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Coronavirus
Inslee: No mask, no service in Yakima County to contain coronavirus
 06.22.20

Yakima County residents will have to wear masks if they go out in public, Gov. Jay Inslee announced Saturday.

Inslee is preparing a proclamation that will make mask use mandatory to avert what he described as an “imminent explosion” of coronavirus in the county. It is expected to be ready on Monday or Tuesday, according to Inslee spokeswoman Tara Lee.

“It is a legal requirement; it is not just a suggestion,” Inslee told reporters during a Saturday news conference. “It is required if we are going to prevent this disaster from overtaking this beautiful valley.”

Under the order, businesses will have to adopt a “No mask, no service” policy, he said.

He also said the state has trained 1,000 contact tracers and is providing the Yakima Health District with $6.5 million in funding to help with efforts to rein in the county’s growing number of coronavirus cases.

Inslee’s announcement comes after a meeting Tuesday with community leaders and business representatives amid a continuing rise in coronavirus cases in the county. Inslee said Yakima County’s per-capita rate of new cases is the highest in the western United States.

As of Thursday, the rate was almost 700 per 100,000 people over the previous two weeks, according to the state Department of Health. That is about 28 times higher than what is required to move to the next phase of the “Safe Start” reopening program.

By comparison, 55.4 people per 100,000 tested positive statewide during the same time period.

Friday also saw Yakima County reach its second-highest daily number of coronavirus cases, with 208 new cases reported, according to the Yakima Health District.

The Yakima Health District said Friday that the county’s three hospitals had exceeded staffing capacity. Virginia Mason Memorial had no intensive care or non-intensive care beds available Thursday night.

Dr. Tanny Davenport, head of quality and safety at Memorial, said 22 people were transferred from the hospital in the past two days, both people with COVID-19 and those without.

“One thing we thought early on (in the pandemic) was that it would be space or equipment issues,” Davenport said, adding that staffing is a bigger issue. “Those patients require more workforce, and we simply don’t have the workforce.”

Earlier, plans were made to reopen the shuttered Astria Regional Medical Center to provide hospital space for non-COVID-19 patients and free up beds at Memorial. Vice Adm. Dr. Raquel Bono, director of the state’s COVID-19 response, said Astria likely would not be reopened because there was adequate bed space statewide.

When her team visited Yakima earlier this year, they found “in order to have Astria facility stood up we’d need additional personnel we did not have … and our better opportunity in supporting any kind of surge was optimizing the capacity across the state,” she said.

Inslee said he fully understands the effect stay-home orders are having on businesses, but “the best thing we can do to strengthen this economy so we can reopen fully is to stop the spread of this disease.”

He noted the efforts by the Greater Yakima Chamber of Commerce to increase mask use before his announcement.

And it is not just Yakima County that could be affected if the virus’ spread is not contained. If Yakima County cannot contain the virus, it will spread to other parts of the state, Inslee warned.

“As Yakima County goes, so does the rest of the state,” Inslee said.

Lilian Bravo, director of public partnerships for the health district, said the governor’s order is in line with the health district’s campaign for people to mask up when they go out in public.

While she does not yet know what role the health district would play in the execution of Inslee’s order, Bravo said the district will likely maintain its policy of educating the public as to why they should use masks.

As for the funding, Bravo said those details are being worked out, but said it would likely be used to enhance the disease outbreak team by providing for more people, as well as improving communication and coordinating help for people to stay isolated if they test positive.

Secretary of Health John Wiseman said it is incredibly important that people stay at home as much as possible and limit contact with others. He strongly encouraged people not to have gatherings for Father’s Day or July 4.

“These are times when we want to be spending time with family and friends and it is simply too dangerous to be doing that,” he said.

Inslee said the situation in Yakima is personal for him, as his three sons were born at Memorial. He said transmission of COVID-19 is occurring everywhere in the community, not just in one sector. And he had strong words for people who downplay the virus.

“These cases are not just numbers, they represent people. And the virus that afflicts them poses a cascade of threats, economic and personal,” he said. “We can’t just put our heads in the sand and let this roll over us.”


Coronavirus
Coronavirus basics: Contact tracers move fast to connect with patients in Yakima County
 06.21.20

Quickly calling newly diagnosed COVID-19 patients to identify other people they have been around is key to stopping the spread of COVID-19, according to public health officials.

In Yakima County, where new cases and hospitalizations are high, the state Department of Health is leading this contact tracing effort.

But what does that look like in practice?

It starts with a test for the respiratory infection, said Yakima Health District spokeswoman Lilian Bravo. Each patient who is tested is told to quarantine at least until they get their results back, and to watch their symptoms in case they need follow-up medical treatment. Then, the test is sent to an approved lab.

When the result is ready, the lab sends it to both the medical provider who ordered the test and to DOH, which begins making calls if there is a confirmed case, Bravo said.

The first call is to the patient.

Contact tracers — people making the call on behalf of DOH, in Yakima County’s case — inform patients that they have a case of COVID-19. They discuss the importance of quarantine and monitoring symptoms. Then, they ask questions about their symptoms, where they have been outside of the house recently and where they work.

Bravo said tracers note if an individual works in a setting where there might be a high risk of exposure to others, such as in health care or child care, so that swift interventions can be taken to prevent an outbreak.

Tracers also ask patients who they have been in close contact with. That means someone who has been within 6 feet of the person for at least 15 minutes within the previous 14 days. They call those individuals next to warn them of their exposure, tell them to isolate for 14 days and to monitor for symptoms of the virus.

Time matters

COVID-19 can spread before symptoms occur or when no symptoms are present. As a result, investigation and contact tracing activities must be swift and thorough, the Centers for Disease Control and Prevention has said.

State tracers aim to contact at least 90% of confirmed patients within 24 hours of a positive result. They also try to make contact with at least 80% of close contacts within 48 hours.

As of Friday, the staff working for the state were exceeding both of those goals, said DOH communications director Amy Reynolds.

In Yakima County, more than 100 new cases have been confirmed each day in the past week. The county has a rate of 700 new cases per 100,000 population in the two weeks prior, according to the Department of Health — well over the state-set goal of less than 25 new cases per 100,000.

While hundreds of state staff and National Guard members have been trained in the investigative work, many health districts statewide have taken on the effort independently.

As of Friday, 62 individuals were actively working with DOH doing case investigations on behalf of local health jurisdictions, including Yakima’s. On top of that, 35 National Guard members were doing daily wellness checks on individuals who were quarantined or isolating to ask about new symptoms, for example. All of those staff help support the efforts in Yakima County, Reynolds said.

Gov. Jay Inslee on Saturday mentioned that contact tracing is a key part of addressing the spread of COVID-19 in Yakima County, along with testing, mask wearing and efforts to help families in isolation.

The state is working to train dual-language staff in contact tracing, such as Spanish speakers, said Reynolds. But already, the staff working for the state have been trained to use interpretive services that allow them to do the work in multiple languages, she said.