Working toward Phase 3 of a Safe Start for Snohomish County

By Kari Bray / Snohomish Health District

The three-week monitoring period between Phase 2 and Phase 3 of the Safe Start reopening plan has passed, but Snohomish County is not currently in a position to apply for Phase 3.

There are specific metrics the county must meet to be considered for approval by the state for Phase 3. These include case rate per 100,000 residents, case investigation and contact tracing, and testing. As of the last two-week reporting period for this data (June 2 to 16), we are not meeting several of those metrics.

• While our case rate was below the limit of 25 per 100,000 for a few weeks, we have recently seen an increase. For the period of June 2 to 16, the rate went up from about 22 per 100,000 to 23.6 per 100,000. If we look at June 13 to 27, we’re at 39.

• Testing levels should be 50 tests per confirmed case. We’re at 37 tests per case.

• The goal is to contact 90% of positive cases within 24 hours of receiving a positive COVID-19 test results. We are at 43% in the June 2-16 report.

• As for the percentage of cases responding to daily monitoring, the target is 80% and we’re at 68%.

The economic impacts of the health and safety measures put in place during this pandemic have been felt throughout the county. We know that many are eagerly awaiting the next phase to bring more people back to work and resume more activities.

We do hope to get there, and the Health District and County will continue monitoring the metrics and preparing an application to be ready for when we can submit it. But we are not there yet.

Snohomish County residents and businesses should expect to remain in Phase 2 at least through the Fourth of July weekend.

“Proceeding at maximum velocity into Phase 3 would be quite risky at the present moment given these recent findings,” said Dr. Chris Spitters, Health Officer for the Snohomish Health District. “We need a week or two to assess and control the current situation, monitor the trend in new daily case reports, and track COVID hospitalizations.”

We want to talk a bit about how to get ready for Phase 3. We also want to share some reminders that are essential if we want to continue moving forward in the phased reopening plan.

Our success relies on keeping some level of social distancing, enhanced hand-washing, cleaning and sanitation, cloth face covers, and other health measures in place through all of the phases.

Why reopen in phases?

Governor Jay Inslee has laid out the phased Safe Start Washington plan. 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.

A phased reopening allows us to monitor the impact of COVID-19 as we resume more in-person interactions and have more opportunities for the virus to spread. Between Phases 2 and 3, we’ve been tracking key metrics and reporting weekly to the state.

The key metrics include:

• COVID-19 cases confirmed in the last two weeks (rate per 100,000 county residents)

• Trends in hospitalizations and hospital/health care system capacity

• Testing capacity and availability

• Case and contact investigations, including turn-around time from the positive lab results to the case investigation and notification of contacts

• Outbreaks reported per week in workplaces, congregate living, or institutional settings.

Weekly reports are now provided online on our case counts page so you can see where we’re at with those metrics. They are generally posted on Fridays.

How can we work together be ready for Phase 3?

Businesses not previously approved to re-open would be able to do so in Phase 3, except for nightclubs and events with more than 50 people. However, all businesses must follow health and safety guidelines, and that means there still would be limitations.

All businesses need to develop and keep on site a written safety plan to prevent the spread of COVID-19. A template is available online to fill out. The plans are not intended to be submitted to the Health District or another agency for review or approval, but must be provided during any inspection by a regulatory agency.

The Department of Labor and Industries (L&I) also has workplace safety information, and individual business plans cannot be any less strict than what is outlined by L&I.

Businesses also must follow industry-specific guidance released by the state. Don’t see any guidance for your industry? Refer to the health and safety plan template and the L&I guidance linked above.

The cap on gatherings also would increase in Phase 3. However, there are some important things to know:

1. Small gatherings are safer than large gatherings, regardless of what phase we’re in.

2. Outside is generally less risky than indoors.

3. People who are at higher risk for severe illness (those who are older than 60 or who have underlying medical conditions like diabetes, heart disease, lung disease, or kidney disease) should avoid gatherings.

4. The cap would be 50 per event or gathering in Phase 3, not 50 at one time. We’ve received questions about whether an event could let in 50 people and, as people leave, let in additional people to fill those spots. No. The total attendance for the gathering may not exceed 50.

5. Health and safety guidance still must be followed during gatherings. That means physical distancing (6 feet of space between people) as much as possible, cloth face covers, readily accessible handwashing stations, and frequent cleaning and sanitizing of high-touch surfaces.

6. Do not attend a gathering if you have any symptoms or if you have been notified that you are a close contact of a confirmed case.

Some events have separate guidance from the state, including faith-based organizations and weddings and funerals.

What about the Fourth of July?

The Phase 2 gathering rules apply – no more than five people outside of your household in a seven-day period. That means a small get-together with family or a few friends is allowed to celebrate the holiday, but not a large barbecue or festival. That’s a damper on many plans, we know. However, a large gathering can spread COVID quickly. One positive case at a gathering can mean that dozens of people need to quarantine, get tested, and may potentially become ill and spread the illness to others in their own households or social circles.

Consider celebrating with small backyard barbecues or picnics, or other outdoor activities that allow for plenty of space between you and others who are not in your household. And remember the maximum limit on non-household members: five or less. Check your city’s website or social media to see what Fourth of July options they may have. Some have planned fireworks displays or parades you can enjoy from your own yard, or contests and activities you can take part in from home. Or watch fireworks displays online from cities around the country.

Will we be in Phase 3 soon? Is Phase 4 next?

Not necessarily. The phased approach to reopening is not linear. It is meant to be adaptable so we can adjust if the spread of COVID-19 increases and there is a need to put stricter health measures back in place.

After we receive approval for Phase 3, when that time comes, the state still has the authority to move Snohomish County back into Phase 2 or Phase 1 if needed. This could become necessary if cases increase again.

As we look ahead, particularly to the fall and winter months when respiratory illnesses like COVID tend to spread more rampantly, renewing stricter measures may be needed to preserve hospital/healthcare capacity and prevent a surge in severe illness and deaths related to COVID. The state also recently announced that they are not allowing any counties to enter Phase 4 at this time.

So how do we keep moving forward?

Keep up with illness prevention measures and approach reopening with an understanding that this pandemic is not over.

• Staying home is still the safest option. Use your best judgment about the need to participate in a social gathering, the risk to yourself and others, and alternative activities that may be less risky.

• Support businesses that are taking the right steps. Many business owners and workers have put in tremendous effort to keep customers safe. Now is a good time to frequent those businesses or recommend them to friends and family. However, if you go to a place of business and notice that they are not meeting health guidelines, like if they are not requiring employees and encouraging customers to wear face covers, don’t patronize that business. You may also submit a complaint through the state online at https://coronavirus.wa.gov/how-you-can-help/covid-19-business-and-worker-inquiries.

• Wash your hands. You’ve heard this countless times during the pandemic, but handwashing is one of our most useful tools in reducing the spread of illness. So wash with soap and warm water for at least 20 seconds, and bring hand sanitizer with you if soap and running water won’t be available.

• Clean and sanitize. Whether you are at home or at work, be sure to clean up and wipe down high-touch surfaces at least daily. That includes counters, doorknobs, handles, light switches, remotes, phones, keyboards and touchpads.

• Wear a cloth face covering. It’s now required statewide. This helps contain the droplets from your mouth and nose that are most likely to spread the virus, which means you are protecting those around you. When they wear face coverings, they help protect you, too.

• Stay home if you are ill. If you have any symptoms of COVID-19, contact your medical provider about getting tested or go to www.snohd.org/drive-thru-testing to sign up for an appointment.

• If you test positive or if you are notified by public health that you are a close contact of someone who has tested positive, follow instructions to isolate or quarantine, and respond promptly to calls or texts from public health staff.

As we look to what is coming for the rest of the summer and into the fall and winter, we know that things will continue to change. We will need to adapt, and that will likely bring new challenges.

Planning for the continued response to this virus includes face coverings and physical distancing, in some capacity, for the foreseeable future. There is no magic “return to normal” date. We need our community to persevere in the efforts that have gotten us this far.

We also want to extend our gratitude: Thank you for all you have done and continue to do to fight COVID-19.

The Public Health Essentials! blog highlights the work of the Snohomish Health District and shares health-related information and tips.