County Public Health Report ~ 3/22

Today, March 22, Jefferson County Public Health Officer Dr. Tom Locke shared his assessment of the pandemic in Jefferson County and answered questions submitted by KPTZ listeners. Department of Emergency Management Director Willie Bence also gave an update on current Emergency Operations actions, in light of the most recent developments.

General Comments:

• Nationally, new COVID-19 cases continue their downward trend, with the caveat that cases have plateaued with an average of 54,000 new cases for the last two weeks, with hospitalizations and deaths also decreasing. These downward trends of new cases still remain similar to the metrics recorded last summer, indicating the amount of circulating virus is higher than the initial surge of cases in March and April of 2020.
• Although Washington has seen a 9% increase in new cases statewide, with 126 per 100,000 population, western states continue to demonstrate lower metrics than the rest of the country. 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.
• Today, the entire state progresses to Phase III with restaurants allowing diners at 50% capacity within the restaurants as long as they are able to meet all the mitigation requirements, as well as sports and movie venues.
• Jefferson County has 344 cases to date, with 8 cases recorded in the last two weeks, reversing last week’s rate up to 25 cases per 100,000 population. Five of the new cases were within one family, who were already in quarantine when additional family members tested positive, lowering the likelihood of wider community transmission.
• Neighboring communities are also continuing to maintain their new cases at a lower rate. Clallam stands at 33 new cases per 100,000, while Kitsap recorded 77 new cases per 100,000 population in the last two weeks.
• New measures go into effect today which will determine each county’s ability to progress with reopening their businesses and activities. Case rates per 100,000 for large counties need to stay at or below 200 new cases for the last two weeks, while smaller counties with 50,000 residents or less need to remain at 30 or below, with no more than 3 hospitalizations during the same two-week period. Dr. Locke, as well as his fellow Public Health Officers, are advocating smaller numbers for new cases and hospitalizations as the metric threshold may be too liberal to contain transmission as we increase density for indoor businesses and events. The goal with a phased reopening is to suppress and maintain lower circulation of the virus and new variants as we gradually increase indoor capacity and certain other types of community gatherings.
• Jefferson County has delivered 17,606 vaccine doses to date, with 80% of all residents 65 and older with at least one dose of the vaccine, and 24% percent of the total population fully vaccinated. Washington has delivered 2.6 million vaccines in its residents arms, with 22% initiating a series and 12.5% fully vaccinated statewide.
• Last Sunday, the joint collaboration of Jefferson County Public Health and the Department of Emergency Management conducted the first of several planned mass vaccine clinics for county residents at Chimicum High School. Dr. Locke praised all involved in planning and volunteering for this event. The clinic was able to deliver 318 doses to those who signed up for appointments, as well as a few volunteers, so they would not waste any doses. As this site plans for further doses of vaccines, Dr. Locke stated that most likely morning appointments would be reserved for first doses and afternoons would take appointments for second doses. In the near future, clinics will be scheduled for Saturdays when vaccine availability is known.
• Vaccine supplies may be limited or not increase for the next 2-3 weeks as adjustments are made statewide. The next tier for eligibility is scheduled to be opened March 31st and will drop to Phase 1B, Tier 3 & 4. Supplies are expected to increase by mid-April and be more available by May 1. Each new tier that opens will outstrip our capacity at any of the vaccination sites and pharmacies to provide vaccines to those who want them.
• Dr. Locke advises all residents to use the state’s WAPhaseFinder website to check if you are eligible to schedule an appointment for the vaccine. The county Public Health site has all available vaccine sites listed, as well as their website links. As of Monday morning, both these sites had appointments.
• Dr. Locke spoke to recent evidence that some residents receiving their first vaccine in a two-dose series, have not returned for the second dose. He suggested that some individuals may fear the reported side effects with the second dose. He encouraged everyone to keep the appointment for the second dose as your duration of protection is improved when you complete the series.
• If your are fully vaccinated AND you are experiencing typical COVID-19 symptoms, Dr. Locke asks you to get tested. There have been about 100 people in this state who have been confirmed with COVID-19 infection after receiving a vaccination. This is due to the fact that not everyone develops sufficient protection from this vaccine, as the 92-95% efficacy means that about 5-8% of the time, vaccinated persons may not benefit from the vaccine’s protection: the majority will, but some may not. Persons with an active infection can pass it onto others. If your infection and symptoms occur close to your vaccination event, it is difficult to determine if the reaction is from side effects of the the vaccine or an actual, unrelated infection. You are advised to isolate and make arrangements to get the test for COVID-19. You can also call the nurse hotline (360-344-3094) at JHC to get advice on what to do. We are also at the stage when the variants of concern have been found in our state and may be the reason for your infection.
• On Friday, Governor Inslee rescinded his travel advisory for this state and now asks all residents to follow the CDC guidelines at this time. The optimal situation is to be fully vaccinated when traveling, get tested 1-3 days prior to travel, and get tested 3-5 days after you return home. Self-quarantine for 7 days if you test negative, and 10 days if you do not get a COVID-19 test after returning home. This is necessary as there are more variants of concern circulating now and some people do not get sufficient protection from their vaccine series. These new variants are more transmissible and have the potential to cause more serious disease and hospitalization.
• Regarding “vaccine cards”, Dr. Locke stated there were no immediate plans to establish proof of vaccination, as there are restrictions on who is eligible at this time. Some entities may establish this requirement for some activities; however that may be in the future.
• Some vaccine manufacturers have initiated vaccine trials for teens 12 years of age and older and expect to have results available by the early summer and possible recommendations and supplies for younger students by early Fall. These initial vaccines have an excellent safety profile and there is every expectation these vaccines will not be problematic for this age group. FDA trials for children 6 months of age and older will take longer and may not be available till 2022 as the FDA process is longer and more stringent for younger age trial participants.
• Dr. Locke stated that the current vaccines confer better protection than getting a natural infection of COVID-19. There are growing concerns for the increased residual effects of becoming infected with COVID-19 among 18-39 year olds, termed “long-haulers”. Vaccines prevent this condition.
• The reports of blood clots among those receiving the Oxford-AstraZeneca vaccine appears to be equivalent in that found in the population at large. The trials of this vaccine also saw no increase of blood clotting between the vaccinated group and those receiving the placebo among 30,000 participants. Although the US has ordered this vaccine, it appears we will have enough of the other three vaccines to vaccinate all citizens who desire the vaccine, and these doses will most likely be shared with other countries who remain in need of doses.

KPTZ listener’s questions:

• The CDC has lowered the social distancing guidelines in school settings under certain circumstances. This is possible when all other mitigation actions remain in place and practiced consistently. This is in an effort to balance public health goals and educational missions. Schools and their ability to reinforce these measures have remained a safe place for teachers and students to learn.
• Eating indoors remains with some risk as we increase indoor capacity. It is necessary to remove your mask while eating and the mixing of unrelated households still presents a chance for the virus to find new people to infect. If concerned, eat outside, or support our food establishments by ordering take-out. If you dine indoors, keep your mask on anytime you are not eating.
• Vaccine eligibility currently makes those working in congregate settings and/or in essential infrastructure fields eligible for making a vaccine appointment (Phase 1B, Tier 2), as well as any pregnant woman 16 years or older.
• Swimming pool use during this time appears to be a lower risk as the humidity of the environment reduces the formation of aerosols by trapping the smaller particles in the air. Continue to use 6 feet of social distancing and when not swimming, wear a mask.
• All the cases recorded in this county have been confirmed by PCR testing, even when initially tested by rapid tests, which provide less-reliable c-19 status of actual infection. Probable cases are treated like confirmed cases with home isolation, until proven otherwise.
• Dr. Locke advised against taking NSAIDS before getting the vaccine. This recommendation has been documented with other viral vaccines and can reduce the effectiveness of the protection you receive. The recommendation, if necessary prior to the vaccination, is to take acetaminophen.
• Dr. Locke explained that your protection from the effects of COVID-19 illness begins to build about 7 days after your first dose from a two-dose vaccine regimen. Antibodies build in an initial surge upon your second dose, then continue to build and peak by the 14th day after your second dose.
• Vaccine clinics are currently being planned for the county mass vaccination clinic at Chimacum High School on the weekends, Jefferson Healthcare 6 days a week, as well as TriArea Pharmacy. Call the DEM vaccine phone line (360-344-9791) to schedule an appointment. Two other pharmacies also provide vaccines: Safeway and QFC in Hadlock.
• Dr. Locke encouraged all seeking to travel to be aware of new case rates and trends before scheduling a trip for mandatory travel. Statewide, there is an overall increase, but it is in specific areas, not necessarily the I-5 corridor in Seattle. Avoid states with increasing rates, who more than likely will experience another wave of new cases as seen on the eastern side of the US.

Willie Bence, Director, Department of Emergency Management:

• Mr. Bence expressed appreciation for the success of the first join effort between JC Public Health and DEM staff for the Sunday, March 21 mass vaccination clinic at Chimacum High School. The current need for volunteers will extend several months and he encourages all those interested to volunteer at the Department of Emergency Management.
• Medical staff are also encouraged to apply at the same website. 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.
• Olympic Area Agency on Aging (OAAA) has been working on no-cost transport for those aged 60 and older with limited options to get to a vaccine site. They will also be working with DEM to establish a program for in-home vaccinations for persons who are currently homebound. They would likely use the one dose Johnson&Johnson vaccines for these individuals.
• Mr. Bence provided a perspective which came from one of our KPTZ Virus Watch Team members, Barney Burke: Roughly 1% of our Jefferson County population is being vaccinated daily, and this does not include the three pharmacies who are delivering roughly 100-200 weekly. Our progress has been considered stellar.