Day 3 of the Outbreak of COVID19 in Greater Seattle

I have worked in the environment and public health for 30+ years. I drafted quarantine laws to help states respond to Mad Cow and SARS while serving in a governor’s cabinet.

COVID-19 IS a public health crisis and NOT a political conspiracy. 

We have an “Outbreak” in Greater Seattle, specifically in the eastern suburb of Kirkland, and the first US deaths have been in Washington State.  This outbreak has occurred by what is called “Community Spread” and will soon be a pandemic. Community spread means the people did not travel to an infected country nor have they knowingly been exposed to someone with the virus. They do not know where they picked up the virus from. 

The first 9 deaths in the US occurred in Greater Seattle in Washington State (WA), making Washington State the US epicenter.

Seasonal flu viruses (which include influenza A and influenza B viruses) and COVID-19 are contagious viruses that cause respiratory illness. With COVID-19 doctors are still trying to understand the full picture of disease symptoms and severity.

The culture in the Pacific Northwest is not to discuss bad news and this is NOT helping us prevent the spread of this disease.

The last pandemic in the US was 1918.  Science has come a long way in the last 100 years.  We need to listen to epidemiologists, health care providers and public health officials.

There are well established protocols for containing the spread of virulent disease.  

The normal influenza or flu death rate for a is 0.1%.  The novel coronavirus (COVID-19) appears to have a higher death rate than that of the flu/influenza. The COVID-19 death rate ranges from 2% to 3.4%.  

The death rate for COVID-19 appears to vary by location and an individual’s age, among other factors. Those experiencing acute respiratory challenges in the US are over 50 years old. No children under age 9 have died.

Let’s play out a scenario of COVID-19 in the United States:

1. The US population is about 330 million people,
2. Assume 50% of the US population gets infected with the COVID-19 virus, and
3. 2% of the infected population die from the virus

This means 3,300,000 US residents could die, which is about 1% of the US population. 

For comparison, according to preliminary estimates from the CDC, with the current Influenza A which many people are experiencing, so far 250,000 people have been hospitalized during the 2019-2020 flu season and 14,000 people have died.

The incubation period for the virus is about 14-21 days and it may be as long as 27 days.  This means that people’s exposure in Washington State likely began in mid-January and continued unchecked and untested for many weeks.

Test kits and testing facilities are in short supply and there was a debacle at FDA and CDC which caused faulty kits to be sent to the states. 

WA has the most regressive tax system in the country and no income tax. Hence WA and its individual counties public health resources are dependent on the federal government’s tool kits.  Because of the shortage of kits, 3 high criteria were established before an individual can be tested with the CDC kits. Because of this most of the remaining patients in the Life Care Center in Kirkland – where 6 of the patients have died – have NOT been tested for COVID-19. Family members are anxious and afraid.  Meanwhile the majority of the 30 firefighters and police officers who transported patients to/from the facility are experiencing symptoms and are under voluntary quarantine at home or in a dedicated fire station.  

WA only has 3 testing facilities and can currently test about 200 samples a day. They are seeking emergency authority from the FDA for the University of Washington to be allowed to test patient specimens from health care providers. 

Phase 1: Social distancing and personal hygiene.  Social distancing is keeping 6 feet away from other humans, no touching, no handshakes AND good personal hygiene practices. 

Excellent hygiene practices include:

• Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available use alcohol-based hand sanitizer, with at least 60% alcohol.
• Avoid touching your eyes, nose and mouth with unwashed hands.
• Avoid close contact with people who are sick.
• Stay home when you are sick.
• Cover your coughs and sneezes. If you don’t have a tissue, cough into your upper sleeve, not your hands. Wash your hands after coughing and sneezing. 
• Clean and disinfect frequently touched objects and surfaces with bleach.
• Wear disposable gloves when you fill your gas tank. 

Meanwhile the epidemiologists have been doing their jobs in the background and working tirelessly to identify who has been in contact with whom and where. Over 750 individuals are in voluntary quarantine in King County, having returned from overseas travel or after being in close contact with someone who was. 

Phase 2: Non-Pharmaceutical Interventions (NPI’s). We are now in Phase 2 which is Phase 1 PLUS.  This means that in addition to good personal hygiene, social distancing increases from 6 feet to quarantine at home. Who needs to stay at home? Any sick or vulnerable person (people over age 60 years, people with underlying conditions, including smoking, vaping, people with chronic health diseases – diabetes, heart conditions, people with compromised immune systems, cancer patients, even people with the flu) need to stay home. If you are vulnerable and not sick you need to expand your social distancing and avoid attending crowded gatherings.

Phase 3: Community Mitigation. Also known as institutional closures and event cancellations. WHO is discussing with impacted countries when to pull the trigger on declaring this a pandemic. When they do we enter Phase 3, Community Mitigation. with the impacted countries.

As I started learning how to blog today, the only deaths in the US from COVID-19 occurred in Washington State. One has now occurred in California. The death toll will increase. In WA the spread is from community spread.  KC and WA state authorities are currently discussing when they pull the trigger on Community Mitigation. Community Mitigation includes public health officials mandating the closure of schools, businesses and cancellation of events.  At present closures are voluntary.

This is why public health officials are telling people to stock up on a 2-4 week supply of food, water and medicines. If we get sick, we must stay inside and not infect others, and we will need food, water and cleaning supplies in our homes/rooms/apartments while we are ill.

WHO and CDC estimate that the first case in Snohomish County – a man who traveled to/from Wuhan China and survived after a month in the hospital on a respirator – began this outbreak. You may recall that they locked down Providence Hospital in Everett and began talking about personal hygiene practices. 

If you share a home, discuss and make plans now on where you will quarantine someone if one of you becomes infected. Who will take care of that person? How will you get that person medical attention IF their symptoms worsen and doctors recommend hospitalization? 

Do NOT take people to the emergency room OR to your doctor’s office without calling first and being directed to do so.  CALL your healthcare provider or use the internet to ask for advice. The emergency rooms and clinics are for very sick people who have been directed by medical providers to go there for immediate care.

Worldwide estimates are that 40-70% of the US population will get the virus and as of March 1, 2020, King County Public Health estimated that 40% of the workforce will get infected and have to stay home from work so as not to further spread the disease. 

We need a plan for how we will function if 40% of our workforce is sick. Businesses, non-profits and governments need to be planning NOW on how to function with less workers, with workers working from home and what to do when their supply chain is affected.

We are already seeing business closures in China and feeling the impact on our national and local economies.  In a matter of three days local companies are telling employees to avoid non-essential travel out of the country and domestically. Airlines are waiving change fees. 

Gratefully some faith communities have one-time funds to help congregants cover emergency costs if they are unable to work. We need similar funds set up by employers and/or local governments, NOW. If we expect employees to stay at home if sick, employees need to receive paid sick leave especially if we want them to follow quarantine at home protocols to prevent the spread of COVID-19!

Much has been said about masks.  Normal people do not need to be wearing masks. Please stop hoarding masks. We need masks for our healthcare workers and caregivers. We need masks for sick people – so they do not expose others.  Here is a source from Public Radio: https://www.npr.org/sections/goatsandsoda/2020/01/29/800531753/face-masks-what-doctors-say-about-their-role-in-containing-coronavirus

We need government to step up and lead. All non-essential meetings and gatherings need to be cancelled.  

We need a plan…