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COVID-19

Effort to identify, slow COVID-19’s spread in Washington hampered by testing lags

Confluence Health staff from left, Nurse Managers Leslie Kees and Jay Bretz, and Dr. Joshua Frank work out the process of using a coronavirus triage tent set up outside the emergency room at Central Washington Hospital in Wenatchee last week. (Don Seabrook / Wenatchee World)

The number of novel coronavirus cases in Washington jumped by nearly another 100 on Thursday, bringing the statewide total to 457 cases in 14 counties, including three east of the Cascades, with 31 confirmed deaths due to the disease.

But health officials believe this number is much lower than the actual number of cases of COVID-19 in the community.

“We think there are probably about 1,000 to 2,000 folks affected in the (Seattle) metro area,” state Secretary of Health John Wiesman said Thursday, referencing local research and modeling.

Those models predict the number of cases will balloon to nearly 25,000 by April if the state takes no intervention actions, Wiesman said. With preventions, health officials hope to curb the spread of the disease.

“Our goal is to see to it that that line doesn’t keep going up, that it’s a slower acceleration and flattens, which is why we need everybody to heed our advice and take this very seriously,” Wiesman said.

But getting a handle on how many cases there are and how to contain them has been hampered by delays in testing efforts, which has left some county health districts, including Spokane’s, in the dark about how the disease could be spreading in communities.

Wiesman said Thursday that the goal of testing is to identify people who are infected so that they can know to stay home and away from others and so health departments can contact them to see who those close contacts may be.

“It’s also about trying to identify where it might be in our communities,” Wiesman said at a news conference.

A lag in test results or a lack of tests conducted can leave public health officials in holding patterns.

While discussing his decision to close schools in just three counties but not the whole state, Gov. Jay Inslee said, “When the transmission rates and the community spread appears to be at a level to justify the downsides of school closures, we’ll make that decision.”

Inslee clarified there are no numerical criteria or a percentage of people with the disease that would trigger actions, but more so that it is a judgment call.

Spokane County, along with 24 others, still does not have confirmed cases of the virus, despite many officials’ belief that it is circulating. Spokane city and county officials are encouraging social distancing and working remotely if possible.

“It’s no secret that there’s not as much testing volume out there as we would like,” Wiesman said. “The governor has been really clear with the vice president and others, and with the commercial companies, that they need to come on board to provide this test. They have very large-scale operations that are all automated, and we are really looking for them to come on board, so anyone who does have symptoms of the virus can be tested if they want to. Given the volume right now … we need to prioritize those high-risk groups.”

The Centers for Disease Control and Prevention sets the guidelines for who can be tested, however, frustrating many people who have tried in recent days to get tested.

The most recent guidance prioritizes hospitalized patients with COVID-19 symptoms that include cough, fever and difficulty breathing. Next, health care providers are advised to test people with symptoms who are older adults or have chronic medical conditions. Health care providers can also authorize testing for a person who has had contact with a confirmed case, or history of travel from a country with wide community spread.

In Washington, health care providers can order sampling to be done at commercial labs they contract with, like LabCorp and Quest, or have patient swab samples sent to the University of Washington to be tested. The state Public Health Lab can also test samples for COVID-19.

Wiesman said he and the governor have had conversations with private lab companies, “encouraging them to prioritize Washington state,” although these companies can send samples elsewhere to a national lab, leading to additional wait time for results.

County health districts are alerted to any positive test results but cannot track how many samples are sent out for testing.

Health districts in Chelan, Douglas, Grant, Okanogan, Ferry, Stevens and Pend Oreille counties are recommending that their residents follow the governor’s gathering guidance by limiting large public gatherings with more than 250 people. School districts are also encouraged to prepare for potential mandatory closure.

There are six confirmed cases of COVID-19 east of the Cascades in three counties.

Kittitas County announced a 56-year-old man tested positive for the respiratory virus Thursday. He is the third case and is unrelated to two previously announced cases in the county. The Kittitas County Public Health Department has notified all close contacts of the man with a confirmed case.

A 67-year-old woman who has tested positive as well as her close family contact are both in stable health, said a release from the local health department. The majority of close contacts of the county’s first two patients occurred outside Kittitas County.

The Yakima Health District learned late Wednesday night that two residents have confirmed cases of COVID-19, and both people are in isolation.

Grant County continues to have had one confirmed case of COVID-19, in a Quincy resident in his 80s who died March 8.

As the virus spreads, disrupting life across the country, state leaders urged residents Thursday to take the threat of COVID-19 spreading seriously.

“We cannot sugarcoat the reality that this virus is going to spread. It is our job to slow down the spread,” Inslee said at a news conference on Thursday, where he also closed school districts in King, Snohomish and Pierce counties starting Tuesday, for six weeks.

Earlier this week, the governor prohibited gatherings of more than 250 people in the same three counties, which have been hit hardest by the COVID-19 outbreak.

So far, the majority of deaths due to COVID-19 in Washington are in older residents of long-term care facilities in Western Washington.

There are 46 “unassigned” confirmed COVID-19 cases, Washington State Department of Health numbers show. Department officials are working to assign those cases to the proper county for jurisdiction.

In Pullman, Mayor Glenn Johnson declared a state of emergency on Thursday, paving the way for the city to receive state and federal assistance in dealing with COVID-19, including loans from the Small Business Administration. In a news release, Johnson urged residents to continue frequenting local businesses to maintain the local economy.

The city also is establishing an Emergency Operations Center at the Pullman Police Department, which will manage information and resources related to the outbreak.

In Western Washington, where the health care system is straining to respond to the growing number of COVID-19 cases, state officials stressed the importance of keeping health care workers healthy and at work. The Department of Health is actively enrolling volunteer health care workers to help respond to the COVID-19 outbreak.

As long as providers are licensed and in good standing in other states, they can register to be a part of the state’s volunteer program and practice here without a Washington state license as a part of the emergency volunteer act in effect.

The state health department also called for blood donations, due to an increase in canceled blood drive events due to the COVID-19 outbreak.

As long as a person has no COVID-19 symptoms or contact with a person who might have it, people are encouraged to donate.

“This is creating a significant public health risk and puts our local blood supply in danger of collapse,” a release from the state health department says.

Medical supplies, particularly personal protective equipment that protect health care workers use when treating patients with COVID-19, are running low nationally. Wiesman said Washington has had to make requests to the federal government’s national stockpile a few times already for supplies.

“The PPE supply is extremely tight. Our health care providers are having a very difficult time ordering those supplies,” Wiesman said. “We have to keep our health care workers safe in order to address this outbreak.”

Spokesman-Review reporter Chad Sokol contributed to this story.

Arielle Dreher's reporting for The Spokesman-Review is primarily funded by the Smith-Barbieri Progressive Fund, with additional support from Report for America and members of the Spokane community. These stories can be republished by other organizations for free under a Creative Commons license. For more information on this, please contact our newspaper’s managing editor.