Spokane County could request to move forward to the next phase in the state’s reopening plan as soon as Friday.
But that’s not likely, Spokane County Health Officer Dr. Bob Lutz said last week. And it probably won’t happen for at least a couple of weeks.
“We will move when the data demonstrate we can move,” Lutz said.
And so far, the data isn’t looking good.
In the last week, Spokane County health officials have seen a surge in COVID-19 cases, recording more than 100 new cases and bringing the county total to 728 cases as of Saturday, including 21 cases from Friday.
While the rate of new cases is one factor state health officials will use when determining when the county can move from Phase 2 to Phase 3 of reopening, it’s not the only one.
A new dashboard that will help determine whether the county is ready to advance also looks at hospital bed space, COVID-19 hospitalizations, the percentage of individuals testing positive and the amount of testing being done.
Spokane County only meets the Phase 3 criteria for hospital bed capacity, which is high, and hospitalizations, which are not.
Even as case counts have soared, hospitalizations in Spokane County have remained relatively flat for the last few weeks with seven in the hospital with the disease on Saturday.
But that doesn’t mean more people won’t be hospitalized as case counts rise. It can take up to 10 days after the onset of symptoms for a person’s illness with COVID-19 to get severe enough to require hospitalization, so few cases confirmed this week likely would show up in the hospital until late next week or the week after.
If more people do require care in a hospital setting, Spokane has enough capacity to meet the need.
And after months of hitting pause on elective surgeries, MultiCare and Providence hospitals have adequate supplies of personal protective equipment and beds to treat not only COVID-19 patients but also other patients needing hospital care.
“All four hospitals have capacity, and we have more than we ever had or wanted to have,” Greg Repetti president of MultiCare hospitals in Spokane told reporters on Friday. “We have excess capacity and have been able to stock enough PPE that should we have a spike up that rivals the ones we saw in the Puget Sound, we’ll be able to handle that.”
Emergency rooms and operating rooms are starting to fill up again. Dan Getz, chief medical officer at Providence hospitals in Spokane, said they track their statistics in order to keep capacity for a potential surge in COVID-19 patients.
“We have people tracking those variables in real time,” Getz said.
While the county hasn’t met the state’s bar for testing capacity, it has greatly expanded access to testing and to robust and rapid contact tracing. In the last two weeks, local providers have conducted nearly 4,000 tests, whereas the two weeks before that, providers conducted about 2,300.
The increase in confirmed cases is likely linked to the increase in testing.
“That’s an exponential increase in the number of tests and as we do more testing, we will find more cases and as we do focused testing, we’ll find clusters,” Lutz said.
The majority of the new cases recorded this week were due to outbreaks and clusters of cases in long-term care facilities, adult family homes and a few work sites. When people test positive, their close contacts are almost immediately notified and able to get tested under current testing guidelines.
Countywide, four long-term care facilities and two adult family homes have confirmed COVID-19 cases in residents and staff, accounting for nearly 90 cases of the virus, according to health district data from last week.
Outbreaks in vulnerable group settings are defined by two positive cases. These facilities have reported high attack rates in some cases, meaning that the virus is spreading quickly and infecting others rapidly. The outbreak at the Spokane Veterans Home, which began in late March, led to 46 residents and 24 staff members testing positive.
Outbreaks at workplaces, including essential businesses that never closed, have also led to increased case counts, due to workers bringing home the virus to their households. There are at least two new workplace outbreaks, in addition to the one recorded in late May at the Philadelphia Macaroni Co. plant.
The good news, Lutz said, is that he is still not seeing wide community spread, meaning there are not many COVID-19 cases that officials can’t connect to an outbreak or cluster they’ve already found. But he does expect there to be an increase in cases in the coming days, due the increased amount of testing in the community.
“Hopefully by next month we’ll be in a better place, but right now we will see more cases because we are doing aggressive and focused testing,” Lutz said.
The outbreaks show that even one slip-up in taking the necessary precautions can lead to increased spread of the virus.
“It speaks to the fact that you can do as much as you possibly can with respect to all the infection prevention strategies, and yet it doesn’t take much to have one little slip-up,” Lutz said. “And one little slip-up in a population that is susceptible can cause an outbreak.”
While the recent spike in cases isn’t good, Lutz said State Health Officer Dr. Kathy Lofy and Secretary of Health John Wiesman have assured him that other factors, like hospitalization rates and the presence or absence of community transmission, are as important as case counts.
In order for Spokane County to advance to Phase 3, Lutz would need to initiate a process similar to the one that resulted in the county advancing to Phase 2.
He would make a recommendation to the Board of Health, which would then work with county commissioners to decide whether to approve it.
“I’m not seeing big community spread, so if (we’re) able to wrap our collective arms around these outbreaks, then I think we can move forward,” Lutz said.
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