County Public Health Report ~ 4/05

Today, April 5, Jefferson County Public Health Officer Dr. Tom Locke shared his assessment of the pandemic in Jefferson County and answered questions submitted by KPTZ listeners.

General comments: 

• The national picture continues to be concerning at this point. An 18% increase was recorded for new cases nationally the last two weeks, with an average of 64,000 cases a day. This may be an undercount of new cases as testing for cases has declined nationally. Upper Lake states such as Michigan and northern states, are recording an increase in new cases, similar to the epidemic curve witnessed at the beginning of the pandemic, a year ago last March 2020. This most recent wave of cases is being driven by the new variants identified, particularly the UK, B.1.1.7 variant.
• All the variants are considered more infectious, as seen by the epidemiological curve playing out through Europe and now Canada, with consequential lockdowns until new cases subside. Home-grown variants, particularly B1.427, found in California, was thought to be the dominant strain causing the increase in cases in California during November and December of 2020. It is predicted that 35% of all new cases are the UK B.1.1.7 variant, with a doubling of these cases seen every 12.3 days. Washington State ranks third in the nation in genetic sequencing of new cases, and expects the UK variant (B.1.1.7) to be the dominant strain here by the end of April. With more infectious strains, epidemiologists and local health officers are monitoring cases weekly, looking towards acting with proven public health mitigation sooner, rather than later, if cases begin doubling week by week. The public showing their fatigue with pandemic measures and failing to suppress new cases, requires the recognition that individual liberty is a distraction here and our ability to act collectively on our own behalf is the limiting factor.
• New cases in this state have increased by 30% over the last two weeks, without a decrease in testing, as seen in other states. Testing rose by 45% over the last two weeks. New case rates stand at 136 per 100,000 population, with 3.4% positivity among those being tested. Pierce, Kittitas, and Yakima counties remain above the 200 new cases per 100,000 population threshold for remaining in the Phase III RoadMapTo Recovery plan outlined by Governor Inslee.
• Washington continues to record an increase in hospitalizations – 9% in the last two weeks – primarily among younger residents. This reflects the massive efforts by our state to get the most vulnerable age groups – 75 years old and up – vaccinated, thus avoiding hospitalization.
• Jefferson County recorded 7 cases last week, bringing our new case rate per 100,000 population to 22, with 1.65% positivity in persons being tested.
• Kitsap County is trending with a steady rise in cases, 104.3 per 100,000 population, with 5.5% case positivity. Clallam County recorded 38 new cases per 100,000 population, with 2.4% new case positivity among those tested.
• Nationwide, nearly three million vaccinations are given every day. Nearly 3.4 million vaccinations have been given in Washington, with 29% receiving at least one dose, and 18% fully vaccinated. Jefferson County has given nearly 23,000 vaccinations, with 49% of all county residents receiving at least one dose, and 34.5% fully vaccinated to date.
• In all regions, it is literally a race between getting residents vaccinated and the continual spread of more infectious COVID-19 variants, as communities struggle to further reopen businesses. Although Jefferson and other surrounding counties were early in receiving and giving available vaccine allotments, there are several issues that now impinge on this effort to get to the 70-80% fully vaccinated status which confers herd immunity. Dr. Locke is asking us all to evaluate the relative risk of all our activities and continue to mask, distance ourselves from others, wash our hands and get vaccinated, refrain from unnecessary travel and refrain from mixing with a lot of non-household persons, outside your small pod.
• Vaccine hesitancy also remains an issue for communities, with many of those wanting the vaccine having already received it. Those not really opposed to vaccines in general, but waiting on safety data from mass vaccination outcomes, need to be encouraged to make an appointment. Vaccine campaigns will stress the necessity to have higher levels of herd immunity to thoroughly reopen our community life with little or no new COVID-19 cases. Since vaccine availability is still ramping up, the playing field is not equitable yet for all residents who are still trying to get in line for vaccinations. Stratifying those who will choose not to get vaccinated, for whatever reason, takes away from our efforts to promote the risks and benefits of this modern and effective vaccine for those willing to consider the greater community benefits. With this virus, herd immunity is our economic ticket out of these recurring waves of new cases and continual threats of business closures.
• Although Jefferson County has one of the highest school exemptions for vaccines, those staunchly opposed to vaccinations are relatively small, about 5% overall.
• The most effective, persuasive model for most people who may be hesitant about getting the vaccine is to talk with a trusted medical provider or public health professional. Experience with other recommended vaccines can also persuade a person as to the risk and benefits of this particular vaccine. What does not seem to persuade anyone is scaring them about the consequences of not receiving the vaccine. It is a personal choice and one everyone should be well informed about.
• Facts about the benefits of having more people vaccinated also makes a difference for some who are hesitant. Dr. Locke pointed to a recent New England Journal of Medicine citing a study that shows the efficiency of reducing the spread of COVID-19 among the most exposed medical workers after their first and second dose of the vaccine. Medical staff were followed from mid-December 2020, through mid-March 2021. Transmission was interrupted by 80% after the first dose and rose to 90% by the end of the third month after the second dose. Dr. Locke cited this as strong evidence of the power of “herd immunity” in an environment with high exposure to circulating COVID-19 virus. These types of studies to determine the ability of the vaccine to stifle new infections were expensive and time-consuming, but necessary in order to document the powers of a fully vaccinated community, and the community benefits of collectively working toward herd immunity.
• Now is the time to expand the entities and organizations giving vaccines, as the cost of the larger organizations have borne the brunt of the organizing clinics, as well as the cost of giving vaccinations. Efforts continue to get other organizations to step up and apply to receive and give the vaccines. All organizations who receive an allotment of vaccines are required to get them dispensed into arms; otherwise, vaccine allotments are reduced if not given within a specific time frame. In the meantime, the three counties of Jefferson, Clallam, and Kitsap have formed a collaborative effort to sustain the scheduling of clinics and labor of getting county residents vaccinated, such as mobile and pop-up clinics for difficult to reach residents and homebound residents. These clinics require fewer resources and can be mobilized with fewer volunteers. A press release is expected soon to announce a pop-up clinic for less populated areas of our counties. The press release will be posted on the Jefferson County Public Health website with details about this clinic and how to make an appointment.
• The joint clinic sponsored by Jefferson County Public Health and the Department of Emergency Management at the Chimicum Schools site will resume Saturday, April 17. For those receiving their first dose at this site on March 17, staff will provide shots for those needing their second dose from 9am to noon. The afternoon will be dedicated to those residents wanting their first dose from noon to 3pm. These Saturday clinics are expected to serve about 600 residents for their first and second vaccinations each Saturday and are a convenient location for eastern Jefferson County residents who are currently working during the week. Residents can call the DEM COVID-19 Vaccine Phone Line for more information at 360-344-9791, M-F from 9 to 5pm.
• Starting April 15, all Washington residents, 18 years and older, are eligible for the COVID-19 vaccine. If the Pfizer vaccine is available, those residents 16 years and older are eligible for that vaccine. Current organizations providing vaccinations include the Jefferson Healthcare drive-thru clinic, near the hospital, as well as three pharmacies: QFC at Port Hadlock, Safeway in Port Townsend and TriArea Pharmacy in Port Hadlock with websites for vaccine registration. The fifth clinic is the PublicHealth joint clinic at Chimicum Schools on Saturdays.

KPTZ listener’s questions:

• Listeners commented on the confusion of CDC guidance for safer traveling versus how that compares to eating indoors at a restaurant.  Dr. Locke admitted it may seem confusing, but cautioned that evaluating risk depends on several factors, including the number of persons in a confined area, time spent indoors, ventilation, adherence to masking, distancing, and mixing of unrelated households.  Airports will not allow anyone to fly if all protocols are not strictly followed. Traveling by air showed few situations where this posed a formidable risk of exposure and infection, whereas there has been clear documentation of outbreaks in restaurants.  If you fly somewhere, exposure has to do more with the activities you engaged in, once you arrived, such as maskless parties. If all the protocols are not followed in a restaurant, such as masking when you are not putting food in your mouth, the risk increases.  
• Data from the Washington State Immunization System contains all the vaccine doses administered to residents within 24 hours of receiving the shot. If this requirement is not met, the organization will not receive future doses of the vaccine allotments.  This is considered the most timely and accurate data on the vaccine rollout in this state. 
• Kitsap County has one confirmed case of the UK variant and Clallam County is reporting three probable cases.  These are considered more infectious than the original strain that circulated the globe in January 2020. 
• Access to COVID-19 PCR testing locally is targeted for those who exhibit typical symptoms for COVID-19 and those with known exposure to a confirmed Covid-19 case.  Although the CDC recommends getting tested 1 to 3 days before travel and 3 to 5 days after your return, sources for funding these sophisticated and costly tests remain limited.  Home test kits have been developed, but are not yet widely available.  Washington state is beginning a free voucher program through Walgreens in Bremerton.  Residents seeking testing due to travel may need to pay from their own funds, until less expensive, yet accurate testing is more widespread. 
• If an unvaccinated couple socializes with another fully vaccinated couple, which couple has the greater risk for exposure or transmission of the virus?  In general, more fully vaccinated persons present among those gathering reduce the risk of exposure for everyone, even those unvaccinated. However, the unvaccinated person needs to evaluate their individual risks, in light of any health conditions they have which may put them at risk of disease progression, once infected.  If the unvaccinated couple is at low risk, no masking or distancing is needed. Masking and social distancing should be used if the unvaccinated person is at high risk for developing complications, once infected. 
• The phased system for reopening the economy is not based on numbers of fully vaccinated residents, it is based on low new case rates, staying at or below a threshold, where current medical and public health resources would not be overwhelmed.  It is a balancing act of the economics of recovery and suppression of circulating viruses by traditional public health measures.  Looking back, ideally, many in charge would have liked to shut down completely until massive suppression of the virus occurred, but we are not ideally set up for the cost to our economy it would have taken to do this, nor was there the political will.

Willie Bence, Director, Department of Emergency Management:

• All those needing a second dose at the JCPH and DEM clinic at Chimicum Schools for the 4/17 mass vaccination clinic have been emailed to remind them to sign up. Those wanting assistance with securing an appointment can call the Vaccine Phone Line at 360-344-9791.
• Mr. Bence urged residents not to sign up more than once for a vaccine series, as once you have an appointment, you are guaranteed a shot, as well as the second dose, with the same organization. If you have signed up for more than one site, please cancel, as there are many waiting to get an appointment. There is no need to make an appointment at more than one site.
• The community mask program continues to produce masks and distribute them in the community. As we all participate more in community life, we will need masks for the foreseeable future. They can be found at food stores, as well as libraries. Disposable masks are seen more and more, littering our environment. If you see a disposable mask on the ground, please place it in a trash can. Mr. Bence also stated that reusable mask need to be laundered regularly.