EVERETT — For weeks, Snohomish County officials have been planning behind the scenes for a potential uptick in COVID-19 cases that may come as the state relaxes social distancing measures in phases.
County officials said they still need to be able to conduct more coronavirus tests daily, and to double the number of people assigned to contact tracing — where investigators track down those who have been in physical contact with people who tested positive, notify them of the exposure and advise them to quarantine.
Their efforts are coinciding with the first phase of the slow, deliberate reviving of the economy and public life.
As of this month, hunting, fishing, hiking and golf are allowed again. Construction work is happening. Auto dealers got the go-ahead Wednesday to restart sales. But the second phase of Gov. Jay Inslee’s four-step plan for reopening the economy — when some indoor dining returns and barber shops reopen — won’t begin until June 1, at the earliest.
An estimated three weeks will lapse between later phases.
Local health officials need to ensure the county is ready in four areas: health care system capacity, testing availability, contact tracing and protection for high-risk populations.
Snohomish County emergency managers aren’t sure if each step will take three weeks, or if some could take longer.
“We’re not looking at this as if we have three weeks to build up enough capacity to get to the next phase,” Snohomish County Department of Emergency Management director Jason Biermann said. “For us, this is an ongoing effort to get us to the point where we can get our community safe, first and foremost, then work through these phases.”
As of Thursday, 115 Snohomish County residents have died from the virus and 2,637 have tested positive, according to the Snohomish Health District.
Meanwhile, some elected officials in Snohomish County appear at odds over the pace sketched by the governor.
On Wednesday, mayors of 10 cities and Republican county councilmembers Sam Low and Nate Nehring asked Inslee in a letter to ease restrictions on small- and medium-sized businesses in this first phase, rather than waiting until later ones.
Many of the business owners, they wrote, could barely make it until May 5, when the stay-home order originally had been slated to expire. The order now runs through May 31, and those businesses are “faced with trying to figure out a way to survive another 4 weeks at minimum,” the political leaders wrote.
They reached out to Inslee two days after Democratic Snohomish County Executive Dave Somers and mayors of 11 cities issued a public statement strongly endorsing the governor’s staged approach. Two mayors — Leonard Kelley of Stanwood and Carla Nichols of Woodway — signed both statements.
Though the stay-home order has effectively flattened the curve, stated the letter headlined by Somers, “it is imperative that we hold steady and sustain this positive momentum.”
The health care system needs to be able to withstand another potential spike in cases. That means having enough personal protective equipment, hospital beds and ventilators to handle extra patients, but there’s no “magic number,” Biermann said.
“We’re not going to be able to control necessarily what the virus does,” he said. “So if there is another uptick, we need to be able to address it.”
Already, the county has a fair amount of surge capacity, or the ability for the health care system to take on patients. Biermann said capacity changes day to day, depending on if there’s a multiple car crash, for example.
The county’s Emergency Coordination Center handles all requests for personal protective equipment, or PPE, and is responsible for ensuring front-line institutions stay stocked. As of Wednesday, they’d processed just shy of 2,600 requests for PPE from more than 700 facilities, such as hospitals and long-term care centers.
So far, Biermann said the county has had enough PPE to outfit workers in direct contact with current or recovered COVID-19 patients. They want to also provide PPE for what are considered “tier two” facilities, like outpatient clinics, where the risk of infection is slightly lower.
But again, Biermann said the county doesn’t have a specific target number for PPE supply.
“It’s more about a capability and an ability to rely on the supply chain,” Biermann said.
As of this week, Snohomish County health care workers can perform roughly 400 to 600 COVID-19 tests on a weekday. That’s up from fewer than 100 per day at the beginning of March.
The numbers need to increase further to be ready for the state’s reopening, said Heather Thomas, spokeswoman for the health district.
The goal is to get to a point where someone showing symptoms, like a dry cough, fever, or difficulty breathing, can get tested that same day or the next morning — and then get results within a day. The health district would like to begin investigating and contact tracing within 24 hours of a positive result.
We’re not there yet, Thomas said.
“It’s improving,” she said. “It’s not ideal (right now) as to where we want it to be.”
The health district still gets reports from people seeking tests being turned away by health care providers. Thomas said the health district is working to reach smaller practices to make sure that doesn’t happen.
The health district is hosting temporary mobile clinics to make accessing tests easier around the county. Sites rolled out in Lynnwood and Monroe in the past week or so, with cities farther north next on the list.
The heath district doesn’t currently have plans to test anyone who isn’t actively showing COVID-19 symptoms, Thomas said. Such testing is only happening in long-term care facilities or as a tool in investigating clusters of illness.
It would take direction from the federal government for people without symptoms to gain widespread access to the tests, Thomas said.
In the long term, Biermann hopes getting a coronavirus test will eventually be just as easy as having a flu or strep test done at your doctor’s office.
By May 11, Gov. Inslee hopes to have 1,500 people, including members of the National Guard, working to identify and quarantine those who have had contact with COVID-19 patients.
As a part of that effort, the Snohomish Health District is bolstering a local fleet of contact investigators.
As of this week, Thomas said the district had five to 20 people working on contact tracing, most of whom have been pulled from other programs. That team is able to do roughly 40 to 50 investigations per day, and it often takes a couple days to respond to each positive COVID-19 test, Thomas said.
The response time needs to get down to about 24 hours, she said. The district hopes to bring on at least 40 more people to help.
“It’s not going to happen overnight,” Thomas said.
The district has always done contact tracing for diseases like measles, tuberculosis and whooping cough, Thomas said. And those illnesses haven’t stopped — they’re just added to the 300-patient pile of COVID-19 cases.
The governor’s plan also calls for local governments to protect populations at the highest risk of harm from COVID-19 — the elderly and those with underlying medical conditions.
In Snohomish County, that means building a team to address outbreaks at long-term care facilities, Biermann said.
The county’s new “pandemic team” known as SAFE — short for SnoCo Agencies for Engagement — is doing contact tracing for people without shelter. Biermann said many unsheltered folks have underlying health conditions, making them more prone to contracting COVID-19.
And as the county begins to reopen, starting this week with parks, health officials are launching a campaign to remind at-risk folks it may not be safe for them to take advantage of loosened restrictions.
Since March 1, nearly 130 people from over a dozen local government organizations have put in more than 12,300 hours at the county’s emergency coordination center, to craft a unified pandemic response.
But reaching phase two of Inslee’s plan depends heavily on the number of new COVID-19 patients coming in.
“And that’s where people and businesses play a role in making sure that they’re following those public health measures that are put in place, to reduce the amount of cases coming in,” Thomas said. “That’s where they have a degree of control in helping us get there quicker.”
Snohomish County officials at odds over Inslee plan
This week, in separate actions, one group of elected leaders in Snohomish County expressed their support for the phases for reopening put forth by Gov. Jay Inslee, while a second group wrote the governor to ask him to let more businesses restart now, rather than later.
On Monday, Snohomish County Executive Dave Somers and mayors of 11 cities issued their joint public statement. You can read it here.
It was signed by Arlington Mayor Barb Tolbert, Bothell Mayor Liam Olsen, Darrington Mayor Dan Rankin, Edmonds Mayor Mike Nelson, Everett Mayor Cassie Franklin, Mill Creek Mayor Pam Pruitt, Mountlake Terrace Mayor Kyoko Matsumoto Wright, Mukilteo Mayor Jennifer Gregerson, Lynnwood Mayor Nicola Smith, Stanwood Mayor Leonard Kelley and Woodway Mayor Carla Nichols.
On Wednesday, 10 mayors and two Snohomish County Councilmembers sent their letter to Inslee. You can find it here.
It was signed by Marysville Mayor Jon Nehring, Lake Stevens Mayor Brett Gailey, Granite Falls Mayor Matthew Hartman, Snohomish Mayor John Kartak, Sultan Mayor Russell Wiita, Stanwood Mayor Leonard Kelley, Monroe Mayor Geoffrey Thomas, Index Mayor Norm Johnson, Woodway Mayor Carla Nichols and Snohomish County Councilmen Nate Nehring and Sam Low.
Julia-Grace Sanders: 425-339-3439; firstname.lastname@example.org.