CDPHE says the information is collected inconsistently, which is why the data they have is not considered a complete picture.
DENVER — As of Wednesday, the Colorado Department of Public Health and Environment (CDPHE) reported there have been at least 2,062 confirmed cases of COVID-19 among healthcare staff in the state and seven confirmed healthcare staff deaths after a confirmed COVID diagnosis.
Caveats must be considered when looking at those numbers. One, while we do know most of these cases and deaths were traced back to nursing homes and senior care facilities, we do not know which position each of those healthcare professionals held. Two, there could be more cases and deaths than we know.
The department says it has an incomplete picture of how many healthcare workers in Colorado have actually contracted the coronavirus.
“Healthcare workers are still prioritized for testing. We do not have a complete picture of the number of healthcare workers who have tested positive, been hospitalized or who have died as the result of COVID-19 because the information is collected inconsistently,” CDPHE told Next with Kyle Clark via email.
The department said the inconsistency comes from the way the data is reported.
“Health care workers are prioritized for testing, and their samples typically are prioritized at each laboratory. Information that allows any single lab to prioritize a ‘health care worker’ and move them to the front of the testing queue isn’t necessarily the information that flows from that lab through our Electronic Laboratory Reporting (ELR) system,” the department said. “We currently don’t receive occupation or a health care worker designation at the test level from laboratories.”
Instead, CDPHE said it looks at its disease reporting database that is completed by a variety of partners, including local public health department staff, hospitals and automated information feeds from laboratories that do not include occupation. Though, the occupation is filled out inconsistently, according to CDPHE.
Then, you have the added layer of defining “healthcare worker.” Darlene Tad-y, MD, is the president of clinical affairs for the Colorado Hospital Association. She said the definition can be wide-ranging and may include medical assistants, patient care technicians and radiology techs, to name just a few less-thought-of examples.
Tad-y, who has also treated COVID-19 patients, said the data can be influenced by a number of factors: which kinds of healthcare workers are included, where they got tested, which kinds of facilities are included and how the person may have actually contracted the virus. It can also vary depending on who is gathering the information and what parameters they are using.
“Because our healthcare workforce is at the front lines of taking care of people who have COVID-19, I think it’s important to understand how well we are practicing the measures we think protect our people from contracting COVID-19,” Tad-y said. “Keeping track of that is important. I think it’s for both directions. One, it’s for us to understand how well we are caring for our staff, our people, and two, it’s how well are we keeping track of the folks that we take care of who have COVID-19 and protecting the general public.”
The state health department said this issue isn’t not exclusive to Colorado.
“There have been many families devastated by loss during the COVID-19 pandemic, and there have been national reports of healthcare workers who have sacrificed their lives helping others. Consistently tracking the number of illnesses and deaths among healthcare workers is a challenge in Colorado and across the country, as there is not an active database,” a spokesperson said via email.
Both the Colorado Hospital Association and CDPHE pointed to a project called “Lost on the Frontline” that honors healthcare workers who have died in the pandemic.
The project is through Kaiser Health News, separate from Kaiser Permanente, and The Guardian. Brian Garrett, who lived in Fort Collins, is included in their work.
“He had a huge heart, a big family person,” Garrett’s nephew Brandon Guthrie said. “Always liked to joke around. A really, really good dad.”
His family said Garrett’s job was to drive patients to medical appointments. Near the beginning of the pandemic, he started feeling sick. He self-isolated and ended up in the hospital.
Garrett died in April, a week before his son’s 11th birthday.
Stories like Garrett’s are included in “Lost on the Frontline” thanks to information from multiple sources like medical examiners, media reports and getting confirmation with friends and family.
Since the project also indicates there is no national tracking available, the numbers can vary from other data sources.
The Colorado Hospital Association said while data is difficult to track, its sense is that Colorado has a lower number of healthcare workers who have fallen sick with COVID-19 because earlier on in the pandemic, healthcare providers took notes from other states like Washington.
In an e-mail Cara Welch, with CHA, explained:
“They advised us to begin PPE (personal protective equipment) conservation practices immediately, even if we weren’t seeing high case volumes yet or anticipating PPE shortages. By putting those efforts in place early on, we believe it helped our hospitals and health systems still maintain an appropriate level of PPE for staff – even when the supply chain became less reliable and cases started to rise.
The second reason is that our hospitals and health systems have infection control in their DNA. It’s something that they focused on 24/7 – even before we were in the midst of the pandemic. CHA works regularly with the infection preventionists that work at all our hospitals, so we know that they are an interconnected group that focuses on best practices for maintaining a safe environment for staff and patients. So when COVID-19 did make it to Colorado, we already had key actions in place (e.g., hand hygiene, co-horting of infectious patients, PPE, etc.) to help continue that safe environment.”
UCHealth said data from antibody testing, which shows whether someone has been exposed to COVID-19 in the past, indicates their employees have lower exposure rates than the general public. They credit that to staff taking precautions both inside and out of the hospitals, keeping themselves and their families safe when outside of work, as well as personal protective equipment and other precautions that have worked to keep employees safe.
Dr. Michelle Barron, an infectious disease specialist with the hospital, said that early antibody test reliability was in question, but the tests UCHealth uses have been developed and are much more reliable. She also said she doesn’t keep track of diagnostic tests from employees to protect their privacy.
In an e-mail a different health system, HealthOne said:
“Currently, at HealthONE, less than 2.5% of our colleagues have tested positive for COVID19. We have policies and procedures in place to remotely monitor and symptom screen any colleague who has had a known exposure to COVID19 to ensure they get the care they need. We offer colleagues paid leave if they are determined to be at a high-level risk after exposure to COVID19 at work. We also offer quarantine pay for staff who are quarantined according to CDC guidelines, regardless of where the exposure occurred. For the safety of our colleagues, our facility follows CDC guidelines for bringing our team members back to work.
Throughout our response to COVID19, our focus has been on meeting patient needs, protecting our colleagues and ensuring our people have enough personal protective equipment (PPE). This includes our universal masking policy, consistent with CDC guidelines, that has been in place since the end of March and requires masks for everyone in our healthcare facilities. We also provide N95 masks for all colleagues treating suspected or confirmed COVID19 positive patients and to colleagues working in high risk areas. While we continue to monitor the situation closely, we currently have adequate supplies and equipment to help ensure the protection of our colleagues and patients.”
The state said families that want to make sure a loved one’s case is recorded should contact their local public health agency.
“In the event the data is collected more consistently, it would be helpful information to have,” they said via email.
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