This story was updated on Thursday, March 5.
The new coronavirus started to spread in Washington state from unknown sources, one step ahead of the state department of health’s ability to adequately test for it. Local health officials now say it’s only a matter of time before the disease spreads in Whatcom County.
With 69 confirmed cases of the virus in King and Snohomish counties as of early March 4, local health officials are no longer aiming to contain the virus. Rather, they’re working to slow its spread so that it won’t overwhelm local health care institutions.
“Containment is no longer the most effective strategy,” said John Wolpers, incident commander for a team that the Whatcom County Health Department assembled to manage a potential local outbreak. Whatcom County held a meeting to update elected officials and others on March 2 at its Unified Emergency Operations Center in Bellingham.
“We are now moving to mitigation and personal prevention as our primary approaches,” Wolpers said at the update. “It is the consensus of public health officials that it is not a question of if, but a question of when, communities will have confirmed cases.”
As more cases popped up in western Washington, beginning on February 28, Whatcom County’s incident response team ramped up its communication and coordination with elected officials, school districts, businesses and other organizations throughout the county. Washington governor Jay Inslee declared a state of emergency on February 29, directing state agencies to do everything reasonably possible in the effort to respond to and recover from the outbreak.
The new coronavirus disease, called COVID-19, is part of a large family of so-called coronaviruses that include the common cold and Severe Acute Respiratory Syndrome (SARS). It was first detected in China late last year and, as of March 5, had infected nearly 100,000 and killed more than 3,300 in at least 80 countries. Of those, 80,000 cases were in mainland China. Like the flu, it killed mostly older people and those with underlying health conditions.
Though 10 people have died in Washington state, about 80 percent of cases worldwide are mild, with no symptoms beyond coughing, fatigue and fever. Some with the virus have no symptoms at all. Many of those infected in Washington – and at least eight of the fatalities – were residents of the Life Care Center nursing facility in Kirkland, the supposed center of the U.S. outbreak. Everyone who died had pre-existing medical conditions, according to the state department of health.
Current data indicates that the fatality rate is about two percent among those with laboratory-confirmed COVID-19, county health department officials said. The fatality rate for all illnesses is likely quite a bit lower, as the disease has a wide range of symptoms and some who carry it have no symptoms at all. Further, that number is based largely on data from China and its accuracy is widely questioned by U.S. health officials. South Korea, which may be doing more testing than any other country, had a mortality rate of about 0.6 percent as of March 5.
What you should do now
The Whatcom County Health Department is not recommending any major changes to daily life. Right now people should concentrate on hygiene and taking some minor steps to avoid crowds and contact.
That includes the following: washing hands frequently with warm soap and water for at least 20 seconds; covering coughs and sneezes; avoiding touching the eyes, nose and mouth; staying away from people who are sick; if you are sick, staying home for the duration of your illness to prevent spreading the infection; reducing handshakes and high-fives; reducing the number of people in close contact with each other; and frequently cleaning and disinfecting door knobs and other frequently touched surfaces.
People should also prepare for the possibility of more aggressive “social distancing measures” such as school and work closures, by planning back-up child care and discussing work-from-home options with employers.
Getting a flu shot is also a good idea; it won’t protect against the new coronavirus disease, but it may be possible to get both viruses at the same time.
Locally, the county health department is the lead organization for responding to the outbreak and will notify people if they recommend taking other precautions against the virus’ spread. The health department is available to consult with employers and organizations about what to do, said Dr. Greg Stern, a health officer with the department. The county health department has more information on the virus and its response online at bit.ly/2wo6gvm.
Whether the county will recommend stricter social distancing measures will depend on a variety of factors, health officials said. There’s no number of Whatcom County cases or other criteria that would trigger stricter recommendations, Stern said, as the effectiveness of those measures would also depend on what’s happening around Whatcom County.
King County, on March 4, began recommending that people over 60, people with underlying health issues and pregnant women stay home and away from large groups of people as much as possible.
At the March 2 briefing, health officials sought to assure elected officials that much of the planning is already in place and has been rehearsed.
“I want to point out that while this is a new disease, our response to it is not,” Wolpers said. “We’re building on the pandemic preparedness that we and many others already have in place.”
Blaine school district
The Blaine school district sent home letters advising that families and staff take the same precautions as they would for the flu: stay home when sick, wash hands frequently with warm soap and water and generally follow the same precautions stressed by the county health department. The district is also being diligent about cleaning surfaces and taking other precautions, said superintendent Christopher Granger.
The Blaine school district will look to the Whatcom County Health Department for guidance on when and if to close schools.
“The health department has been very helpful and very responsive,” Granger said. “We are connected, we are constantly receiving information and discussing it internally. We have everything in place to keep our students and families safe and we will always keep student safety the number one priority.”
Granger said the district isn’t preparing for online learning in the event of extended school closures because it can’t ensure that all students would be able to participate.
“We couldn’t guarantee that every child would have that same access. I think every school would struggle with how to make that equitable,” he said. Granger has four kids, and noted that his household may have four cell phones but not four laptops. It would be much harder to do school work on a cell phone compared to a computer screen, he said.
In a letter to state school districts about the coronavirus, the Washington State Office of Superintendent of Public Instruction discouraged holding online classes unless they could be accessed by all students: “It will likely make more sense to cancel school and/or district services and make up missed days at the end of the school year, rather than deploying a distance learning model that can be accessed by some, but not all, of your students,” the letter said.
By March 2, about a dozen schools around the state had closed to clean and disinfect, or because of possible cases amongst staff and students. Schools that closed so far were not instructed to do so by local health departments.
School closures and other social distancing measures should strike a careful balance, local health experts said. About half the students in Blaine schools qualify for free or reduced lunch and may go hungry if schools are closed for an extended time, for example.
With larger closures, “we need to balance the decision of whether it’s going to be effective and when the benefits outweigh the consequences,” Stern said.
The city of Blaine
Blaine city manager Michael Jones attended the county’s March 2 update, along with police chief Donnell Tanksley, and he said that the city’s role in a potential outbreak will be to maintain key services like drinking water and public safety.
“At this point we are not really changing operations; however, we are staying abreast of the information,” Jones said. “The county health department is the lead jurisdiction for a virus outbreak. We are taking our direction from the experts.”
He noted that the city has put hand sanitizer in key locations in its buildings and is increasing the amount of cleaning done to heavily used surfaces and objects. City staff are also preparing for other possibilities like telecommuting for employees and holding meetings by phone rather than gathering large groups of people.
“These are all things that most employers should probably be thinking about at this point,” Jones said.
PeaceHealth
Robert Taylor, PeaceHealth’s emergency management coordinator, said hospitals throughout PeaceHealth’s network, including St. Joseph Medical Center in Bellingham, have been preparing for weeks. He could not say how many patients PeaceHealth could quarantine or isolate, but said that its plan for epidemics includes a lot of flexibility.
“We can always make changes to our locations. We work with public health to reshape our approach. We can find better settings for [current patients] in the event we need the space, whether it’s a long-term care facility or other places that aren’t exposed,” he said. “As it stands now, we’re more than prepared to handle more patients.”
Taylor noted that most of PeaceHealth’s primary care patient rooms are single rooms and patients are already treated in isolation.
PeaceHealth asks that patients call the clinic before arriving if they have recently traveled outside the U.S. or have been in contact with a person known to have COVID-19 and exhibit symptoms including a fever or cough. For many patients with symptoms of the new coronavirus, PeaceHealth staff can care for them at home, Taylor said.
CBP and DHS
The Centers for Disease Control and Prevention (CDC) have added health screening capabilities at border crossings in Blaine, Buffalo, New York and San Ysidro, California, said Jason Givens, public affairs specialist for U.S. Customs and Border Protection (CBP).
CBP is working with the CDC to identify arriving travelers who have been in mainland China or Iran within the past 14 days, he said. Those travelers go through an enhanced health screening conducted by the CDC.
“All CBP ports of entry are following the same operational guidance as issued by the Presidential proclamations and the Department of Homeland Security (DHS),” Givens said in an email. “With exceptions specified in the proclamations, foreign nationals (other than immediate family of U.S. citizens, permanent residents and flight crew) who have been physically present in China or Iran within 14 days of their arrival at a U.S. port of entry will be denied entry into the United States.”
The U.S. Citizenship and Immigration Services (USCIS) office in Tukwila closed Tuesday and Wednesday due to concerns over the new coronavirus after an employee who visited Life Care Center in Kirkland got sick, according to DHS.
Blaine immigration lawyer Len Saunders said two of his Canadian clients, including one who lives in Birch Bay and another in Lynden, had citizenship interviews at the office cancelled. Neither client had visited the office on or after February 24, when DHS said the sick employee was there, Saunders said. Two separate clients, one from Point Roberts and one from the Birch Bay area, were in the office at the same time as the sick USCIS employee, but had not been instructed to self-quarantine.
How we got here
Until February 28, Washington state’s only cases of the virus were associated with people who had traveled to places with known outbreaks or had contact with other known cases.
Cases in patients with no travel history or contact with known cases (known as “community spread” by health officials) began popping up on February 28. That’s the first day the state health department began testing for it, after the initial test kits sent all over the country by the CDC turned out to be flawed and produced inconclusive results. As of March 5, the state’s tests had confirmed new cases every day since.
In other words, the state health department began to confirm cases on February 28 not because that’s when the disease arrived in Washington, but because that’s when they could begin testing for it. Prior to that, test samples were sent to the CDC’s lab in Atlanta, and getting results took days. Before February 28, 37 Washington residents were tested for the new coronavirus, said Kristen Maki, a public information officer with the state department of health.
As of early March 5, four Whatcom County residents had been tested for the new coronavirus, and the results for three were still pending.
The Washington State Department of Health said on March 1 that genetic testing showed the virus had likely been circulating in western Washington since about January 20.
As several news outlets reported, the CDC removed information about how many individuals had been tested in the U.S. from its website on March 2. At that time, the country’s testing ability was rapidly improving, with state health departments around the country getting their tests up and running.
Still, before the information was hidden from the public, the CDC had recorded 472 people tested nationwide; the CDC’s testing ability seemed to lag behind virtually every other country to have a coronavirus outbreak. South Korea tests more than 10,000 people every day.
The CDC did not respond to a phone call or email with questions about how many people have been tested in the U.S. and why that information was removed from its website.
Note: Unsolicited comments regarding COVID-19 from non-experts are not being accepted.
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