 2021): The State Board of Health has approved emergency rules requiring vaccination for staff in licensed healthcare settings. The Board met today to consider a request from Governor Polis to implement rules requiring licensed healthcare facilities to mandate their personnel — including employees, direct contractors, and support staff– who interact with individuals seeking medical care to receive the COVID-19 vaccine.
At this time, approximately 30% of the healthcare workforce remain unvaccinated. With the rise in the delta variant and increased stress on the healthcare system, ensuring that all workers in licensed healthcare facilities are vaccinated is one of the most effective means the state can take to protect the public health, safety, and welfare of the most at-risk Coloradans and end this ongoing pandemic.
The vaccine requirement is limited to only those health care facilities that are listed in Colorado Revised Statute 25-1.5-103(1)(a)(1). The department does not have authority over individual health care practitioners or staff, nor does it oversee other settings where patients seek medical care including primary care offices and urgent care locations.
The Board of Health will convene again in October to consider the rule in a regular session.
Additionally, the state of Colorado is requiring the COVID-19 vaccine for employees working in state-run 24/7 health care facilities and interacting with vulnerable patients. The state has also implemented a policy requiring all state employees to verify their vaccination status by September 20 or submit to twice-weekly testing. The Department of Public Health, Department of Corrections and Department of Human Services have announced that agency staff members that interact with vulnerable populations and those living in congregate living settings will be required to get vaccinated.
Continue to stay up to date by visiting covid19.colorado.gov.
August 11, 2021
Email from Suzanne Harp to Clinical Managers:
Hi all,
Here is a summary of recent CDPHE guidance for facilities from the meeting today. This guidance applies to our patients in residential facilities, but the CDPHE has updated their guidance to match CMS and CDC guidance so I think we can anticipate other changes for our organization as the state and local health departments evaluate the need for public health orders in addition to these changes.
COVID 19 update
Pretty much the whole state has high incidence of cases. There are only 2 counties in the state with low incidence currently, everywhere else is moderate to high transmission rates. The 2 counties with low incidence are not in our service area. The alpha variant and the delta variant account for over 65% of all cases in Colorado. The delta variant is increasing, but currently the alpha variant accounts for more cases.
There are new outbreaks in the following counties in our service area: Adams, Arapahoe, Boulder, Jefferson, Larimer, and Weld, but there are other existing outbreaks in the counties we currently serve.
Universal masking:
- everyone who enters a residential facility is required to wear a medical grade mask or respirator. The only exception is if all people present are fully vaccinated in a meeting room or break room, not a common area. No cloth masks allowed in facilities with patient care/contact.
- in shared spaces such as meeting rooms and break rooms, if even one staff person (or facility resident) is present who is not fully vaccinated, then all individuals will be required to wear a mask.
Testing:
- Compassionate care staff, regardless of vaccination status, will be required to have twice weekly negative PCR tests to visit patients in facilities. Unvaccinated visiting staff members will have to complete daily rapid testing in addition to the twice weekly PCR test. Facilities are moving toward antigen testing for daily rapid testing. The data suggests they are more reliable for those who are symptomatic or with higher viral loads. CDPHE has sent all rapid testing supplies out to facilities as of last week.
- An outbreak is defined as one positive test within a facility. Hospice staff will still be able to visit, but family and friends will not be able to visit until the outbreak status is cleared. During an outbreak, all vaccinated and unvaccinated staff and hospice providers will be required to complete a daily rapid test in addition to the twice weekly PCR test.
- CDPHE has reversed its position on discordant results from 2 weeks ago. A negative PCR will no longer automatically overrule a positive rapid test. When there are discordant test results, CDPHE will need to be contacted for consultation regarding isolation or quarantine.
High risk exposure:
If there is a high-risk exposure (close contact with an individual with confirmed positive COVID test) vaccinated staff that remain asymptomatic will not be required to quarantine, but they will need an immediate PCR test and daily rapid tests during their 14-day incubation period.
Example: a TRU RN is vaccinated, and the facility notifies her that she cared for a COVID positive patient yesterday. She has a PCR test done immediately, and then has rapid testing done every day she enters the facility for the next 14 days.
***Unvaccinated staff will be quarantined for 14 days after a high-risk exposure and will not have to complete daily rapid testing. They will not be able to visit patients until the quarantine period is over.
If vaccinated or unvaccinated staff members test positive, they will need to isolate for 10 days. There was no update on this in today’s meeting, so I am assuming that it hasn’t changed since the last meeting.
The last part of the meeting was regarding survey tags. Not surprisingly a lot of facilities are getting tags on infection control. The main areas of concern are:
- improper hand hygiene: not knowing when to wash hands or use hand sanitizer; not washing hands for a full 20 seconds; not offering hand sanitizer to residents prior to meals; not using hand sanitizer between sets of gloves, and housekeepers not changing gloves between rooms.
- compassionate care visiting staff and other facility staff: not wearing PPE appropriately, such as not wearing medical grade mask over nose and mouth, and not discarding PPE prior to entering common areas after leaving a contaminated room.
- proper visitor screening: lack of screening oversight especially at night and on weekends; allowing vendors to enter without screening or wearing a mask
- failure to follow testing requirements
- failure to report positive rapid test results
I will be out of the office tomorrow (8/12), but please reach out with any needs or for clarification and I will reply as soon as possible on Friday.
Suzanne Harp, RN BSN
Clinical Educator and Infection Control Nurse
SuzanneHarp@trucare.org
2594 Trailridge Drive East | Lafayette, CO 80026
P (303) 926-4715 | F 303.604.5393 | www.TRUcare.org
