thedenverpost--2020-11-22--Banks didn’t cause this recession, but they won’t escape it either

Banks and mortgage lenders weren ’ t front and center in this year ’ s economic downturn as they were in the Great Recession , but that doesn ’ t mean 2020 hasn ’ t been a tumultuous year for them .
Colorado banks and community lenders faced a crush of requests under the U.S. Small Business Administration ’ s Paycheck Protection Program , processing 109,170 loans worth $ 10.4 billion in a few short weeks .
Mortgage lending also exploded after the Federal Reserve ’ s low rate policies set off a rush to obtain 30-year loans at under @ @ @ @ @ @ @ in far fewer people walking into bank locations this year , raising a question in the industry of whether all those branches were truly needed .
And it has forced banks to up their efforts to deliver services digitally .
“ Branch lobby traffic has not returned to pre-pandemic levels , ” said Kelly Kaminskas , president of retail and branch strategy at Lakewood-based FirstBank , during the “ Banking on a Better Future ” webinar hosted by the South Metro Denver Chamber .
As in many other areas , the pandemic accelerated @ @ @ @ @ @ @ .
About 95 % of households have a banking relationship , and branches remain important for many customers .
Brick and mortar is here to stay , but bankers are asking themselves how many branches they really need , Kaminskas said .
FirstBank closed six locations in 2020 and dropped its last two grocery store branches at area King Soopers .
U.S. Bank , one of the largest banks operating in the state , closed more than two dozen locations or about a fifth of its Colorado branches at the start of the @ @ @ @ @ @ @ bank branches has been falling since 2009 , and the trend accelerated this year .
Bankers , long focused on convenience , have come to realize during the pandemic that consumers don ’ t need branches two or three miles apart .
But they also won ’ t tolerate driving 20 miles to receive subpar service , she said .
FirstBank didn ’ t see a jump in new accounts set up digitally but did see a surge in customers using their smartphones to deposit their checks .
The bank also saw a @ @ @ @ @ @ @ , a digital app that allows people to transfer funds to each other .
Digital log-ins also spiked as customers constantly checked their devices to see if their federal stimulus payments had arrived , taxing the servers at some banks .
Colorado bank assets reached $ 69.3 billion as of June 30 , up from $ 58.3 billion a year earlier , according to the Federal Deposit Insurance Corporation .
That ’ s not normally what would be expected during a recession .
But in banking , a loan is an asset , @ @ @ @ @ @ @ make lots and lots of loans .
The next heavy workload coming down on banks is reviewing applications for forgiveness on all the PPP loans that were made .
The SBA has granted blanket forgiveness for loans under $ 50,000 , but bankers are pushing to have that cap raised to $ 150,000 , which would cover 85 % of loans , said Don Childears , CEO of the Colorado Bankers Association .
And there will be the issue of dealing with all the fraud that got through in the rush to get @ @ @ @ @ @ @ Inspector General found that of $ 192 billion approved by the SBA under its Economic Injury Disaster Loan program , $ 58 billion was traced to businesses that had the same internet address .
And about $ 13.4 billion went into bank accounts with names that differed from what was listed on the initial application .
“ We will be hearing about fraud in all of the federal lending program .
It has had a rough rollout , ” Childears said during the webinar .
Loan defaults are likely to become a more @ @ @ @ @ @ @ the industries that require a high degree of human contact , including restaurants , retailers and tourism operations .
With another wave of COVID-19 infections hitting the state , the pressure on them will only intensify .
So far this year , the share of bank loans that are past due in Colorado has actually fallen to 0.75 % of the total on June 30 , down from 0.84 % a year earlier , according to the FDIC .
But that isn ’ t expected to remain the case .
Jerry Foster , @ @ @ @ @ @ @ Colorado is leading the mountain west region for the number of bankruptcies among medium-sized businesses in the third quarter .
He expects the more severe reckoning will come down after borrowers complete and submit their 2020 financial statements .
“ Regulators have been reasonable so far , but in every one of these cycles there comes a time when they say we can no longer be tolerant .
That time will come , ” Childears said .
Richard Morgan , a senior vice president with Academy Bank , estimates that through the first @ @ @ @ @ @ @ Denver has had 500,000 square feet of retail space come back onto the market , largely because of business failures and lease defaults .
As the market tries to digest that , another 1 million square feet of retail space is under construction .
“ The retail sector will continue to contract .
The impact is not fully realized yet , ” Morgan warned during the webinar .
Likewise , metro Denver has about 3.3 million square feet of office space under construction , of which 80 % was started on a speculative @ @ @ @ @ @ @ up to occupy it , Morgan said .
Forced to send their workers home , many businesses are realizing they can probably get by with much less space than they thought necessary before the pandemic .
In their favor , financial institutions entered this downturn in a much stronger financial position than they did in the prior one , when excessive risk-taking and laxer regulations contributed to a financial crisis .
But that doesn ’ t mean they won ’ t take a hit and become more risk-averse going forward .
“ One @ @ @ @ @ @ @ to do is strike out on new customers .
We are really looking to our ( existing ) customer base to grow our business , ” Morgan said .
Besides the surge in PPP and other emergency loans , banks have had to cope with a huge surge in demand for mortgage loans , both refinancings and loans to purchase a home .
“ Lenders found their pipeline for mortgages doubling , tripling , even quadrupling in size overnight , ” said Mike Jacobs , vice president of mortgage origination with Alpine Bank @ @ @ @ @ @ @ able to staff up enough to handle the crush .
The mortgage industry also faced an existential crisis during the early days of the outbreak .
The CARES Act included a federal program that allowed mortgage borrowers struggling because of the pandemic to skip up to a year of payments .
By the first week of June , 8.55 % of all U.S. mortgages were in forbearance , according to the Mortgage Bankers Association .
“ Unfortunately , huge numbers of borrowers took advantage of that program that didn ’ t need to @ @ @ @ @ @ @ , ” Jacobs said .
Mortage servicers , the firms that collect payments , are required to cover any missing money and submit it to the holders of mortgage securities .
So many people asked for forbearance that servicers couldn ’ t cover the missing payments , which required the U.S. Treasury Department and the Federal Reserve to step in and provide liquidity .
Just under 5.5 % of U.S. residential mortgages were still under a forbearance plan as of last week , representing 2.7 million loans .
Although most borrowers have equity @ @ @ @ @ @ @ from the Great Recession , the clock will eventually run out on the grace period and they will have to start making payments again , whether they are in a position to do so or not .

Banks and mortgage lenders weren’t front and center in this year’s economic downturn as they were in the Great Recession, but that doesn’t mean 2020 hasn’t been a tumultuous year for them.
Colorado banks and community lenders faced a crush of requests under the U.S. Small Business Administration’s Paycheck Protection Program, processing 109,170 loans worth $10.4 billion in a few short weeks. Mortgage lending also exploded after the Federal Reserve’s low rate policies set off a rush to obtain 30-year loans at under 3%.
The pandemic has resulted in far fewer people walking into bank locations this year, raising a question in the industry of whether all those branches were truly needed. And it has forced banks to up their efforts to deliver services digitally.
“Branch lobby traffic has not returned to pre-pandemic levels,” said Kelly Kaminskas, president of retail and branch strategy at Lakewood-based FirstBank, during the “Banking on a Better Future” webinar hosted by the South Metro Denver Chamber.
As in many other areas, the pandemic accelerated the acceptance and use of digital channels. About 95% of households have a banking relationship, and branches remain important for many customers. Brick and mortar is here to stay, but bankers are asking themselves how many branches they really need, Kaminskas said.
FirstBank closed six locations in 2020 and dropped its last two grocery store branches at area King Soopers. U.S. Bank, one of the largest banks operating in the state, closed more than two dozen locations or about a fifth of its Colorado branches at the start of the month. Nationally, the number of bank branches has been falling since 2009, and the trend accelerated this year.
Bankers, long focused on convenience, have come to realize during the pandemic that consumers don’t need branches two or three miles apart. But they also won’t tolerate driving 20 miles to receive subpar service, she said.
FirstBank didn’t see a jump in new accounts set up digitally but did see a surge in customers using their smartphones to deposit their checks. The bank also saw a big increase in the use of Zell, a digital app that allows people to transfer funds to each other. Digital log-ins also spiked as customers constantly checked their devices to see if their federal stimulus payments had arrived, taxing the servers at some banks.
Colorado bank assets reached $69.3 billion as of June 30, up from $58.3 billion a year earlier, according to the Federal Deposit Insurance Corporation. That’s not normally what would be expected during a recession. But in banking, a loan is an asset, and the government called on banks to make lots and lots of loans.
The next heavy workload coming down on banks is reviewing applications for forgiveness on all the PPP loans that were made. The SBA has granted near-blanket forgiveness for loans under $50,000, but bankers are pushing to have that cap raised to $150,000, which would cover 85% of loans, said Don Childears, CEO of the Colorado Bankers Association.
And there will be the issue of dealing with all the fraud that got through in the rush to get assistance out quickly. The U.S. Inspector General found that of $192 billion approved by the SBA under its Economic Injury Disaster Loan program, $58 billion was traced to businesses that had the same internet address. And about $13.4 billion went into bank accounts with names that differed from what was listed on the initial application.
“We will be hearing about fraud in all of the federal lending program. It has had a rough rollout,” Childears said during the webinar.
Loan defaults are likely to become a more pressing concern next year, especially in the industries that require a high degree of human contact, including restaurants, retailers and tourism operations. With another wave of COVID-19 infections hitting the state, the pressure on them will only intensify.
So far this year, the share of bank loans that are past due in Colorado has actually fallen to 0.75% of the total on June 30, down from 0.84% a year earlier, according to the FDIC. But that isn’t expected to remain the case.
Jerry Foster, founder of Resolute Commercial Services, said Colorado is leading the mountain west region for the number of bankruptcies among medium-sized businesses in the third quarter. He expects the more severe reckoning will come down after borrowers complete and submit their 2020 financial statements.
“Regulators have been reasonable so far, but in every one of these cycles there comes a time when they say we can no longer be tolerant. That time will come,” Childears said.
Richard Morgan, a senior vice president with Academy Bank, estimates that through the first three quarters of the year, metro Denver has had 500,000 square feet of retail space come back onto the market, largely because of business failures and lease defaults. As the market tries to digest that, another 1 million square feet of retail space is under construction.
“The retail sector will continue to contract. The impact is not fully realized yet,” Morgan warned during the webinar.
Likewise, metro Denver has about 3.3 million square feet of office space under construction, of which 80% was started on a speculative basis, meaning no tenant had signed up to occupy it, Morgan said. Forced to send their workers home, many businesses are realizing they can probably get by with much less space than they thought necessary before the pandemic.
In their favor, financial institutions entered this downturn in a much stronger financial position than they did in the prior one, when excessive risk-taking and laxer regulations contributed to a financial crisis. But that doesn’t mean they won’t take a hit and become more risk-averse going forward.
“One of the last things the bank wants to do is strike out on new customers. We are really looking to our (existing) customer base to grow our business,” Morgan said.
Besides the surge in PPP and other emergency loans, banks have had to cope with a huge surge in demand for mortgage loans, both refinancings and loans to purchase a home.
“Lenders found their pipeline for mortgages doubling, tripling, even quadrupling in size overnight,” said Mike Jacobs, vice president of mortgage origination with Alpine Bank Mortgage. They simply weren’t able to staff up enough to handle the crush.
The mortgage industry also faced an existential crisis during the early days of the outbreak. The CARES Act included a federal program that allowed mortgage borrowers struggling because of the pandemic to skip up to a year of payments. By the first week of June, 8.55% of all U.S. mortgages were in forbearance, according to the Mortgage Bankers Association.
“Unfortunately, huge numbers of borrowers took advantage of that program that didn’t need to, who weren’t experiencing hardships,” Jacobs said.
Mortage servicers, the firms that collect payments, are required to cover any missing money and submit it to the holders of mortgage securities. So many people asked for forbearance that servicers couldn’t cover the missing payments, which required the U.S. Treasury Department and the Federal Reserve to step in and provide liquidity.
Just under 5.5% of U.S. residential mortgages were still under a forbearance plan as of last week, representing 2.7 million loans. Although most borrowers have equity in their homes, a big difference from the Great Recession, the clock will eventually run out on the grace period and they will have to start making payments again, whether they are in a position to do so or not.


thedenverpost--2020-11-22--Coronavirus pandemic’s third wave threatens to flood Colorado hospitals

When Gov .
Jared Polis stood in front of a podium on Nov. 13 and asked Colorado ’ s hospitals to prepare for a flood of COVID-19 patients and staff shortages , it was an omen of the days to come .
Sometime that weekend , a doctor in Denver spoke to her dying patient one last time .
By Monday , hospital staff in Pueblo were transferring patients to facilities in Colorado Springs and Denver .
Hospitals in Mesa County ran out of intensive-care beds Wednesday .
Two days later , the governor reported just three ICU beds were @ @ @ @ @ @ @ Denver area , hospitals began turning ambulances away because their facilities continued to fill .
“ This is absolutely insane that we are going through this for the third time , and we are burned out , ” said Dr. Amy Olson , medical director of the Pulmonary Physiology Unit at National Jewish Health in Denver .
The novel coronavirus is coursing through the state at the highest rate since the pandemic began .
An estimated one in 49 Coloradans are currently infected , and transmission is so uncontrolled that public health employees @ @ @ @ @ @ @ demand for testing — let alone being able to contact every infected person to find out who else could be at risk .
Cases have soared to new heights , setting records seven weeks in a row , with six times as many new infections reported in the second week of November as in the first week of October .
Hospitalizations also skyrocketed , and were more than five times higher on Nov. 20 than they were on Oct. 1 .
Now deaths , too , are on the rise , from about @ @ @ @ @ @ @ more than 20 a day in mid-November .
And those facing the brunt of the third wave in Colorado are the doctors , nurses and other health care workers , who for the past eight months have toiled on the frontlines of the pandemic .
They face a fiercer wave of coronavirus hospitalizations than during the early spring surge because the number of patients is growing at an unprecedented rate , their coworkers are becoming sick with COVID-19 and they must care for more patients who don ’ t have the new coronavirus @ @ @ @ @ @ @ re on their own .
With cases increasing across the entire nation , there won ’ t be volunteers from around the country to ease the burden .
State officials have pointed to staffing , rather than beds , as the point where the system may break down .
More than one-third of Colorado hospitals reported Friday that they could be short of staff in the next week , while 14 % expected to run out of intensive-care beds .
The Denver Post spoke to 14 hospital workers in Colorado about their experiences @ @ @ @ @ @ @ the condition of anonymity because their employers would not allow them to talk to reporters .
They described the emotional toll of losing patients , their frustrations of responding to yet another surge and fears about the approaching Thanksgiving holiday .
The wave that hit Colorado ’ s hospitals this fall was like a hurricane gathering strength as it neared land , triggering weeks of warnings that became increasingly specific and dire .
When Polis made his announcement , cases had been rising for six weeks .
The average number of cases each @ @ @ @ @ @ @ weeks , from 1,947 at the end of October to 4,461 on Nov. 13 .
Health officials warned hospitals could run out of beds by mid-January , then by late December , then before Christmas .
As of Friday , 86 % of intensive-care beds statewide already were in use , as were 84 % of beds for general care .
Statewide , 1,564 people were hospitalized with confirmed cases of COVID-19 .
The Colorado Department of Public Health and Environment says there are 1,698 intensive-care beds statewide , though health care groups @ @ @ @ @ @ @ half of them are in the Denver area , where all but 9 % of those beds were filled Friday .
In other regions , a larger percentage were available , but that could change quickly because of the small number of beds on the Eastern Plains and in the San Luis Valley .
In the spring , the state ordered a shutdown because the virus was widespread in the community .
The stay-at-home order flattened the curve , though cases and hospitalizations increased again , first with summer festivities , then as @ @ @ @ @ @ @ fall .
In the past four weeks , new infections and hospitalizations have skyrocketed and there is once again community transmission , said Margaret Huffman , the director of Jefferson County Public Health .
The virus is so widespread it ’ s unclear how people are getting infected , although officials said small gatherings are contributing to the spread .
This is a sign of just how much the transmission of COVID-19 is straining the state ’ s testing and contract-testing capabilities .
The latter is the ability to locate people with the @ @ @ @ @ @ @ ask people to isolate and quarantine .
“ Now you start to see that community transmission really roll out of control , ” Huffman said , adding that the virus is so ubiquitous that everyone is at risk of getting the disease .
Like with hospital staffing , the challenge in increasing testing and contact-tracing abilities mostly comes down to two things : there is a finite amount of resources and every community across the nation is competing for them .
“ There is a point where you can ’ t buy yourself @ @ @ @ @ @ @ one of those places , ” said Theresa Anselmo , executive director of the Colorado Association of Local Public Health Officials .
“ I ’ m seeing something I ’ ve never seen ” Normally , hospitals in the Denver area accept patients in need of high-level care from Montana to Oklahoma , but now they ’ re scrambling to find a place that can take local patients , a nurse leader at a HealthOne hospital said .
National Jewish is one of the few exceptions that ’ s still accepting transfers from @ @ @ @ @ @ @ the nurse leader ’ s Denver-area hospital was keeping five patients who needed to be in an intensive care unit in the emergency room , which is set up to quickly treat patients and send them either home or upstairs , she said .
“ I ’ m seeing something I ’ ve never seen in my career , ” she said .
“ It ’ s crazy.
” Stephanie Sullivan , spokeswoman for HealthOne , said in an email that the surge has strained hospital staffing across Colorado and the mountain states @ @ @ @ @ @ @ nurses who put in extra time , and they are hiring travel nurses , she said .
An intensive care nurse who floats between HealthOne hospitals said she ’ s caring for four patients at a time , and often all are on ventilators .
The safest thing is for each patient to have a nurse monitoring their oxygen levels and making sure they don ’ t pull out the tube allowing them to breathe , but that ’ s not possible because so many of her coworkers are out sick , she @ @ @ @ @ @ @ physician , said her work requires her to perform higher-risk procedures that can send the virus into the air through tiny drops of water .
Most of her colleagues who are getting sick don ’ t seem to be picking up the virus in those scary situations .
Instead , it ’ s through innocuous interactions outside the hospital walls .
“ It ’ s not like March , I don ’ t know that I even heard of one of us getting it in this hospital , ” she said .
“ @ @ @ @ @ @ @ on our windows and doors .
I don ’ t know where people have gotten it.
” Alyssa Tousignant , a registered nurse at the Rocky Mountain Regional VA Medical Center in Aurora , said increases in patients and sick colleagues have further strained a facility that couldn ’ t hire enough nurses before the pandemic .
Normally , she cares for four patients at a time , but this week leadership announced that likely will increase to seven , she said .
If that happens , she may not have time to @ @ @ @ @ @ @ .
“ I ’ m here to make sure everyone is alive , essentially , ” with that many patients , she said .
“ That ’ s not why I became a nurse.
” There ’ s a culture of “ toughing it out ” in nursing , and before COVID-19 hit , most nurses only stayed home if they had a fever or were vomiting , said a nurse at Spalding Rehabilitation Hospital in Aurora .
They can ’ t do that anymore , because a person with mild symptoms from @ @ @ @ @ @ @ coworker seriously ill , she said .
“ Now , if you even have the sniffles , you ’ re calling into work and trying to get a rapid test , ” she said .
Even though her unit doesn ’ t treat patients with COVID-19 , they ’ ve been affected because floating nurses are being sent to help with coronavirus patients , and aren ’ t available to relieve short staffing elsewhere , the Spalding nurse said .
She said her unit is short-staffed almost every day .
Long hours are @ @ @ @ @ @ @ and other staff , particularly since they didn ’ t completely return to normal operations after the spring wave , said state Rep. Kyle Mullica , an Adams County Democrat and emergency room nurse at Presbyterian-St. Luke ’ s Hospital in Denver .
“ People are quick to call us heroes… but we ’ re normal people , too , ” he said .
“ The best thing you can do to show your appreciation is to do everything you can to stop the spread.
” Hospitals know more about how to treat @ @ @ @ @ @ @ in the spring : they ’ re putting fewer patients on ventilators , and the average patient goes home a few days sooner than in April .
That ’ s allowed Denver Health to treat more total patients with the same space they had during the first wave , said Dr. Connie Savor Price , chief medical officer at Denver Health .
Hospitals do also face some strains they didn ’ t in the spring , when the state ordered most non-emergency medical services to stop so they could conserve protective equipment like @ @ @ @ @ @ @ , state public health officials have not issued a moratorium on elective surgeries , although Polis has raised the possibility of such a measure .
Instead , hospitals are postponing or canceling non-emergency procedures themselves based on their needs .
Parkview Medical Center in Pueblo canceled inpatient surgeries , and Denver Health is asking patients to reschedule procedures that require an overnight stay , if the problem isn ’ t likely to worsen in the near future , Price said .
“ If they ’ re going to take up a bed or @ @ @ @ @ @ @ re asking them to put that off if they can , ” she said .
Mullica said that during the spring surge , patients were too afraid to come to the hospital for conditions other than COVID-19 .
It ’ s a good thing those patients are seeking care now , but it ’ s putting more strain on staff during the current surge , he said .
In the spring , hospitals in the worst-hit areas also could call on others for help .
Dr. Josh Solomon , a critical care physician @ @ @ @ @ @ @ York to help with the crush of patients hitting their hospitals .
Now , reinforcements aren ’ t likely .
Hospitals around the country are running out of space and staff , with a health system in Idaho warning it could be forced to ration care and a hospital in Reno , Nevada , moving patients into its parking garage .
“ If there is a surge only in New York or in Los Angeles , they can pull from wherever , ” Solomon said .
“ Nobody has a lot of staff @ @ @ @ @ @ @ need it , that ’ s the problem.
” Normally , when a hospital doesn ’ t have space or staff to treat all patients , they arrange a transfer to another facility .
That hasn ’ t been possible in all cases , as some Denver-metro hospitals began turning away ambulances last week .
Colorado has three alternative care sites — St. Anthony North in Westminster , St. Mary-Corwin Medical Center in Pueblo and the Colorado Convention Center in Denver — that the governor has said will be activated as a last @ @ @ @ @ @ @ to receive patients within two to four weeks after they are activated , but won ’ t be equipped to treat those who are seriously ill.
It ’ s unclear how many employees the alternative care sites will need .
A spokesperson for the state Department of Public Health and Environment said in an email that it will depend on the number of patients .
The workers will come from private agencies the state has contracts with and volunteer health care workers .
So far , the state has issued 461 emergency licenses @ @ @ @ @ @ @ workers to reenter the field and help with the pandemic .
Most of the licenses were for registered nurses and certified nursing assistants .
The state recently activated medical staffing contracts to supplement hospital staffing , although it ’ s unclear where those workers are coming from , other than that they are from the Denver area .
The state health department declined to name the contracting agencies .
“ Hospitals are currently staffed appropriately , ” said the state health department spokesperson , who did not provide a name .
Medical facilities @ @ @ @ @ @ @ staffing themselves by moving employees around and inviting retired nurses to come back .
“ We are turning over every stone to find compassionate caregivers to care for our patients , ” said Kevin Massey , a spokesman for Centura Health .
At Denver Health , there are plans to have an experienced ICU nurse oversee others who worked in different units , and “ helpers ” who aren ’ t licensed to provide medical care can run for supplies and provide other support , Price said .
If the situation continues to @ @ @ @ @ @ @ services and ask those staffers to help on COVID-19 units , she said .
Kevin Stansbury , CEO of Lincoln Community Hospital in Hugo , said they don ’ t have an ICU and normally send their sickest patients to Denver .
But they have purchased one ventilator to help out if other hospitals can ’ t take someone who needs to be intubated , he said .
About two weeks ago , staff at Parkview Medical Center in Pueblo began converting other parts of the hospital into COVID-19 units .
Parkview officials @ @ @ @ @ @ @ about taking bodies if the hospital reaches the point that more people die than can be stored in its morgue , which can hold about 12 bodies .
If hospitalizations increase , Parkview will cancel outpatient surgeries so that it can transform its surgery recovery unit into an ICU , said Dr. Sandeep Vijan , chief medical officer .
“ After that we are at capacity , geographically , in terms of where we could put the patients , ” he said .
If all those plans aren ’ t enough , and @ @ @ @ @ @ @ come up with enough beds and staff to treat every patient , they could be forced to resort to the crisis standards of care the state approved in the spring , said Price , the Denver Health chief medical officer .
“ Then we have to start making choices we don ’ t want to make , ” she said .
The crisis standards criteria for rationing care assign points on six measures of lung , heart , kidney and liver function .
Patients with the highest scores are considered least likely to @ @ @ @ @ @ @ after , and are given the lowest priority if hospitals must ration resources .
Age and other chronic conditions also raise a patient ’ s score .
A previously healthy 50-year-old would have one point added for age , while a 40-year-old with breast cancer that had spread would have six more points .
Even with clear criteria , it ’ s still traumatic for the health care workers to make choices about who they can ’ t save , Price said .
The effects could echo for some time as highly skilled @ @ @ @ @ @ @ in medicine anymore , she said .
In April , much of the discussion focused on who would get the last ventilator , but fewer patients needed those machines than expected .
If Colorado has to go to crisis standards , hospitals are more likely to have to decide who needs intensive care but has to go to a general unit , because they don ’ t have enough staff to safely care for everyone at that level , Price said .
“ Do you add one more ( patient ) on and @ @ @ @ @ @ @ .
Doctors described feeling emotionally drained from not only the amount of death they have faced during the pandemic , but the longevity of the crisis .
The HealthOne ICU nurse said she ’ s frustrated by people who decide they ’ re tired of following precautions and will risk what they think is a mild infection .
She ’ s seen generally healthy , middle-aged people die from the virus , and others being discharged with feeding tubes in their abdomens and tracheostomy tubes in their windpipes so they can breathe .
@ @ @ @ @ @ @ rules ) could kill someone , ” she said .
Olson , the National Jewish physician , said a patient she ’ d treated for about six years recently was hospitalized for COVID-19 .
The patient , who had an underlying lung disease , didn ’ t want to go on a ventilator — not that it would have helped .
The patient ’ s lungs were so ravaged by COVID-19 that the chances of her coming off the machine and surviving “ were slim , ” Olson said .
With the help @ @ @ @ @ @ @ to talk to her patient one last time , and worked with the staff to make her as comfortable as possible .
The patient was anxious , because she couldn ’ t breathe .
By the next morning , 20 minutes after her family came to say goodbye , the patient died .
“ I had a 50-year-old die the same weekend , and that ’ s my age , ” Olson said .
“ When people are dying that are your age with kids , it ’ s devastating .
”

When Gov. Jared Polis stood in front of a podium on Nov. 13 and asked Colorado’s hospitals to prepare for a flood of COVID-19 patients and staff shortages, it was an omen of the days to come.
Sometime that weekend, a doctor in Denver spoke to her dying patient one last time. By Monday, hospital staff in Pueblo were transferring patients to facilities in Colorado Springs and Denver. Hospitals in Mesa County ran out of intensive-care beds Wednesday. Two days later, the governor reported just three ICU beds were available throughout Weld County.
Across the Denver area, hospitals began turning ambulances away because their facilities continued to fill.
“This is absolutely insane that we are going through this for the third time, and we are burned out,” said Dr. Amy Olson, medical director of the Pulmonary Physiology Unit at National Jewish Health in Denver.
The novel coronavirus is coursing through the state at the highest rate since the pandemic began. An estimated one in 49 Coloradans are currently infected, and transmission is so uncontrolled that public health employees are struggling to keep up with the demand for testing — let alone being able to contact every infected person to find out who else could be at risk.
Cases have soared to new heights, setting records seven weeks in a row, with six times as many new infections reported in the second week of November as in the first week of October. Hospitalizations also skyrocketed, and were more than five times higher on Nov. 20 than they were on Oct. 1.
Now deaths, too, are on the rise, from about six per day in early October to more than 20 a day in mid-November.
And those facing the brunt of the third wave in Colorado are the doctors, nurses and other health care workers, who for the past eight months have toiled on the frontlines of the pandemic. They face a fiercer wave of coronavirus hospitalizations than during the early spring surge because the number of patients is growing at an unprecedented rate, their coworkers are becoming sick with COVID-19 and they must care for more patients who don’t have the new coronavirus.
And this time, they’re on their own. With cases increasing across the entire nation, there won’t be volunteers from around the country to ease the burden.
State officials have pointed to staffing, rather than beds, as the point where the system may break down. More than one-third of Colorado hospitals reported Friday that they could be short of staff in the next week, while 14% expected to run out of intensive-care beds.
The Denver Post spoke to 14 hospital workers in Colorado about their experiences in recent weeks. Some spoke on the condition of anonymity because their employers would not allow them to talk to reporters. They described the emotional toll of losing patients, their frustrations of responding to yet another surge and fears about the approaching Thanksgiving holiday.
Reality worse than predicted
The wave that hit Colorado’s hospitals this fall was like a hurricane gathering strength as it neared land, triggering weeks of warnings that became increasingly specific and dire.
When Polis made his announcement, cases had been rising for six weeks. The average number of cases each day had more than doubled in two weeks, from 1,947 at the end of October to 4,461 on Nov. 13. Health officials warned hospitals could run out of beds by mid-January, then by late December, then before Christmas.
As of Friday, 86% of intensive-care beds statewide already were in use, as were 84% of beds for general care. Statewide, 1,564 people were hospitalized with confirmed cases of COVID-19.
The Colorado Department of Public Health and Environment says there are 1,698 intensive-care beds statewide, though health care groups have given different estimates. More than half of them are in the Denver area, where all but 9% of those beds were filled Friday. In other regions, a larger percentage were available, but that could change quickly because of the small number of beds on the Eastern Plains and in the San Luis Valley.
COVID-19 basics Symptoms of COVID-19 — including fever, cough, shortness of breath, sore throat, loss of taste and smell, and nausea — can appear between two and 14 days after exposure, the CDC says. Public health recommendations: — Wear masks that cover your mouth and nose — Stay at least 6 feet from others — Wash hands with soap and water for at least 20 seconds More guidelines: covid19.colorado.gov
In the spring, the state ordered a shutdown because the virus was widespread in the community. The stay-at-home order flattened the curve, though cases and hospitalizations increased again, first with summer festivities, then as students returned to universities in the early fall.
In the past four weeks, new infections and hospitalizations have skyrocketed and there is once again community transmission, said Margaret Huffman, the director of community health services at Jefferson County Public Health.
The virus is so widespread it’s unclear how people are getting infected, although officials said small gatherings are contributing to the spread. This is a sign of just how much the transmission of COVID-19 is straining the state’s testing and contact-testing capabilities. The latter is the ability to locate people with the disease, identify their close contacts and ask people to isolate and quarantine.
“Now you start to see that community transmission really roll out of control,” Huffman said, adding that the virus is so ubiquitous that everyone is at risk of getting the disease.
Like with hospital staffing, the challenge in increasing testing and contact-tracing abilities mostly comes down to two things: there is a finite amount of resources and every community across the nation is competing for them.
“There is a point where you can’t buy yourself out of something and this may be one of those places,” said Theresa Anselmo, executive director of the Colorado Association of Local Public Health Officials.
“I’m seeing something I’ve never seen”
Normally, hospitals in the Denver area accept patients in need of high-level care from Montana to Oklahoma, but now they’re scrambling to find a place that can take local patients, a nurse leader at a HealthOne hospital said. National Jewish is one of the few exceptions that’s still accepting transfers from outside Colorado.
At one point, the nurse leader’s Denver-area hospital was keeping five patients who needed to be in an intensive care unit in the emergency room, which is set up to quickly treat patients and send them either home or upstairs, she said.
“I’m seeing something I’ve never seen in my career,” she said. “It’s crazy.”
Stephanie Sullivan, spokeswoman for HealthOne, said in an email that the surge has strained hospital staffing across Colorado and the mountain states. Their hospitals have offered incentives to nurses who put in extra time, and they are hiring travel nurses, she said.
An intensive care nurse who floats between HealthOne hospitals said she’s caring for four patients at a time, and often all are on ventilators. The safest thing is for each patient to have a nurse monitoring their oxygen levels and making sure they don’t pull out the tube allowing them to breathe, but that’s not possible because so many of her coworkers are out sick, she said.
Olson, the National Jewish physician, said her work requires her to perform higher-risk procedures that can send the virus into the air through tiny drops of water. Most of her colleagues who are getting sick don’t seem to be picking up the virus in those scary situations. Instead, it’s through innocuous interactions outside the hospital walls.
“It’s not like March, I don’t know that I even heard of one of us getting it in this hospital,” she said. “I feel like it’s knocking on our windows and doors. I don’t know where people have gotten it.”
Alyssa Tousignant, a registered nurse at the Rocky Mountain Regional VA Medical Center in Aurora, said increases in patients and sick colleagues have further strained a facility that couldn’t hire enough nurses before the pandemic. Normally, she cares for four patients at a time, but this week leadership announced that likely will increase to seven, she said. If that happens, she may not have time to bathe patients or even brush their teeth.
“I’m here to make sure everyone is alive, essentially,” with that many patients, she said. “That’s not why I became a nurse.”
There’s a culture of “toughing it out” in nursing, and before COVID-19 hit, most nurses only stayed home if they had a fever or were vomiting, said a nurse at Spalding Rehabilitation Hospital in Aurora. They can’t do that anymore, because a person with mild symptoms from the virus could make a patient or coworker seriously ill, she said.
“Now, if you even have the sniffles, you’re calling into work and trying to get a rapid test,” she said.
Even though her unit doesn’t treat patients with COVID-19, they’ve been affected because floating nurses are being sent to help with coronavirus patients, and aren’t available to relieve short staffing elsewhere, the Spalding nurse said. She said her unit is short-staffed almost every day.
Long hours are starting to take a toll on nurses and other staff, particularly since they didn’t completely return to normal operations after the spring wave, said state Rep. Kyle Mullica, an Adams County Democrat and emergency room nurse at Presbyterian-St. Luke’s Hospital in Denver.
“People are quick to call us heroes… but we’re normal people, too,” he said. “The best thing you can do to show your appreciation is to do everything you can to stop the spread.”
More knowledge, limited resources to fight virus
Hospitals know more about how to treat patients during this surge than they did in the spring: they’re putting fewer patients on ventilators, and the average patient goes home a few days sooner than in April. That’s allowed Denver Health to treat more total patients with the same space they had during the first wave, said Dr. Connie Savor Price, chief medical officer at Denver Health.
Hospitals do also face some strains they didn’t in the spring, when the state ordered most non-emergency medical services to stop so they could conserve protective equipment like masks, Price said. For now, state public health officials have not issued a moratorium on elective surgeries, although Polis has raised the possibility of such a measure. Instead, hospitals are postponing or canceling non-emergency procedures themselves based on their needs.
Parkview Medical Center in Pueblo canceled inpatient surgeries, and Denver Health is asking patients to reschedule procedures that require an overnight stay, if the problem isn’t likely to worsen in the near future, Price said.
“If they’re going to take up a bed or take up a nurse, we’re asking them to put that off if they can,” she said.
Mullica said that during the spring surge, patients were too afraid to come to the hospital for conditions other than COVID-19. It’s a good thing those patients are seeking care now, but it’s putting more strain on staff during the current surge, he said.
In the spring, hospitals in the worst-hit areas also could call on others for help. Dr. Josh Solomon, a critical care physician at National Jewish, traveled to New York to help with the crush of patients hitting their hospitals. Now, reinforcements aren’t likely.
Hospitals around the country are running out of space and staff, with a health system in Idaho warning it could be forced to ration care and a hospital in Reno, Nevada, moving patients into its parking garage.
“If there is a surge only in New York or in Los Angeles, they can pull from wherever,” Solomon said. “Nobody has a lot of staff where you can pull from if you need it, that’s the problem.”
Surge plans buffer wave, for now
Normally, when a hospital doesn’t have space or staff to treat all patients, they arrange a transfer to another facility. That hasn’t been possible in all cases, as some Denver-metro hospitals began turning away ambulances last week.
Colorado has three alternative care sites — St. Anthony North in Westminster, St. Mary-Corwin Medical Center in Pueblo and the Colorado Convention Center in Denver — that the governor has said will be activated as a last resort. These locations will be able to receive patients within two to four weeks after they are activated, but won’t be equipped to treat those who are seriously ill.
It’s unclear how many employees the alternative care sites will need. A spokesperson for the state Department of Public Health and Environment said in an email that it will depend on the number of patients. The workers will come from private agencies the state has contracts with and volunteer health care workers.
So far, the state has issued 461 emergency licenses to allow retired and other health care workers to reenter the field and help with the pandemic. Most of the licenses were for registered nurses and certified nursing assistants.
The state recently activated medical staffing contracts to supplement hospital staffing, although it’s unclear where those workers are coming from, other than that they are from the Denver area. The state health department declined to name the contracting agencies.
“Hospitals are currently staffed appropriately,” said the state health department spokesperson, who did not provide a name.
Medical facilities are also trying to beef up their staffing themselves by moving employees around and inviting retired nurses to come back.
“We are turning over every stone to find compassionate caregivers to care for our patients,” said Kevin Massey, a spokesman for Centura Health.
At Denver Health, there are plans to have an experienced ICU nurse oversee others who worked in different units, and “helpers” who aren’t licensed to provide medical care can run for supplies and provide other support, Price said. If the situation continues to worsen, they could shut down more services and ask those staffers to help on COVID-19 units, she said.
Kevin Stansbury, CEO of Lincoln Community Hospital in Hugo, said they don’t have an ICU and normally send their sickest patients to Denver. But they have purchased one ventilator to help out if other hospitals can’t take someone who needs to be intubated, he said.
About two weeks ago, staff at Parkview Medical Center in Pueblo began converting other parts of the hospital into COVID-19 units. Parkview officials also have spoken to the county coroner about taking bodies if the hospital reaches the point that more people die than can be stored in its morgue, which can hold about 12 bodies.
If hospitalizations increase, Parkview will cancel outpatient surgeries so that it can transform its surgery recovery unit into an ICU, said Dr. Sandeep Vijan, chief medical officer.
“After that we are at capacity, geographically, in terms of where we could put the patients,” he said.
If all those plans aren’t enough, and hospitals across the state can’t come up with enough beds and staff to treat every patient, they could be forced to resort to the crisis standards of care the state approved in the spring, said Price, the Denver Health chief medical officer.
“Then we have to start making choices we don’t want to make,” she said.
The crisis standards criteria for rationing care assign points on six measures of lung, heart, kidney and liver function. Patients with the highest scores are considered least likely to survive COVID-19, or for a year after, and are given the lowest priority if hospitals must ration resources.
Age and other chronic conditions also raise a patient’s score. A previously healthy 50-year-old would have one point added for age, while a 40-year-old with breast cancer that had spread would have six more points.
Even with clear criteria, it’s still traumatic for the health care workers to make choices about who they can’t save, Price said. The effects could echo for some time as highly skilled people decide they can’t work in medicine anymore, she said.
In April, much of the discussion focused on who would get the last ventilator, but fewer patients needed those machines than expected. If Colorado has to go to crisis standards, hospitals are more likely to have to decide who needs intensive care but has to go to a general unit, because they don’t have enough staff to safely care for everyone at that level, Price said.
“Do you add one more (patient) on and possibly compromise all?” she said.
“It’s devastating”
Doctors described feeling emotionally drained from not only the amount of death they have faced during the pandemic, but the longevity of the crisis.
The HealthOne ICU nurse said she’s frustrated by people who decide they’re tired of following precautions and will risk what they think is a mild infection. She’s seen generally healthy, middle-aged people die from the virus, and others being discharged with feeding tubes in their abdomens and tracheostomy tubes in their windpipes so they can breathe.
“That exception (to following the rules) could kill someone,” she said.
Olson, the National Jewish physician, said a patient she’d treated for about six years recently was hospitalized for COVID-19. The patient, who had an underlying lung disease, didn’t want to go on a ventilator — not that it would have helped. The patient’s lungs were so ravaged by COVID-19 that the chances of her coming off the machine and surviving “were slim,” Olson said.
With the help of another doctor, Olson used FaceTime to talk to her patient one last time, and worked with the staff to make her as comfortable as possible. The patient was anxious, because she couldn’t breathe.
By the next morning, 20 minutes after her family came to say goodbye, the patient died.
“I had a 50-year-old die the same weekend, and that’s my age,” Olson said. “When people are dying that are your age with kids, it’s devastating.”


thedenverpost--2020-11-22--PHOTOS: Staff at National Jewish Health work as COVID-19 surges

When Gov .
Jared Polis stood in front of a podium on Nov. 13 and asked Colorado ’ s hospitals to prepare for a flood of COVID-19 patients and staff shortages , it was — perhaps unknowingly — an omen of the days to come .
“ This is absolutely insane that we are going through this for the third time , and we are burned out , ” said Dr. Amy Olson , medical director of the Pulmonary Physiology Unit at National Jewish Health in Denver .
The novel coronavirus is coursing through the state at the highest rate @ @ @ @ @ @ @ one in 49 Coloradans are currently infected , and transmission is so uncontrolled that public health employees are struggling to keep up with the demand for testing — let alone being able to contact every infected person to find out who else could be at risk .
The Denver Post spoke to 14 hospital workers in Colorado about their experiences in recent weeks .
Click here to read their stories .
Denver Post photojournalist AAron Ontiveroz spent a recent day with the staff of National Jewish Health as they continue their work , @ @ @ @ @ @ @ COVID-19 cases .

When Gov. Jared Polis stood in front of a podium on Nov. 13 and asked Colorado’s hospitals to prepare for a flood of COVID-19 patients and staff shortages, it was — perhaps unknowingly — an omen of the days to come.
“This is absolutely insane that we are going through this for the third time, and we are burned out,” said Dr. Amy Olson, medical director of the Pulmonary Physiology Unit at National Jewish Health in Denver.
The novel coronavirus is coursing through the state at the highest rate since the pandemic began. An estimated one in 49 Coloradans are currently infected, and transmission is so uncontrolled that public health employees are struggling to keep up with the demand for testing — let alone being able to contact every infected person to find out who else could be at risk.
The Denver Post spoke to 14 hospital workers in Colorado about their experiences in recent weeks. Click here to read their stories.
Denver Post photojournalist AAron Ontiveroz spent a recent day with the staff of National Jewish Health as they continue their work, treating their patients amid the rise of COVID-19 cases.


thedenverpost--2020-11-22--The quest to save a dying Spanish dialect in Colorado’s San Luis Valley: “A treasure that exists now

The quest to save a dying Spanish dialect in Colorado’s San Luis Valley: “A treasure that exists nowhere else in the world”

SAN LUIS VALLEY — Dennis Lopez can trace his lineage here back to 1847 , when pioneers from Mexico first put down roots in the area .
He still tends to a ranch owned by his wife ’ s family in San Luis , a small valley community of less than 1,000 people that ’ s regarded as the oldest town in Colorado .
Language , however , is where Lopez finds his true passion — in particular a unique Spanish dialect native to northern New Mexico and southern Colorado .
It ’ s a version of the archaic language @ @ @ @ @ @ @ .
The former Adams State University professor ’ s eyes light up when he articulates the differences in this dialect , which over the years infused words from various Native American tribes , French fur trappers and American settlers into the classic Spanish brought over by early settlers into Mexico and up through the San Luis Valley .
But the language that Lopez holds so dearly , and a point of pride he cherishes about his heritage , is fading away .
Much like the dialect itself , its declining usage comes from @ @ @ @ @ @ @ and peer pressure , stereotyping and xenophobia .
Old Catholic nuns used to whack students with rulers if they didn ’ t speak English .
Lopez won ’ t just let it go .
He used to teach a class at Adams State on lifestyles of the San Luis Valley , and now gives lectures on its history and the importance of preserving their way of speaking here .
But it feels like he ’ s preaching to the choir .
“ I always end my talks by saying , ‘ We have @ @ @ @ @ @ @ a treasure , a treasure that exists nowhere else in the world , ' ” Lopez said .
‘ ” Speak to your children and teach them : Don ’ t let this jewel go to waste .
Don ’ t let this treasure get lost . '
” The “ Spanish Dialect of the Upper Rio Grande Region ” — a description Lopez coined — became what it is today through a combination of necessity and isolation .
The Spaniards who made their way north to southern Colorado from what is modern-day @ @ @ @ @ @ @ had never seen before .
So what did they do ?
They used Native words , adding in Spanish inflections and tones .
A few examples include “ jején ” for mosquito and “ tecolote ” for owl .
Both words are adaptions from Nahuatl , spoken by neighboring Aztecs .
The Spaniards also took words from the Pueblo Indians , such as “ cunque ” for coffee grounds , and from French fur trappers who moved West .
After English-speakers moved into the region in the 1800s , new words came into @ @ @ @ @ @ @ cookies and “ tiquete ” for ticket , among others .
Meanwhile , the Spanish language continued to evolve in Spain and Mexico City .
But the settlers in southern Colorado and northern New Mexico were so isolated from those power centers that the Spanish stayed in its archaic form — plus its New World additions , Lopez said .
Many families in the San Luis Valley can look back at previous generations to see just how the distinct dialect began to whither .
Demetrio Valdez still lives on the sprawling ranch in @ @ @ @ @ @ @ a few miles from the New Mexico border .
Valdez , 73 , is partially retired now , but he still keeps a collection of horses , cows , pigs and chickens worthy of Noah ’ s ark over hundreds of acres that stretch across the Conejos River .
Ranching in the valley is what his family has always done .
Both Valdez ’ s grandfather and father spoke fluent Spanish of the local variety , but “ every generation the Spanish got worse , ” Valdez said .
He remembers his mother @ @ @ @ @ @ @ it with Formica and plastic “ because she wanted to be modern , ” Valdez said .
That meant the adobe chicken coop had to go as well , replaced by a metal building .
“ She didn ’ t want to be different , ” he said .
Reyes Garcia , whose family also dates back to the earliest Spanish settlers in the region , remembers driving out to California with his parents in the early 1950s .
They stopped at a hotel somewhere in Arizona for the night , and his @ @ @ @ @ @ @ room .
The Garcias were an illustrious family , descendants of Spanish royalty .
They owned hundreds of acres of land near Antonito and thousands of sheep .
That meant something in the San Luis Valley .
But at that Arizona hotel , Garcia ’ s father only looked like a foreigner .
“ We don ’ t have vacancy for your kind , ” Garcia remembers the clerk telling his father .
It was young Garcia ’ s first encounter with racism .
“ There was a misunderstanding of who were , @ @ @ @ @ @ @ been in our homeland for 400 years.
” As a result , Garcia ’ s parents didn ’ t speak to him and his siblings in San Luis Valley Spanish .
They heard the language , but they didn ’ t speak it , “ so we wouldn ’ t experience the racism that was so prevalent , ” Garcia said .
Education also played a major role in the language ’ s transformation in the region .
For a long time , schools in Conjeos County were run by nuns who didn @ @ @ @ @ @ @ recalls walking to school every day because kids were kicked off the school bus if they spoke anything but English .
Then in the classroom , the nuns would whack you with a ruler if they heard you speak Spanish , he said .
“ They wanted us to forget Spanish completely , ” Valdez said .
“ They wanted to turn us into white people.
” “ If you don ’ t use it , you lose it ” For younger generations in the San Luis Valley , there ’ s a @ @ @ @ @ @ @ if some millennials there question whether the unique dialect spoken by their grandparents will stick around .
Growing up in San Luis , Alonzo Lobato remembers a strange thing happening when he asked his father for help on his Spanish homework .
“ He ’ s fully bilingual , but when he helped with my homework , I would get a worse grade !
” Lobato said with a laugh .
“ The Spanish he grew up speaking was slightly different than the Spanish they ’ re teaching me out of the book @ @ @ @ @ @ @ thing in school and learning a different thing outside of school.
” Lobato , 32 , says he and his friends who grew up in the valley wish they spoke better Spanish , but it just wasn ’ t prioritized at home .
Now he ’ s nagging his younger sisters to speak because he ’ s seen how helpful being bilingual can be for jobs in the region .
As a nurse , Lobato regularly receives patients who don ’ t speak English , so he ’ s pushed himself to get @ @ @ @ @ @ @ dialect his father used on his old homework assignments ?
“ If you don ’ t use it , you lose it , ” Lobato said .
“ It ’ ll slowly fade out more and more until it ’ ll be lost to the past.
” Justin Garoutte , whose family dates back generations in Antonito , has seen the language slowly fade throughout his own family .
He likens the regional dialect ’ s dissipation to the forced assimilation of Native American tribes through boarding schools and systemic racism that puts @ @ @ @ @ @ @ I mean , it ’ s sad , ” Garoutte said .
“ But at the same time , it ’ s part of cultures moving forward and progressing .
Things get lost that aren ’ t valued or useful anymore .
I don ’ t know there is enough of a cohesive cultural group to keep this Spanish alive.
” Fighting to keep it alive For longtime San Luis Valley residents , the future of their distinct dialect is up in the air .
But there are still those fighting to keep @ @ @ @ @ @ @ up in the tiny valley town of Capulin , Julie Chacon recalled living in two worlds .
She knew it was disrespectful to speak to her grandparents in English .
But then at school , she couldn ’ t speak in Spanish .
“ I feel it dying away within me now because my grandparents are gone , ” Chacon said .
But when Chacon became the executive director of the Sangre de Cristo National Heritage Area in Alamosa , she made it a mission to remind people about the uniqueness of their @ @ @ @ @ @ @ oral histories that were done in the 1970s and ’ 80s , in which people such as Dennis Lopez and Valdez , the rancher , speak about the rich history and culture in the San Luis Valley .
The heritage center is also making workbooks that teach the local Spanish and organizing heritage camps that would take kids to older farms in the area .
“ Our goal as a heritage area is to let the local youth be prideful of their history , their language , because it is very unique , @ @ @ @ @ @ @ s not really the history you see in the textbook.
” As Lopez , the former Adams State professor , continues to harp on the importance of keeping their linguistic rarity alive , he struggles within his own family to do the same .
“ My children in their 30s — they don ’ t speak it , ” Lopez said .
“ Even though my wife and I encourage it .
For them , it ’ s a dying language.
” He expressed frustration that society , in his mind , doesn @ @ @ @ @ @ @ Lopez speaks with Spanish-speakers from Mexico or Central America , they often tell him he ’ s speaking incorrectly .
His workplace , an Alamosa health center , switched over their documents to the more academic Spanish to appease those who pushed for it , he said .
But despite an uphill battle , Lopez will continue giving his talks and working with the heritage center to promote the language that he holds so dearly .
“ I ’ ve given it the old college try , ” he said .
“ I @ @ @ @ @ @ @ our language .
I , by myself , can ’ t do it alone , so all I can do is present my work and hope other people pick up on it .
”

SAN LUIS VALLEY — Dennis Lopez can trace his lineage here back to 1847, when pioneers from Mexico first put down roots in the area.
He still tends to a ranch owned by his wife’s family in San Luis, a small valley community of less than 1,000 people that’s regarded as the oldest town in Colorado.
Language, however, is where Lopez finds his true passion — in particular a unique Spanish dialect native to northern New Mexico and southern Colorado. It’s a version of the archaic language found nowhere else in the Spanish-speaking world.
The former Adams State University professor’s eyes light up when he articulates the differences in this dialect, which over the years infused words from various Native American tribes, French fur trappers and American settlers into the classic Spanish brought over by early settlers into Mexico and up through the San Luis Valley.
But the language that Lopez holds so dearly, and a point of pride he cherishes about his heritage, is fading away.
Much like the dialect itself, its declining usage comes from an amalgamation of different factors: television and peer pressure, stereotyping and xenophobia. Old Catholic nuns used to whack students with rulers if they didn’t speak English.
Lopez won’t just let it go. He used to teach a class at Adams State on lifestyles of the San Luis Valley, and now gives lectures on its history and the importance of preserving their way of speaking here. But it feels like he’s preaching to the choir.
“I always end my talks by saying, ‘We have to understand and realize that we have a treasure, a treasure that exists nowhere else in the world,'” Lopez said. ‘”Speak to your children and teach them: Don’t let this jewel go to waste. Don’t let this treasure get lost.'”
History of the dialect
The “Spanish Dialect of the Upper Rio Grande Region” — a description Lopez coined — became what it is today through a combination of necessity and isolation.
The Spaniards who made their way north to southern Colorado from what is modern-day Mexico encountered a host of items they had never seen before.
So what did they do? They used Native words, adding in Spanish inflections and tones. A few examples include “jején” for mosquito and “tecolote” for owl. Both words are adaptions from Nahuatl, spoken by neighboring Aztecs.
The Spaniards also took words from the Pueblo Indians, such as “cunque” for coffee grounds, and from French fur trappers who moved West. After English-speakers moved into the region in the 1800s, new words came into the mix: “cuques” for cookies and “tiquete” for ticket, among others.
Meanwhile, the Spanish language continued to evolve in Spain and Mexico City. But the settlers in southern Colorado and northern New Mexico were so isolated from those power centers that the Spanish stayed in its archaic form — plus its New World additions, Lopez said.
How a dialect starts to fade
Many families in the San Luis Valley can look back at previous generations to see just how the distinct dialect began to whither.
Demetrio Valdez still lives on the sprawling ranch in Antonito that his ancestors bought generations ago a few miles from the New Mexico border. Valdez, 73, is partially retired now, but he still keeps a collection of horses, cows, pigs and chickens worthy of Noah’s ark over hundreds of acres that stretch across the Conejos River. Ranching in the valley is what his family has always done.
Both Valdez’s grandfather and father spoke fluent Spanish of the local variety, but “every generation the Spanish got worse,” Valdez said.
He remembers his mother tossing their old world furniture and replacing it with Formica and plastic “because she wanted to be modern,” Valdez said. That meant the adobe chicken coop had to go as well, replaced by a metal building.
“She didn’t want to be different,” he said.
Reyes Garcia, whose family also dates back to the earliest Spanish settlers in the region, remembers driving out to California with his parents in the early 1950s. They stopped at a hotel somewhere in Arizona for the night, and his father went up to ask for a room.
The Garcias were an illustrious family, descendants of Spanish royalty. They owned hundreds of acres of land near Antonito and thousands of sheep. That meant something in the San Luis Valley.
But at that Arizona hotel, Garcia’s father only looked like a foreigner.
“We don’t have vacancy for your kind,” Garcia remembers the clerk telling his father. It was young Garcia’s first encounter with racism.
“There was a misunderstanding of who were,” Garcia said. “We had been in our homeland for 400 years.”
As a result, Garcia’s parents didn’t speak to him and his siblings in San Luis Valley Spanish. They heard the language, but they didn’t speak it, “so we wouldn’t experience the racism that was so prevalent,” Garcia said.
Education also played a major role in the language’s transformation in the region.
For a long time, schools in Conjeos County were run by nuns who didn’t speak any Spanish. Valdez recalls walking to school every day because kids were kicked off the school bus if they spoke anything but English.
Then in the classroom, the nuns would whack you with a ruler if they heard you speak Spanish, he said.
“They wanted us to forget Spanish completely,” Valdez said. “They wanted to turn us into white people.”
“If you don’t use it, you lose it”
For younger generations in the San Luis Valley, there’s a newfound appreciation for being bilingual — even if some millennials there question whether the unique dialect spoken by their grandparents will stick around.
Growing up in San Luis, Alonzo Lobato remembers a strange thing happening when he asked his father for help on his Spanish homework.
“He’s fully bilingual, but when he helped with my homework, I would get a worse grade!” Lobato said with a laugh. “The Spanish he grew up speaking was slightly different than the Spanish they’re teaching me out of the book. So I’m learning one thing in school and learning a different thing outside of school.”
Lobato, 32, says he and his friends who grew up in the valley wish they spoke better Spanish, but it just wasn’t prioritized at home. Now he’s nagging his younger sisters to speak because he’s seen how helpful being bilingual can be for jobs in the region.
As a nurse, Lobato regularly receives patients who don’t speak English, so he’s pushed himself to get better.
But as for the unique dialect his father used on his old homework assignments?
“If you don’t use it, you lose it,” Lobato said. “It’ll slowly fade out more and more until it’ll be lost to the past.”
Justin Garoutte, whose family dates back generations in Antonito, has seen the language slowly fade throughout his own family. He likens the regional dialect’s dissipation to the forced assimilation of Native American tribes through boarding schools and systemic racism that puts American English above other languages.
“I mean, it’s sad,” Garoutte said. “But at the same time, it’s part of cultures moving forward and progressing. Things get lost that aren’t valued or useful anymore. I don’t know there is enough of a cohesive cultural group to keep this Spanish alive.”
Fighting to keep it alive
For longtime San Luis Valley residents, the future of their distinct dialect is up in the air. But there are still those fighting to keep it alive.
As a child growing up in the tiny valley town of Capulin, Julie Chacon recalled living in two worlds. She knew it was disrespectful to speak to her grandparents in English. But then at school, she couldn’t speak in Spanish.
“I feel it dying away within me now because my grandparents are gone,” Chacon said.
But when Chacon became the executive director of the Sangre de Cristo National Heritage Area in Alamosa, she made it a mission to remind people about the uniqueness of their region. Chacon spearheaded a restoration of oral histories that were done in the 1970s and ’80s, in which people such as Dennis Lopez and Valdez, the rancher, speak about the rich history and culture in the San Luis Valley.
The heritage center is also making workbooks that teach the local Spanish and organizing heritage camps that would take kids to older farms in the area.
“Our goal as a heritage area is to let the local youth be prideful of their history, their language, because it is very unique,” Chacon said. “It’s not really the history you see in the textbook.”
As Lopez, the former Adams State professor, continues to harp on the importance of keeping their linguistic rarity alive, he struggles within his own family to do the same.
“My children in their 30s — they don’t speak it,” Lopez said. “Even though my wife and I encourage it. For them, it’s a dying language.”
He expressed frustration that society, in his mind, doesn’t value Spanish-speakers. Even when Lopez speaks with Spanish-speakers from Mexico or Central America, they often tell him he’s speaking incorrectly. His workplace, an Alamosa health center, switched over their documents to the more academic Spanish to appease those who pushed for it, he said.
But despite an uphill battle, Lopez will continue giving his talks and working with the heritage center to promote the language that he holds so dearly.
“I’ve given it the old college try,” he said. “I’ve made every attempt to promote our language. I, by myself, can’t do it alone, so all I can do is present my work and hope other people pick up on it.”


thedenverpost--2020-11-22--Gary Miller: When should you fire your kid from the family business?

John Marce had dreamed that Alex , his son , would take over the family business someday .
John was the second generation of business ownership since his father had founded the company 47 years earlier — Marce Distribution Co .
It had a large presence throughout the Midwest .
Clients included wholesalers , retailers , Amazon and other online channels generating over $ 30 million a year in revenues and pre-tax earnings of $ 550,000 per year .
The company had an excellent reputation , low employee turnover and a “ family ” culture environment .
Each year ’ @ @ @ @ @ @ @ past 10 years .
When Alex graduated from college , John put him in a managerial role almost immediately .
Alex had a strong personality and had always demonstrated leadership skills while growing up .
Alex ’ s first assignment was managing the warehouse logistics and the supply chain of the firm .
Things started off fine , but soon it became clear to other managers that Alex had little affinity for the business .
He appeared uninterested in filling and shipping orders accurately and on time .
Vendor relationships began to deteriorate @ @ @ @ @ @ @ Alex ’ s presence .
Alex treated warehouse employees with disrespect — displaying a condescending attitude toward them .
As a result , productivity and morale declined .
John begin to realize that he had a bigger problem as longtime trusted employees were handing in their resignations .
As time went on , revenues began to decline , and customer complaints began to increase .
Soon John received calls from customers complaining that they had not received their shipments on time or that their orders were improperly packaged , or short of the @ @ @ @ @ @ @ the situation .
The employees unloaded on him about all of the problems that his son was creating .
They told John that his son was abrasive , abusive , arrogant and downright mean to them .
John now realized that the rise in employee resignations and customer complaints were because of his son ’ s personality and lack of management experience .
However , John ignored the red flags and created a new department .
He assigned Alex to develop and launch new product lines .
But , one initiative after another @ @ @ @ @ @ @ that Alex refused to listen to their feedback and advice .
They told John they could not sell the new products as designed .
Customers would not buy them .
As time went on , revenues and profits continued to fall .
Disappointed , John reluctantly realized that Alex was not a good fit and would not be capable of leading the company in the future .
If he kept Alex on , he could very well damage the company beyond repair .
There was simply no place for him in the company @ @ @ @ @ @ @ mind were : “ Can I really fire my only son ?
” John kept asking himself , “ What will this do to the family ?
How will it affect Alex ’ s and my relationship ?
The fact is there is no easy way to fire your children .
According to Harvard Business Review , “ The consequences of firing your children are life long … no matter how well it is done.
” So , here are some recommendations to help you survive one of the most difficult times in @ @ @ @ @ @ @ • Sit down and have a heart-to-heart discussion with your child just as you would with any other employee .
• Treat you son/daughter with the same respect that you would treat any other employee .
• Keep your demeanor low-key , but firm , and nonaccusatory .
• Don ’ t downplay the seriousness of the situation .
• Be objective and show him/her the data and the financial performance .
• Compare the financial performance to the expectations that they had agreed upon .
• Elicit his/her reactions to the problems @ @ @ @ @ @ @ plan for your child .
John would not be in this position if he had asked himself the following questions as put forth by the Harvard Business Review : • “ Are you unintentionally setting up your child to fail with amorphous or unrealistic expectations.
” • “ Does your child have the right experience and skill sets to be successful ” ?
• “ Is your child being held to the same standards as other employees ” ?
• “ Is your child in the right role ?
” If there was @ @ @ @ @ @ @ about the answers to the questions , he should seek a trusted third-party adviser such as a board member , a close business friend , or a business consultant for an independent assessment .
If he had a close relationships to any of those resources , he could ask one of them to mentor Alex .
In John ’ s case , he didn ’ t hire his son based on skill sets needed for success .
He had no succession plan in place .
He didn ’ t analyze the cultural fit @ @ @ @ @ @ @ hired him because he was his son .
According to The Family Firm Institute , only about 30 % of family businesses survive into the second generation , 12 % are viable into the third generation , and only about 3 % of all family businesses operate into the fourth generation or beyond .
Some family businesses simply have a life cycle that will not go on forever .
Gary Miller is CEO of GEM Strategy Management , Inc. , a M & A advisory firm advising small and medium sized businesses throughout @ @ @ @ @ @ @ throughout the transaction process from preparing them to go to market , selling their companies , acquiring companies and raising capital .
He has been a frequent keynote speaker at conferences and workshops on mergers and acquisitions .
Reach Gary at 303.409.7740 or gmiller @ gemstrategymanagement.com .

John Marce had dreamed that Alex, his son, would take over the family business someday. John was the second generation of business ownership since his father had founded the company 47 years earlier — Marce Distribution Co.
It had a large presence throughout the Midwest. Clients included wholesalers, retailers, Amazon and other online channels generating over $30 million a year in revenues and pre-tax earnings of $550,000 per year. The company had an excellent reputation, low employee turnover and a “family” culture environment. Each year’s growth goals were met for the past 10 years.
When Alex graduated from college, John put him in a managerial role almost immediately. Alex had a strong personality and had always demonstrated leadership skills while growing up. Alex’s first assignment was managing the warehouse logistics and the supply chain of the firm.
Things started off fine, but soon it became clear to other managers that Alex had little affinity for the business. He appeared uninterested in filling and shipping orders accurately and on time. Vendor relationships began to deteriorate. Employees soon became discouraged and resented Alex’s presence.
Alex treated warehouse employees with disrespect — displaying a condescending attitude toward them. As a result, productivity and morale declined. John begin to realize that he had a bigger problem as longtime trusted employees were handing in their resignations.
As time went on, revenues began to decline, and customer complaints began to increase. Soon John received calls from customers complaining that they had not received their shipments on time or that their orders were improperly packaged, or short of the merchandize they had ordered.
John investigated the situation. The employees unloaded on him about all of the problems that his son was creating. They told John that his son was abrasive, abusive, arrogant and downright mean to them.
John now realized that the rise in employee resignations and customer complaints were because of his son’s personality and lack of management experience. However, John ignored the red flags and created a new department. He assigned Alex to develop and launch new product lines. But, one initiative after another failed. The sales department complained bitterly that Alex refused to listen to their feedback and advice. They told John they could not sell the new products as designed. Customers would not buy them.
As time went on, revenues and profits continued to fall. Disappointed, John reluctantly realized that Alex was not a good fit and would not be capable of leading the company in the future. If he kept Alex on, he could very well damage the company beyond repair. There was simply no place for him in the company.
Questions looming in John’s mind were: “Can I really fire my only son?” John kept asking himself, “What will this do to the family? How will it affect Alex’s and my relationship?
The fact is there is no easy way to fire your children. According to Harvard Business Review, “The consequences of firing your children are life long … no matter how well it is done.”
So, here are some recommendations to help you survive one of the most difficult times in your life both personally and professionally.
Sit down and have a heart-to-heart discussion with your child just as you would with any other employee. Treat you son/daughter with the same respect that you would treat any other employee. Keep your demeanor low-key, but firm, and nonaccusatory. Don’t downplay the seriousness of the situation. Be objective and show him/her the data and the financial performance. Compare the financial performance to the expectations that they had agreed upon. Elicit his/her reactions to the problems being discussed. Provide an exit plan for your child.
John would not be in this position if he had asked himself the following questions as put forth by the Harvard Business Review:
“Are expectations clear and mutually agreed upon?” “Are you unintentionally setting up your child to fail with amorphous or unrealistic expectations.” “Are you clearly defining his/her roles?” “Does your child have the right experience and skill sets to be successful”? “Is your child being held to the same standards as other employees”? “Are there clear metrics to hold him/her accountable”? “Is your child in the right role?”
If there was any doubt in John’s mind about the answers to the questions, he should seek a trusted third-party adviser such as a board member, a close business friend, or a business consultant for an independent assessment. If he had a close relationships to any of those resources, he could ask one of them to mentor Alex.
In John’s case, he didn’t hire his son based on skill sets needed for success. He had no succession plan in place. He didn’t analyze the cultural fit requirements for his business. He just hired him because he was his son.
According to The Family Firm Institute, only about 30% of family businesses survive into the second generation, 12% are viable into the third generation, and only about 3% of all family businesses operate into the fourth generation or beyond.
Some family businesses simply have a life cycle that will not go on forever.
Gary Miller is CEO of GEM Strategy Management, Inc., a M&A advisory firm advising small and medium sized businesses throughout the U.S. He represents business owners throughout the transaction process from preparing them to go to market, selling their companies, acquiring companies and raising capital. He has been a frequent keynote speaker at conferences and workshops on mergers and acquisitions. Reach Gary at 303.409.7740 or gmiller@gemstrategymanagement.com.


thedenverpost--2020-11-22--Not just sore throats and scraped knees: School nurses play pivotal role in containing COVID-19 in C

Not just sore throats and scraped knees: School nurses play pivotal role in containing COVID-19 in Colorado

Over the nearly 20 years Marnie McKercher has been in school nursing , she ’ s seen the profession change — but perhaps never as quickly as it has this year , when a global pandemic put infectious disease mitigation at the top of her priorities list .
School nurses are no strangers to disease prevention and intervention , as they ’ re tasked with ensuring students are immunized against preventable illnesses such as the measles and tracking cases or outbreaks of other diseases identified by public health experts .
It ’ s normally a small part of the job @ @ @ @ @ @ @ nurse consultant for Aurora Public Schools .
But as COVID-19 took center stage in 2020 , so too did more intense disease mitigation efforts .
Over the summer , for example , nursing staff played a crucial role in providing and contextualizing relevant epidemiological data to help administrators decide how — or whether — they could safely reopen schools .
“ That 5 % to 10 % of what we did is now probably closer to 95 % or greater of what school nurses are doing , ” said McKercher .
“ We @ @ @ @ @ @ @ everybody else .
We , just like everyone else , were surprised at how fast things transpired in March.
” Even during a typical school year the job of the school nurse goes well beyond “ Band-Aids and sore throats , ” she said .
The short list of duties includes screening students for vision or hearing impairments , teaching health education , administering medications to kids with chronic conditions , addressing the needs of students with individualized education programs and 504 plans , assessing suicide risks , and providing first aid to @ @ @ @ @ @ @ ’ s one overarching goal for school nurses , and that is to remove health-related barriers to learning , ” McKercher said .
In Aurora Public Schools , specifically , that also includes connecting families to needed resources such as housing and meals .
“ If you don ’ t have access to basic necessities , it ’ s hard to be available to learn.
” Adopting telehealth and other new duties The COVID-19 era has brought new practices to help ensure students and staff members are healthy even before they enter the @ @ @ @ @ @ @ has in-person learning , nurse Rebecca Sposato posts up at one of two Denver Public Schools facilities to which she is assigned , ready to support teachers as they welcome students with infrared thermometers .
Anyone who comes to Sposato ’ s office feeling unwell during the school day is evaluated based on their potential COVID-19 risk .
Her office at Whittier Elementary School has been expanded to include two rest areas : one for students experiencing “ minor ” or general cold symptoms , and one for students experiencing “ major ” @ @ @ @ @ @ @ COVID-19 .
No symptom , no matter how mundane , should be taken lightly and students are usually sent home , especially if they have a fever or respiratory issues .
“ I have had a couple kids come in with low-level symptoms , like you know booger noses and cough , which typically I would say the student is fine , just be good hygiene-wise , ” Sposato said .
“ This year , we ’ re a little bit more guarded even about those.
” How long a child ’ s @ @ @ @ @ @ @ to school , and Sposato works with each family on that timeline .
When a student receives a positive test result , she collects preliminary contact tracing information , such as the last day they attended school and a list of their classmates , before engaging DPS ’ s COVID-19 response team to further investigate .
She uses the same protocol when students call in sick .
That system worked for schools hosting in-person learning .
However , as more districts opt to move classes online , nurses have to increasingly rely on @ @ @ @ @ @ @ adjustment for Lexi Barrere , an instructor at the University of Colorado ’ s College of Nursing and nurse practitioner at a school-based health clinic serving families in Sheridan School District No .
2 .
Barrere and her colleagues would traditionally go into schools to provide services such as sports physicals and mental , dental or behavioral health care , but now they rely on connecting with patients virtually , which is limiting families ’ access to care , she said .
“ That has changed our ability to interact with the kids @ @ @ @ @ @ @ the essence of school-based health care , ” Barrere said .
“ It ’ s changed the way that we practice as a pediatric team , both at our school-based health center and at our primary care clinic.
” Telehealth has also exposed glaring technological inequities in the regional community .
Some households don ’ t have a reliable wifi connection , adding yet another barrier to receiving the services they may need .
“ That ’ s where I see a huge need is treating broadband internet just like water , like @ @ @ @ @ @ @ be a basic necessity , especially during a time like this , ” Barrere said .
Doing more with less For as much as has changed for school nurses during the pandemic , one thing hasn ’ t : They ’ re still woefully understaffed .
McKercher , Sposato and Barrere all listed an increased workload among the biggest challenges they ’ re facing right now .
In a recent meeting with the Douglas County School District board , interim Superintendent Corey Wise said the nursing staff was “ at a tipping point @ @ @ @ @ @ @ contact tracing daily on dozens of cases in addition to other school-based duties .
The district has 45 nurses total , he said , which is not enough for each Dougco school to have its own .
That ’ s not uncommon .
According to the Colorado Association of School Nurses , there were 756 part-time and full-time school nurses in Colorado during the 2019-20 school year .
With 913,223 students in Colorado ’ s 1,914 public schools , the organization said there was one full-time school nurse for every 1,331 students in @ @ @ @ @ @ @ Colorado schools said they had access to a licensed school nurse during class hours last school year , according to the Department of Education .
In 2018 , about 25 % of schools nationwide did not have a nurse , according to the National Association of School Nurses .
Barrere was an advocate for having a nurse in every school prior to the pandemic and believes having medical professionals to support individual schools during this health crisis would be invaluable .
Not only would they minimize the spread and impact of COVID-19 , @ @ @ @ @ @ @ anxiety within the community .
Sposato agrees .
The more individualized attention students can get during this time , the better , she said , especially since educators ’ workloads are also swelling .
“ All those students who we were concerned about falling through cracks academically , I feel like the crack got so much wider , ” Sposato said .
“ Teachers , they ’ re trained in teaching .
And to have them take on nursing duties is giving them more tasks at hand .
”

Over the nearly 20 years Marnie McKercher has been in school nursing, she’s seen the profession change — but perhaps never as quickly as it has this year, when a global pandemic put infectious disease mitigation at the top of her priorities list.
School nurses are no strangers to disease prevention and intervention, as they’re tasked with ensuring students are immunized against preventable illnesses such as the measles and tracking cases or outbreaks of other diseases identified by public health experts. It’s normally a small part of the job, said McKercher, the lead school nurse consultant for Aurora Public Schools.
But as COVID-19 took center stage in 2020, so too did more intense disease mitigation efforts. Over the summer, for example, nursing staff played a crucial role in providing and contextualizing relevant epidemiological data to help administrators decide how — or whether — they could safely reopen schools.
“That 5% to 10% of what we did is now probably closer to 95% or greater of what school nurses are doing,” said McKercher. “We were watching (the coronavirus) like everybody else. We, just like everyone else, were surprised at how fast things transpired in March.”
Even during a typical school year the job of the school nurse goes well beyond “Band-Aids and sore throats,” she said. The short list of duties includes screening students for vision or hearing impairments, teaching health education, administering medications to kids with chronic conditions, addressing the needs of students with individualized education programs and 504 plans, assessing suicide risks, and providing first aid to sick or injured children.
“There’s one overarching goal for school nurses, and that is to remove health-related barriers to learning,” McKercher said. In Aurora Public Schools, specifically, that also includes connecting families to needed resources such as housing and meals. “If you don’t have access to basic necessities, it’s hard to be available to learn.”
Adopting telehealth and other new duties
The COVID-19 era has brought new practices to help ensure students and staff members are healthy even before they enter the building. Every weekday morning when DPS has in-person learning, nurse Rebecca Sposato posts up at one of two Denver Public Schools facilities to which she is assigned, ready to support teachers as they welcome students with infrared thermometers.
Anyone who comes to Sposato’s office feeling unwell during the school day is evaluated based on their potential COVID-19 risk. Her office at Whittier Elementary School has been expanded to include two rest areas: one for students experiencing “minor” or general cold symptoms, and one for students experiencing “major” symptoms or those most commonly associated with COVID-19.
No symptom, no matter how mundane, should be taken lightly and students are usually sent home, especially if they have a fever or respiratory issues.
“I have had a couple kids come in with low-level symptoms, like you know booger noses and cough, which typically I would say the student is fine, just be good hygiene-wise,” Sposato said. “This year, we’re a little bit more guarded even about those.”
How long a child’s symptoms last determines when they may return to school, and Sposato works with each family on that timeline. When a student receives a positive test result, she collects preliminary contact tracing information, such as the last day they attended school and a list of their classmates, before engaging DPS’s COVID-19 response team to further investigate. She uses the same protocol when students call in sick.
That system worked for schools hosting in-person learning. However, as more districts opt to move classes online, nurses have to increasingly rely on telehealth.
That’s been an adjustment for Lexi Barrere, an instructor at the University of Colorado’s College of Nursing and nurse practitioner at a school-based health clinic serving families in Sheridan School District No. 2. Barrere and her colleagues would traditionally go into schools to provide services such as sports physicals and mental, dental or behavioral health care, but now they rely on connecting with patients virtually, which is limiting families’ access to care, she said.
“That has changed our ability to interact with the kids in their space, which is really the essence of school-based health care,” Barrere said. “It’s changed the way that we practice as a pediatric team, both at our school-based health center and at our primary care clinic.”
Telehealth has also exposed glaring technological inequities in the regional community. Some households don’t have a reliable wifi connection, adding yet another barrier to receiving the services they may need.
“That’s where I see a huge need is treating broadband internet just like water, like sewer, like electricity. It should be a basic necessity, especially during a time like this,” Barrere said.
Doing more with less
For as much as has changed for school nurses during the pandemic, one thing hasn’t: They’re still woefully understaffed. McKercher, Sposato and Barrere all listed an increased workload among the biggest challenges they’re facing right now.
In a recent meeting with the Douglas County School District board, interim Superintendent Corey Wise said the nursing staff was “at a tipping point,” overwhelmed by having to conduct contact tracing daily on dozens of cases in addition to other school-based duties. The district has 45 nurses total, he said, which is not enough for each Dougco school to have its own.
That’s not uncommon. According to the Colorado Association of School Nurses, there were 756 part-time and full-time school nurses in Colorado during the 2019-20 school year. With 913,223 students in Colorado’s 1,914 public schools, the organization said there was one full-time school nurse for every 1,331 students in the state.
About 89% of Colorado schools said they had access to a licensed school nurse during class hours last school year, according to the Department of Education. In 2018, about 25% of schools nationwide did not have a nurse, according to the National Association of School Nurses.
Barrere was an advocate for having a nurse in every school prior to the pandemic and believes having medical professionals to support individual schools during this health crisis would be invaluable. Not only would they minimize the spread and impact of COVID-19, but they also would decrease stress and anxiety within the community.
Sposato agrees. The more individualized attention students can get during this time, the better, she said, especially since educators’ workloads are also swelling.
“All those students who we were concerned about falling through cracks academically, I feel like the crack got so much wider,” Sposato said. “Teachers, they’re trained in teaching. And to have them take on nursing duties is giving them more tasks at hand.”


thedenverpost--2020-11-23--Northbound I-25 closed at 17th Street due to motorcycle crash

Northbound Interstate 25 at 17th Street has been shut down after a motorcycle crash , according to Denver police .
@ @ @ @ @ as to when the highway will reopen .
The driver of the motorcycle suffered serious @ @

Northbound Interstate 25 at 17th Street has been reopened after closing due to a motorcycle crash, according to Denver police.
The driver of the motorcycle suffered serious but non-life-threatening injuries, police say.
TRAFFIC: #Denver Officers are on scene of a single motorcycle crash with serious injury at NB I-25 at 17th Street. All of NB I-25 will be shut down. Alternate routes advised. pic.twitter.com/vQcRc5egiK — Denver Police Dept. (@DenverPolice) November 23, 2020