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Does a recent surge in cases mean more spread of the coronavirus in Spokane County? The answer could determine how the county moves forward in reopening

Volunteer Barb Warton, center, pulls on latex gloves as she joins Kylie Kingsbury, left, Homeless Outreach Coordinator with the Spokane Regional Health District and volunteer Brent Conrad, right, in preparing before doing COVID-19 screenings for the homeless on Thursday at the Spokane Arena. (Tyler Tjomsland / The Spokesman-Review)

The threat of COVID-19 in Spokane County seemed to be waning in late April. And then came the last 10 days of May.

Following weeks when the number of daily positive test results was low or nonexistent, they began to climb on May 21, when 13 new cases were reported. In the days since, the numbers of people with COVID-19 has continued to rise.

On Wednesday, the county saw its highest daily count of cases reported since the pandemic began, when 23 new cases were reported. Two days later, that record of confirmed new infections was broken, when 30 people tested positive. Another 18 new cases were reported Saturday, bringing the county’s total caseload to 588.

The surge in cases started just after the county moved to Phase 2 of the state’s reopening plan, which was predicated in part on low case counts that haven’t held.

As local officials work to not only preserve the county’s place in Phase 2 but also aim to move it forward in the reopening process, they’re taking a hard look at the recent rise and numbers and trying to figure out how it might affect their containment efforts.

One thing they’ve noticed is that the virus has disproportionately been detected in a group that hasn’t suffered the worst effects of the respiratory disease: young people.

More than 100 Spokane County residents in their 20s have contracted COVID-19, more than any other decade-based age group in the county.

The trend follows a similar pattern playing out statewide. As case counts have increased, adults under the age of 40 now make up a third of the state’s total case count.

Spokane County Health Officer Dr. Bob Lutz said this is likely due to a large number of 20-somethings being deemed essential workers in the midst of the pandemic.

“Many people who have employment and they have been deemed essential, they are working and, unfortunately, the working conditions are not always conducive to following infection-prevention protocols,” Lutz said.

From grocery stores to manufacturing facilities to food production plants, essential businesses have stayed open throughout the pandemic. And some have had outbreaks.

While safety precautions have been put in place in many of these settings to prevent COVID-19’s spread, they haven’t always worked.

Take, for example, Spokane’s Philadelphia Macaroni Co. pasta factory.

Lutz and other officials have said the company followed all of their recommendations – giving all employees temperature readings and health screenings at the start of their shift; requiring employees to wear masks and maintain 6 feet of social distance; staggering breaks; and sanitizing high-contact surfaces every three hours. When one worker tested positive, the company did the right thing: closed the factory.

But that didn’t stop the virus from spreading to about half of its 72-person workforce and to some of those workers’ family members.

While cases tied to the pasta factory account for a large share of the recent surge in Spokane County, officials’ ability to identify those cases – many of which were found in people without any symptoms – demonstrates another important factor in the recent rise positives: increased testing and contact tracing.

Those efforts suggest connections between the new cases. Lutz said that 20 of the new 30 cases reported Friday were known to be associated with other confirmed cases.

As part of being in Phase 2 of the state’s reopening plan, Spokane County is working to train more volunteers to help with contact tracing investigations.

The health district has a goal of having more than 70 contact tracers ready to go by mid-June, but in the meantime it is seeking support from the state Department of Health, especially with the surge of new cases.

Health officials are finding clusters of cases, particularly in households, when a family member who has the virus brings it home.

While a lag in negative testsbeing reported to the state health department makes it difficult to determine exactly how much more testing has occurred in recent weeks, it has undoubtedly ramped up.

At the Spokane County Interstate Fairgrounds testing site, Lutz said 160 people were tested during the week of May 18. Last week, at least 265 people were tested. These counts do not include tests that local health care providers have conducted.

Increased testing is partly a result of significantly relaxed testing criteria. Early in the pandemic, only those who exhibited symptoms were tested. Now, however, anyone who has been in contact with someone who has a confirmed case of COVID-19 can be tested, even if they are showing no signs of illness.

In Spokane County, the testing of asymptomatic people has shows that the virus has spread among people without symptoms. For example, half of the workers at the pasta factory who tested positive were asymptomatic.

Increased testing and contact tracing have led to an uptick in reported cases. The question officials will try to answer in the coming weeks is whether the move to Phase 2 and the reopening of some businesses has led to more community spread of the virus, Lutz said.

Community spread of the virus and the inability to trace contacts would concern state health officials.

“We would be concerned if we can’t start making those connections of who they were in contact with,” state Secretary of Health Dr. John Wiesman told reporters Tuesday.

He added that it’s possible to move through the phases safely, if everyone is willing to alter behaviors such as wearing masks and keeping a distance.

“It means each of us needs to take responsibility for how we now behave differently moving forward,” Wiesman said.

In Phase 2, gatherings of up to five people outside a person’s household are allowed. While jungle gyms, bars, theaters and large group gatherings remain prohibited, hair salons, restaurants and retail stores are now open with capacity caps and regulations in place.

Spokane County must remain in Phase 2 for at least three weeks before advancing to the next phase. Health officials have guidelines from the Department of Health that will determine whether they are ready to advance to the next phase.

Spokane County will need to have fewer than 130 new cases in a 14-day period to advance to Phase 3, according to the state’s new criteria. Hospitalizations also need to remain flat or decline.

So far, the county’s hospitalizations have remained relatively steady, with seven people currently hospitalized.

Health officials will also evaluate testing capacity and percent positivity of the tests being conducted, before a county can move to the next phase.

This week, Lutz encouraged the Spokane Regional Health District Board of Health to temper community expectations about jumping to Phase 3 in exactly three weeks.

“Yes, the three-week clock started last Friday (May 22), but it will undoubtedly be extended,” Lutz told the board. “And people need to understand that going forward there is no timeline. It will be when we are comfortable with the data provided to us by the Department of Health.”

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.