County Public Health Report ~ 3/15

The following is a summary of the presentation made by Dr. Tom Locke, our local Public Health Officer and Willie Bence, Director, EOC, Jefferson County, during the Public Health briefings at this week’s Board of County Commissioners (BOCC) meeting:

General Comments:

  • Nationally, new COVID-19 cases continue their downward trend, with the caveat that cases have plateaued with an average 55,000 new cases for this last week, which represents a 19% decrease from the previous two weeks. Hospitalizations and deaths also continue to decrease. These downward trends of new cases still remain above the numbers seen in the initial two months of the pandemic as well as the second wave during the summer of last year.
  • Washington state has followed trends similar to the national picture. New cases have declined 15% in the last two weeks with an average of new cases just below 700 a day. Washington ranks 47th among all states with the lowest metrics, along with Oregon and California. New cases in our state are 140 per 100,000 population. This trend may be temporary as more and more restrictions are lifted. Increases in larger group events such as sporting and higher capacity indoor dining have forced some European countries to impose more restrictive measures as they brace for an increase of new cases (a 4th wave), when protective measures were abandoned prematurely.
  • Of great concern statewide is the increase of the UK variant now found here, as increased genetic sequencing testing on nasal specimens occurs. The UK strain accounts for about 20% of all new cases in the United States. Washington so far has detected 100 cases of the UK variant, which is known to be more transmissible to others, and more difficult to control. This variant is expected to be the dominant strain in Washington by late March or early April. Another concern was reported by Dr. Lindquist, the state Epidemiologist for Washington’s Department of Health, regarding an increase of new cases in the 20-39 year old age group. This continues to be an effort to balance lessening restrictions and the accompanying less cautious human behavior, with vaccinating as many persons as possible.
  • This last weekend, Jefferson County ran a mock mass vaccination clinic in Chimicum in anticipation of new tiers being added to the list of those who could get a vaccination, as well as the steadily increasing supply of vaccine doses delivered to this county. This vaccination clinic is a partnership between Public Health and the Department of Emergency Management (DEM).
  • Dr. Locke explained that Jefferson County still continues to suppress the circulation of this virus with 336 cases to date and a caveat about how public health counts cases in this pandemic, which sheds light on the most recent case added to our count. Cases testing positive with PCR testing are considered “confirmed” cases, while “probable” cases reflect persons testing positive with the less accurate rapid tests, without known exposure to a confirmed case. Both classifications are reported in local, state and national statistics. One case locally falls into this later “probable” category and was found upon surveillance for infection with a rapid test.
  • Neighboring counties also continue to demonstrate suppression of circulating viruses in their case data. Clallam County has 37 new cases per 100,000 population, with Kitsap at 64 and Mason at 65 new cases, respectively, per 100,000 population.
  • Dr. Locke also added that metrics used for recovery stages and re-opening phases will change at the state level. Gone are the percent of case positivity measures. The focus will be on changes in new cases per 100,000 population and hospitalizations for each county, based on a threshold population either above or below 50,000. Regional grouping with other neighboring counties will also cease as of next week when considering progression to reopening to higher indoor capacity and allowable activities.
  • Vaccinations statewide are at or above 45,000 doses given each day, with 19% of all Washingtonians having received one dose, and 11% being fully vaccinated. Locally, 35% of residents have received their first dose, while 19.4% are fully immunized. Only Clallam county beats us with nearly quarter (23%) of residents with full vaccinations.
  • Dr. Locke again expressed the goal of getting the vaccines into arms as soon as they are delivered to Jefferson County from the state. However, there will be a new allocation system which will adjust the number of doses to this county in the next few weeks ahead, to be sure other counties have their fair share to date. Jefferson County received a full vaccine as ordered this past week and will share some of this supply with Public Health for the vaccination clinic in Chimicum this weekend.
  • A significant supply of the Johnson & Johnson vaccine is expected to be available sometime in April. It has become more popular as it only requires one dose and provides the same protection against hospitalization and death as the other two vaccines. Thousands of doses are expected nationwide for this vaccine in May and June.
  • On Wednesday of this week, more groups and individuals will be eligible for available vaccines. Currently all persons in 1A – 1B (Tiers 1 and 2) are eligible for vaccinations. The next group to be eligible is 1B-Tier 3. Those in Tier 4 can expect to be eligible near the end of April. Those healthy, who do not qualify earlier by the WAPhaseFinder hierarchy can expect to receive the vaccine by May. The tiers are designed on epidemiology factors of risk of severe disease and death either by age, occupation or comorbidities. Details can be found in the Washington state WAPhaseFinder.
  • Restaurant workers have not been prioritized higher than the general public due to the lack of evidence of outbreaks among restaurant workers. The primary risk in indoor dining settings has been the higher risk to other diners. And locally, outbreaks have been among gatherings of unrelated, non-household members. The CDC has placed restaurant workers in the lowest tier.

KPTZ listener’s questions:

  • Regarding the ethics of crossing county lines to get vaccinated, some facilities, such as the Jamestown Health Clinic, have not put restrictions on who is vaccinated, as they are a sovereign nation. Their goal is to get vaccines into anyone who goes through their drive-thru clinic, including anyone in the car. Just recently, all the vaccines available in the drive thru have not been used. Jefferson County will monitor usage of any local clinics and may consider adjusting plans if available vaccine doses slow down or go unused.
  • Pharmacy now accounts for about 19% of all vaccines delivered in Jefferson County. Some residents have received doses when not in priority category through “leftover” doses at the end of the day. All vaccine clinics, in an attempt to not waste doses, have lists of persons to call who may be next in line when a person has not shown up for their appointment, or has canceled with short notice. Once vaccines are prepared for the day, they must be given within a specified time period. Dr. Locke stated it requires a bit of luck to get a vaccine in these circumstances, and second doses are guaranteed in these situations.
  • For those fully vaccinated, the CDC guidance is specific in keeping small gatherings and types of activities in detailing “safer” scenarios. Those in this category are advised to think of all the activities, and need to keep in mind no situation is without risk. Although not specified in the CDC guidance, Dr. Locke would consider below 30 persons would be a medium size group and upwards of 200 a large group. Singing with others close by, so as to hear each other, would be pushing the envelope on what could be considered safe. All elements of numbers, type of activity, closeness, setting and ventilation must be considered.
  • Monoclonal antibody treatment, nicknamed BAM, is available through Jefferson Healthcare as well as other standards of treatments for those with more severe disease progression.
  • All vaccines in current use are authorized under the FDA’s Emergency Use Authorization (EUA). Full approval involves application to the FDA for full approval and involves submitting detailed documentation regarding safety and efficacy data. Pfizer has indicated its intention to submit an application in the near future, similar to their briefing reports submitted for their EUA last November. There are over 30 million people who have received vaccines at this point in time, supplying sufficient data points for evaluating this vaccine for full approval.

Willie Bence, Director, Department of Emergency Management (DEM):

  • This weekend was spent preparing for the first mass vaccination clinic sponsored through Public Health and the DEM. The clinic is set to run this Sunday, March 21, details to follow. They expect to have 300 doses available of the Moderna vaccine.
  • The clinic is by appointment only based on the current eligible populations specified in the WAPhaseFinder. More dates will be added week by week, as the vaccine supplies are confirmed. The goal is eventually to have about 600 doses each day a clinic is scheduled. Appointments can be made through the DEM Vaccine phone line at 360-344-9791.
  • These clinics are all volunteer lead and staffed by community members. This means that volunteers will be needed for the next several months. Volunteers can sign up for future clinic needs at [email protected].
  • Medical staff is also encouraged to apply at the above email address. Only those wishing to give vaccinations must have an active medical license in Washington. Retired medical practitioners from other states or non-active licenses can volunteer in roles that need a medical background, such as monitoring post vaccination reactions in patients or reviewing medical questionnaires with those waiting to be vaccinated.
  • For those applying to volunteer, the DEM is trying to respond to your inquiries within 48 hours, but be patient as many community members have stepped forward to help. The weekend clinics need as many as 100 volunteers every weekend, so there will be a role for all who want to help. Volunteers will still be needed for the Jefferson Healthcare site as well, which is running 6 days a week, with 300-350 patients receiving a vaccine.

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