UPDATE

Please direct any general questions to callcenter@gunnisoncounty.org.

VIRTUAL TOWN HALL MEETING:

The Virtual Town Hall Meetings have shifted to Thursday evenings at 5 p.m.

Sign up ahead of time for the Zoom webinar here. We will also be live streaming the meeting onto Gunnison County Health and Human Services Facebook page.

FEELING SICK

What is the procedure if you’re feeling symptomatic?

If you are symptomatic and seeking testing, please contact the Call Center at 970-641-7660. The Call Center is open Monday-Friday, 9 a.m.-12 p.m. The Call Center is closed Saturday and Sunday.

We ask that you not show up to the screening site until you call first.

If you are symptomatic, but otherwise stable, please self-isolate for 10 days and self-report at gunnisoncounty.org/covid19.

If it is an emergency, please call 911.

PUBLIC HEALTH ORDER

What does the current blue level mean for us locally?

Here is a breakdown of the Blue Level Public health order.

Covid-19 Monitoring Dashboard

  • What is the top graph shown on Gunnison County’s COVID-19 dashboard and how it is meant to be used?

The top graph is meant to provide an indication of whether the number of people currently infected with the virus is increasing, decreasing, or staying stable over the last 30 days.  Because it is showing active infections, it does not include antibody tests, which are an indicator of whether someone was infected in the past.

  •  Why do we show the number of people getting tested because of illness separately, in the graph below?

The number of people getting tested because of illness could be a leading indicator of a jump in infection rate.  Because people can get tested for other reasons (e.g., contact tracing), we want to be transparent on how many tests are being performed because of symptoms.

  •  Why does the county show the positivity rate, and why a 14 day rolling average?

The positivity rate provides insight into the overall infection rate in the county.  If the positivity rate is high, it suggests there are a lot of people who are infected that are not being tested.  The goal is to have a positivity rate below 5%.  We calculate it as a 14 day rolling average to smooth out differences between days (e.g., just by chance, a small number of tests could be given on a day and a single positive would skew the results).  We use 14 days to calculate the rolling average, following the state’s use of 14 days for assessing Gunnison County’s performance.

  •  How is positivity calculated?

For the last 14 days we divide the total number of positive tests by the total number of tests which produced negative or positive results.

  • Why does Gunnison County show a rolling average for the number of tests which are conducted?

We want to be transparent about the number of tests being performed because that is an important measure of our ability to understand what is happening locally with the virus.  If we are conducting too few tests, it means we do not have a good sense of whether there is an outbreak in Gunnison County.  We use the rolling average because there can be quite a bit of daily fluctuations in testing (e.g., weekends, bad weather) unrelated to the county’s overall success at conducting tests.  A rolling average reveals the county’s general performance.

  • Who gets tested for the COVID-19 virus?

People receive tests for many reasons.  The Gunnison Valley Hospital (GVH) and Gunnison County Public Health operate a testing center that tests individuals for free who are symptomatic, are an essential worker, or have been in close contact with an individual who has tested positive.  GVH has been providing antibody testing upon demand (for any reason) as a paid service and starting Oct. 1, 2020 will also perform testing upon demand for active viral infections.  The hospital and local clinics also test individuals going into surgery.  Individuals working and living in long-term care facilities  (e.g., Gunnison’s Senior Care Center) are also regularly tested.  

  •  Is the total number of people getting tested a good indicator of how many people have symptoms consistent with being infected?

No.  There are many reasons people are getting tested other than being symptomatic, including but not limited to being an essential worker, contact tracing, and pre-operative care. The dashboard includes a separate graph showing the number of people who were tested on a given day due to illness.

  • We show our daily testing capacity as 35.  Why are more being performed on some days?

The daily capacity refers to the average number of viral RNA tests (often referred to as PCR tests) that the Gunnison public testing center is capable of performing and is based upon the number of swabs the county receives from the state.  Gunnison County does have the capacity to increase daily testing beyond 35 if we experienced an outbreak, though we could not sustain it for extended periods of time.  

The daily testing capacity of 35 does not include rapid tests, or tests being performed by other entities (Senior Care facility, pre-operative tests, local clinics).  We show the capacity of the public testing center, excluding other tests, because it provides insight into the community’s capacity for testing symptomatic individuals and managing an outbreak.  

  •  Why are there sometimes big jumps in the number of tests?

The Senior Care Facility must test all employees and residents on a regular basis.  When they are on one of their testing cycles, you will see a big jump in the number of tests being performed.  For example, there was a big jump in the number of tests the week of Sept. 14, which was largely driven by tests performed at the Senior Care facility.  Gunnison County also started testing essential workers which increased testing numbers in September.

  •  How many tests should Gunnison be conducting?

The number depends in part on current infection rates as well as the kind of tests that are being performed (e.g., symptomatic individuals, contact tracing, essential workers, etc.).  On Sept. 28th, the Harvard Global Health Institute estimated that in Colorado we should be performing 2.25 tests per thousand people per day (or about 40.5 tests/day for Gunnison County) to mitigate or reduce the spread, of the virus.  To suppress the virus they estimated we should be conducting 8.18 tests per thousand people per day  (or about 147 tests/day for Gunnison County) to suppress the virus.

  • What kind of test results are posted on the Gunnison dashboard?

There are three main types of tests:  viral RNA (typically swabs that collect cells that are then tested for the presence of RNA molecules unique to the virus), antigen tests (often these are rapid tests that detect the presence of proteins associated with the virus), and antibody tests (which detect molecules that our bodies produce to defend against the virus).  The viral RNA tests are the most reliable tests, and are considered the gold standard against which other tests are evaluated.  The viral RNA and antigen tests indicate a current infection, whereas antibodies indicate your body has warded off the virus at some point in the past.  Because we use the dashboard to understand active infection rates, rather than as an indicator of how many people in Gunnison have been infected at some point in the past, we post only the results of the viral RNA tests and the antigen tests.

  •  How long does it take to get test results for active infections?

Gunnison County typically has results from the Rapid tests the same day.  At the end of every weekday, the viral RNA tests are driven to the state lab for processing (though bad weather can delay this) and we typically, though not always, receive results within 3 days.  If the state lab gets backed up, the State Lab will send swabs for processing to the Mayo Lab, or other labs, which introduces further delays in results. 

  •  How long does it take for Gunnison County to post results to the dashboard?

By law (HIPAA) once the state lab obtains the results they fax the results to the lab (e.g., GVH or a private lab) that ordered the test.  The lab then faxes the results to Gunnison Public Health. Test results are typically entered by hand into the Gunnison database the same day they are faxed to Gunnison Public Health, though if the results are received late in the day, they are received on the weekend, or it is a busy day, they may not be posted until the next business day. Once they are in the database they show up automatically on the dashboard.

  • After a large event or happening that might cause a jump in infections, how many days will it take to see a jump in detected cases?  

We expect to see a jump in 7-14 days after an event.  The average time from infection to someone displaying symptoms is about 5 days, though it can be shorter or even much longer. Because it may take a day or two for someone to notice the symptoms and get tested, we expect to see a jump in positive cases about a week after the event.  However, keep in mind that with a two day delay (or longer) in getting test results, it may be 9+ days before we can actually see a jump in cases.   

  • Whose test results are included in the Gunnison dashboard?

Gunnison County residents.  Gunnison County public health receives results of tests taken anywhere in Colorado for all Gunnison County residents.  We post all of those results.  Depending upon the level of communication and coordination we may receive results from Gunnison residents from outside the state and we post those. While the public testing center processes samples for non-residents, they are not posted on the public dashboard.

  •  Why doesn’t the county include results from non-residents on the public dashboard?

The primary purpose of the public dashboard is to provide insight into trends in infection rate. Because the number of non-residents in the county varies dramatically across seasons, and within the non-resident community there is considerable variability in length of stay, focusing on residents gives us a consistent metric of how infection rates are changing.  This is also consistent with how the state tracks results, which minimizes double counting.

  • Why don’t the number of positive and negative tests results that Gunnison posts match results shown by the state of Colorado or other entities reporting for Colorado?

Differences in how results are tracked by the county and state create differences in the numbers.  For example, following CDC guidelines Gunnison associates a test with the date the sample was taken.  This approach has several advantages, including making it easier to understand disease transmission dynamics (since when a sample is taken is indicative of symptoms and disease progression, whereas when the test is processed can be more of a reflection of how backed up the state lab is.)  Additionally, because of how we have set up the dashboard, showing the date the sample was taken allows the public to clearly see what the delays are in processing samples, which is a critical measure of how well our testing system is performing.  The State of Colorado, however, associates a test with the date the results are generated in the laboratory.  

  •  Should Gunnison County follow how the state of Colorado reports results?

We have tried to reconcile county and state results.  However, the state has changed their reporting a number of times, so we have decided to simply follow best practices, which provide greater insight into the temporal progression of the disease in Gunnison, and creates more transparency around testing delays.

  • What is an inconclusive test result?  

An inconclusive test means that the test results were unable to distinguish between a positive or negative result.  This can happen for several reasons, including having a small amount of DNA consistent with the virus, but not enough to conclusively determine it is the virus.

  •  How reliable are tests?

Care has to be taken in interpreting results.  All medical diagnostic  tests have some small chance of false negatives and false positives.  Some people can test negative but still have the virus (“false negative”) or someone can test positive who does not have the virus (“false positive”).  It is also true that someone can correctly test positive for the virus but not be infectious.  Each type of test (e.g., rapid tests versus viral RNA tests from swabs) has a different kind of error, with the best results generated by the PCR/viral RNA analysis of swabs taken from the nasopharyngeal cavity; there is evidence that some rapid tests have more false negatives than viral RNA swab tests.   For the purposes of the graphs, however, the general trends are what we are interested in.  Even with the different kinds of errors they give us a sense of whether the virus is increasing, decreasing, or stable.

  • If I have more questions, who do I contact?

Send questions to callcenter@gunnisoncounty.org