Important Message from the Health Center

Email from Ruben Zorrilla, MD, Medical Director; Berkin Ulgen, MD; and Steve Monaco, Director of the Health Center at Auraria

March 19, 2020

Potential Exposure Guidance

The Coronavirus pandemic is constantly changing, hence the guidance set forth below may be modified if circumstances and new clinical findings warrant content revisions.

Due to the widespread communicability of the Coronavirus disease, medical personnel and public health agencies have had to adjust guidance for how to best respond to the increasing number of positive Coronavirus cases in the United States and locally.

Under normal circumstances, when a positive case of a communicable disease is reported in a community or subset of a particular population group, public health officials attempt to inform individuals who may have potentially been exposed. However, given the rapid  infiltration of the Coronavirus into the U.S., with a rapid escalation of positive cases, public health officials must utilize their resources differently, reprioritizing their standard procedures, to more effectively respond to the immediate needs of the American public.

Given the highly contagious characteristics of Coronavirus, the ongoing community spread and limited resources, the priority of the medical community has shifted from a containment strategy to a mitigation strategy. As a result, it is not feasible to inform individuals who may have been in contact with someone who has tested positive. Consequently, there is no need to inform the Director of the Health Center at Auraria if you test positive for the Coronavirus, since results are verified and collected by the Colorado Department of Public Health and Environment. Effective 3/18/20 the following new guidance is provided so that individuals can better respond to their particular needs.

In all three (3) scenarios outlined below, the following recommendations apply:

• Call a medical provider if you have any concerns about your symptoms
• If you have a medical emergency, call 911
• Wash your hands
  • Wash your hands often with soap and water for at least 20 seconds especially after you have been in a public place, or after blowing your nose, coughing, or sneezing.
  • If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol. Cover all surfaces of your hands and rub them together until they feel dry.
  • Avoid touching your eyes, nose, and mouth with unwashed hands.
• Clean surfaces regularly with an available disinfectant product.

Symptoms, Self-Quarantine, Self-Isolation and When Individuals Qualify For Testing

Scenario #1: You have symptoms typically associated with Coronavirus (fever, cough, shortness of breath).

• You should treat yourself as if you may have COVID-19.
• The vast majority of individuals who test positive will have mild symptoms or be asymptomatic (with no symptoms). If symptoms are mild, over the counter medications can be considered.
• Self-isolate for 10 days. Self-isolation is defined as staying at home away from others, isolating completely away from family members living in the same household. While at home self-monitor your symptoms (e.g., take your temperature if feeling feverish). If symptoms are well managed at home, you should self-isolate for 10 days AND be fever free for 72 hours (without taking a fever reducing medicine), before self-isolation is ended.
• At this time, test kits and personal protective equipment are in short supply in the U.S. and in Colorado. Due to this shortage, specific criteria must be met in order to qualify for Coronavirus testing. However, please know that the CDC and State Health Officials may change the testing criteria at any time.
• Current testing criteria: You are 65 or older, a healthcare worker, or have one of the following conditions: pregnancy, uncontrolled diabetes, hemodialysis, chronic lung disease (e.g. on supplemental oxygen, pulmonary hypertension), cancer, on chemotherapy, organ transplant, HIV or AIDS, immune deficiencies, conditions requiring treatment with immunosuppressive agents or other significant risk factors.
• If you are 65 or older, a healthcare worker, or have been diagnosed with additional health concerns (as per above), call your medical provider when symptoms first occur, to have them assess if you should be seen in person and/or if you should be tested for Coronavirus.
• Call a medical provider if you have any concerns about your symptoms.
• If you have a medical emergency, call 911.
• CDC CORONAVIRUS FACT SHEET
• CDC SYMPTOMS INFORMATION

• Self-quarantine for 14 days. Self-quarantine is defined as staying at home so you do not potentially spread the disease to others. Within family households attempt to maintain social distancing as much as practically possible. If you remain asymptomatic (with no symptoms) for 14 days, you can end your self-quarantine. However, continue to practice social distancing to protect yourself.
• At this time, test kits and personal protective equipment are in short supply in the U.S. and in Colorado. Due to this shortage, specific criteria must be met in order to qualify for Coronavirus testing. However, please know that the CDC and State Health Officials may change the testing criteria at any time. In this instance, assuming you remain asymptomatic (without any symptoms), it is unlikely that you will qualify for Coronavirus testing, based on current guidelines.
• If you should become symptomatic (i.e., you develop symptoms) during your self-quarantine period, please refer to the content outlined in scenario #1 above.
• If you have a medical emergency, call 911.

Scenario #3: You have NO symptoms and NO known contacts with someone who tested positive for COVID-19.

• Consistently practice social distancing; limit activities and where you go to reduce your contact with others as much as possible, attempting to stay 6 feet apart from others. You should avoid going into public places at prime times; instead, consider shopping online.
• Wash your hands and clean surfaces regularly as outlined within this document.
• HOW TO PROTECT YOURSELF

During this global pandemic, it is important to ensure that you receive accurate information. The following links are provided as additional resources.

• COLORADO DEPARTMENT OF PUBLIC HEALTH & ENVIRONMENT
• CENTERS FOR DISEASE CONTROL AND PREVENTION
• WORLD HEALTH ORGANIZATION