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COVID-19 spread in assisted-living centers, schools and non-coronavirus-related facilities than other outbreak sites. (Photo by Debbie Kelley)

Residential assisted-living and skilled-nursing centers continued to amass the most COVID-19 cases among outbreak sites in El Paso County in November, according to state and county public health dashboards that compile lists of active and inactive infections.

A total of 211 infections and nine deaths occurred at 18 local facilities last month, where the elderly and infirmed live, data shows.

But schools became the largest sites of infection over the past 30 days.

About one in four of the county’s 114 outbreaks since Nov. 1 have happened at K-12 schools. Public health officials define an outbreak as two or more positive COVID-19 cases in a given location within 14 days, among non-family members.

In all, 104 positive cases were logged among students and staff at 28 K-12 buildings, and another 11 cases were traced to four area childcare centers.

Non-COVID-related medical facilities had the second highest number of local outbreaks, such as rehab centers, pediatric therapy and other outpatient treatment, excluding residential facilities.

“It's important to note that outbreaks are a reflection of what is happening in the broader community,” said El Paso County Public Health and Environment spokeswoman Michelle Hewitt.

Officials expect outbreaks to increase, she said, as community-wide transmission hits the highest levels seen since the pandemic was identified in March.

Outbreaks are common in long-term care centers and schools for several reasons, Hewitt said in an email, including the congregate nature of the facilities and prolonged periods of close contact between staff and residents or students.

“This is not unique to COVID-19; it's common in the winter months to see other outbreaks such as influenza or norovirus within these same congregate settings,” she said.

Outbreaks at local schools in November were 12 times higher than outbreaks associated with restaurants, shows an analysis by Professor Phoebe Lostroh, who teaches molecular biology and the study of infectious diseases at Colorado College and is currently working with the National Science Foundation.

Because of the high levels of COVID-19 infections in El Paso County, restaurants now are banned from indoor dining service under public health orders, and Gov. Jared Polis has called on school districts to at least keep elementary schools open for in-person instruction, saying schools are safe and children are less likely to be severely affected by the virus.

Many Pikes Peak region schools have switched to remote learning as of Monday, largely due to strict quarantine measures that in recent days Polis has relaxed, and a shortage of substitute teachers.

In Teller County, four of 12 current outbreak locations on the state’s list are schools, two in Cripple Creek, an elementary school in Divide and one in Woodland Park.

When classrooms first reopened for the fall, transmission was not occurring at schools, rather the virus was being brought into schools, said Devra Ashby, spokeswoman for Colorado Springs School District 11.

As the rate of infection began climbing across the county in recent weeks, so did transmission at schools, she said.

Academy School District 20 had just one official outbreak until about 10 days before last week’s Thanksgiving break, said spokeswoman Allison Cortez.

A rapid increase occurred this month, she said, but for the most part the cases have involved less than three people.

“This tells us the controls we have in place — the local and state isolation and quarantine guidance — are working,” she said. “Seeing schools at the top of the county’s outbreak list does not mean they are unsafe or that there is rampant spread of the disease.”

It does mean school districts are following local and state guidelines for reporting and managing the disease, she said.

Lostroh recommends schools improve ventilation systems and add humidifiers to classrooms, since “relative humidity between 40% and 60% is essential for reducing the spread of respiratory viruses because the cilia lining our respiratory tracts need 40% humidity to be able to move properly and expel viruses from our bodies,” she said.

Most indoor sites in Colorado Springs have much lower relative humidity in the winter without adding moisture to the air, she added.

“We should plan for at least some schools to open back up for face-to-face learning before everyone can be vaccinated, and a humidifier plus a hygrometer (to measure relative humidity) are cheap interventions,” Lostroh said in this week’s pandemic report.

Cleaning, filtering and improving air quality in schools have been a topic of discussion since the pandemic started, said D-11's Ashby. 

All Colorado Springs D-11 schools have had ventilation systems upgraded, she said, which was one reason the fall semester started in-person learning later than expected.

If humidifiers become a recommendation from health officials, Academy D-20 would follow the guidelines, Cortez said.

D-20 also reprogrammed its ventilation systems so they are drawing in fresh air more frequently, she said.

"We used to program the ventilation to run less in the evenings and overnight — this was to be more green — but now we have reversed that so we can draw in more air to increase they air flow, which is said to help with COVID-19," Cortez said.

Contact the writer: 719-476-1656.

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