Cost of Washington’s measles outbreak tops $1M

By Jake Goldstein-Street / Seattle Times

OLYMPIA — The cost of Washington’s measles outbreak has surpassed $1 million as more than 200 health-department staffers from the state and Clark County focus their efforts on the disease.

As of Tuesday, there were 63 confirmed cases of measles in Clark County, 44 of which were in children under 10 years old, according to the county’s Public Health department, which is also investigating one suspected case. There is also a single case reported in King County, bringing the statewide total to 64, according to the state Department of Health (DOH).

DOH has spent approximately $614,000 on staff and supplies as of Tuesday, in addition to about $115,000 in other non-budgeted expenditures, according to state epidemiologist Dr. Scott Lindquist, who expects the total response to eventually cost the state “well over a million dollars.”

Meanwhile, Clark County Public Health has spent about $500,000 responding to the measles outbreak, bringing the statewide total over $1 million, says Dr. Alan Melnick, the county’s public health director.

“This is taxpayer money for something that could have been completely, utterly preventable in the first place,” he told the Seattle Times.

Out of approximately 1,900 total staffers, 166 state Department of Health staff members, working approximately 8,700 hours, have been assigned to the measles outbreak so far, according to Lindquist. Some are communicable disease epidemiologists, normally focusing on issues such as hepatitis and day-to-day food-borne illness outbreaks — duties that have largely been put on the back burner.

“It’s going to slow down everything else,” Lindquist said, noting that usual work is picked up by the remaining staff or is put aside. “The current public health infrastructure is really threatened by events like this.”

Each Department of Health staffer spends about two weeks at a time in Clark County, which means the state must pay for hotel rooms, their day-to-day costs and travel, according to Lindquist.

Of about 110 full-time employees, Clark County Public Health has 40 to 50 staffers working on measles at any given time, according to Melnick.

Epidemiological staff members, who were working on sexually transmitted diseases and tuberculosis among other health concerns, are being forced to shift their focus onto measles, as are environmental-health staff members, some of whom do restaurant inspections. Melnick says restaurants are still safe for eating because those inspections will still get done, but they could be carried out slower.

Two additional Epidemic Intelligence Service officers, who conduct outbreak investigations and are assigned by the federal Centers for Disease Control and Prevention (CDC), were set to go to Clark County again Wednesday. Volunteers from the Medical Reserve Corps have also lent their time to the ongoing efforts.

The state Military Department’s Emergency Operations Center, which coordinates resources in support of the DOH, brought in a five-person incident management team with medical specialties from North Dakota, which finished a 19-day stint in Washington on Monday, along with two disease investigators from Idaho, who were here from Feb. 2 to Sunday, according to Robert Ezelle, director of the department’s Emergency Management Division.

The team from North Dakota cost the state just over $24,000, while the Idaho investigators cost a little more than $8,000, according to Ezelle.

As the outbreak slowed recently, Ezelle says there are no plans to bring more resources to Washington from other states.

Measles has spread since the start of the year primarily through children who aren’t vaccinated, with 55 of the 63 confirmed cases in Clark County in patients who have not been immunized. Clark County, which includes Vancouver, has uncharacteristically high vaccine exemption rates for school-age children.

While the nonmedical exemption rate for kindergarten enrollment in the 2017-2018 school year was approximately 2 percent nationwide, according to the CDC, Washington had an exemption rate on philosophical, personal or religious grounds of 4 percent. By comparison, Clark County, had a 6.7 percent exemption rate, according to state health-department data.

In hopes of reducing the possibility of future outbreaks, lawmakers in Olympia have proposed two measures to tighten the personal or philosophical exemption used to excuse children from vaccines necessary for school entry. Legislation moving through the House would eliminate the objection for the measles, mumps and rubella vaccine, while a Senate bill, subject of a committee hearing Wednesday in Olympia, aims to get rid of the personal exemption for all vaccines needed to attend school or a licensed day-care center.

Given that cases tend to come in waves, Tara Lee, a spokeswoman for Gov. Jay Inslee, said there is not an end date for the state of emergency he declared on Jan. 25, which allows Washington to get resources from other states.

“We will keep it open as long as necessary,” Lee said. Lindquist, of the state DOH, says he is “cautiously optimistic” that the upsurge is slowing, but it’s too early to predict.

Clark County’s Melnick notes that the outbreak will only be considered over after 42 days, or two full incubation periods, pass without any new cases.

“This could easily go on for another month or two,” he said. “Or even beyond.”