Increase of COVID-19 in Pierce County threatens move to Phase 3. Can we slow it down?
Story has been updated with Saturday’s new case totals.
It wasn’t long ago that Pierce County‘s new cases of COVID-19 had slowed to a trickle.
During mid-May and early June, confirmed cases reported daily hovered in the single digits. Social distancing prevailed as most businesses remained closed.
Phase 2 took effect for Pierce County on June 5, expanding openings for malls, more businesses and drinking/dining establishments.
It didn’t take long for confirmed COVID-19 cases to begin to rise.
Last week, the county had seven new outbreaks at congregate care facilities, construction businesses and a child care facility. That’s up from one the previous week.
The target, according to the health department, is fewer than 2.
On Wednesday, the health department reported that new cases had pushed past 40. Thursday it was more than 30. Friday, 23. Saturday: 55.
On Friday, the director of the Tacoma-Pierce County Health Department announced he would recommend an expansion of Phase 2, instead of applying for Phase 3 and its loosened restrictions on businesses and events.
Welcome to the coronavirus roller coaster in Pierce County.
Phase 2.5
The expanded Phase 2 proposal, if approved, would allow outdoor gatherings of up to 25 people for social and recreational purposes, according to the health department’s announcement on Friday.
It would not allow recreational activities such as team sports and swimming at public pools where respiratory droplets, blamed for the spread of COVID-19, are more likely to be released.
It would limit indoor gatherings to five people per week outside the household. Libraries and museums would operate with physical distancing and Phase 3 safety plans.
All other businesses and religious services would stay under Phase 2 requirements.
Dr. Anthony Chen, director of the Tacoma-Pierce County Health Department, said Friday the county has increased testing and contact tracing capacity, but more work needs to be done before he could recommend a move to Phase 3.
“We do not want to rush to open when we continue to see an increase in COVID-19,” Chen said Friday in a statement announcing the proposal.
“Pierce County residents have remained strong and have stuck together so we can move through these phases of re-opening. Proposing an expanded Phase 2 is the right choice for our health and the right choice for our society and economy,” Chen said.
As Pierce County officials prepare to consider the proposal July 1, the surge in new cases show the pandemic isn’t loosening its grip.
A changing landscape
While it was alarming to see the higher number of cases in recent days, it bears noting not all new cases are equal in terms of level of illness severity.
More than Phase 2 has changed the landscape.
With testing now more widely available to the general public, “we are seeing a little lower percentage in terms of the people diagnosed who wind up in the hospital,” said David Carlson, MultiCare’s senior vice president, provider enterprises and chief physician officer.
Those who do wind up in the hospital now are still “very ill,” Carlson told The News Tribune in a phone interview Friday. “That part hasn’t changed.”
And asymptomatic spread remains a continued threat.
The Washington Department of Health this week noted the rise in local cases was not the result of expanded testing.
Its situation report as of the evening of June 25 stated that “in King, Snohomish and Pierce counties, we see a recent upwards trend in daily COVID-19 positives. Interpretation of this trend is difficult given the recent increases in testing volume in King County; however, the upward trends in Snohomish and Pierce counties are not accompanied by a large testing volume change, suggesting that the upwards trends are connected to increasing transmission across the Puget Sound area.”
It added, “Our findings in the Puget Sound area highlight the state’s precarious position overall, despite the difficult-to-quantify uncertainties associated with the effects of new masking and testing measures.”
While there has been expansion in testing in Pierce County, it’s still short of the “Number of People Tested per Positive Result” on the Safe Start dashboard, according to Stacy Page, COVID-19 communications lead for the health department.
The target is 50 tests for every positive case reported.
“On the dashboard, it is 37.9 as of June 7-13. We will update this number weekly, and we expect this number to worsen,” Page said.
Another measure the county isn’t quite reaching is the percentage of infected people contacted within 24 hours of a positive lab test result, 76 percent vs. a target of 90 percent or more. That’s not entirely the department’s fault, according to Page.
“We are working at improving the consistency of our process and training more case investigators to reach out to quickly contact the increased number of cases. We analyzed our data and found that most of the people we were not able to reach were for reasons beyond our control,” Page told The News Tribune. “For example, incorrect phone numbers or not everyone answers when we call. This influences our ability to meet this target.”
By the numbers
The Tacoma-Pierce County Health Department included other additional details this week on its COVID-19 tracking page. One involves community spread and percentage of cases not linked to others.
The more cases not linked, the more random course the virus is taking.
That measurement, not part of the official Safe Start metrics, was added as additional information the state Department of Health asked the county to report. DOH did not set a target or threshold, according to Page.
“Cumulatively, about three-quarters of COVID-19 cases do not have a link to other cases,” Page told The News Tribune on Friday in response to questions. “For the first two weeks of June, the percent fell to 66 percent. We are now at 48 percent. This is headed in the right direction.”
Still, no one’s declaring victory just yet.
“We’ve had a couple of pediatric cases that have been hospitalized,” Carlson said, “The distribution of illness is broad, so it’s affecting all age groups.”
It’s also affecting the whole county, which has seen 2,466 cases and 87 deaths as of Saturday since the first case was reported March 6.
Here’s a look at Friday’s number of cumulative cases since the start of the pandemic as compared with June 5 numbers for the same locations in parentheses:
▪ Bonney Lake: 51 (48)
▪ Central Pierce County: 161 (146)
▪ East Pierce County: 62 (58)
▪ Edgewood/Fife/Milton: 108 (93)
▪ Frederickson: 80 (66)
▪ Gig Harbor area: 65 (55)
▪ Graham: 74 (64)
▪ JBLM: No longer reported
▪ Key Peninsula: 11 (7)
▪ Lake Tapps/Sumner area: 66 (50)
▪ Lakewood: 249 (209)
▪ Parkland: 138 (120)
▪ Puyallup: 167 (143)
▪ South Hill: 124 (105)
▪ South Pierce County: 47 (38)
▪ Southwest Pierce County: 28 (21)
▪ Spanaway: 82 (66)
▪ Tacoma: 778 (649)
▪ University Place: 100 (69)
▪ Unknown: 20 (11)
In a blog post earlier this week, Chen acknowledged that no single group was to blame for the rise in cases, noting, “Pierce County, it is all of us.”
Hospitals ready for surge
The health department and the two health systems in Pierce County, MultiCare and CHI Franciscan, told The News Tribune in separate responses that they were confident in the county’s hospital capacity.
That includes, the health department noted, 500 surge beds if a surge of new cases did come in.
Pierce County Emergency Management has several weeks’ supply of personal protective equipment to draw from.
Representatives for CHI Franciscan said items in its PPE supply, including masks, respirators, isolation gowns, gloves and goggles, ranged from 68 days to 500+ days.
Representatives for MultiCare said it had a 14-day supply of PPE on hand, including N-95 respirators, surgical masks, face shields, gloves and gowns, with some of its glove supply stored with its vendor.
In terms of beds and supplies, “we’re very comfortable where we are,” Carlson said.
He noted that MultiCare currently is treating about 26 COVID-19 patients in its system statewide, with about 15 in this area, including one from Yakima County, which saw a surge in cases peaking in late May.
“In the worst of the crisis here, early on, we had right around 100 patients with COVID-19 in our hospitals, which were by no means full ... I’m comfortable that we have the capacity,” Carlson said.
“I do think, and this is an informed guess, as I’m watching and seeing these patterns that have emerged before, in the next couple of weeks, we’ll see a moderate increase in the number of hospitalizations. ... It’s not a tsunami, it sort of marches up in this slow, steady progression, so you can feel it coming.”
It’s also summer, when illnesses such as flu and pneumonia generally are in retreat.
“I do worry about the fall, when we get into the next respiratory season,” Carlson said.
Working together is key
It will take the community working together to lower the numbers again, Carlson noted.
“If you look at places around the world that have done really well, they did a couple of things we haven’t done well. They’re just the basics — it’s pandemic blocking and tackling,” he said. “Identify someone who has the disease, isolate them, treat them, and for the society to work toward all the preventive measures — physical distancing and masks.
“Their society and their leadership has been in sync for the greater good.”
Carlson cited Japan, South Korea and notably New Zealand, which sought elimination of the virus and as of this week was down to just 10 active cases.
“There’s not been a really strong, consistent approach ... that’s done all of these things effectively for a long period of time,” Carlson said of the United States. “You have communities that are doing well, but, in general, we’ve not taken on those measures.”
Masks, masks, masks
Wearing masks has been one issue where inconsistency is hurting, Carlson said.
“Speaking broadly, if you go out and about, you see varying use of masks,” he said. “In the absence of being able to be physically distant from people, everybody wearing a mask is a highly effective way to reduce the transmission of this disease.”
At least one union representing essential workers at grocery stores, warehouses and in health care has joined the campaign to promote mask use.
Faye Guenther, president of UFCW 21, took part in Gov. Jay Inslee’s news conference Tuesday when a new statewide mask initiative was announced.
UFCW nationwide has taken on several labor causes in the pandemic, not only seeking better wages for its workers, but also for restored hazard pay, creation of a national registry accessible to the public to log COVID-19 cases in front-line workers and to require face coverings worn by customers.
On Friday, Guenther sent a statement to The News Tribune on the effects of the pandemic on her union members.
“Essential workers face higher risk of exposure to COVID-19 in order to serve our communities,” she said. “We’re very glad the public is joining in, and we appreciate the governor’s proclamation because face coverings are most effective when we’re all wearing them to protect each other.”
Carlson reiterated what’s important at this point.
“Keep physical distance, stay home if you’re sick, keep your social circle with people that you know really well and you’re comfortable with that are doing the same things that you’re doing, and wear your mask,” he said.
And, prepare for fall, and the flu, which could add even more stress on the hospitals, testing and medical supplies.
“It is super important that everyone gets a flu vaccine this year,” Carlson added.
This story was originally published June 27, 2020 at 7:00 AM.
