Health officials toward reopening in early May

For the first time since the initial COVID-19 case was diagnosed on the North Olympic Peninsula on March 6, no additional cases were discovered in Clallam or Jefferson counties this past weekend.

Health officers from both counties started to look ahead this week to future testing conditions and which parts of the economy might be targeted to reopen first following the expiration of Gov. Jay Inslee’s “Stay Home, Stay Healthy” order May 4.

Testing kits are becoming more available for the health agencies to increase testing for respiratory patients, and Dr. Tom Locke, the Jefferson County health officer, predicts the county will soon have enough to test all patients with respiratory illnesses.

It should be easier to sort through potential cases, since the influenza season has abruptly ended, he said.

“Our testing protocols up to this point have been defined by scarcity; scarcity of lab resources, scarcity even of the specimen collection kits,” Locke said. “But those things are finally beginning to be fixed.”

Locke said the state received 1 million testing swabs on Monday, and the state labs have built up their capacity.

“We think this week we will be able to finally do what we wanted to do all along, and that is very intensive testing,” he said. “Essentially test anyone with any kind of respiratory or COVID-like illness like fever or cough.”

Clallam County Health Officer Dr. Allison Unthank agreed Monday, saying the county is expanding its criteria for testing. Any essential worker with even mild symptoms — fever, cough, shortness of breath — can now get tested, she said.

Those people are also urged to stay at home and not go out to work even with mild symptoms, she said.

“I do believe we have passed our peak in Clallam County,” Unthank said. “The trick is we have to get down the side a little further before social distancing can be relaxed.”

“Our last case was the end of last week,” she continued. “If we keep doing what we’re doing, and we keep physical distancing, we should be in a good spot by May 4.”

Unthank said health officials would like to see a “persistent” decrease in COVID-19 cases for at least two weeks before easing work restrictions.

Despite the downtrend in cases last week, she said there’s no reason to believe Inslee’s order will be lifted early.

“We are actually doing quite well,” Unthank said. “We know people are getting tired, but don’t plan on anything before May 4.”

“If everybody starts relaxing early and spending time in close quarters, we’ll see a rebound,” she said.

Neither county has so far seen a medical surge in cases that was initially predicted when the first cases began to be reported in the state, as social distancing and community mitigation methods have appeared to have been so far successful in limiting the spread of the virus, Locke told the Board of Jefferson County Commissioners on Monday in Port Townsend.

“Neither of us are really experiencing a medical surge,” Locke said. “We hope it stays that way, but we have no guarantees.”

Jefferson County has had 28 confirmed cases, with no new cases reported for the last 11 days, while Clallam County has 14 confirmed cases, the most recent two reported last Wednesday and believed to be an out-of-county transmission, officials said.

Jefferson County has a conducted more than 700 tests and has a positive infection rate of 4 percent, according to Jefferson County Public Health.

There have been 925 tests conducted in Clallam County, as of April 21, with 875 negative and 36 pending.

“This is only the first wave,” Locke cautioned. “Here in Washington state, we’re in the process of dealing with the first wave, but we think there is going to be other waves, and the overall imperatives of this is to try and control those as best we can.”

“The good news in this is we know that physical distancing works. It’s an extreme measure, it comes with enormous economic cost, but it does slow the progression of infection through the population.”

However, if restrictions are lifted too soon, the number of cases could potentially return to spreading rapidly and reverse the work that has been done so far, Locke said.

“In kind of the bad news with this, is the gains — especially in King County and Snohomish — are precarious,” Locke said. “If, for instance, they were to stop community-mitigation efforts, they would start to be right back into exponential growth in one to two weeks.

“The projections are that their surge at this point it, if it resumed, would be three to five times worse than the surge that they’re having now.”

To start to reopen the economy, both health officers said more testing is needed, and Locke also wants to increase outbreak investigations, so if a case is confirmed, they can test everyone who has been in contact with the positive case to prevent further spread.

“When we get the positive test, we have to react very fast, very aggressively to investigate cases, identify contacts, get people appropriately isolated or quarantined,” Locke said. “Actually do all this within 24 hours of learning of the case, and then do a bunch of things to monitor and support people during their isolation and quarantine.”

Unthank said changes she expects to see next month include companies needing to make sure employees have sick leave so they don’t come to work sick.

Some businesses that have workers close together may want to make some changes to create more physical distance between employees in the workplace, she added.

Unthank expects people who work outdoors in building trade and others who can easily maintain 6 feet of distance from others while on the job will likely be allowed first into the workplace, but that will depend on Inslee’s order.

Locke expected outdoor construction and recreational activities that pose the least amount of potential for infection to also be on the list.

Masks arrive

The Washington State Hospital Association on April 16 delivered 40,000 surgical face masks to Clallam County.

Of the masks that arrived last week, 30,000 went to Olympic Medical Center in Port Angeles and Sequim, and 10,000 were earmarked for Forks Community Hospital, authorities said.

Jefferson Healthcare hospital in Port Townsend was not one of the hospitals to benefit from the initial delivery from the Washington State Hospital Association (WSHA), but the Jefferson Emergency Operations Center has been ordering more personal protective equipment for the county, Locke said.

“Really, all hospitals have a need for critical supplies,” Locke said. “This emergency has shown us that hospitals have an inadequate inventory of protective equipment.”

Cassie Sauer, WSHA president and CEO, said the April 16 delivery to nine facilities statewide was just the first round, and more deliveries are expected.

The delivery of face masks is meant to prepare for an uptick in cases that is expected once the restrictions put in place by Gov. Jay Inslee’s stay-home order is lifted, Unthank said.

Health care workers are using masks daily as they see patients and perform tests.

“By getting more masks to our hospitals, it will keep our health care workers safe and help prevent the spread of infection,” Unthank said.

“While we do plan on opening, we have to wait for the right time. It’s soon, but not quite yet.”

“We appreciate the Washington State Hospital Association for bolstering our procedural mask supply,” said Bobby Beeman, OMC spokesperson, in an email.

“As Olympic Medical Center encourages patients to continue to attend to their medical needs and seek the clinical care they require to be healthy and well, these masks will be incredibly valuable in those settings.

“We anticipate COVID-19 being part of our way of life for some time, and having an adequate supply of these masks positions our organization well as we navigate an environment where masks aren’t easily attainable at times.”

Bastian Hardtke, purchasing manager at Olympic Medical Center, left, takes a box from Boeing Employee’s Flying Association member Doug Weller of Seattle after two aircraft containing 30,000 surgical masks for the hospital arrived on Thursday, APril 16, at William R. Fairchild International Airport in Port Angeles. Photo by Keith Thorpe/Olympic Peninsula News Group

Bastian Hardtke, purchasing manager at Olympic Medical Center, left, takes a box from Boeing Employee’s Flying Association member Doug Weller of Seattle after two aircraft containing 30,000 surgical masks for the hospital arrived on Thursday, APril 16, at William R. Fairchild International Airport in Port Angeles. Photo by Keith Thorpe/Olympic Peninsula News Group

WSHA is working with the Washington State Rural Health Collaborative to distribute the masks. Both organizations are donating the costs of logistics and transportation.

Volunteer pilots from the Boeing Employees’ Flying Association (BEFA) delivered the masks to OMC and Forks on Thursday by plane, officials said.

“WSHA has never imported or distributed supplies to its members or other organizations, and we had no idea how to do it, but we made it happen nonetheless,” Sauer said.

“Our hospitals and other care providers are desperate for supplies to keep staff and patients safe. Our actions were fueled by this desperation.”

Locke said hospitals would stock only what they need and would easily be able to order more before the COVID-19 pandemic, but now there is a worldwide shortage as hospitals across the world are fighting the virus.

While the U.S. has increased production, it has not been enough to meet the need, he said.

If counties do see an increase in cases, more protective equipment will be needed, Locke said.

“The more of a surge we have in cases, the more protective equipment we need,” he said. “We think we may be at the plateau of the surge for King and Snohomish counties, but we’re not certain if and when we will see our surge.

“We’re not out of the woods yet. We’re in a public health emergency that could stretch over years versus weeks or months.”