What are the symptoms of COVID-19?

Download the Symptom Chart

The Centers for Disease Control and Prevention (CDC) symptoms for COVID-19 include:

• Cough
• Shortness of breath or difficulty breathing
• Fever, chills, repeated shaking with chills
• Muscle pain, headache, sore throat
• New loss of taste or smell For more CDC information, visit here.

What happens if I have symptoms?

Get tested! The following medical clinics provide testing:

UCHealth Yampa Valley Medical Center ()

Northwest Colorado Health ()

Pediatrics of Steamboat Springs ()

Sleeping Bear Pediatrics ()

South Routt Medical Center ()

Steamboat Emergency Center ()

Steamboat Springs Family Medicine ()

Yampa Valley Medical Associates ()

If you do not have insurance or are under insured you can book an appointment with Routt County Public Health Book online or call to set up an appointment. The Routt County Department of Public Health's criteria for testing includes anyone with symptoms or anyone who has been in contact with someone who has tested positive to get tested.If you have health insurance, please use your medical provider to get tested so we can reserve public health resources for those individuals without health insurance and/or limited resources.

What happens if I have come in direct contact with someone who has tested positive? What should I do?

There are two things you can do. Quarantine for 14 days and get tested 5-7 days after contact. The following medical clinics provide testing:

UCHealth Yampa Valley Medical Center ()

Northwest Colorado Health ()

Pediatrics of Steamboat Springs ()

Sleeping Bear Pediatrics ()

South Routt Medical Center ()

Steamboat Emergency Center ()

Steamboat Springs Family Medicine ()

Yampa Valley Medical Associates ()

If you do not have insurance or are under insured you can book an appointment with Routt County Public Health Book online or call to set up an appointment.

Did the CDC change its quarantine guidelines?

The CDC changed their quarantine guidelines on December 2, 2020. The incubation period for COVID-19 has not changed, it’s 14 days. But the shortened guidance may alleviate some of the constraints on people staying home for 14 days. In some populations like congregate care and residential care, the guidelines will not shorten the quarantine times. But for the general public, contacts who have monitored themselves for symptoms and have not had any signs or symptoms of COVID-19 their quarantine can end after ten days; but they still need to monitor for signs and symptoms for 14 days. Additionally, if someone is monitoring for signs and symptoms and has either a molecular or antigen test performed on day five of quarantine and the test is negative, 48 hours later on day 7, you can end your quarantine, but you still have to monitor your symptoms for the full 14 days. for more info, check the CDC's guidelines.

What should individuals be doing right now?

Take the personal pledge and follow “The Six Commitments of Containment:”

• I will maintain 6 feet of physical distance
• I will wash my hands often
• I will wear a face mask in public
• I will stay home when I am sick
• I will get tested immediately if I have symptoms
• I will keep personal gatherings small in within my family/household

Should I be wearing a facemask to protect myself?

• The Routt County Public Health Order requires you to wear a facemask in businesses such as grocery stores, pharmacies, hardware stores, etc. Employees and customers are required to wear facemasks.
• Wearing a mask is primarily intended to protect others but recent research shows that it also protects the wearer. We know that many people may be carriers of the virus and shedding it without knowing it. Wearing the mask can help individuals who are asymptomatic from shedding the disease to others.
• In addition to the Public Health Order of wearing facemasks in a public setting, it is recommended to wear a facemask when you are not able to stay within six feet of people whether you are inside or outside.
• Wearing a mask is most critical at locations where individuals will be in the same area with people outside their household, such as grocery stores, pharmacies, gas stations, etc.

Can a diagnostic RT-PCR test show how infectious someone is?

No. RT-PCR tests are used to identify and diagnose an active infection but cannot be used to show how infectious someone is.

What is a cycle threshold (Ct) value from a RT-PCR test?

To improve the test’s ability to detect virus, an RT-PCR test creates many copies of the same genetic material from the virus in a process called amplification. The cycle threshold (Ct value) is the point at which a reaction reaches a fluorescent intensity above background levels. The Ct value indicates when the nucleic acid target is detectable in the amplification process. There is a correlation between the Ct value and the amount of viral genetic material that was present in the specimen.

Can a Ct value determine how much viral genetic material is present in an individual patient specimen?

A Ct value does not indicate how much virus is present, but only whether or not viral genetic material was detected at a defined threshold. RT-PCR tests can be either qualitative or quantitative, and this affects how a Ct value is interpreted. As of October 23, 2020, all diagnostic RT-PCR tests that had received a U.S. Food and Drug Administration (FDA) Emergency Use Authorization (EUA) for SARS-CoV-2 testing were qualitative tests.

In a qualitative RT-PCR test, known amounts of virus are used during the development of the test to determine what Ct values are associated with positive and negative specimens. A Ct value is generated when testing a patient specimen. The Ct value is interpreted as positive or negative but cannot be used to determine how much virus is present in an individual patient specimen. In a quantitative RT-PCR test, a range of known numbers of genome copies, called reference samples, are tested alongside each RT-PCR reaction. By comparing the Ct value of a patient specimen to the Ct values from the reference samples, the test can calculate the copy number of target nucleic acid. The correlation between Ct value and viral load can be used in evaluating data from groups of people in categories such as symptomatic or asymptomatic and can be applied to infer the difference in the relative amount of viral load between the two. Although a quantitative RT-PCR test can estimate the level of viral load in a population, a quantitative RT-PCR test cannot determine how much virus is present in an individual patient specimen.

Can a Ct value predict how infectious an individual with COVID-19 is?

No. Ct values should not be used to determine a patient’s viral load, how infectious a person may be, or when a person can be released from isolation or quarantine.

An RT-PCR test uses multiple repeating amplification cycles to create more and more copies of the virus’ genetic material. Specimens with lower amounts of virus will require more cycles to amplify that genetic material to reach an amount that can be detected, resulting in a higher Ct value. Thus, there is a correlation between the Ct value and the amount of starting viral genetic material that was present in the specimen.

For both qualitative and quantitative RT-PCR assays, the correlation between Ct values and the amount of virus in the original specimen is imperfect. It is therefore problematic to infer any relationship between an individual patient’s Ct value and their viral load. Ct values can also be affected by factors other than viral load. For example, if the specimen is not collected or stored properly or the specimen is collected early during the infection, the Ct value may be higher than it would be under ideal conditions. Thus, a high Ct value could also result from factors not related to the amount of virus in the specimen. The correlation between Ct and viral load can be used to evaluate data from groups of people and infer the difference in the relative amount of viral load between the two groups (e.g., between symptomatic and asymptomatic individuals).

If a Ct value can be affected like factors like specimen collection, how do I know if my RT-PCR test results is accurate?

In addition to detecting SARS-CoV-2 genetic material, each RT-PCR diagnostic test also detects a small portion of a patient’s genome. Detecting the patient’s genetic material in the specimen confirms the quality of the specimen and the processing steps of the test. If the patient’s genetic material is detected, then we can be reasonably sure that the viral genetic material was not degraded, and the test result is accurate.

Can Ct values from different RT-PCR test be compared?

No. For a given RT-PCR diagnostic test, the genetic material from a patient sample must be processed using a specific series of steps to produce a valid test result. However, the steps used to process the genetic material, the specific genetic target being measured, and the amount of the patient sample used varies among RT-PCR tests. Because the nucleic acid target (the pathogen of interest), platform and format differ, Ct values from different RT-PCR tests cannot be compared.

How do I find out about positive cases and testing in Routt County?

You can track the number of tests taken, positive results and other information on the covid19routtcounty.com website.

What is contact tracing and how does it work?

Public health agencies have used contact tracing as a standard tool in controlling the spread of disease for decades. Contact tracing is the process where public health tracks how the disease is spreading and notifies people who may have been exposed. As we await a vaccine and effective treatments for COVID-19, contact tracing is one of many important tools for containing the virus. Contact tracers and case interviewers talk to those who test positive for COVID-19 and identify and notify their close contacts. A “close contact” means the person spent 15 minutes or longer within 6 feet of a known case. If you’re contacted by public health about a positive test or potential exposure to COVID-19, all your information is kept confidential. How contact tracing works: The state or local public health agency will contact you to provide you with guidance and resources. Public health will ask about where you have been and with whom you’ve been in contact. They’ll then notify people who may have been exposed by you. However, they will not give those people your identity. Public health calls your contacts to provide important information but doesn’t tell them their information came from you. Contact tracing, safety, and privacy • All contact tracers are trained in how to manage health and other sensitive information in order to protect your privacy. • The public health worker who contacts you will state their name and their organization. They should provide you a number to call back to verify their identity and contact information for their supervisor when the caller requests it. • Public health will never ask for your social security number or financial information. If a caller asks for this information, do not give it. • Currently, public health will not be going “door to door” to conduct contact tracing. For the foreseeable future, all contact tracing for COVID-19 will be over the phone or through secure online forms. • Only certain people at your local public health agency and the state health department can see your information. It is only used to reach out to your contacts with important information about testing and next steps. Public health will not share your information with other entities or outside organizations. • Public health does not share your health or personal identifying information without your permission. • Public health stores records securely. Answer the call! You are the key to making contact tracing work. You are not required to talk to public health. But we hope you will. We can give you important information you need to keep yourself and your loved ones safe. You can provide valuable information to help us contain this deadly virus and keep the economy open. Together, we can slow the spread of COVID-19 to keep our community healthy and our economy running.

Who does contact tracing? In Colorado, local public health agencies lead contact tracing efforts in their communities. The state supports local agencies in their efforts and may call individuals on behalf of local agencies in some circumstances. The state provides coordination of the data and technical assistance as needed.

Is contact tracing mandated by law? Colorado statute gives local public health agencies authority “to investigate and control the causes of epidemic diseases and conditions” and also to establish, maintain, and enforce quarantine and isolation to protect the public health. Public health agencies have used contact tracing to contain other viruses and disease outbreaks.

Does Routt County do contact tracing for residents and non-residents? All positive cases from tests in Routt County trigger local contact tracing, regardless of residence. We have done local contact tracing questioning on all cases. If a case is a patient with residence out of Routt County, we have contacted their home public health department in some cases. We have a couple scenarios: a. The person has been here for some time, say a second home owner, but has legal residence in Texas. Their positive test is relevant to Routt County. We do full contact tracing. b. Texas resident for example, who was visiting for a week and has returned to Texas. We talk with person who is positive and do local contact tracing and then turn over Texas contact tracing to their local public health department.

How does CDPHE decide where someone’s legal residence is for the total case count? From beginning of the pandemic, people get listed by their legal residence regardless of where test was obtained.

Explain the steps of contact tracing:

• Let’s say there is a BBQ in Routt County where there are 10 people in attendance • A few days later, one of the attendees gets symptoms of COVID-19 and gets tested. • The person who got tested finds out he/she is positive for COVID-19 • The provider that did the testing will let the person know of the positive result. Sometimes this call might come directly from Routt County Public Health nurses. Initial information will be gathered, and the positive case will be issued isolation orders. This is a 10-day isolation period for the positive person and this timeframe is dependent on symptoms being experienced. • Routt County Public Health contact tracers call the person with the positive test to learn the places he/she has been and with whom he/she has had close contact. • Public Health asks him/her questions and advise him/her on how to stay safe and keep others from getting sick. • The contact tracer who interviewed the positive person is not allowed to tell anyone that the positive person may have exposed others to COVID-19 or that the positive person supplied names to be interviewed by public health. • Those who had close contact with the positive patient are asked to get tested and to quarantine for 14 days while she/he wait for results. • Two things could happen: He/she tests positive and will need to quarantine and supply public health with his/her close contacts and places visited, OR he/she tests negative but he/she still stays in quarantine for 14 days to ensure there are no symptoms.

If I don't get tested, what should I do?

There is currently no vaccine to prevent novel coronavirus (COVID-19). Below are suggested measures from the CDC that can prevent the spread of respiratory diseases:

• Practice physical distancing of six feet or more.
• Wear a facemask in public places.
• Follow guidelines on travel.
• Avoid close contact with people who are sick.
• Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing. If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol.
• Avoid touching your eyes, nose, and mouth.
• Stay home when you are sick and keep your children at home when they are sick.
• Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
• Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe or using an EPA-approved cleaning product.
• It is important to call ahead before going to see a doctor or emergency room to prevent the spread of illness. Tell them your symptoms and that you suspect you were exposed to someone with COVID-19 or had recent travel to a country that is experiencing community spread.

Do we have enough hospital beds?

Locally, UCHealth Yampa Valley Medical Center is a 39-bed hospital. The hospital has visitor restrictions in place to keep its patients, staff and physicians as safe and healthy as possible.  The community’s public health professionals have plans in place to address growth and if additional resources are required.

Why are officials not releasing the exact locations where infected people visited?

According to Public Health guidelines and to protect privacy, names and locations are not released. Health officials determined it is unlikely that releasing those locations would help. Medical experts believe the virus cannot survive on a surface for more than three days and typically do not receive information about the places where patients may have been until after the three-day window had passed. It appears that close proximity contact is more relevant than simply knowing a location.

What do I do if someone at work tests positive?

According to the State Safer at Home Order, sick employees need to be separated and sent home.

If an employee reports any symptoms, refer symptomatic employees to the Routt County Symptom Tracker and take all of the following steps:

Send employee home immediately

Increase cleaning in your facility and require social distancing of staff at least 6 feet apart from one another

Exclude employee until they are fever-free and without medication for 72 hours and 10 days have passed since their first symptom

If two or more employees have these symptoms, consult CDPHE’s outbreak guidance, contact the Routt County Public Health Department and cooperate in any disease outbreak investigations

Eliminate or regularly clean and disinfect any items in common spaces, such as break rooms that are shared between individuals, condiments, coffee makers, and vending machines.

If an employee is confirmed to have COVID-19 infection, employers should inform fellow employees of their possible exposure to COVID-19 in the workplace but maintain confidentiality as required by the Americans with Disabilities Act (ADA).

Sick employees should not return to work until the criteria to discontinue home isolation are met (generally 10 days after symptom onset with improved respiratory symptoms and at least 3 days fever-free without fever-reducing medications).

Take action if an employee is suspected or confirmed to have COVID-19 infection:

In most cases, you do not need to shut down your workplace/facility.

If it has been less than 7 days since the sick employee has been in the facility, close off any areas used for prolonged periods of time by the sick person:

Wait 24 hours since the sick person used the area before cleaning and disinfecting to minimize potential for other employees being exposed to respiratory droplets. If waiting 24 hours is not feasible, wait as long as possible.

During this waiting period, open outside doors and windows to increase air circulation in these areas.

If it has been 7 days or more since the sick employee used the facility, additional cleaning and disinfection is not necessary. Continue routinely cleaning and disinfecting all high-touch surfaces in the facility.

If an individual has had close contact (less than 6 feet) or more than 15 minutes with a confirmed positive case, they must stay at home until 14 days after last exposure and maintain social distance from others at all times.

Self-monitor for symptoms

Check temperature twice a day

Watch for fever, cough, or shortness of breath or other symptoms of COVID-19

Avoid contact with people at higher risk for severe illness from COVID-19

Follow the CDC cleaning and disinfection recommendations.

What is the Definition of exposure?

Recent COVID-19 exposure: Having close contact (generally less than 6 feet for at least 15 minutes, depending on the exposure) with a person with COVID-19 from two days before their symptom onset (or positive COVID-19 test) until they meet criteria to discontinue isolation. Depending on the workplace environment and types of person-to-person interactions, high-risk "close contact" exposures can occur in fewer than 15 minutes. Note, close contact isn't necessarily 15 consecutive minutes. Someone who was close to a sick person multiple times during a work shift may have been exposed and need to be quarantined.

For more information on COVID-19, click here.

If my child is in quarantine, do other family members have to be in quarantine or have extra restrictions on their activities?

No. The quarantine restrictions apply only to the person who was in close contact with a COVID-19 case. These restrictions do not apply to family members of the quarantined student.

Can a child or teacher "test out of quarantine?" Will a negative COVID test allow a person to stop being in quarantine?

No. COVID tests are imperfect, and only tell us the infection status on the date of the test. However, if an individual has had both shots of the COVID-19 vaccine, they do not have to quarantine.

If my child tested positive last month for COVID-19, does she/he need to go into quarantine again if a classmate has COVID-19 this month?

No. The CDC allows that if a person has a positive COVID-19 test and infection, they are not required to go into quarantine during the following 90 days if they come in close contact with another COVID-19 case.

What is the difference between quarantine and isolation?

Isolation means stay away from other until:

No fever for 24 hours (without taking fever-reducing medicine)

Other symptoms have improved

10 days have passed since symptoms first appeared

Quarantine: For people who are not sick, but may have been exposed. Stay away from others for 14 days to see if you get sick.

When should I get a COVID test after being in close contact to an infected person?

The ideal time frame for getting a COVID test is 5-7 days after the last contact with the infected person.

Where should I go to get tested?

The Routt County Public Health Department provide community testing by appointment. Routt County Public Health is testing anyone with COVID-19 symptoms and anyone who has been in contact with someone who has tested positive for COVID-19. Patients with health insurance are encouraged to contact their primary clinic for testing. Please note that community testing is NOT for people who need COVID-19 tests to travel. For more information, click here.

If I am a close contact, which test should I get?

People without symptoms, which will be most close contacts, should only get a PCR test. Antigen tests should only be used for people with COVID-19 symptoms.

If my antigen (also called the rapid test) test was negative, does that mean I do not have COVID-19?

No, a negative antigen test does not necessarily mean you do not have COVID-19. Antigen tests are not as sensitive as PCR tests for detecting COVID-19 and can provide false negative results. Also, antigen test sensitivities vary greatly between different antigen tests. If you have COVID-19 symptoms and your antigen test was negative, you must also do a backup PCR test to confirm you do not have COVID-19.

What is the difference between the types of tests available for COVID-19?

There are two different types of tests – diagnostic tests and antibody tests. 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 (RT-PCR) tests that detect the virus's genetic material, and antigen tests that detect specific proteins on the surface of the virus. Samples are typically collected with a nasal or throat swab, or saliva collected by spitting into a tube.

An antibody test looks for antibodies that are made by the immune system in response to a threat, such as a specific virus. Antibodies can help fight infections. Antibodies can take several days or weeks to develop after you have an infection and may stay in your blood for several weeks after recovery.