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9-R Community Update from Medical Director - 2/24/21

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Hello.  I am Dr. Heidi McMillan and, as many of you know, I serve as medical director for the Durango 9-R school district. 

Today, I am giving the executive team a break and plan to share with you our latest updates as they pertain to our school district. 

As we all know, it has been a long and challenging year so far, but we have glimmers of hope with the vaccine, especially in our community where we have been able to move a little quicker than other parts of the country.  

I think we could all share ways in how covid has shaped our lives… some tragic and some with a greater appreciation for each of us.  For all of us it is different in some way.

One way that it is different for me is that I start every morning reading about COVID news before zooming with our district nurses and Vanessa Giddings to prepare for the day of COVID monitoring.   Then we move through the day, weaving our ‘old’ job in with our new.  Then, typically we check in at the end of day, hoping there were not too many cases.  I have gained incredible appreciation for the Durango staff at every level  and for community partners from the health department to the medical providers.  So many are working tirelessly, evaluating data, implementing systems, helping in any way to provide safety and create eventually some semblance of normalcy. 

Today, in our weekly COVID update, I’d like to briefly cover 5 topics:

  • The COVID dial
  • Vaccine
  • Testing options: 
  • Mask updates: really important with variants; CDC update 
  • Isolation & Quarantine update 
  1. COVID dial:  while we recently were designated blue, we are now switching back to yellow. This does not impact the schools directly and our processes will stay the same. 
  2. VACCINE update: Thanks to SJBPH- we have a clinic this weekend.
  3. A word on testing: As a reminder, tests come in several forms.   A diagnostic test can show if you have an active coronavirus infection and should take steps to quarantine or isolate yourself from others. Currently there are two types of diagnostic tests– molecular tests, such as RT-PCR tests, that detect the virus’s genetic material, and antigen tests that detect specific proteins from the virus.  

We currently have access to both tests and will use them in different ways. 

Many of you may have heard in the news that schools will have access to rapid tests, specifically tests called BINAX NOW. These are an antigen test that has been compared in its ease of use to a home pregnancy test.  These have been made available to our teachers and staff through a program through the state of Colorado. We may also have a limited supply for students. I anticipate that in the next year, we are going to see these readily available for individuals to use at home as yet another strategy of mitigation. 

The usefulness of these tests lie in the speed (15 minutes vs 24-48 hrs) and accuracy of a positive test.  If the test yields a positive result, then we are able to trust the result with near 100% confidence.  In the school setting, this  would allow us to swiftly act to decrease further transmission.  

The down-side of this is that it does not capture all of the positive cases. In other words, there may be false negatives.  So, if a person has symptoms and this test is negative, we would recommend getting a PCR test to confirm. 

The PCR tests remain important as they are able to both rule-in and rule-out COVID to a greater degree.  The down-side of these tests is that they take 24-48 hrs in general.  We are lucky that we have several testing options in the community and work closely with two organizations.  The two that we have partnered with to support the district include: 

  1. TestDirectly (formerly Cedar diagnostics), these generally take 24-36 hrs and they take insurance. However, the self pay cost is $180.  
  2. Covid Colorado testing at Fort Lewis College- the turnaround is 36-48 hrs and is free as it is subsidized by the state. 

Both of these are easy to use though require appointments online.   

  1. Masking: Masking and social distancing remain the most effective  ways to reduce transmission.  With concern for new variants that are more contagious, wearing masks properly and consistently becomes increasingly important.  Modeling data today for colorado relayed that a decrease in the percentage of persons wearing masks and practicing social distancing to 60% would yield 1000 more deaths in the next several months. 

I’ve been really encouraged by seeing most in our community wearing masks consistently.  Keep it up!  It really does save lives.  

New information regarding masking include that snug fitting masks and double masking are even more effective.  

In a recent study, researchers found that if two people are both wearing surgical masks that are knotted and tucked flush to the face — or if both are wearing a cloth mask over a surgical mask — exposure to viral particles is cut by more than 95%.

Isolation and Quarantine updates: 

Prior to diving into updates… Let’s briefly review:

ISOLATION  applies to a person who is ill with COVID.  In order to decrease spread, they must isolate themselves from others.    Ideally, this means having their own room, own bathroom and wearing a mask, even at home. 

To be cleared from Isolation, one must ISOLATE for at least 10 days and be free of symptoms or fever for >24 hrs. 

To be cleared to return to school, this also means obtaining a doctor’s note.  The reason for this is so that we have the assurance that your doctor believes that your student is free of COVID, and more importantly,  for you to have anticipatory guidance from your child’s medical provider with regard to this potentially serious illness. 

QUARANTINE applies to persons who have been exposed to one who has COVID-19 and is deemed a ‘close contact.’  

If one is considered a ‘close contact,’ they must quarantine, which means that they stay home and away from others.  They do not go to stores, gyms, school or work. 

The safest QUARANTINE period is 14 days.   This is because the incubation period for SARs CoV-2, the virus that causes COVID-19 is up to 14 days.  That means that if one is exposed to the virus, they could develop COVID-19 for up to 14 days. 

However, it has been discovered that if one is symptom-free for ten days they only have a 1-10% chance of developing COVID-19. 

Also, if one is symptom-free for 7 days and test negative after day 5, they have a 5-15% risk of developing COVID-19.  

Our district Policy has changed, in effect yesterday, is that we will adopt a 10 day quarantine period since it is reasonably safe.  

Special Examples:  

Individuals who have had COVID-19

Fully vaccinated individuals

If I have had COVID-19 and recovered, can I get it again? 

Yes, but it is rare and highly unlikely prior to 90 days after due to protective antibodies?

If I have COVID-19 do I need to wear a mask once I recovered? Yes, because even with protective antibodies one can still ‘catch the virus from others,’ carry it in their nose and pass it to others without ever getting sick themselves. 

If I have COVID-19 and are exposed again, do I need to test again or quarantine? 

  1. The current recommendation is:
    1. If it is within 90 days of illness, no one does not need to quarantine and should not test (as they may still test positive for 90 days without being considered contagious).  HOWEVER as previously discussed, they must wear a mask. 
    2. If it is beyond 90 days, then yes, they should quarantine and be tested 

If I have the vaccine, do I still need to quarantine? 

  1. Per the CDC...One may avoid quarantine after exposure, if they are fully vaccinated...meaning  -- having had both shots with at least two weeks having passed since the second shot. That's because it takes two weeks to build full immunity after the second dose of vaccine.
  2. However… currently, it is recommended that if they develop symptoms three months after receiving the second dose, they should test and if exposed, quarantine because currently we don’t know how long the immunity will last.  STAY TUNED AS THIS WILL LIKELY BE UPDATED. 

Thank you for your time today to tune in for these 9-R related updates.   

More importantly, thank you all for your support of our schools and our brave staff who have committed to serving our children and community.   


Colorado COVID restrictions:


SJBPH quarantine/Isolation:


TESTING options for 9-R


CDC mask wearing guidelines: