In an effort to give you the facts, here is both a video and the transcription of this morning’s Press Briefing by Snohomish County Executive Dave Somers, Dr. Chris Spitters from the Snohomish Health District and Dr. Matthew Beecroft from Providence Regional Medical Center. There’s a lot of information here if you are interested in where things stand for Everett and Snohomish County.
Snohomish County Executive Dave Somers:
Thank you. Good morning. Thanks for joining us today. It was back on January 21 the first case of coronavirus in the U.S. was confirmed right here in Snohomish County. And we knew immediately that our community would need to come together to really face the challenge in front of us. Since then, we’ve done a lot, an amazing amount, and extraordinary things really to respond to the pandemic. Excuse me. So we got in ahead of the curve, it appears that we are flattening the curve, but we can’t stop now. We have lost over 60 people to the virus and unfortunately more will be lost. It’s imperative that we not slacken up. We must hold the line and we must stay the course.
So some of the things we’ve done, we have stood up our emergency management center. It’s been open now for 41 days. We have reinforced relationships between public and private sectors there at the ECC. We’ve shut down non essential activities throughout the county. We’ve moved people out of shelters and into hotel rooms to give them some isolation. We’ve been coordinating across the county and the region and the state with our partners throughout the state. We have worked hard to ensure that our frontline workers have personal protective equipment. We worked hard to ensure that children who rely on free or reduced lunches have food. Our schools have revamped their processes for teaching and there’s a lot of online teaching and stay at home teaching going on now as much as possible. We closed our parks facilities and many of our outdoor activity areas. We established an isolation and quarantine facility there in Everett. And we’ve really set up a whole number of ways to continue our processes at county government. Most of our employees are still working and working online and things are going well there. There’s no in person meetings, unless absolutely necessary, but county government continues to work.
And we’ve also begun planning. We know that the county, we are going to have a drop in revenues because of the loss of sales tax, and we were putting in place a hiring freeze and other actions to really meet that challenge with revenue losses. So we have a much better sense of the expected scale and probable impacts of the pandemic on our community. But even after all the work, there’s much, much more to do. We still must practice social distancing, particularly since our numbers look encouraging, we must keep going. If we slack off now we could see a rebound. If we stay disciplined, stay home and keep our distance for a few more weeks, we may be able to start dialing back restrictions, but it will take everyone doing their part now. And I emphasize “may.” The response of the virus to social distancing and any slacking up is yet to be seen. So we have to be cautious.
So most people in Snohomish County have been doing an incredible job of adapting to this new reality. But I need to stress in that strongest possible terms, we must keep our strategy of social distancing or we risk having to continue these actions and stay at home restrictions much, much longer than we want. We must hold the line, we must stay the course. And with that I’ll turn it over Dr. Spitters from the Snohomish County Health District. Go ahead, Chris.
Dr. Chris Spitters:
Good morning. Thank you, Executive Somers, and thanks to the help of the county working together with the health district, the health services sector and the all government, all sector, all society approach that’s needed to respond to this pandemic and the support of the county has really been indispensable in this multi faceted problem we’re facing of public health, economics and all the consequences thereof.
As I mentioned earlier this week, we are starting to see early indications that things are headed in the right direction. However, remember, it’s important to see the numbers we see today reflect what was going on in terms of transmission a week or two ago. It’s also to remember that the apparent decline in cases occurring recently is a signal that what we are doing is working and that the hard work and sacrifices from our residents and businesses is showing an effect. But as Executive Somers said we cannot stop or even ease up on the social distancing or we will end up right back where we were a month ago with cases increasing and all the problems and anxiety associated with that. We are not done by any stretch of the imagination, not close to the end of social distancing much less to the end of the pandemic. We still have just over 100 people in hospitals right now with COVID-19 and people are dying every day from this disease and Snohomish County.
We’re probably looking at at least another month of the current level of social distancing, possibly a bit longer until this conditions are suitable to begin consideration of any relaxation of what we’re trying to do to interrupt transmission of the virus. Even then whatever changes occur are likely to be incremental in nature. We phased into the current mitigation efforts and we will likely need to phase back out of them.
We also have to show that as a community, we can hear a little good news like we’ve been delivering lately without losing our focus, discipline and the patience that it takes to get to the other side of this event. Now is not really a time to celebrate, but just humbly take stock in what we appear to have achieved so far. We need to remain resolute in helping one another and those who are struggling by sustaining these efforts.
I mentioned on Tuesday that it’s like having a 10 point lead in the third quarter of a big game. And so while we’re on track to top win we are not by any means done yet. Those of us who are Seahawks fans know how important the final two quarters of the game are, especially the final minutes and seconds. So it’s important that we don’t declare victory too soon, only to lose our lead when it matters most.
Because of that, I have a specific request for all of the reporters who are listening in today. You play an absolutely critical role in this event and in all of our public health education efforts. We need you to encourage your audiences to persevere. We need you to reiterate in no uncertain terms that everyone must stay home unless essential trips are absolutely necessary. Please consider your headlines, story angles, photography and captions with this in mind, make sure that if someone reads just the headline or a short teaser they won’t come away with the wrong idea. Highlight the hard work and sacrifice is being done. Please don’t sensationalize those who are ignoring orders and jeopardizing lives. The sunshine and warmer weather will make this even harder for our communities to remain resolute, but we cannot waiver. Your help partnering with public health to get that message out loud and clear is needed and very much appreciated. We cannot do it without you.
The last thing I want to cover is about testing capacity. It’s important to remember the testing capability for this virus has only been around for three months. We have also had private sector firms developing more robust testing capabilities like rapid on site testing. And from that perspective, it’s really quite remarkable that this infection that only really began to affect humans four months ago is now something that can be diagnosed at the point of care. That being said, we certainly understand the frustrations by residents and healthcare partners on the early restrictions and backlogs that occurred in testing capability and testing supplies. A current
complication we have is the shortage of personal protective equipment or PPE that is needed to protect the health care workers who administer these tests. Things are improving though, testing capacity in laboratories has increased. Remember, in the beginning, we just had the public health lab. Now, all the major commercial labs are involved and the technology is moving forward to create point of care testing that will be available even prior to specimens being sent to the laboratory. So this is a much needed relief, but it takes a while for these processes to mature and there are likely to be, you know, future hiccups here and there in the supply chain or bottlenecks in specimen collection and processing. But please hang with us and know that this is a process that’s under development and overall the trajectory is a good one.
We have tested more than 2000 individuals in a relatively short amount of time through the drive through testing site that was put up with the help of the Federal Emergency Management administration and the Snohomish health district.
We’ve also seen reported numbers of cases decreasing in recent days, as well as testing participant registration which we think is a signal that maybe indeed the level of illness and the amount of cases out there is decreasing. But there are still people who want to be tested who would not meet the criteria for the drive through testing site. We would encourage them to talk to their medical provider to see if they should be tested. It is important to remember that, for otherwise healthy individuals who are not high risk or who are not working in essential business or service functions, the advice they would be given whether to be tested or not for COVID-19 would be the same. If you have any symptoms of respiratory illness, fever, cough, difficulty breathing, sore throat, stay home and do so until 72 hours after the fever has resolved and the symptoms have begun to improve and until at least seven days have passed from the initial symptoms having occurred. And while the stay home, stay healthy order is in place even healthy individuals should be home, except for essential work and essential errands. We are continuing to work on transition planning for the site with the federal support and testing that ends today. Please look for a press release from us with more details on that later today.
So with that, I will turn it over to Dr. Beecroft to share more about what he’s seeing in the emergency department at Providence Medical Center in Everett, Washington.
Dr. Matthew Beecroft:
Thanks Dr. Spitters. As Executive Somers and Dr. Spitters said, on the front lines I think we’re seeing some early signs of encouragement. And a lot of this has to do with their efforts and many others in the county. We at the hospital at Providence Everett really want to say thanks to Executive Somers and Dr. Spitters and all the people involved in this effort. I worked a lot of shifts when this first started a few weeks ago when our volumes really started to tick up. It came fast. What we saw on the front lines was just a sudden and very rapid increase in patients with respiratory illness.
It felt too many of us like suddenly we were in a car speeding towards the edge of a cliff. And I think we all just started to pump the brakes immediately and do that through social distancing and putting in these important public health measures. And I think where we’re at now is we have, we seem to have hit the brakes, we seem to, as Dr. Spitters mentioned kind of be in the third quarter. I feel like our car has stopped before the edge of the cliff through all the efforts of the county and the health department. Excuse me. And other places weren’t so lucky. I think other countries, other cities weren’t so lucky. But we seem to be kind of one wheel over the edge of the cliff and have maybe stopped just in time and now we’re kind of very carefully getting out of the car and hoping it doesn’t tip over.
It was it was close. From our perspective, it felt like it was going to turn into a major disaster and now it seems like we have a real chance of averting that. We had fears of running out of ventilators, we had fears of running out of beds and at this point if we continue the current trajectory I think we have a chance of avoiding that and maintaining a functional hospital for the community, which was our goal.
So for the last few weeks, we’ve seen pretty steady volumes, we are still seeing patients with COVID-19, we are still seeing sick patients. So I want to add the emphasis that we’re not out of this yet. Progress is definitely been made through social distancing measures. It absolutely works. From our perspective, though, people are still coming in sick, we still are seeing people every day, there’s people in emergency department right now who have active symptoms. But again, it’s less. So keep doing what we’re doing and be encouraged by the progress, but I agree that it’s not time to relax anything. We’ve seen the progress and now we need to finish the job.
As far as people coming into the emergency department and when to come in, we still want to encourage people who have symptoms and who feel they’re sick to come in and be seen. We don’t want asymptomatic people coming in for testing. We want, we’re there to, you know, provide medical care for people who are sick. That’s who needs us. Our volumes are we have good capacity now to see people. Our hospital is doing okay. There are beds, there are ventilators. So I want everybody to be encouraged that we’re in good shape in that regard.
The other thing I want to mention that I think is important that is starting to emerge in the patients we’re seeing is, we’re seeing patients that should come to the hospital with other diseases, congestive heart failure, COPD, diabetes, people who have symptoms that seem like a stroke, people who are having chest pain that might be a heart attack. We’re seeing those people stay away from the hospital, maybe out of fear. I want to encourage people that we at this point are fairly dialed in so much as I think a hospital can be in regards to having our patients with respiratory illness isolated and separated. Coming to the hospital is safe and it’s important. We’re seeing this more and more, and this is emerging as a problem every day. And I think it’s going to become a trend and I have a real concern that people are putting off medical care that need medical care. Again, chronic conditions, CHF, maybe anemia, cancer treatments, COPD, diabetes, all these chronic health conditions which are prevalent in our community and many others. I think some care is being deferred out of people staying away from the health care system. So please do still seek emergency care when appropriate. We have PPE, we are keeping our patients with non respiratory illnesses separate on separate floors as an inpatient, on an entirely separate blocked off area of the ER. So we’re doing our best as a hospital to not only provide support and care for people who have active COVID-19 infections, but for everybody else who still needs medical care. So just know that we’ve I think at this point we are fairly dialed in to the process of isolation, the process of PPE and the process of protecting our patients who don’t have this disease from other patients who do.
And that’s about all I had. I’ll mute here for questions.
Dave Somers: Dr. Spitters, you want to take the first one with more about the testing situation.
Dr. Chris Spitters: Sure, sure. So there’s really two linked questions. So maybe I’ll just try to cover them cover them both. One: Can someone talk more about the testing situation. Self swab tests are now FDA approved and require less PPE for healthcare workers. Any chance we see that in Snohomish County? And then why is the federal government ending it’s testing support for the county test site. What does that mean for testing in the county. So maybe I’ll take
that part first. Part A. The FEMA fomented testing was meant as a short term surge to really foment testing by in the community, provide supplemental testing, but it was not intended as a long term endeavor by the federal government. So they’ve come, we’ve done our I think we’ve done two, three full weeks of testing and, you know their commitment is done. So now that responsibility will move on to the state and local control to continue some form of drive through testing to supplement what is occurring through other medical facilities in the county. So that’s, that’s something you should stay tuned to hear about in our press release later today. And then the other related question is about testing technology. As I had said earlier it’s moving along quickly. I mean, now we’re moving from centralized lab testing. There’s more point of care tests available. We’re moving from being limited to nasal pharyngeal swabs, which require a healthcare provider to administer, to just swabbing the nose and that can be done by someone themselves, either in their car or at home. And so that does open up the possibilities for, one, making testing more accessible to folks as well as reducing the need for PPE and much of that is already being done. In fact, a lot of the formative work. That got the Food and Drug Administration approval for nasal swab testing and for self testing was the Everett Clinic and Dr. Tu there so that some of that it was actually spawned here locally and it’s already in practice and, you know, I think that that you’ll just see more and more of that as time evolves. Testing being done, meaning the analytic part, the laboratory part and the results being done closer to home, closer to the clinic, closer to the place of collection. And, you know, less demand for providers collecting the swab themselves and exposing themselves and needing to use the personal protective equipment. So that’s already underway and I think it’ll just become more and more.
We do have in our supply, the Health District supply of swabs, for its testing capacity we have and are using those nasal swaps right now there’s a limitation with the viral transport media, the liquid that the swab has to go into. So we’re working on getting more of that. And again, Dr. Tu at the Everett Clinic is working on study to see whether just putting the swabs in a dry tube or in a saltwater tube is as effective as the viral transport media that would again, you know, open up a bottleneck in the system.
Dave Somers: Question about the next phase, next month and what will the impact of COVID impacts in the county look like in that next phase.
Dr. Chris Spitters: Well, I guess, speaking from the public health end I think that’s a multi faceted question. So there’s the social distancing aspects, there’s the sort of winding down of the intensity of social distancing. I would think of that as coming off in layers. But the exact parameters of that, what would trigger it and how much we would let up at a time, is to be determined. That’s something that’s under development with national experts, looking at what has worked and not worked in other counries when they’re at this moment in time and trying to come up with something that, you know, anything to work in this respect is going to have to be harmonized across geographic areas. So we’re likely to look at a regional approach. And that’s why the state health department’s leadership in this is so important.
Certainly the containment efforts will not turn down until this is really gone. And the containment part meaning when we see clusters of cases like in health care facilities, particularly in long term care is what I’m referring to, you know, we will continue to jump on that, try to isolate the people who are infected, quarantine those who are not infected but who have been exposed, and then do case finding among those quarantined individuals. And that will continue until this is long gone. And so part of that you referred to testing capacity. Ramping up testing capacity is a huge
part of the ongoing surveillance effort looking into the future long past when we think we’ve seen the last case.
Dave Somers: Dr. Beecroft, you have anything to add?
Dr. Matthew Beecroft: No, I think that was well. I was going to address the question regarding PPE. We’re doing okay right now. And thanks to, there’s members of the community who have donated PPE to us. We appreciate that at the hospital. It’s essential for us to do our jobs we are doing okay on it now. Luckily we we belong to a large hospital system so we actually are fortunate in that case, to have a little bit of purchasing power and ability to share resources between hospitals. So we’ve actually been able to, I think, I think we have a little bit of we’re fortunate there to be to able to have more PPE, I think, then some places. So we’re doing okay on that and we appreciate everyone’s efforts and donations and, you know, keeping us safe. In the beginning it was a real concern when we saw the flood of patients and you start doing the calculations. You look at exponential growth and you say, how many cases are going to be here in two weeks, and you start to realize you may not have enough. But through everyone’s efforts we’re looking okay for the time being. We have masks for patients who come in. And, you know, we’re hanging in on our supplies.
Dave Somers: One thing I’d like to add about PPE is a lot of folks at home that want to do something to help sew masks and that kind of thing. So the county’s initiated a program, we spoke with our food banks throughout the county and they’ve agreed to serve as both drop off and pick up sites for the homemade cloth based PPE for the public. The food banks are very busy and there are, as I mentioned, food banks throughout the county and we’re hopeful that distributing those homemade masks out to the public will take some of the pressure off the medical grade and higher quality things that really are needed by our medical facilities.
Dave Somers: Question about specific numbers of patients that county hospitals have and what hospitals.
Dr. Chris Spitters: So I don’t have the specific numbers at my fingertips right now, but the general is 40 to 50 in each of the two major hospitals, Providence Everett and Swedish Edmonds. And then five to 10 in the two smaller hospitals up in Arlington and out Monroe.
Dr. Matthew Beecroft: And for us, those volumes have been, that number has been a pretty steady one between 40 and 50 for, you know, probably it’s been a couple weeks now. So that’s again been encouraging. The job’s not done, but it’s encouraging.
Dave Somers: Anything else
Joint Information Center: Thank you all. This is Kari in the joint Information Center hoping you can hear me. Thumbs up if you can. All right, awesome. So not seeing any additional questions and coming up here on 10 o’clock. I want to thank everyone for joining us today. This video will be available online at the Snohomish Health District’s COVID-19 page by noon today. We’ll also work to get a transcript available and that will be shared on social media. And please stay tuned for future media availabilities. Thank you so much for joining us.
Dave Somers: Thank you.
Dr. Chris Spitters: Thanks.
Dr. Matthew Beecroft: Thank you very much.
April 10, 2020
Everett