COVID-19 and Phase 2 of a Safe Start for Snohomish County

By Kari Bray / Snohomish Health District

Snohomish County is now in Phase 2 of the Safe Start plan for reopening businesses and activities in Washington.

An application to move to Phase 2 was submitted Monday, June 1, and we received notice on Friday, June 5, that it had been approved by the state Secretary of Health. (Read the letter here.)

While moving to Phase 2 is an important step, we still have work ahead of us to stay in Phase 2 and, later, to move on to Phases 3 and 4. It is important for people to learn more about what moving to Phase 2 means, and what we need to do as individuals and as a community to continue making progress against this pandemic.

A phased approach to reopening

Prior to June 1, a state order was in place for Washingtonians to stay home except for essential work and errands. This was to reduce the spread of COVID-19. And while it feels like everything shut down abruptly, the reopening cannot be sudden – not if we want to maintain the progress we’ve made against this disease.

As a state, we have moved from Stay Home, Stay Healthy to the Safe Start Plan. And while the Stay Home order has expired, many of the same health and safety precautions remain in place under Safe Start.

If we go straight from staying home and minimizing in-person contact back to the day-to-day interactions we had before COVID-19, we can expect a rise in cases and the need to re-instate social distancing measures. Increased transmission of this virus would jeopardize lives and could rapidly overwhelm the medical system, not only for those who are ill with COVID-19 but also those with other critical healthcare needs.

Governor Jay Inslee has laid out the phased Safe Start Washington plan. The phases are not starting at the same time in every county. As counties are able to demonstrate that they meet requirements for health and safety, they can apply to move from one phase to the next. There is a required wait time between phases, as well as criteria to meet.

While Snohomish County has met criteria to move to Phase 2, it will be a minimum of three weeks until we can apply for Phase 3. Remember, too, that we may not be ready for Phase 3 in three weeks. It is too soon to give a firm timeline. We also will need to see the next set of criteria from the state for progressing through the phases.

Qualifying for Phase 2

Measures that every county and local health jurisdiction, including Snohomish County and the Snohomish Health District, have looked at to determine progress toward Phase 2 include:

• Health care system readiness

· Hospitals need adequate surge capacity for potential increase in patients and a supply of personal protective equipment for staff. Snohomish County is in good shape on this one. Providing letters from hospitals is part of the application process for Phase 2.

• Testing capacity and availability

· We are currently at about 2,500 tests per week being done in Snohomish County, which includes testing from medical providers as well as community based or drive-thru testing by the Health District. While this is slightly below the target of 4,000 to 4,500 tests actually being completed, we do have adequate capacity for testing. Countywide testing capacity is 5,000 to 6,000 tests per week.

• Case and contact investigations

· We are on track to ensure adequate contact tracing. The goal as outlined for the Safe Start plan is to be able to contact at least 90 percent of new cases within 24 hours of the positive test results, and to call at least 80 percent of the cases’ close contacts within another 24 hours. Ideally, we aim to contact everyone in a timely fashion, but these numbers give us some metrics to measure against.

· Exact numbers of staff needed to keep up with the caseload are expected to vary throughout this response. We have about 30 workers for investigations and contact tracing at the Health District, along with surge capacity from the Washington State Department of Health. Federal CARES Act funding that was recently allocated to the Health District also will be used to bolster disease investigation/contact tracing capacity.

· An isolation and quarantine facility is available in Snohomish County for those who cannot isolate or quarantine at home.

• Ability to protect high-risk populations

· We have been seeing one or two outbreaks in long-term care facilities per week, which is within the state criteria for Phase 2. A team at the Health District continues to work directly with long-term care facilities on testing and illness prevention and we also have teams in place to address potential outbreaks in workplaces and other settings.

What about case counts?

Things are moving in the right direction, and we believe that we currently have the infrastructure, plans and partnerships in place to enter into Phase 2 with reasonable confidence that we can continue to suppress transmission of the virus.

Our 14-day case count for May 12 to May 26 was 18.4 per 100,000, which is within the updated state criteria of 25 or fewer per 100,000. This case rate is confirmed cases only and is calculated based on guidance from the Department of Health.

Life may not look a whole lot different in Phase 2

While getting to Phase 2 is an important step that opens more businesses and activities, the overall change from Phase 1 to Phase 2 is not a drastic one.

There are four phases of this recovery, as outlined in the Safe Start Plan. Phase 2 gets us partway down the road, but it’s not the finish line. And we expect this to be a winding road; we may have to stop or turn back at times, and stricter social distancing measures may be put in place again if cases, hospitalizations, or deaths increase.

In Phase 2, general guidelines include:

• Gatherings with fewer than five people from outside your household per week. This includes only having small groups (you and 1-4 others) for outdoor recreation.

• High-risk populations – such as people older than 60 and those with underlying health conditions – should continue to stay home aside from essential business and errands.
• Non-essential travel is limited to activities approved to reopen under Phase 2, and those will come with health and safety guidance to follow. For example, restaurants may reopen at limited on-site capacity, with appropriate social distancing, cleaning and sanitation, no more than five customers per table, six feet between tables, and no bar-area seating.
• For people who can continue to work remotely, teleworking is strongly encouraged.
This means that a number of people may be able to return to work in certain industries, which is good news. But they will need to be dedicated to reducing the spread of disease in the workplace and at home if we hope to keep moving forward on reopening.
For personal interactions, many people will likely find that it’s a relief to be able to see a small group of friends or family in person. Remember, though, that you don’t want to expose the people you care about to this virus. So keep groups to five or less, maintain distance as much as possible, and carefully consider who you are visiting. Meeting a friend who is not high risk and has not been ill to go for a walk or to grab lunch is a better plan than a large get-together or rushing to give hugs and kisses to a loved one who is high-risk.
As businesses reopen, there will be health measures in place
Allowing more businesses and activities to reopen does not mean that it will be business as usual. There are guidelines that employers will need to follow through all of the phases. A brief overview is below, but more is outlined in the Safe Start Plan.
• A business is only allowed to reopen after it can implement state guidelines available at coronavirus.wa.gov/what-you-need-know/safe-start.
• Limit close interactions with customers. Arrange for six-foot physical distance between employees and patrons and use other measures, such as barriers to block sneezes and coughs, if distancing isn’t realistic for specific tasks.
• Ensure sanitation and hand hygiene are available to all workers and visitors.
• Frequently clean and disinfect the workspace, especially high-touch surfaces.
• Follow Labor and Industries and industry-specific guidance regarding personal protective equipment or cloth face covers for workers.
• Make a plan for addressing illness, including requiring ill employees to stay home and deep cleaning if an employee tests positive for COVID-19.
• Provide information to employees about COVID-19 and illness prevention. This could include signs or posters with information.
• Follow any additional guidance that is specific to your industry, as provided by local, state or federal public health professionals.
Businesses also must wait until they have industry-specific health and safety guidance from the state before reopening within the proper phase. Guidance for all businesses may not be available at the same time. For example, Phase 2 guidance for construction was issued on May 15 while guidance for real estate was issued on May 19. The governor’s office maintains a list of guidance for industries that is frequently updated or added to.
The City of Everett, in partnership with the Snohomish Health District, has also developed a toolkit to help small businesses navigate Phase 2. The valuable resource is available at www.everettforeverett.com/safeopening.

Some things still have to wait
Even in Phase 2, some of the activities we’ve been getting the most questions about have not been approved to reopen.
According to the Safe Start plan, recreational sports with more than 5 people in the same area or in close contact, as well as places like gyms or pools, aren’t on the list until Phase 3, and even then the group size will be capped – no more than 50 people. Professional sports like baseball could potentially resume without a live audience long before crowds will be back in stadiums. Restaurants still have limited capacity even in Phase 3, with limited bar seating, as well.
More businesses could resume in Phase 3, if they weren’t able to under Phase 2, but telework would continue to be strongly encouraged and certain businesses would still be restricted. Large gatherings like concerts, sports events, or other performance venues are not on the list until Phase 4.
We don’t have a firm date or timeline for the third and fourth phases, and social distancing measures may have to be re-instated and then re-lifted along the way.
It is important to keep in mind that things could change, and that the details of what activities and businesses are allowed within each phase may be modified. Please check back and monitor guidance from the state for your specific industry.
What we do know is that we have been working diligently to get to Phase 2. But getting to future phases will require everyone to contribute and cooperate. We can help our county reopen and keep people safe by:
• respecting social distancing (at least six feet between us and others who are not in our household)
• minimizing travel and in-person contacts outside of our household
• wearing cloth face covers when we go to a public place where we can’t maintain distance
• keeping up on regular hand hygiene (wash with soap and water, and keep hand sanitizer handy if you’re going out)
• cleaning and disinfecting in our homes and workplaces.
There is still a worldwide pandemic, and we are seeing daily cases in our community. As of June 4, we’ve lost 152 people in Snohomish County. As we move through the phases of the Safe Start plan, we cannot forget the importance of the individual decisions we make and the actions we take to reduce the spread of illness.
We are geared up to handle new surges in cases, and yes, that is crucial.
But ultimately, what happens next with the transmission of this virus and our ability to continue reopening our county depends on all of us.
The Public Health Essentials! blog highlights the work of the Snohomish Health District and shares health-related information and tips.

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