County Public Health Report ~ 5/03

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 meeting:

Today, May 3, 2021, our local Public Health Officer, Dr. Tom Locke shared his assessment of the pandemic in Jefferson County and answered questions submitted by KPTZ listeners.

General comments: 

  • Nationally, the pandemic picture shows a leveling of new cases, dropping about 27% from the previous two weeks. This trend continues to be driven by the decrease in new infections among the states in the upper Midwest, as well as the states along the Atlantic seaboard. Washington and Oregon’s new cases have begun to level off, with Washington recording a 3% increase of new cases for the last two weeks. The fourth wave has peaked and now is trending slightly downward.
  • Although the rise of new cases has slowed and in some areas new cases are continuing to decline, the newer variants continue to severely affect different geographical areas, such as India and South America, where the epidemic continues to take its toll on human life and medical resources.
  • Hospitalizations in Washington continued to increase (24%) over the previous two week period, with 250 cases per 100,000 population, still not under the threshold of 200 per 100,000 population needed to remain in Phase III of the RoadMap to Recovery Plan for larger counties. Counties along the I-5 corridor remain the center of the epidemic for this state, with the recognition that the fourth wave has likely peaked and that new cases will continue to decrease as more residents get vaccinated.
  • May 3 marks the day Washington State would have announced any rollback to Phase II for those counties not meeting the state’s thresholds in controlling community spread. It has been delayed until Tuesday to give Governor Inslee more time to consider the public health impact such measures would bring, as well as data collected over the weekend. There has been no hint as to whether the Governor will strictly follow the RoadMap or if input from public health leaders will guide the actions to be taken at this juncture, when wider vaccination availability could further limit community spread. Larger gatherings and indoor activities such as indoor dining continue to be high transmission risks for the community.
  • Jefferson County reported 19 new cases in the last two weeks, with six reported over the weekend, bringing our case rate just under 60 per 100,000. Kitsap reported 213 per 100,000, with 7.9% case positivity, with recent cases diagnosed in Jefferson County having exposure to cases in Kitsap County. Clallam County remains steady at 103 per 100,000, after recording outbreaks among three large gatherings.
  • Approximately 5.4 million Washington residents have received the COVID-19 vaccine, with Jefferson County leading in the highest numbers (50%), followed by San Juan and King County. One third all Washington residents live in King County and they are third in the state for the highest number of first doses received. If just considering 16 years of age and older, then Jefferson has 55.4% of its residents fully vaccinated. If just considering first doses, Jefferson has 70% of its residents vaccinated.
  • Vaccine hesitancy remains a challenge, with one-third of the US population stating they will not be vaccinated and about 7% willing to consider the vaccine.
  • This was evident in the recent clinics offered in Jefferson county where available doses were not used (54 doses out of 100 doses available). Men nationwide seem to be the biggest group opposed to the COVID-19 vaccine, not as a lack of knowledge, but a stance of belief. This group would most likely not be influenced by public health messaging campaigns, but may be influenced by close family members, family physicians or pastors.
  • The concept of herd immunity for a unique infection is not precisely known, but is based on the evidence of infectiousness of a particular disease. Generally, as infectiousness increases, herd immunity needs to be increased. Originally, herd immunity for the novel coronavirus was established as 70% or above of all residents needing to be vaccinated. With the wider circulation of more infectious variants, the herd immunity needs to be increased to 80% or above. If vaccination efforts stall, then herd immunity will not be reached. We would likely have repeated outbreaks, versus the surges we have experienced the last 16 months.
  • It will be important in any message about vaccinations to focus on the reality of our situation, such as increasing dominance of more infectious variants, and when cases increase, exposure increases. Additionally, herd immunity is achieved either by actual infection and/or vaccinations. Consequences of actual disease need to be included as well as adding the information we are gaining with the actual immunity provided upon being fully vaccinated. It will require the additional aspect of not just the advantage to one’s own personal health if vaccinated, such as preventing the most devastating consequence of hospitalization and/or death, but the benefit to the community as a whole.
  • Some resistance may be rooted in the difference between actual infection conferring immunity and that provided by the vaccine. Acknowledgement of what we know is key when someone may doubt the benefits of the vaccine. COVID-19 disease and the vaccine are new and so we don’t have extensive specific experience, however, we do have knowledge of infectious diseases and immunity in general. We know that the degree of antibody development is related to severity of the illness, as we can measure antibody titer (presence and level of antibodies in the blood) during onset and recovery, but the severity of this infection brings more risk than is currently documented if you get the vaccine.
  • Misinformation about the pandemic and vaccines will be addressed by Dr. Locke at the next meeting of the local health board. It is important to be truthful and honest about what we know in general and specifically about COVID-19. Our knowledge about infectious diseases guides our understanding about the current pandemic, as well as the vast experience with the safety and health benefits of vaccines. Our internal quandary with vaccine hesitancy is a stark contrast to how many countries internationally are envious of our access and availability to these safe and effective treatments and vaccines.
  • One of the Commissioners was concerned that navigating getting a vaccine is still confusing to many residents, possibly too many options with limited access. Wastage of vaccine doses is partly to blame for this situation, due to the reality that once a vial is opened, it must be used in a specific time frame, thus needing an appointment strategy. The vaccine supply is now being disbursed to pharmacies who may adopt a daily clinic based on doses in vials and regular walk-in hours as we go forward. Once the doses are used, the clinic will close. The best website for information remains on the Jefferson County Public Health website. The Department of Emergency Management continues to operate the vaccine phone line to assist residents at 360-344-9791. A new option has also been added: type 438829 into a text message and receive information on sites available near you who have available doses.
  • Family gatherings with fully vaccinated members in other areas pose limited risk , but Dr. Locke asked those traveling to other areas to know the profile of the destination, and assess the risk of exposure to themselves or others. Don’t necessarily restrict yourself, just consider the risk of the activities you expect to do and apply the recommendations of public health officials in always trying to layer the safety for yourself and others, like utilizing outdoor settings with limited attendees.

KPTZ listener’s questions:

  • All persons 16 years and up receive the same dose of the COVID-19 vaccine. It is not based on weight, sex or co-morbitities. The main goal is to have enough of the vaccine component that stimulates your body to mount an immune response. Typically children 6 months and older receive an altered amount of the vaccine component based on the maturity of their immune system, but in most vaccines available now, those aged 12 years and older, receive the same dose as older individuals.
  • Public toilets could pose a risk because they are usually poorly ventilated, not because the COVID-19 virus can be passed by touching a contaminated surface. Poor ventilation keeps airborne infected droplets floating in the environment. Although it has been postulated that high pressure flushing could become aerosolized from human waste when flushing, this has not been the likely source of outbreaks or clusters of infection. The advice is to take care of your business and exit the public restroom quickly, being sure to always wash your hands.
  • A breakthrough COVID-19 infection has been confirmed in Jefferson County this week. Infections in fully vaccinated persons is expected by public health officials as the vaccine is not 100% protective and the vaccine may be less efficient as we age. Breakthrough infections tend to be less severe when you are fully vaccinated.
  • Friends that state the vaccine may affect their pregnancy and fertility may be misinformed. There is no evidence to date that the COVID-19 vaccine impacts the ability to conceive. While there is no long-term evidence about impact on fertility, pregnancy is a complication if a woman experiences a concurrent COVID-19 infection, suffering more severe disease progression, hospitalization and death. The risks of COVID-19 complications during pregnancy far outweigh the risks for vaccination while pregnant.
  • The current COVID-19 vaccine is protective against many of the variants circulating, especially the two California and the British variants of concern. While all vaccines are designed to stimulate an immune response, some variants reduce the effectiveness of the vaccine response. For those breakthrough infections, these are often sequenced to follow the spread of these variants.

Willie Bence, Director, Department of Emergency Management:

  • Efforts to reach specific areas of the county are proceeding with a pop-up clinic in Brinnon this past weekend. Available appointments are not currently being filled. While 100 doses of Moderna were available, only 54 doses were dispensed. Outreach for the community is coordinated through local means of notification, such as word of mouth or through the Fire Department. An additional clinic was held at the Catholic Church in Port Townsend for Spanish speaking residents, with 15 persons receiving their vaccinations.
  • Clinics at Chimacum schools are filling appointments for Moderna second doses for May 15 and May 22 in the mornings. There are also clinics through Jefferson Healthcare this Thursday for the first dose of Moderna, as well as a Friday morning clinic for the Johnson & Johnson vaccine, with 150 doses available. Several pharmacies also continue to provide vaccine doses each day and appointments are needed.
  • Expect a press release soon regarding the opportunity to receive the J & J vaccine during the Chimacum May 15 vaccination clinic.
  • Homebound residents have also been served this week with 8 doses given. The public is encouraged to help homebound neighbors call the COVID-19 Vaccine Phone Line at 360-344-9791 to enroll in the mobile outreach clinic. The staff will utilize the mobile clinic and travel to the residents home to provide the vaccination.
  • The clinic has already exhausted their list of homebound residents, but will continue to take names for the next mobile home visits, to be scheduled.
  • The Department of Emergency Management continues to work with other community organizations who serve or assist unique populations that want the vaccine, such as homeless residents. DOH is providing guidance to public officials as to which vaccine provides the greatest confidence and likelihood of getting the vaccine for these affected populations.