Today, February 8, 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.

Submit your Public Health questions to Dr. Tom Locke 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.

General Remarks:

• Nationally, new COVID-19 are declining rapidly, noting a 31% drop from two (2) weeks ago, with an average of 118,000 new cases a day, which was last seen in November 2020.  There has also been a decline in COVID-19 testing, suggesting many actual cases may go undetected. 
• Washington, having seen a surge in December and January, has seen a similar drop (27%) in new cases detected, with 298 cases per 100,000 population and 7% case positivity.  Washington state ranks third (3rd) in the nation behind North Dakota and Hawaii in the decline of new cases. 
• As of this day, Jefferson County has reported 321 cases, up from the previous two (2) weeks. Our case rate now stands at 125 per 100,000 population, up from 72 per 100,000 population in the previous reporting period, with an increased case positivity of 4.46%.  Increased cases are driven by cluster outbreaks, with 23 cases within a contained, non-public setting and the others by small non-household gatherings. These clusters, investigated quickly, limit spread to the wider community, making containment possible when close contacts are quarantined prior to testing positive. Dr. Locke reaffirmed the efficacy of the PCR test with regard to the cycle threshold (Ct) criticism mentioned during public comments today. 
• Neighboring Clallam County has 82 cases per 100,000 population with 3% new case positivity.  Kitsap County reported 132 cases per 100,000 and 5.7% new case positivity, while Mason County recorded 143 cases per 100,000 population and 8.1% new case positivity. 
• Vaccine supplies from the state continued to be limited, with 5,945 vaccinations given by Jefferson Healthcare(JHC) to date, while local pharmacies have vaccinated an additional 890 county residents. Our allotments locally have been reduced temporarily to give previously under-allotted counties their fair share. Currently, nearly two-thirds (2/3rds) of supplies ordered have been left unfilled. Vaccine allotments and shipments are expected to stabilize towards the end of February with an expectation that counties will know the allotment quantity weeks ahead of planning appointments.  Although JHC is set up to vaccinate large numbers of residents a day, they have not received a supply for prime doses for a few weeks.  This is expected to be resolved over time, with expectations of receipt of supplies to match the demand for vaccinations, including the Johnson & Johnson vaccine candidate that is seeking an Emergency Use Authorization (EUA) hearing from the FDA scheduled for February 27, 2021. 
• Three (3) variants currently found in the US, discovered by genomic sequencing, are being tracked. Mutations in viruses are expected due to the high frequency with which they replicate, however, these changes appear to make these variants more readily transmitted to another person by as much as 30%.  These strains have varying sensitivity to the current vaccines being used. Hence, strenuous control efforts need to be increased, to reduce chances for replication and the virus “escaping” the vaccines’ mechanisms of mounting an immune response. 
• The current focus to reduce the spread of the new variants revolves around  improving the science behind masking design and use.  Guidelines for a better fit, improved filtration, and source control will be addressed by a new statement from the CDC to be released soon.  Dr. Locke warned that face shields only provide eye protection from flying debris and are useless to protect from infection or as a mechanism for source control.  Surgical masks, now more widely available, worn under cloth masks reduce your risk of infection and better protect others. He expects these protective measures to continue for the next few months, until a steep and sustained drop in new cases occurs.  
• Dr. Locke addressed residents going to other county pharmacies to get the vaccine. He stated the counties were not in competition as the goal is to get as many residents vaccinated as soon as possible, although he cautioned that getting the second (2nd) dose should be given at the same site of the first (1st) dose. He noted that Mason County ranks first (1st) in completion rate of both vaccine doses delivered,  while Clallam County, supplemented by vaccine supplies from the Jamestown Family Health Clinic, ranks first (1st) among all counties in rate per 10,000 residents vaccinated for the prime dose.

KPTZ listeners questions:

• The proposed revamping of health board regions by the Governor was purported to be linked to an area’s healthcare and hospital surge capacity, but does not appear supported by epidemiological data, per Dr. Locke. Plans are still being considered in senate committees, with an eye toward significant funding of public health infrastructure to possibly come from the health insurance system, in recognition of the long-standing, under funding of this vital disease prevention program.  
• A new COVID-19 test kit will soon be available for home use. This new device uses a link to your smartphone, reports the results to the state DOH, and in combination with symptoms, reliably indicates infection.  Sensitivity of this COVID-19 test (the reliability of a true indication of infection), remains dependent on when the test is taken in your disease process.  
• Currently, individuals who are over 75 years, or undergoing chemotherapy, or other complicated medical conditions remain the focus for prime vaccinations as supplies permit. Jefferson Healthcare is using its current patient database to identify these individuals for appointments or when next they interact with the healthcare system to provide the prime dose.  Unidentified high-risk elders are encouraged to contact their primary care provider for assistance in getting in the queue for a prime dose. 
• With vaccine supplies limited currently, appointments for those in the 65-74 year old age cohort may have to rely on area pharmacies to provide vaccinations, as Jefferson Healthcare is still allowing appointments only for the 75 year old and up age cohort, due to their high risk of severe disease progression and death.   
• Timing of the second dose of the vaccine series can be reasonably delayed and still provide expected protection from severe disease and death. It does not need to be matched exactly to manufacturer’s time frame, but should not be a problem if vaccine supplies are limited.  Most vaccine providers are making appointments for the second dose when the prime dose is delivered, however, actual vaccinations are supply-dependent at this time. 
• The question of transmission of the coronavirus to others once you have been vaccinated has not been thoroughly studied, as this is difficult to study and carry out.  There is some preliminary, non-peer-reviewed data that suggests interruption of transmission is possible with a vaccine currently in clinical trials, AstraZeneca. It’s not exactly clear at this point in time, but may be an unexpected benefit of the vaccination.
• Clinical trials are currently enrolling teenagers to answer questions of safety and efficacy. Pfizer is studying 12 to 16 year olds, with Moderna enrolling 12 to 18 year olds. It may take until the summer to have initial data for the older age groups.  Children 11 years and under typically have very mild symptoms and may not be involved in clinical trials in the near future. 
• Vaccines developed by Moderna and Pfizer used messenger RNA technologies to create their vaccines, which delivers a bit of the genetic code to cells, providing the RNA recipe to make surface spike proteins which activate your immune response. It requires a prime dose and a final dose within 3 to 4 weeks of the first dose.  The Johnson & Johnson and AstraZeneca vaccines use a more common technology called viral vectored vaccines. This method uses a harmless adenovirus engineered to carry the genetic code for the SARS-Cov-2 spike protein into cells and requires only one dose.  All these vaccines prevent progression to severe disease and death, have side effects similar to seasonal flu vaccines, and can be reformatted easily if regional variants become predominant in an area. 

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

• State medical licensing boards are allowing medical practitioners in retirement, without a current license, to apply for emergency authorization during this pandemic to assist with mass vaccination efforts. So the medical pool for these events has grown.  Non-medical volunteers have also stepped up to volunteer, although the current need has been filled.  Mr. Bence stated that 112 shifts were filled in about 4 hours, demonstrating the willingness of this community to support the goal of mass vaccination events as the supplies increase over time, providing us a prospective view of this long-term commitment.  
• President Biden has enacted changes to the Stanford Act by Executive Order that will allow states and counties to recover more of their local costs due to this pandemic. Counties can now recover 100% of their costs through FEMA and our local DEM is currently reviewing their costs and will resubmit their documents for more reimbursement, which means the traditional 25% local match is recouped by our county.  This is retroactive to January 2020, the start of the pandemic.