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COVID-19

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1. What can I do to help prevent the spread of COVID-19?

GCPH wants to emphasize the importance of taking the necessary precautions to protect each other. We all have a role to play in limiting the spread of this virus. Steps that everyone can take to slow the spread of the virus include:

• Limit gatherings to small groups, do not congregate
• Anyone showing signs or symptoms of being sick must stay home
• Employers conduct symptom screenings of all employees daily
• Limit, where possible, all high and medium risk interactions
• Practice good personal hygiene (wash hands frequently, cover coughs, do not touch your face)
• Wear face coverings in public areas
• Protect our vulnerable populations like the elderly and people with pre-existing conditions
• Maintain 6-foot distancing from others
• Increase ventilation as much as possible in all facilities
• Frequent sanitation of high touch surfaces
• Use cleaning and sanitizing products that meet EPA standards and CDC requirements

2. What is a close contact?

For COVID-19, close contact includes:

• Living in the same household as a sick person with COVID-19.
• Caring for a sick person with COVID-19.
• Being within 6 feet of a sick person with COVID-19, although just passing by a person for a few seconds should not cause you to be overly concerned.
• Being in direct contact with fluids from a sick person with COVID-19. This includes being coughed on, kissing, sharing utensils, etc.

3. What is “Contact Tracing”?

Disease investigations, including contact tracing, are part of the process of supporting patients with suspected or confirmed COVID-19 infection. Grand County Public Health (GCPH) completes contact tracing for every positive case in the county. In contact tracing, Grand County Public Health (GCPH) works with a patient to help them recall everyone with whom they have had close contact during the timeframe while they may have been infectious. They then warn these exposed individuals (contacts) of their potential exposure as rapidly and sensitively as possible. Contacts are provided with education, information, and support to understand their risk, what they should do to separate themselves from others who have not been exposed, monitor themselves for illness, and the possibility that they could spread the infection to others even if they themselves do not feel ill. Anyone contacted is assessed for symptoms throughout their quarantine. The contact is then tested for COVID-19 at the end of the 14-day period if symptoms arise. Anyone ordered to quarantine is not able to test out of quarantine due to the long incubation period of the virus.

4. What is the difference between Quarantine and Isolation?

Quarantine is for people who are not currently sick but who have been or may have been exposed to a communicable disease, like COVID-19. If you have been in contact with someone who has been placed on quarantine: they are not contagious---yet. They are being monitored for symptoms and are not identified as a COVID-19 positive case. Your contact with a quarantined individual does not put you at risk. Quarantined individuals have been in direct contact with a positive COVID-19 case but may not have enough virus in their system to be contagious, or even develop the illness at all. Should that quarantined person develop symptoms or test positive, their contact with you within the investigation timeframe could be considered in their case investigation.

Isolation happens when a person is infected with a communicable disease, like COVID-19, and is separated from people who are healthy.

5. Can isolation and quarantine be enforced?

State and local public health agencies request that Coloradans and visitors from other states or countries voluntarily cooperate with isolation and quarantine instructions. State or local public health agencies may issue isolation and quarantine orders in some high-risk situations or if non-compliance is anticipated. If people do not follow the orders, public health agencies can involve law enforcement. If enforcement were to become necessary, the entity that issued the order (the state or local public health agency) could file an enforcement action in state district court asking a judge to enforce the order. The court could also levy fines but, on the whole, public health is more interested in compliance with the terms of the order.

6. I have been diagnosed with or am showing symptoms of COVID-19 – what should I do?

If you tested positive for COVID-19 using a PCR test, stay away from others and follow the instructions on how to isolate. If you have a positive test result for COVID-19, public health may contact you to collect information about your exposures and give you more information about preventing transmission to others.If you develop symptoms, contact your health care provider or take advantage of other testing sites to get tested. Follow the instructions on how to isolate.

Coloradans who are sick and receive negative COVID-19 test results should continue to stay home while they are sick and should consult with their health care provider about the need for additional testing and the appropriate time to resume normal activities.

If you need medical advice, call a healthcare provider or nurse line. It is important to CALL ahead BEFORE going to see a health care provider, urgent care, or emergency room in order to limit the spread of COVID-19. Tell them your symptoms and where or how you might have been exposed. If you are having a medical emergency, call 911. Tell the dispatcher your symptoms.

7. I think I have been exposed to COVID-19, but I’m not showing symptoms - what should I do?

If you think you have been exposed to COVID-19, but you don’t have symptoms, follow the instructions on how to quarantine for 14 days after exposure. You may also want to get tested, but wait at least seven days after the date you think you were exposed to get tested using a PCR test. If you get tested too early, there may not be enough viral material for the test to detect.

While it’s a good idea to wait about seven days to be tested after the date of exposure if you don’t have symptoms, some people may not become ill for up to 14 days. For that reason, people who have been exposed to COVID-19 should minimize their contact with others for 14 days from the date of their exposure, even if they test negative before the full two weeks have passed.

8. I think I was in contact with a person who tested positive for COVID-19. Now What?

Grand County Public Health (GCPH) completes contact tracing for every positive case in the county. Contact tracing is the process by which Grand County Public Health finds high-risk contacts and those individuals in very close, prolonged contact with the infected patient. There is a time frame of exposure risk that is investigated for each positive case. Once identified as a close contact, individuals are notified about the possibility of COVID-19 exposure and provided guidance. If you are not notified during the Contact Tracing process, it means that you were not identified by GCPH as someone in close contact, during the time frame of risk, with the individual who tested positive.

Grand County public Health uses the following criteria to determine contact risk exposure during contact tracing. Normally, only individuals identified as Medium and High Rigk are contacted during the contact tracing process.

High Risk: 1) Individuals living in the same household as, 2) being an intimate partner of, or 3) providing care in a non-healthcare setting (such as a home) for a person with symptomatic laboratory-confirmed COVID-19 infection without using recommended precautions for home care and home isolation

Medium Risk (assumes no exposures in the high-risk category): 1) Individuals who have close contact with a person with symptomatic laboratory-confirmed COVID-19, or 2) Individuals on aircraft who are seated within 6 feet (2 seats in each direction) of a traveler with symptomatic laboratory-confirmed COVID-19 infection, or 3) Individuals living in the same household as, an intimate partner of, or caring for a person in a non-healthcare setting (such as a home) to a person with symptomatic laboratory-confirmed COVID-19 infection while consistently using recommended precautions for home care and home isolation

Low Risk (assumes no exposures in the high-risk category): 1) Individuals having been in the same indoor environment (e.g., a classroom, a hospital waiting room) as a person with symptomatic laboratory-confirmed COVID-19 for a prolonged period of time but not meeting the definition of close contact.

No Identifiable Risk: Individuals having interactions with a person with symptomatic laboratory-confirmed COVID-19 infection that do not meet any of the high-, medium- or low-risk conditions above, such as walking by the infected person or being briefly in the same room.

9. I was told to quarantine, but I got tested and the test was negative, can I go back to work?

No, you need to stay home until the full 14 days of quarantine are over.

10. Can I get the antibody blood test to see if I had COVID-19?

Middle Park Health is now offering antibody testing and testing for non-symptomatic individuals. Prices for walk-in cash pay patients (no order required) are $50 for antibody test and $100 for the nasal swab. Please understand that some antibody tests are resulting in what are known as “false positives.” Thus, we encourage everyone to be very cautious about results from an antibody test and understand that the test does not guarantee immunity. You should continue to follow all recommended precautions to avoid catching or spreading COVID-19, even if you think you have had COVID-19 in the past or if you’ve gotten a positive result from an antibody test.

11. Can you get tested in Grand County for COVID-19 if you meet the protocol? Once the person is tested, where is the specimen sent for confirmation? When will Grand County get rapid testing?

If you meet criteria, yes, you can be tested for COVID-19 in Grand County at any healthcare facility. The tests are then sent to the state laboratory to be processed. Currently, we have no news on the rapid tests being available in Grand County.

Middle Park Health is now offering antibody testing and testing for non-symptomatic individuals. Prices for walk-in cash pay patients (no order required) are $50 for antibody test and $100 for the nasal swab.

12. What are the Activity Specific Protective Measures and Guidance Playbooks?

The industry sector, recreation, event, and other activities’ Protective Measures and operating protocols contained in the Grand County COVID-19 Suppression Plan and Playbooks shall apply for all applicable businesses and activities at all times until further notice. These Activity Specific Protective Measures change regularly depending on the COVID-19 health of the County and State. In particular, due to the dynamic nature of CDPHE Public Health Orders and variability of COVID-19 threats locally, capacity limits for different industries, activities, events, and sectors may change regularly.

13. What is the Compliance Verification Form?

Businesses, employers, sole proprietors, and organizers of events and activities shall submit a Compliance Verification Form through Grand County Public Health for each activity subject to Activity Specific Protection Measures and display approved acceptance documentation prior to opening and receiving customers, or commencing an event or other activity.

14. What is Protect Our Neighbors?

Protect Our Neighbors means that communities that meet certain criteria have less stringent restrictions than under Stay at Home and Safer at Home. Strong local public health and health care systems are the key to reopening the economy. Different communities will be at different phases, based on local conditions and capabilities. Local communities can also still apply for a variance from Safer at Home.

15. How do we apply for Protect Our Neighbors?

Grand County has to meet specific criteria to apply for the Protect Our Neighbors level and ensure that the following are met within our county:

• Sufficient hospital bed capacity.
• Sufficient PPE Supply.
• Stable or declining COVID-19 hospitalizations.
• Fewer new cases.
• Sufficient testing capacity.
• Ability to implement case investigation and contact tracing protocol.
• Documented surge-capacity plan for case investigation and contact tracing.
• Documented strategies to offer testing to close contacts.

16. How do I know what level my community is in? What rules do I follow?

People should be aware of and follow the rules in their specific community and in the communities they are visiting.

Grand County’s Public Health Order is complementary to State public health orders. Therefore, the Order should

not be relied upon solely. To the extent any State orders or laws conflict with the express terms of this Order, the provisions of this local June 26, 2020 GCPH Public Health Order control, regardless of whether the State orders or laws are more or less restrictive than what is set forth herein. However, except for those specifically identified measures contained herein, the Order is not intended to limit, rescind, alter, or amend any other applicable public health orders, restrictions, or requirements of the federal, state or local governments.

All members of the public are responsible for following all other provisions of the Governor’s orders, CDPHE orders, and local orders that do not conflict with the specific protective measures in the Grand County COVID- 19 Suppression Plan and Playbooks. Individuals should be aware that new orders are being issued on a regular basis from Governor Polis and CDPHE.

17. I own a Short-Term Rental, am I allowed to operate?

Yes and there are protective measures in place that are meant for private, short-term vacation-style rentals such as those arranged through an online hosting platform, including but not limited to VRBO or Airbnb, homeowner rentals, and privately owned residences for rent that are rented for thirty (30) days or less per stay.

Owners, managers, operators, and/or employers must implement the protective measures found in the Grand County Lodging Playbook in addition to filling out a Compliance Verification Form prior to taking renters.

18. I own a business in Grand County, what do I need to do to open?

Businesses, employers, sole proprietors, and organizers of events and activities shall submit a Compliance Verification Form through Grand County Public Health for each activity subject to Activity Specific Protection Measures and display approved acceptance documentation prior to opening and receiving customers, or commencing an event or other activity.

19. What is an antibody test?

Antibody tests, antibody blood tests, and serologic tests refer to the same thing. It is a test to check your blood to look for antibodies, which are proteins that help fight off infections. Antibody tests can show if you had a previous infection with a virus.

20. Do you recommend antibody testing? Why not?

According to the CDC, the test may not find antibodies in someone with a current COVID-19 infection. It depends on when someone was infected and the timing of the test.

• Antibody tests cannot be used as the only way to diagnose someone as currently being sick with COVID-19.
• We don’t yet know if a positive antibody test means you are immune to COVID-19.
• Antibody tests may react with other seasonal viruses and result in false-positive results.

21. Why do the numbers change/differ from my local health department?

Information on this dashboard may change as new or different information is discovered through case investigations performed at the local level. Labs, hospitals, and state and local public health agencies enter initial data into CEDRS. Then, local health agency epidemiologists investigate the cases to gather more information. As they gather more information about a case, they update the data reported to their local public health agencies and to the state via CEDRS. Therefore, numbers and information provided by local agencies may be more up-to-date than this statewide dashboard.

22. How is it determined which county a case belongs in?

Cases and deaths are attributed to the county of residence of each individual.

People who test positive for COVID-19 in Colorado while visiting are included in the county where they were identified.

23. What’s the difference between confirmed and probable cases?

The total number of cases includes both confirmed and probable cases.  

• Cases are considered confirmed when there has been a positive molecular amplification test (such as PCR) performed by a lab. These tests commonly involve taking a nasal swab which is then sent to specific laboratories for results. 
• A molecular amplification test detects genetic material from the virus indicating the presence of the virus.
• Cases are considered probable when they meet one of the following criteria: 
  • A person exhibited symptoms AND had close contact with someone who tested positive 
    • OR
  • A person exhibited symptoms AND tested positive using an antigen or serologic test. 
    • An antigen or serologic test is a blood test that looks for antibodies in your blood. This test can detect the body’s immune response to the infection caused by the virus rather than detecting the virus itself. 
    • OR
  • A person has an epidemiologic link^*AND has tested positive using an antigen or serologic test
    • *An epidemiologically-link is close contact with a confirmed or probable case of COVID-19 disease OR travel to or residence in an area with sustained, ongoing community transmission OR a member of a risk cohort as defined by public health authorities during an outbreak.
    • OR
• A death certificate lists COVID-19 disease or SARS-CoV-2 as a cause of death or a significant condition contributing to death with no confirmatory laboratory testing performed for COVID-19.

24. What community resources are available?

If you are wondering where to find resources to supplement lost income because of COVID-19, you can find them on the “Healthy Grand County” website. Healthy Grand County is the result of a community-wide strategic plan for Mental Health; Maternal, Infant and Child Health (MICH); and Health Information and Awareness. The need for greater awareness of existing services in Grand County and the ability for residents and providers to easily find those services is a top priority.

25. What type of healthcare is being provided?

Primary healthcare providers throughout the county are offering different options for services. All of Middle Park Health’s campuses, Denver Health in Winter Park, Fraser Medical Clinic, and Byers Peak Family Medicine are offering telemedicine options and in-person care. Please call prior to visiting any provider, as services and operational hours vary. Let your primary care provider know if you are concerned about payment. They can connect you with resources such as A.C.H.E.S. & P.A.I.N.S. vouchers from the Grand County Rural Health Network for our low-income and uninsured residents. For Coloradans who lose their jobs and their health insurance, coverage through the Connect for Health Colorado website is available: www.connectforhealthco.com

26. What mental health and anxiety resources are available to the Grand County community?

If you are stressed, anxious, lonely, depressed, angry, or all of the above, you are not alone. We are in this together, and caring mental health professionals are available if you need to talk. Just call 877-519-7505. MindSpringsHealth.org/COVID and Facebook.com/MindSpringsHealth offer self-guided meditations, soothing self-care exercises, and coping and resiliency skills, with new resources added every day. All Mind Springs Health offices are open for business virtually, providing services by video or over the phone. Call 970-887-2179 to learn more or to make an appointment. You can also call Colorado Crisis Services for free, confidential, professional, 24/7 support (1-844-493-8255; Text “TALK” to 38255).