County Public Health Report ~ 2/01

The following is a summary of the presentation made by Dr. Tom Locke, our local Health Officer, during the Public Health briefings at this week’s Board of County Commissioner’s meeting:

Submit your Public Health questions to Dr. Tom Locke by emailing Note: The weekly deadline for these to be submitted is on Fridays at noon, to be answered at the following Monday’s BOCC meeting.

General Remarks:

  • Nationally, new COVID-19 are declining, noting a 40% drop from the peak in January, with hospitalizations decreasing 24% after rising to an all-time peak.
  • Washington, having seen a surge in December and January, has seen a 52% drop in new cases, with a concurrent 19% drop in hospitalizations. The state rate of new COVID-19 cases is 392 per 100,000 population, down from the previous week of 462 cases per 100,000, with a high 9.6% case positivity.
  • As of this day, Jefferson County reported triple its new cases (28), as compared to the previous week of 8 cases reported. Our case rate now stands at 106 per 100,000 population, up from 72 the previous reporting period, with 3.23% positivity.
  • Neighboring Clallam County has 84 cases per 100,000 population with 3.25% new case positivity. Mason County has recorded 174 cases per 100,000 population and 14% positivity, with Kitsap County at 155 cases per 100,000 and 7.3 % new case positivity. Local public health websites in our regional area continue to be the more reliable source for DOH metrics, as the state has lags in reporting and recording data.
  • Dr. Locke first addressed the concerning worldwide news of new virus variants being reported, stating the regional mutations to the spike protein impacts the state of the pandemic, making the virus easier to transmit to another person. While vaccination efforts are ramping up, the public health tools of masking, distancing, and sanitizing our environment become critically important to stop the spread and subsequent replication of the virus when it finds a new host. Evidence continues to demonstrate the mutations are more transmissible and emerging evidence shows it is more likely some mutations are more deadly, making vaccination campaigns more urgent. Politicizing the pandemic imperils our recovery, as evidenced by some states repealing mask mandates previously implemented.
  • Locally, 5,019 doses of vaccines have been given out, with 90% of all vaccines given by Jefferson HealthCare and 10% given by three local pharmacies. The next allotment (about 1,000) heading to Jefferson County will be used to support those needing their second dose. A small proportion will be used for older, very high risk seniors for a first dose, especially those identified as receiving cancer treatment or with other immunosuppressive conditions.
  • Washington’s allotments have increased slightly to about 155,000 doses a week, with the majority going to first dose needs and a small portion being used for second doses. The state is now managing second-dose logistics, releasing the local counties of this burden. All vaccine allotments are required to be given within 7 days and are being used as fast as they arrive in the local counties, with no holding second doses in reserve. The number of doses given statewide reflects a delay in recording and reporting local data. Currently, 62% of vaccine allotments have been given to Washington residents.
  • Our allotments locally have been reduced temporarily to give previously under-allotted counties their fair share. Vaccine allotments and shipments are expected to stabilize towards the end of February, and the state has predicted that counties will know the allotment quantity weeks ahead of planning appointments. Jefferson County continues to focus on getting those at highest risk of severe disease and death vaccinated. Dr. Locke is asking those healthy residents, aged 65-75 years to wait to get the vaccine so the available supplies go to the most vulnerable at this time.
  • Pharmacies are following state guidelines as to the targeted populations for vaccines, currently those aged 65 years and older in Washington.
  • Mass vaccinations events are being planned for Jefferson County when supplies of vaccines outpace the current method used for the drive thru setup near the hospital. A plan has been submitted to the state to indicate our readiness to receive larger allotments. Efforts are underway for increasing availability of volunteers and equipment for this eventuality in the months ahead, as it is estimated that 70-80% of our residents intend to get the vaccine.
  • The Jefferson HealthCare website still remains the central source of information related to vaccination availability. National production is steady, but not enough for the current need of those wanting the vaccine.
  • The the RoadMap to Recovery statewide plan from the Governor has received criticism due to the faulty methodology employed in determining progression to re-opening. It is a case of flawed methods leading to flawed policy, as evidenced by those areas with the highest prevalence being able to progress to re-opening before lower prevalence areas, especially when a percent reduction is employed in the calculations. There is some logic in recognizing our connectedness, especially as many people travel to high prevalence areas for work. However, increasing opportunities to gather more indoors, especially dining, could accelerate new cases, prompting closures again.
  • For our Northwest Regional area, Kitsap and Mason counties continue to influence our collective epidemiology picture, with Kitsap having the largest population and Mason County being the site of the prison medical facility for COVID-19 inmate cases for the state.
  • To reduce the prevalence of cases now and with the emerging evidence of normal, but concerning mutations, Dr. Locke is advising all residents to double mask for several months. The inner mask should be a surgical mask, then covered with a cloth mask to seal any gaps, especially when in closed, crowded public spaces.
  • Public health officers are limited in the facts they can share with the public regarding cluster outbreaks, so the remarks are general here regarding a cluster outbreak in our community. In large population areas, these cluster outbreaks are common and relatively easy to prevent ongoing spread to the wider community. As a rule, containment is the goal in cluster outbreaks.
  • Focus on the specific cycle thresholds being used for PCR tests conducted mainly at the University of Washington is being used, in Dr. Locke’s opinion, as an argument, to undermine the reliability of these tests. This is an issue of timing in the disease process, whether at the beginning or the end of the infectious stage, as well the amount of virus present in the nasal swabs. The PCR is a highly reliable indicator of current infection, as well as other epidemiological information collected when conducting case investigations. There is no reason for the public to doubt its reliability and sensitivity at this point in time.
  • Long-term care residents and staff are now getting the vaccine, after a slow initial roll-out by the contracted, national pharmacy chains. Locally, Jefferson County used some of their allocations to vaccinate staff, as this is the potential introduction of the virus into these facilities. Protection of the most frail was the biggest consideration in taking this action.
  • A vaccine manufacturer, Johnson and Johnson, just released their efficacy data in a press announcement. They reported a 70% plus efficacy in preventing severe disease and no hospitalizations, which in Dr. Locke’s opinion is excellent for a one-shot, easy-to-store coronavirus vaccine. After application and approval of an Emergency Use Authorization (EUA), supplies are expected by early April.
  • The placement of teachers in the hierarchy of the statewide plan considers this group to be an essential worker, which is the next group to be included, but focuses on those 50 years of age or older. Schools are seen as low-risk environments according to the epidemiology. As supplies increase, teachers of all ages will be included. Many of the details in the state’s plans are difficult to operationalize for local health officers.
  • Serious reactions are very rare with this vaccine, so if this occurs for an individual on the first inoculation, they are advised not to get the second shot. It is critical to know why a person reacted, to determine if another vaccine is more appropriate, especially if they reacted to a component of the vaccine.
  • The timing of the second dose can be either a few days early or up to 6 weeks after the first dose, according to a newly published CDC document.

Willie Bence’s response to our current situation:

  • He thanked the many residents registering to help with future vaccine clinics. About 200 non-clinical residents applied as well as 40-50 clinical volunteers. The goal is to register a lot of volunteers, as work shifts require a volunteer to be on their feet all day, which is about walking 7 miles for those directing traffic. He stated this needs to be a whole community effort with lots of residents taking turns for several months.
  • Jefferson HealthCare continues to be the most up-to-date site for vaccine appointments. He encouraged all persons 65-75 years of age to sign up on this website to be notified when appointments become available. In the future, the county may become the central site for information, especially if more entities apply and get approved for vaccine allocations in our county.
  • Residents can refer to the state website for metrics pertaining to the progression to the next phase for re-opening our economy. The next date for calculations is Feb 12, with implementation to begin on Feb 15.