BOH COVIDUpdate 090921 FINALa (1)

COVID-19 UpdateJohn M. Douglas, Jr, MD

Executive DirectorTri-County Health Department

Tri-County Health Department Board of Health MeetingSeptember 9, 2021

•Update on COVID 19 Trends •Update on Vaccination•Update on CSPH Modeling•Looking Forward

Overview

Update on COVID-19 Trends

Trends in Variants of Concern Colorado (9/8/21)

9/8/21

Colorado Pediatric Case Rates by Age Group (9/7/21)

TCHD Area Pediatric Case Rates by Age Group (9/8/21)

COVID-19 Percent Positivity by Age Group in TCHD Area (9/7/21)

Trends in School Outbreaks of COVID across Colorado (8/31/21)

Trends in School Outbreaks TCHD Area: Fall 2021Data are Provisional

Active School Outbreaks in TCHD as of 9/7/21Preliminary Data

County School level # CONFIRMED outbreaks

# staff confirmed outbreak cases

# student confirmed outbreak cases

Total # confirmed outbreak cases

# SUSPECT outbreaks*

Adams (n=3 outbreaks, 25 cases)

HS/MS 0 0 0 0 0

Elementary/ESC 2 2 14 18 3

Other (Mixed) 1 1 6 7 2

Arapahoe (n=12 outbreaks, 67 cases)

HS/MS 3 1 13 14 2



Douglas (n=21, 238 cases)

HS/MS 7 16 115 131 3



*Case Counts not included for suspect outbreaks

Active Child Care Center Outbreaks in TCHD as of 9/7/21Preliminary Data

County # Confirmed Outbreaks

# Staff Confirmed

Outbreak Cases

# Students Confirmed

Outbreak Cases

Total # Confirmed

Outbreak Cases

# Suspect Outbreaks*

Adams 2 5 9 14 2Arapahoe 3 10 29 39 3Douglas 1 7 3 10 1*Case Counts not included for suspect outbreaks

Preliminary estimate 24% reduction

CDPHE Analysis of Differences in Case Rates Between School Districts with and without Mask Mandates: Georgia (9/7/21 update)

CDPHE Analysis of Differences in Case Rates Between School Districts with and without Mask Mandates: Indiana (9/7/21 update)


CDPHE Analysis of Differences in Case Rates Between School Districts with and without Mask Mandates: Colorado (9/7/21 update)


Two-Week Case Rates by Census Tract in TCHD Area (9/8/21)

Trends in Hospital Admissions among Persons with COVID-19: Colorado (9/8/21)

Number of Current Hospitalizations for COVID-19 in Colorado (9/8/21)

Trends in Hospitalizations in TCHD Area: Past Two Months (9/8/21)

Trends in Hospitalizations by Age in TCHD Area: Past Two Months (9/8/21)

Trends in Pediatric Hospitalizations due to Respiratory Viruses (09/07/21)

Hospital Capacity by State Region and in TCHD Area (9/8/21)

Vaccine Uptake Across Census Tracts in Metro Denver Counties (9/8/2021)

Vaccine Coverage Progress: Trying to Finish the Marathon (9/8)

Vaccination Rates by County in Colorado (9/8)

Vaccine Coverage by Age (8/11 to 9/8)

Cumulative COVID-19 Vaccine Initiation by Race/Ethnicity (9/8)

Adams, Arapahoe, Douglas Counties (wk of 5/3/21)

Vaccination Administration Trends in High Priority Neighborhoods (9/8)

• TCHD supports formal (from CBO vaccine and navigation funding opportunity) and informal (any other) partners Weekly office hours for partners to ask questions, get guidance on promotion and navigation issues (eg, 3rd vs booster doses). Weekly update emails and bi‐weekly talking points

• Vaccine Champions program – Growing the program to meet increasing demand (3 currently, several more being recruited. All bi‐lingual Spanish speakers. – In the process of hiring a nurse champion to be available for “Ask‐a‐nurse” events focused on building confidence in advance of vaccine clinics.

• Provider outreach– Working with CDPHE, Colorado Access and the TCHD Regional Health Connectors to outreach to providers about COVID‐19 and flu vaccine planning in areas with low‐vaccine rates for Medicaid populations

– Requested info on hospital capacity/plans regarding health care worker Vx requirements after 8/30 State BOH rule.

• Fixed and mobile sites TCHD teams at jails, GEO and events for People Experiencing Homelessness and other vulnerable populations Community partners and Jogan Health at LTCF, homebound, schools and other community events.

• Incentive funding request approved by CDPHE – $100 Visa cards at community vaccine events in priority neighborhoods for 1st and 2nd doses where Jogan Health is the vaccine provider.

TCHD District Wide Efforts to Enhance Vaccine Uptake (9/8/21)

Estimates of Vaccine Effectiveness in Colorado: Solid to Prevent Severe Disease but Beginning to Slip Against All Infections (9/7/21)

Colorado COVID Cases by Vaccination Status (8/27/21)

Colorado Hospital Admission Rates by Vaccination Status (8/31/21)

Update on CSPH Modeling

Update on CSPH COVID Modeling: Observed Hospitalizations (9/1/21)

Update on CSPH COVID Modeling: Declining Transmission Control (9/1/21)

Update on CSPH COVID Modeling: Projected Increase Hospitalizations (9/1/21)

Update on CSPH COVID Modeling: Estimated Prevalence of Infection (9/1/21)

Update on CSPH COVID Modeling: Estimated Levels of Immunity Based on Prior Infection and Vaccination (9/1/21)

• Vaccines• Increasing efforts to increase uptake post licensure• Additional doses for immunocompromised• Additional boosters for older adults• Authorization for children

• Safety in public spaces with highly effective but not perfect vaccine•Masks• Ventilation

• Treatments• Public Health messaging• Coming to terms with how long the pandemic is going on• Evolving structure of TCHD and impact on staff and services

Looking Ahead

•Case rates by county and census tract•County case and hospitalization rates among children•Hospital capacity•School case and outbreak numbers and trends•Vaccination rates among 12‐18 and > 18•Updated expert advice (CDC, CDPHE, AAP)

Metrics to Follow Regarding Need for Face Masks in Schools

• Although controversial, universal masking in schools isShown to have substantial benefit in reducing transmission when rates are high and vaccination is insufficient

Strongly recommended by expert groups (CDC, AAP)•Mask mandates could be ended when infection rates are low based on

Recommendation by expert groupsLocally developed criteria

• Discussions regarding local criteriaUnderway w CDPHE to assess whether/what metrics being used in other jurisdictionsConsiderations could includePrimary: low transmission rates in school aged youth (CDC defined as < 10/100,000/week)Supportive: rising vaccination rates, low school outbreak rates

Considerations for Ending Mask Mandates

Questions & Discussion

BOH COVIDUpdate 090921 FINALa (1)

Documents

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