General questions and answers

COVID-19 is a disease caused by a virus called SARS-CoV-2. This virus was first identified in December 2019 and quickly spread around the world. Most people with COVID-19 have mild illness. But some people get very sick, and some die from the disease. While most people recover in a few weeks, some may not fully recover for a long time. Because COVID-19 spreads easily and can be dangerous, it has caused a worldwide public health emergency.

SARS-CoV-2 is a type of coronavirus. Coronaviruses are a very common large family of viruses. They can cause illness ranging from the common cold to more severe diseases, such as the Severe Acute Respiratory Syndrome (SARS-CoV) that was first identified in China in 2003 and the Middle East Respiratory Syndrome (MERS-CoV) that was first identified in Saudi Arabia in 2012.

Coronaviruses are common in people and many different species of animals, including camels, cattle, civet cats, and bats. Coronaviruses are zoonotic, meaning they are transmitted between animals and people. This transmission is called spillover. The spillover can happen either by mutation or by very close contact to animals.
 
In December 2019, scientists identified a new type of coronavirus that had not been previously seen in humans. They found this new virus during an investigation into an outbreak in Wuhan, China. The World Health Organization (WHO) named this virus Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). This name was chosen because the virus is genetically related to the coronavirus responsible for the SARS outbreak of 2003. The disease caused by this virus is known as Coronavirus Disease 2019, or COVID-19.

COVID-19 typically spreads three ways.

• Respiratory droplets:

  • When a person is infected with the virus that causes COVID-19, they produce small droplets containing the virus when they sneeze, cough, or talk. These droplets are often not visible to the naked eye, but can be seen on slow motion cameras. A healthy person who is close to the infected person can then breathe in these droplets and catch the virus. This is similar to how flu and cold viruses spread.

• Airborne transmission: 

  • Sometimes very small respiratory droplets can stay in the air for several hours and travel longer distances. A healthy person can then breathe in these droplets and catch the virus. This happens more often in indoor settings that are not well ventilated.

• Infected surfaces or objects:  

  • It may be possible to get COVID-19 by touching a surface or object that has the virus on it and then touching your mouth, nose, or eyes. This type of spread is thought to be less common with COVID-19, especially when you wash your hands regularly.

Symptoms of COVID-19 can be mild, like the symptoms of a common cold or allergies. They can also be serious, like shortness of breath or trouble breathing. In the most serious cases, COVID-19 can cause pneumonia, acute respiratory distress syndrome, organ failure, or death. These severe outcomes are more likely to happen in people with risk factors for severe disease, as well as people who aren’t vaccinated or haven’t gotten all their recommended vaccine doses.

Symptoms can include, but are not limited to:

• Cough.

• Tiredness.

• Fever.

• Loss of taste and/or smell.

• Shortness of breath or difficulty breathing.

• Muscle or body aches.

• Headache.

• Sore throat.

• Congestion or runny nose.

• Nausea or vomiting.

• Diarrhea.

People who have any COVID-like symptoms should get tested as soon as possible and isolate.
 
Emergency warning signs
 
If someone is showing any of these signs, seek emergency medical care immediately by calling 911 or going to your local emergency facility:

• Trouble breathing.

• Persistent pain or pressure in the chest.

• New confusion.

• Inability to wake up or stay awake.

• Pale, gray, or blue-colored skin, lips, or nail beds, depending on skin tone.

This list does not include all possible severe symptoms. Please call your medical provider for any other symptoms that are severe or concerning to you. 

Yes. Some people who get COVID-19 don’t feel any symptoms. This is called an asymptomatic case. People who are asymptomatic can still spread the virus to other people. That is why it’s important to practice public health protocols, like washing your hands and wearing a mask if COVID-19 is spreading in your community, even if you feel well.

If you think or know you have been exposed, but you don’t have symptoms, you should get tested at least five days after you think you were in contact with a person who had COVID-19.

It usually takes between two and 14 days to start feeling symptoms. This is called the “incubation period” of the virus.

It depends on how serious the illness is. Many people with mild symptoms feel better after a week. People who are up to date on their COVID-19 vaccinations are more likely to have mild symptoms and recover more quickly. People who get seriously sick may need six weeks or more to recover. Some people suffer long-term health impacts after getting sick with COVID-19. CDC has more information on Post-COVID Conditions.

COVID-19 can be mild or it can be very serious. According to the World Health Organization, most of COVID-19 cases are mild. However, the more serious cases can lead to long-term health problems or even death.

While anyone can get seriously sick from COVID-19, some people are at higher risk for severe illness than others. Higher risk groups include: 

• People who have not been vaccinated against COVID-19.

• People who are 65 and older.

• People of any age with certain underlying health conditions.

The best way to protect yourself and others from COVID-19 is to get all of your recommended doses of COVID-19 vaccine. All Coloradans aged 6 months and older can get vaccinated. 

Other ways to prevent the spread of illness include:

• Staying home when you are sick.

• Staying informed with reliable resources, like CDPHE, CDC, FDA, and WHO.

• Wearing a well-fitted mask in crowded indoor areas, especially when the COVID-19 community level in your county is medium or high. 

• Avoiding crowded indoor or poorly ventilated areas, especially if you are at high risk of getting severely ill with COVID-19. 

• Improving the ventilation in your home and workplace. 

• Washing your hands frequently.

• Getting tested when you know or think you were exposed or before gathering with others.

Yes. If you have tested positive for COVID-19, you may be able to get medicine to help you recover. These medicines can help keep you from getting seriously sick and keep you out of the hospital. Some of these medicines require an injection or IV, and others can be given as pills taken by mouth.

All of these medicines must be started very soon after you develop COVID-19. It is important that you get tested as soon as possible to get these medicines. Some providers offer both testing and medicine at the same location.

The currently available medicines are for people who are at risk of getting very sick from COVID-19. People at high risk include people aged 65 and older, people who are obese or overweight, and people with certain medical conditions, including mental health conditions.

There are also some medicines recommended by the National Institutes of Health for severely ill people who are hospitalized.

Yes. The FDA has approved and authorized multiple COVID-19 vaccines. These vaccines are available to all Coloradans aged 6 months and older. For more information about COVID-19 vaccines, please visit our vaccine FAQ.

Everyone is at risk of getting COVID-19. 

People at the greatest risk of infection are are people who:

• Have not been vaccinated or who have not received all vaccine doses recommended for them.
• Have been to areas where widespread community transmission is occurring.  
• Spent time in a poorly ventilated area with someone who has COVID-19.
• Spent time in large groups or crowded areas.
• Had direct or close contact with someone who has COVID-19.

• If you have tested positive for COVID-19 or have symptoms of COVID-19, you should stay away from other people for a certain amount of time while you are infectious. This is called “isolation.” Staying away from other people while you are contagious prevents the virus from spreading. Learn more about how to isolate.

• Generally speaking, eating and drinking is not a way coronaviruses are spread. The natural processes of digestion kill these viruses. 
• Generally speaking, food is not contaminated with coronaviruses, and cooking would kill any virus in the food.
• According to the Water Environment Federation, there is no evidence that coronavirus survives the disinfection process for drinking water and wastewater. The COVID-19 virus has not been detected in drinking water.

It can. Current evidence shows that some people catch COVID-19 after being exposed to small droplets and particles that stay in the air for minutes to hours after an infected person has left a space. This is more likely to happen if the space is enclosed and poorly ventilated.

It’s very unlikely that packages would be contaminated with COVID-19. Coronaviruses are generally spread through respiratory droplets and don’t survive well on surfaces. There is no evidence that COVID-19 is transmitted through imported goods or shipped packages. However, washing your hands before touching your face can even further reduce this low risk.

No. Normal swimming pool disinfection techniques are thought to be effective against COVID-19. 

Close contact means you have been in direct contact (like hugging, feeding, or being coughed on) with someone who is sick. You can also be exposed as a close contact if you are within six feet of an infected person for more than 15 minutes over a 24-hour period. That doesn’t have to be 15 minutes in a row. If you were close to an infected person for five minutes in the morning and 10 minutes in the afternoon on the same day, you’ve had close contact with someone with COVID-19.  When community transmission levels are high, it is possible to have close contact and be exposed without knowing it because you are more likely to have contact with people who are infected.

Community spread or community transmission means many people have been infected with the virus in an area, including some who are not sure how or where they became infected. Visit the CDC’s COVID data tracker map to see how much COVID-19 is spreading by county throughout the United States. Each health department determines community spread differently based on local conditions. For information on community spread in your area, please contact your public health department.

Yes, it’s possible for people to transmit the virus before they have symptoms or without having symptoms at all. People start to be contagious two days before developing symptoms. For that reason, it is critical for people to take precautions around others after exposure to COVID-19.

People of different national origins and racial or ethnic groups are no more likely to contract or spread COVID-19 if they have been exposed, and COVID-19 is present in all communities. However, some racial and ethnic minority groups are disproportionately affected by COVID. Conditions in the places where people live, learn, work, play, and worship affect a wide range of health risks and outcomes, such as COVID-19 infection, severe illness, and death. These conditions are known as social determinants of health. Long-standing inequities in social determinants of health that affect specific communities more than others, such as poverty and health care access, are interrelated and influence a wide range of health and quality-of-life risks and outcomes.

The name of this disease is Coronavirus Disease 2019, abbreviated as COVID-19. In COVID-19, ‘CO’ stands for ‘corona,’ ‘VI’ for ‘virus,’ and ‘D’ for disease. Formerly, this disease was referred to as “2019 novel coronavirus” or “2019-nCoV.”

• Yes. Under Colorado’s Healthy Families and Workplaces Act, your employer has to give you paid time off if you get sick with COVID-19.

• Your employer also has to give you paid time off while you go to your vaccine appointment or take a family member to get vaccinated. If you have side effects from the vaccine that keep you from working, you should get paid time off while you recover as well.

The Colorado Department of Public Health and Environment and local public health agencies do not have, and cannot provide, a letter clearing you to go back to work. If you had symptoms consistent with COVID-19, you should isolate yourself for at least five full days after symptoms started, and continue isolating yourself until you are fever-free (without the use of fever-reducing medications) for 24 hours and your symptoms are improving. You should then wear a well-fitting mask around other people and avoid traveling for five more full days. Public health does not require people to have a negative test to return to work. If your employer is requiring this, you may want to contact your doctor, or another health care provider, or direct your employer to this Q&A.

Ask your employer about their COVID-19 plans and policies. If you are an employee with a disability who is at high risk, you can ask your employer to make reasonable accommodations under the ADA.

If you can, you should get a COVID-19 vaccine and stay up to date with recommended doses for the best possible protection from getting sick.

If you are moderately to severely immunocompromised, or you have a medical contraindication (like a severe allergy) to COVID-19 vaccines, you may be eligible for a preventive therapy called Evusheld. You should get a dose of Evusheld every six months. Learn more about getting preventive treatment for COVID-19.

Wearing a well-fitting, high-quality mask, washing hands frequently, and having good ventilation at work can also help protect you from COVID-19.

• No, it’s illegal to discriminate against anyone based on age, disability, pregnancy. Anyone believing they have been discriminated against or not accommodated should contact Colorado Civil Rights Division or the Equal Employment Opportunity Commission.

• Find the latest data for Colorado on our COVID-19 data dashboard. 
• Find COVID-19 data for the United States on CDC's website.
• Find data for other countries on the World Health Organization’s website.

• It varies depending on the data source and when the data is reported to the state.
• Vital records data is updated periodically after the CDC codes the data. We report out vital records data to account for deaths from COVID-19. 
• Epidemiological data, like the number of confirmed cases, is updated Monday through Friday at 4 p.m. and accounts for cases reported to the state as of the previous day.
• Facility outbreak data is updated every Wednesday at 4 p.m.
• Please note that the data is only as up to date as what has been reported to the state. You may notice lags in data or changes in numbers as labs, hospitals, facilities, and local agencies report their data to the state.

Information on the state’s 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 a database. Then, local health agency epidemiologists may investigate the cases to gather more information. As they gather more information about a case, they update the data. 

The timing of when data is pulled and published may also vary between the state and local public health departments.

Cases and deaths are attributed to the county of residence of each individual according to guidelines published by CDC.

Cases of COVID-19 can be classified as suspect, probable, or confirmed. Our data and CDC’s data includes confirmed and probable cases. Colorado aligns with current case definitions published by CDC. However, regardless of whether a person is a confirmed, probable, or suspect case, they should follow isolation guidance and their close contacts should follow the guidance for people who have been exposed. 

Tracking and collecting racial and ethnic data is vital for our healthcare system to achieve equity and eliminate disparities.

• Data presented on the demographics dashboard represents more than 75% of all reported COVID-19 cases. Cases with an unknown race or ethnicity are excluded from these calculations, so it does not provide an accurate view of statewide trends. 
• The state is working with hospitals and medical providers that interact directly with patients to encourage them to collect and report this data. 
• As an important note, race and ethnicity data can be challenging to collect and report accurately if a medical provider does not ask the patient to self-report it.  

• Individual hospitals and health systems report data about hospitalized patients with COVID directly to CDPHE. This allows us to track the number of people hospitalized with COVID and how severe their illness is.

• The Colorado Hospital Association also shares hospitalization data with CDPHE through a data-sharing agreement.

Colorado provides death data related to COVID-19 in two ways:

• Deaths caused by COVID-19:
  • The vital records death data is based on CDC coding of death certificates, and it reflects the number of deaths due to COVID-19, based on the expert judgment of health care providers and coroners. 
    • The number comes from death certificates where COVID-19 is listed as the cause of death or a significant condition contributing to death.
    • This number is determined by the CDC and is updated daily for dates through the previous Saturday.  
• Deaths among people who died with COVID-19:
  • The epidemiological death data reflects people who died with COVID-19. For deaths occurring on or after January 1, 2023, deaths among cases include cases of COVID-19 where:
    • A death certificate indicates COVID-19 or an equivalent term as an immediate, underlying, or contributing cause of death, OR a case investigation determines COVID-19 was a cause of death, and
      The death occurred up to one year after the COVID-19 infection.
  • For deaths that occurred May 15, 2020 through Dec. 31, 2022, deaths among cases included all deaths among people who died within 30 days of being identified as a COVID-19 case, regardless of the cause of death. This methodology included people who died of COVID-19, as well as some who died of causes other than COVID-19. It also excluded deaths that occurred more than 30 days after being identified as a COVID-19 case, even if the death was due to COVID-19. The strength of this methodology was that it made data available quickly, so health experts could understand the impact of the disease in real time.

• The numbers of deaths due to COVID-19 and deaths among people with COVID-19 should not be added together to determine a total death count. They are from separate data sources.
• The numbers of deaths due to COVID-19 and deaths among people with COVID-19 are reported from two different systems that are updated on different timelines. These numbers cannot be compared day-to-day to determine how many deaths have occurred in each category.
• The number of deaths due to COVID-19 are not necessarily included in the number of deaths among people with COVID-19. After review, at either the state or national level, some deaths may not be counted as COVID-19 deaths. This is rare, and the expectation is that in the end the numbers will closely align. 
• The deaths due to COVID-19 are provisional counts and often track several weeks behind other data. The number reported indicates the number of deaths from records that have been analyzed as of the date indicated. However, due to the one- to eight-week timeframe it can take to completely process death records, counts from previous weeks are continually revised as more records are received and processed. 
• The deaths due to COVID-19 are provisional counts and often track several weeks behind the epidemiological data. The number reported indicates the number of deaths from records that have been analyzed as of the date indicated. However, due to the one- to eight-week timeframe it can take to completely process death records, counts from previous weeks are continually revised as more records are received and processed. 

More information about CDC’s COVID-19 Death Data and Resources.

3-Day average of cases of COVID-19 by date reported to the state

• What this graph shows: Each column represents a three-day average of the number of COVID-19 cases, by the date the cases are reported to public health.
• What to know about this data: 
  • This graph shows the same data as the Cases of COVID-19 by date reported to the state graph, but averages 3 days worth of data into one column.
    • A 3-day average provides a more accurate picture of trends and smooths out data from reporting delays or other processes that may create artificial peaks and valleys.
  • This graph does not track the number of newly-diagnosed cases from day to day.
  • The reported date of a case can be re-assigned to an earlier date on rare occasions. 
  • The day someone got sick, the day they were tested, and the day public health was notified of the positive results might be several days apart

Cases of COVID-19 by date reported to the state 

• What this graph shows: The number of COVID-19 cases being reported to public health each day because someone had a positive lab test or had symptoms of COVID-19 and were linked to someone with a positive lab test. 
• What to know about this data: 
  • This graph does not track the number of newly-diagnosed cases from day to day.
  • The reported date of a case can be re-assigned to an earlier date on rare occasions. 
  • The day someone got sick, the day they were tested, and the day public health was notified of the positive results might be several days apart.

Cases of COVID-19 by date of illness onset

• What this graph shows: The estimated date of when symptoms began for cases of COVID-19 reported to public health.
• What to know about this data: 
  • This graph does not track the number of newly-diagnosed cases each day.
  • This graph is referred to as the “epi curve” and shows the frequency of new cases based on the date of onset of disease. Over time, this graph will provide the best picture of the actual progression of illness during an outbreak. 
  • This graph will change every day as new cases are investigated and information is entered about when symptoms started for each person. Cases that test positive today could show up with a symptom onset date of several days or weeks prior. 
  • Date of symptom onset is usually obtained after public health is able to investigate a case. Because it takes time to investigate cases, this graph is often several weeks behind in providing an accurate picture of transmission.

Cumulative number of cases of COVID-19 in Colorado by reported date to the state

• What this graph shows: A cumulative total of the new number of COVID-19 cases that correspond to the date the case was reported to public health. 
• What to know about this data:
  • This graph shows that we continue to have cases reported every day.
  • This graph does not track the number of cases reported from one day to the next
  • As long as cases continue to be reported, this graph will always go up.
  • The reported date of a case can be re-assigned to an earlier date on rare occasions. 

Cumulative number of cases of COVID-19 in Colorado by date of illness onset

• What this graph shows: A cumulative total of the cases by the estimated date of when symptoms began. 
• What to know about this data:: 
  • This graph does not track the number of newly-diagnosed cases each day.
  • This graph will change every day as new cases are investigated and information is entered about when symptoms started for each person. 
  • Date of symptom onset is usually obtained after an epidemiologist is able to investigate a case. Due to the time it takes to investigate cases, this graph is often several weeks behind in providing accurate cumulative totals by onset date of illness.

Cases of COVID-19 in Colorado by county

• What this graph shows: The number of people testing positive for, or determined as a probable case of, COVID-19 in each county.
• What to know about this data:
  • Sometimes there is missing information or errors in preliminary data regarding county of residence. As more information is learned through case investigations, these numbers may change.

Case Rates per 100,000 People in Colorado by county

• What this graph shows: The rate of people testing positive for, or determined as a probable case of, COVID-19 in each county. 
  • NOTE ABOUT RATES: Because population sizes vary widely, rates are often used instead of counts to better compare the level of disease across different populations. This is done by dividing the number of cases in a community by the population of that community, and then multiplying that number by 100,000. Regardless of the true population of any given county, an estimated comparison can be made across populations by using a baseline of 100,000 people. 
• What to know about this data:: 
  • Caution should be used when interpreting rates in counties with small populations. In smaller populations with fewer cases, there is not enough information to make a valid comparison. Rates are not shown for counties with less than 5 cases. 
  • People who test positive in Colorado while visiting are included in the county where they were identified.
  • Sometimes there is missing information or errors in preliminary data regarding county of residence. As more information is learned through case investigations, these numbers may change.

Number of deaths among COVID-19 cases  in Colorado by date of death

• What this graph shows: The number of deaths among people diagnosed with COVID-19 or with COVID-19 listed on their death certificate, recorded by the date a death occurred. 
• What to know about this data:
  • Due to standard delays in the process of recording deaths in Colorado, it may be several days between the day a death occurs and the day the death appears in this graph. This means the number of deaths reported may change on a day-to-day basis (particularly within the past week) as reports of new deaths are received.
  • This graph includes deaths among people with COVID-19 - COVID-19 may or may not be listed as the cause of death on the death certificate.

Cumulative number of deaths among COVID-19 cases in Colorado by reported date to the state

• What this graph shows: The cumulative number of deaths reported among people diagnosed with COVID-19 or with COVID-19 listed on their death certificate, corresponding to the date a person was reported to have COVID-19. The date a death is reported is often not the same as the actual date of death or the same as the date the case was initially reported to public health.
• What to know about this data:
  • This graph does not track the date a death was reported 
  • This graph does not track the number of deaths reported from one day to the next
    • Although we are tracking and collecting the date of death for each case, it can take several days before we receive a death certificate and are able to match the death to a known case. CDPHE is working with other state partners to streamline the process of reporting date of death in a more timely manner.
  • This graph includes deaths among people with COVID-19 - COVID-19 may or may not be listed as the cause of death on the death certificate.
  • This graph will change every day as new deaths occur and those deaths are attributed to when cases were first reported for each person..
  • The furthest column to the right provides an accurate accounting of the total deaths of COVID-19 to date. 

Cumulative number of deaths among COVID-19 cases in Colorado by date of illness onset

• What this graph shows: The cumulative number of deaths among people diagnosed with COVID-19 or with COVID-19 listed on their death certificate, corresponding to the date a person began experiencing symptoms.
• What to know about this data: 
  • This graph does not track the date a death was reported 
  • This graph does not track deaths from one day to the next
    • Although we are tracking and collecting the date of death for each case, it can take several days before we receive a death certificate and are able to match the death to a known case. CDPHE is working with other state partners to streamline the process of reporting date of death in a more timely manner.
  • This graph includes deaths among people with COVID-19 - COVID-19 may or may not be listed as the cause of death on the death certificate.
  • The furthest column to the right provides an accurate accounting of the total deaths of COVID-19 to date.

Cumulative number of hospitalized cases of COVID-19 in Colorado by date reported to the state

• What this graph shows: A cumulative running total of the number of people hospitalized with COVID-19, corresponding to the date their illness was reported. 
• What to know about this data:
  • Knowing how many people have been hospitalized helps us understand the severity of disease.
  • As long as cases continue to be hospitalized, this graph will always go up.
  • This graph does not track the cumulative number of people who are newly-hospitalized each day.
  • This graph does not track the number of people who have been discharged from the hospital.
    • Admission and discharge dates are not readily available for each patient. CDPHE is currently working with other partners to streamline this data and make it available.

Cumulative number of hospitalized cases of COVID-19 in Colorado by date of illness onset

• What this graph shows: A cumulative running total of the number of people hospitalized with COVID-19, corresponding to the date they began experiencing symptoms. 
• What to know about this data:
  • This graph does not track the number of newly-hospitalized cases each day.
  • This graph does not track the number of people who have been discharged from the hospital.
    • Admission and discharge dates are not readily available for each patient. CDPHE is currently working with other partners to streamline this data and make it available. 
  • This graph will change every day as new cases are investigated and information is entered about when symptoms started for each hospitalized person. Cases that are hospitalized today could show up with a symptom onset date of several days or weeks prior. 
  • Date of symptom onset is usually obtained after an epidemiologist is able to investigate a case. Due to the time it takes to investigate cases, this graph is often several weeks behind in providing an accurate picture of hospitalizations.

Positivity data from clinical laboratories

• What this graph shows: The total number of tests reported to CDPHE as being performed each day - and the percent of those tests that are positive for COVID-19. 
  • The number of tests from CDPHE’s state laboratory are indicated in tan, the number of tests from other commercial labs are indicated in blue. Test numbers correspond to the scale on the left side of the graph.
  • The red line indicates the percent of tests reported that are positive. The percent of positive tests correspond to the scale on the right side of the graph.
• What to know about this data:
  • The percent of positive tests is helpful for public health to track whether symptoms of people being tested are caused by COVID-19 (a higher positivity rate) or if their symptoms are being caused by something else (a lower positivity rate).
  • Total number of people tested might be underestimated because while most laboratories report all COVID test results to CDPHE, they are only required to report positive results.

Testing encounters

• This data is a cumulative total from the positivity graph, which shows the total number of people tested each day. Many people get tested multiple times, and each of those tests is counted in the positivity graph as long as the tests were taken on separate days. If an individual was tested more than once in a given day, they will only be counted once for each day they have been tested.  
• The Testing Encounters totals are higher than those represented in the People Tested numbers because in the People Tested numbers, individuals only are counted once, regardless of how many times they have been tested. 

Methods for the two-week cumulative incidence map and the epidemic curve map are based on guidance from the CDC. National-level maps can be accessed here. 

Two-Week Cumulative Incidence Rate

The two-week cumulative incidence rate summarizes new cases reported in the past two weeks per 100,000 people. It looks at recent incidence to capture the potential burden of currently ill people who may be infectious and/or currently accessing healthcare. 

The sum of each region’s number of reported cases in the past two weeks (in other words, the difference between the total number of cases from two weeks ago from the current total number of cases) is divided by that region’s population. The resulting rate is multiplied by 100,000 to get a two-week cumulative incidence rate per 100,000 people.

• Low: There have been 10 or fewer new cases per 100,000 people in the past two weeks.
• Moderate: There have been between 10 and 50 new cases per 100,000 people in the past two weeks.
• Moderately high: There have been between 50 and 100 new cases per 100,000 people in the past two weeks.
• High: There have been more than 100 new cases per 100,000 people in the past two weeks.

Current Epidemic Curve

The current epidemic curve categorizes counties into phases of the epidemic curve based on two-week incidence and recent slope. It provides a more detailed view into the burden of illness and the trajectory of new illnesses. 

Counties are categorized based on (1) the number of new cases per 100,000 in the past two weeks, and (2) the trajectory of the three-day moving average daily incidence per 100,000. By hovering over each region, you can see a figure detailing how three-day moving averages of daily incidence and the corresponding phase of the epidemic curve have changed over the past month. 

The ‘Two-Week Cumulative Incidence Rate’ section above details how the number of new cases per 100,000 in the past two weeks is calculated for each region.

Three-day moving average daily incidence rates per 100,000 are calculated for each region by first totaling the number of new cases by date reported to the state. The total number of cases reported on each day is divided by each region’s population, and multiplied by 100,000 to get a daily incidence rate per 100,000 people. The three-day moving average is the mean of daily incidence rates per 100,000 for the current and past two days. 

• Low incidence growth: There have been ten or fewer new cases per 100,000 in the past two weeks. Incidence is low, but increasing.
• Elevated incidence growth: There have been more than ten new cases per 100,000 in the past two weeks. Incidence is high and increasing.
• Elevated incidence plateau: There have been more than ten new cases per 100,000 in the past two weeks. Incidence is high and remaining stable.
• Sustained decline: Incidence is consistently decreasing. 
• Low incidence plateau: There have been ten or fewer new cases per 100,000 in the past two weeks. Incidence is low and remaining stable.

Region-Specific Incidence

For regions with >5 cases in the past two weeks, a smoothing trend line was fit to three-day moving average incidence by date reported to the state. 

The magnitude and direction of change of the smoothing trend line is shown below incidence. This line describes the changes that are occurring in the above smoothing trend line.

Variable explanations

In what types of facilities are outbreaks reported?

• In health care settings, including long-term care facilities, assisted living facilities, independent living facilities/senior communities that offer health care, inpatient rehab facilities, and long-term acute care hospitals.
• In correctional settings, including state prisons, county and city jails, community corrections, detention settings, work release facilities.
• In other settings, including factories, workplaces with crowded work conditions, camps, schools, child care centers, and independent living facilities/senior communities that do not offer health care. 

What is the definition of a confirmed outbreak of COVID-19?

• Confirmed COVID-19 Outbreak: Two or more Confirmed cases of COVID-19 in a facility or (non-household) group with onset in a 14 day period.
• Confirmed COVID-19 Outbreak in a Healthcare Facility: Two or more Confirmed COVID-19 cases in residents with onset in a 14 day period.
• Confirmed COVID-19 Outbreak in a Correctional Setting: Two or more Confirmed COVID-19 cases in residents/inmates/detainees/etc with onset in a 14 day period.

Why is the definition of an outbreak different for every kind of facility? Does facility size play a factor?

In general, the definition is the same: Two or more confirmed cases that began in a 14-day period. The definition for non-hospital health care facilities is more specific because outbreaks of any kind in these facilities tend to spread very rapidly and because the residents are at higher risk of severe illness and death. A more lenient definition means interventions to control the outbreak can occur more quickly. 

We use illness in residents to define outbreaks in nursing homes and correctional settings because it's a better indicator of spread of infection in the facility. Once we’ve identified there is an outbreak, staff are included in the case counts. 

When is an outbreak considered over?

A COVID-19 outbreak is over when 28 days have passed with no new illness.

What happens when there is an outbreak at a facility?

1. A facility suspects an outbreak based on defined criteria and notifies local or state public health.
2. Public health assesses the facility’s current practices and provides the facility with l assistance and support regarding infection prevention, personal protective equipment, testing strategies, and staffing recommendations.
3. The facility implements appropriate mitigation measures, focusing on controlling the outbreak.
4. The facility submits a final outbreak report to CDPHE once the outbreak is considered over.

Who notifies families of residents when there is an outbreak in a nursing home?

CDPHE 's nursing home rules require that all nursing homes have a policy regarding notification to a resident's representative. Notifications must be made for incidents, accidents, and changes of status, which could include illness. These rules do not specify notification of a family member when a resident is ill, but each facility's policy should address when and for what reasons notifications to resident representatives occur. CDPHE recommends communication with residents and families in the COVID-19 Preparation and Rapid Response guidance. To be as transparent as possible during the pandemic, CDPHE is releasing facility outbreak information before investigations are complete. Anyone can go to covid19.colorado.gov for the latest weekly update.

What if I suspect there is an outbreak at a facility that is not on this list?

Outbreaks should be reported to the local public health agency in the county where the suspected outbreak is located.

When is outbreak data updated?

The state updates information about outbreaks weekly on Wednesdays by about 4 p.m.

What are other challenges in collecting outbreak data during a COVID-19 outbreak?

Although public health is typically notified immediately about a possible outbreak, specific information, like the number of cases, is not available until epidemiologists can investigate the facility to gather more details. There are many complexities in this type of investigation that require further information gathering and analysis to provide an accurate account of the outbreak. Some of these factors include:

• Some sites, such as hospice care facilities, have populations that already exhibit a variety of illnesses and who experience a higher mortality rate than the general population. It is not necessarily obvious whether someone is ill or died due to COVID-19 or due to their existing medical conditions.
• Some residents of the facilities have do-not-resuscitate orders in place. This can mean that they will not receive advanced medical care and testing that might determine the cause of their death. 
• Laboratory-confirmed positive cases are only reported as long as facilities are testing. Once there is confirmed transmission in a facility, it isn’t necessary to continue testing all new cases since they meet the probable case definition.
• All facilities must report probable cases, as well as confirmed cases, to public health. Probable cases change frequently as epidemiologists investigate further and facilities require additional testing to rule out other respiratory illnesses. Facilities must report a full accounting of probable cases after an outbreak is over.

Does this data represent all cases (confirmed and probable) in a facility?

Because facilities are focused on disease control measures during an outbreak, the number of cases reported for each facility may be incomplete. A full accounting of all cases in an outbreak is made available when a facility submits their final report at the end of the outbreak.

How do you know a case wasn't exposed elsewhere in the community and not the outbreak facility?

It is possible that a person may have been exposed elsewhere (and we can rarely prove where any individual was exposed with a person-to-person pathogen), but when a person worked/lived/spent time in a facility with a known outbreak, we attribute their illness to the outbreak even if there is no definitive determination that the case acquired the illness at the facility. This approach is consistent across all outbreak types.

• If you test positive for COVID-19, have symptoms but haven’t been able to get tested, or are waiting for the results of your 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 test positive for COVID-19, you may be able to get medicine to help you recover. Learn more about medicine for COVID-19.

• Coloradans who are sick and test negative for COVID-19 should continue to stay home while they are sick. They may consult with their health care provider about whether they should get tested again with a more sensitive test.

• If you need medical advice, call a health care 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 about your symptoms.

If you think you have been exposed to COVID-19, but you don’t have symptoms, follow the instructions on how to take precautions around others for 10 full days. You should get tested five full days after the date you think you were exposed, even if you don’t develop symptoms. A PCR test is preferable; a negative result from an antigen (at-home) test may need to be confirmed by a PCR test. If you get tested too early, there may not be enough viral material for the test to detect, and you still may become contagious to others later. To get a PCR test, contact your health care provider or find a local pharmacy that has PCR tests. To get antigen (at-home) tests, find free rapid test pick-up locations near you. 

Guidance for wearing masks.

• While it is believed to be rare, there have been some animals that have gotten COVID-19 from their owners or caregivers.

• At this time there is no evidence to suggest that any animals, including pets or livestock, play a significant role in spreading COVID-19 to people.

• If your pet develops mild illness, call your veterinarian. Depending on your pet’s symptoms, your veterinarian may recommend that you isolate your pet at home.

• If your veterinarian recommends home isolation and you are able to care for your pet at home, keep your pet at home except to get medical care. A pet can be isolated in the same way as a person sick with COVID-19. 

• Protect yourself when caring for a sick pet by following the same precautions recommended for people caring for an infected person at home. This includes wearing a well-fitting mask around your pet and washing your hands before and after feeding and caring for your pet.

• Sick cats should be kept inside. Do not allow cats that have tested positive for COVID-19 to roam outside. 

• If your pet’s symptoms worsen, contact your veterinarian immediately. Let them know that your pet needs to be evaluated.

Testing of symptomatic animals for COVID-19 is rare. It can be allowed in a joint decision between the state veterinarian and the state public health veterinarian in consultation with the National Veterinary Services Laboratory.

• Get vaccinated with all recommended doses when you are due for them.

• Wear a well-fitting mask in indoor public places or crowded outdoor places. Check with your local public health agency to find out if there are more restrictive mask requirements in your community.

• Frequently and thoroughly wash your hands with soap and water for at least 20 seconds. If soap and water are not available, use hand sanitizer with at least 60% alcohol.

• Cover coughs and sneezes with a tissue, then throw the tissue in the trash, or use your inner elbow or sleeve.

• Avoid touching your eyes, nose, and mouth with unwashed hands.

• Stay home and isolate if you’re sick, and keep your children home if they are sick.

• Get tested if you know or think you were exposed or if you develop symptoms.

• Have a plan for getting COVID-19 medicine if you test positive.

• Anyone who wants a test can and should get one. If you have symptoms of COVID-19, which can feel like a cold, you should get tested as soon as possible, even if you’re fully vaccinated or aren’t sure if you’ve been exposed. Follow instructions on how to isolate until you feel better.
• If you think you have been exposed to COVID-19, you should take precautions after exposure follow the instructions on how to quarantine to prevent potential disease transmissionspread. Wait at least five days from the time you think you were exposed, and get tested.  Get tested at least five 5 full days after your last exposure, even if you don’t develop symptoms.

• Many Coloradans can get tested through their usual health care provider or at a local pharmacy. Coloradans can also use at-home rapid antigen tests available at many  rapid test distribution centers around Colorado.

• Find where to get a COVID-19 test in Colorado.

• If you have health insurance, work with your insurer to find a provider. Your health care provider may not do the tests for COVID-19 themselves; the tests are collected at designated testing sites and analyzed at medical laboratories. A health care provider or nurseline can help you by discussing with you whether you need to be tested and giving information about where to go to get tested. Remember to always contact a health care provider first before going to an office, clinic, or emergency room for testing. 
• Coloradans without insurance are encouraged to apply for Health First Colorado - Colorado's Medicaid Program.

• Under state and federal law, COVID-19 testing is required to be covered by insurance. People with insurance should not have co-pays, deductibles, or coinsurance.
• Free at-home tests are available at distribution centers around Colorado.
• No-cost and low-cost tests are available for people without insurance at locations participating in the federal Increasing Community Access to Testing (ICATT) program.

• The health care provider or pharmacy where you took the test will communicate your results to you.

• If you took a laboratory test, you may get your result in one to three days depending on the type of test and the facility where you got tested. Some facilities may take longer than three days to return your test result during times of high demand.

• Rapid at-home tests give results within 15 to 30 minutes.

• No. Your test results will only tell you if you are positive or negative for COVID-19, not the specific variant you have. However, the COVID-19 data dashboard shows which variants are most prevalent throughout the state.

• If you got tested at a testing site, the lab that processed your test or the health care provider who ordered it will report your test results to public health.

• If you tested yourself with an at-home rapid antigen test, you should report your positive result to public health. Find instructions on how to report your result.

• Yes. A negative test result means that the virus that causes COVID-19 was not found in the person’s sample. This can happen when a person is tested too early in their incubation period and there isn’t enough viral material for the test to detect.

• False negative PCR results can also occur if a sample was collected improperly or not handled or stored at proper temperatures.

• If your PCR test is negative and you got tested while you had symptoms, it is likely that you do not have COVID-19. Your symptoms may be due to a different illness. However, this is not 100% certain.

• Rapid antigen tests (also known as at-home rapid tests) can offer faster results, but they are less sensitive than PCR tests. If you have symptoms and you test negative using a rapid test, you may need to take a PCR test to confirm the results.

• People who test positive using a rapid test are generally considered to have COVID-19 and must isolate.

Diagnostic tests:

• Diagnostic tests can show if you have COVID-19 or not. There are two main types of diagnostic tests:

  • Molecular diagnostic test, also called a PCR test (Polymerase Chain Reaction). The main features of PCR tests are:

    • The virus is diagnosed by its genetic fingerprint (the RNA of the virus). 

    • These tests are the most accurate ones available. They were created to be highly specific to the COVID-19 virus, thereby detecting early infection and minimizing false positive or negative results.

    •  These tests require skilled staff and sophisticated lab equipment.

    • They take more time to get results. 

    • They require swabbing your nose, mouth, or throat, or collecting a saliva sample. 

  • Antigen diagnostic test, also known as a rapid test. The main features of these tests are: 

    • Antigen tests detect proteins unique to the virus that are shed in patient tissues, like the nostrils or saliva.

    • They are less sensitive than PCR tests, so they may have false negative results. False positive results are very rare. 

    • They produce quick results.

    • They don’t require sophisticated lab equipment.

    • They involve swabbing your own nose or throat. 

    • They can be performed in a lab, at a point of care, or at home (via self testing). 

Self-testing: 

• Self-testing is an important strategy to reduce the chances of COVID-19 transmission. At-home self tests may be used regardless of vaccination or symptom status, though they are generally more accurate in people who have symptoms.

•  Many locations across Colorado are partnering with CDPHE to distribute rapid tests that provide a result in 15 minutes. You can view the list and the map for these locations at the CDPHE Testing for COVID-19 webpage.

• Health First Colorado and Child Health Plan Plus (CHP+) pay for at-home COVID-19 tests for members. You can get free at-home tests only at pharmacies that serve Health First Colorado and CHP+ members.

“Antibody test,” “antibody blood test,” and “serologic test” all mean the same thing. An antibody test is a test to check your blood for antibodies, which are proteins that help fight off infections. Antibody tests may be able to show if you had a previous infection with a virus, depending on the type of antibody test. 

• CDC and CDPHE don’t recommend antibody testing to find out if you have COVID-19. According to CDC, antibody tests may not be able to detect a current COVID-19 infection because it takes time for the body to make antibodies. 

• 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.

• As the COVID-19 virus changes with new variants, antibodies from earlier variants may become more or less effective at fighting the virus. In many cases, they become less effective as the virus changes. This is often called immune evasion

• Antibody tests may react with other seasonal viruses and result in false positive results. They may also be affected by prior vaccination.

• If you get an antibody test, and it is positive, that means you may have antibodies from a prior COVID-19 infection, vaccination, or possibly another coronavirus infection.

• Certain antibody tests may be able to distinguish between antibodies from an infection or from vaccination by looking at different types of antibodies.

• Please discuss any additional antibody questions with your provider.

Currently, these tests should primarily be used for research or surveillance purposes. They are rarely used to help diagnose conditions such as Multisystem Inflammatory Syndrome in Children (MIS-C). 

• covid19.colorado.gov is the main site for all COVID-19 information and resources provided by the Colorado State Emergency Operations Center and the Colorado Department of Public Health and Environment.

• Center for Disease Control and Prevention (CDC) COVID-19 Page.

• U.S Food and Drug Administration(FDA) COVID-19 Page  

• World Health Organization COVID-19 page. 

• Colorado Peak is the place to apply for and manage benefits online.

• 2-1-1 Colorado Streamline Services- COVID-19 information and resources where you can find many resources by categories or zip code.

• Colorado Emergency Rental and Mortgage Assistance Program

• Housing assistance counseling program

• U.S Department of Housing and Urban Development — Colorado Home Ownership Assistance Programs.

• Activated Respite — COVID-19 Isolation for People Experiencing Homelessness.

• Colorado Food Finder

• Supplemental Nutrition Assistance Program (SNAP)

• Denver Metro Food Pantry Operating Status

• The Action Center: is a non profit organization based in Lakewood, but serving all of Jefferson County.

• Health First Colorado: Colorado’s Medicaid program

• Telehealth and nurse line directory in Colorado

• Colorado Consumer Health Initiative helps Coloradans who experience issues with their health coverage.

• Connect for Health Colorado: This resource was established by the Colorado General Assembly as a public, non-profit entity to create a health insurance marketplace for individuals, families and small employers across Colorado to purchase health insurance and get financial help. 

• Low-income Energy Assistance Program (LEAP)

• Healthy Families and Workplaces Act (“HFWA”): Paid Leave Rights

• OnwardCO is an initiative of companies, foundations, and humans to get Colorado workers displaced by COVID-19 essential life services and back to work as quickly as possible.

• Candid Learning: This site provides a list of resources where you can find emergency financial resources for COVID-19 hardships. 

• Colorado Child Care Assistance Program

• Renaissance Children’s Center (for low-income families and those experiencing homelessness)

• National COVID-19  Resource Center for Refugees, Immigrants, and Migrants (NRC-RIM) in more than 100 languages. 

• Center of Excellence in Newcomer Health-COVID-19 Translated Materials in more than 64 languages

• Southwest Telehealth Resources Center- Fact Sheets in Navajo and Spanish.

• Colorado Commission for the Deaf, Hard of Hearing, and Deafblind

• Disability Determination Services

• Colorado Crisis Services Call 1-844-493-8255 or text “TALK” to 38255

• How to Care for Yourself When Social Distancing 

• How to Help Someone with Anxiety or Depression During COVID-19