COVID-19 cases continue rise on peninsula, cases straining area health care

Clallam County medical personnel already are feeling the strain of a “significant uptick” in COVID-19 cases, Health Officer Dr. Allison Unthank said during the monthly meeting of the Clallam County Board of Health.

Clallam County confirmed 13 new cases of COVID-19 on Wednesday, while Jefferson County added two additional cases, county health officers said.

Both counties are in the state’s high-risk category with case rates of 96 per 100,000 population for the past two weeks in Clallam County and 100.31 per 100,000 for the two weeks prior in Jefferson County as of Monday.

Unthank, on double duty as a doctor and mom to her 1-year-old daughter during the Nov. 17 meeting, offered more information on the frailty of the county medical community and the potential fallout for non-COVID medical procedures and in-person school instruction if cases continue to mount.

“We are monitoring multiple outbreaks throughout the county,” she said. “We have two health care facility outbreaks, a long-term care facility outbreak and an outbreak related to a church.

“The health care facility outbreaks are significantly straining our health care system.

“We didn’t have a lot of doctors and nurses here before, and so when we have a lot of folks get diagnosed with COVID-19, that stresses the health care system quite quickly.”

Unthank said there has not been a dramatic uptick in hospitalizations at this point.

“That’s usually a lagging number, and we can expect that in two to three weeks after this rise in cases,” she said.

“What we are seeing, unfortunately, is a rise in infections among health care workers. And that is already straining our system.”

The county health department is working through the Emergency Operations Center to find staffing for the long-term care facility, she said.

“The challenge is the whole state and nation is having rises in cases at the same time, and health care workers are stretched throughout the country, so getting access to traveling nurses is a challenge right now.

“We are currently able to trace all of our current cases with help of the state.”

Clallam County Commissioner Mark Ozias asked Unthank to elaborate on the impact of the strain on health care providers.

“There are a couple of things already going on and things we are worried about,” she said. “Very likely on the horizon, if things continue the way they are, we will have to cancel elective surgeries again.

“We are already at a point with the long-term care facility where we are having to pull medical professionals from other areas to staff that long-term care facility because so many staff are positive.

“We have requested assistance from the state, that’s our first preference, but if we can’t get assistance from the state, we are going to have to pull medical professionals from other clinics to staff the long-term facility. And that would mean that those people’s patients don’t get seen while they are working at the long-term care facility.”

Unthank also said the health department has reached out to Peninsula College to potentially provide trainees as front-line workers, particularly for COVID-19 testing.

“Certainly not having them do patient care before they are ready, but things they are qualified to do,” she said.

Available hospital and ICU beds are a common part of the COVID-19 discussion, but Unthank clarified the concern.

“One of the more severe strains we could see, and one of the things we talk a lot about, is beds in the hospital, but what we really need is staffed beds. Beds where people who are capable of providing that care [are available].

“If we lost a lot of the staff, for instance, in our ICU, we would have to move people who don’t usually work in an ICU to work in an ICU, and that’s not safe. And that’s very much on the horizon, if we get to the point where we see ongoing rising cases amongst our health care workers.”

Unthank said the goal for county schools would be to continue to provide in-person education, but plans to add additional grade levels have been halted for the time being.

“The reason why we have decided it is reasonable to keep schools open is not only they are an incredible benefit to the children who go and to the families that have children in school, but also because we haven’t seen transmission within our schools or other schools (located in areas) where there are high rates of transmission.”

She said data shows that, when protocols are followed within schools, it reduces transmission.

“The thing that would trigger us to actually go to online, remote learning, is if we lost the ability to trace,” Unthank said. “So that’s what we are trying to protect, the ability to trace.”

Unthank also discussed recent vaccine developments. Pharmaceutical companies Pfizer and Moderna each have provided in-house data showing their prospective vaccines work.

“Very good news for an area like us is the second vaccine, Moderna,” Unthank said. “Both are over 90 percent effective, and now we need a little more data to make a final review.

“Why the Moderna results are so exciting is that it can be maintained at regular freezer and refrigerator temperatures, so this is likely the vaccine that we will be provided.

“Just based on the Pfizer vaccine, the state expects to receive 200,000 doses by the end of the year. To put that in context, the state has 500,000 health care workers, and they would get it in the first round due to the risk of contracting the virus at work.”

Unthank said the vaccine roll out would be expanded to priority groups set up by the federal Centers for Disease Control and Prevention along with the state Department of Health.

“Rough plans are health care workers, EMTs and first responders, long-term care facility workers, those with multiple co-morbidities, people over 65, teachers, and then on to the general population,” Unthank said.

She expects a spring or early summer time frame for the general public to receive the vaccine.

Unthank also said dedicated funding would be needed to distribute the vaccine.

“There’s not any funding for vaccine distribution,” she said. “We will make it happen, we will do it with our people — people from the hospital and clinics — but we need to look at that.”

Clallam County has confirmed 365 cases of COVID-19 since March, with 70 active cases, more than 300 people in quarantine due to exposure and two deaths, Unthank said.

Jefferson County has confirmed 127 cases since March, with at least 24 active cases, more than 60 people in quarantine due to exposure and no deaths, Locke said.

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