The following is a summary of the presentation during the Public Health briefings at this week’s Board of County Commissioners meeting made by Jefferson and Clallam County Public Health Officer Dr. Allison Berry. Spokespeople from Jefferson Healthcare joined to address the meeting. Also Willie Bence, Director, Director of Emergency Management, gave a report. The summary was provided by and used with the permission of Jefferson County Government.

Jefferson Healthcare’s CEO/Administrator Mike Glenn, Chief Medical Officer Dr. Joe Mattern, and Chief of Medicine Dr. Tracy Harris joined Dr. Berry in briefings to the Commissioners about the state of the pandemic in Jefferson County. Dr. Barry said the numbers in Jefferson continue to rise. “It’s a wildfire.” Jefferson had a huge increase in positive cases over this holiday weekend, with 56 new cases added today. 

“We’re up to a total of 805 documented cases of COVID-19 in our region,” she reported. “We have 108 people known to be in isolation at this time. Our current case rate in the last two weeks is 485 per 100,000. That’s certainly the highest we have ever seen out here.” She said the case rate just passed 1,000 cases per 100,000 in Clallam County which is “unprecedented.” 
Dr. Berry said hospitals are stretched to capacity throughout the state. “We’ve moved to a system where new admissions get triaged to different hospitals throughout the state so that we can try to share the load, but every hospital is hurting.”

Hospital Administrator Mike Glenn provided a dire overview of the situation at Jefferson Healthcare. “It’s been a really difficult last four weeks,” explained Glenn. “Our emergency department and in-patient activity has surged, mostly due to an increase of COVID-19 patients. Over the weekend we peaked at 20 patients, with seven being COVID-positive. “This is a heavy load for us and really strained an already tired and stretched team of caregivers. This level of activity, and bracing for what might come, is impacting our ability to take care of other care needs in the community.”

The Hospital has suspended all inpatient elective procedures, The biggest limiting factor continues to be staffing. “We’re facing the same crisis as every other hospital healthcare provider,” said Glenn. “We continue to operate all of our other COVID-19 outpatient services like testing, vaccinations, monoclonal antibody clinic, and other services our community requires.

“This is, by far, the worst it’s been at Jefferson Healthcare,” said Glenn. “And, to make matters worse, our caregivers are tired and a little fed up with the continuation of what we know can be more effectively curtailed. We welcome the mask mandate and the restaurant vaccination mandate and fully support all the COVID-19 risk mitigation protocols recommended by Dr. Berry.”

Dr. Tracy Harris explained what it was like to be an in-patient nurse during this time. “This is my 14th straight day of taking care of patients,” she said. “Nurses simply cannot provide care to as many patients as they could if they didn’t require this level of infection control. “It’s emotionally impactful to feel like you can’t do the job the way that you want to on a day-to-day basis.”
Dr. Joe Mattern said the hospital is diverting staff and resources to deal with COVID -19.

“We are continuing to divert resources now to manage COVID-19.  So, probably about 300 test results over the last three to four days were coming through our testing just to monitor and identify people who are sick or need testing through our system. That means nurses, that means labs, that means all these other resources. “We don’t have the staff to take care of patients so we’re diverting staff to try to offer monoclonal antibody treatments which can be helpful for people in the early stage of illness. And that is something we want to do because it decreases hospitalizations. But, it does not decrease hospitalizations the way that vaccinations decrease hospitalizations. So, the need to have more people vaccinated is what is really going to get us to a point that’s going to reduce the strain.”

Mattern said while Dr. Harris was focusing on the inpatient, he spent a lot of time focusing on the outpatient and his role as hospice director. He was admitting patients with COVID-19 on the hospice team, which he said is also stretched thin so even being able to provide proper palliative care to patients is challenging.

Dr. Barry provided a powerful and straightforward plea to the community during her update to the Commissioners: “I want to acknowledge we know how to stop this. If everyone went out and got vaccinated today, we could stop this. If everyone wore a mask when they were indoors and avoided these crowded indoor settings, we could stop this. We know how to stop COVID-19. Now we just need everyone to do it. The vaccine is incredibly safe. It is incredibly effective. It would make all the difference. So if you are unvaccinated right now, please go get vaccinated today. Please wear a mask when you are indoors, as we’ve discussed in response to this critical rise in cases and hospitalizations, the strain on our healthcare system, and in an attempt to keep our schools open.

“I did announce at the end of last week a mandate requiring proof of vaccination to enter restaurants and bars in our community. The primary reason for that is we know these are high-risk spaces; they are some of the only spaces left where we go in and take our masks off and stay there for an hour or two. We know that transmission happens in those spaces – it’s happened in Jefferson County, it’s happened in Clallam County. And, we know we can have very large outbreaks resulting from that. One of the largest outbreaks we’ve had in Clallam County resulted in a total of 117 cases from unmasked spread within a bar. So it really is a very strong driver of transmission. We’re trying to do what we can to curtail it, and we are trying to do what we can to make this as focused of an intervention as possible. 

Our other options include closing these industries – closing restaurants, closing bars, closing places where people come together. We are trying to not do that because we know our businesses have struggled through the pandemic and we want to keep them open. A vaccination requirement makes it safer for the staff who go there to work every day, and it makes it safer for the patrons who come to participate in those activities. “It is actually much safer to go out to eat now if you are fully vaccinated. A quick reminder that this only applies to indoor dining, it does not apply to outdoor dining. So those who have outdoor seating, you can still participate in that if you are unvaccinated. You can still get takeout. 

“I did hear from folks who were worried about how this would affect our local businesses, and I would encourage folks, to the extent that you are able, to support our local businesses – get some takeout, even the outdoor dining if you’re vaccinated. You can eat indoors and it’s a lot safer than it used to be. There’s we can all support our businesses. This does not have to hurt our businesses. In fact in many cases, I think it will actually help. There are a lot of people who have been staying away from restaurants because they don’t feel safe there. And it’s much, much safer if everyone’s vaccinated, in that space.

Submit your Public Health questions to Dr. Allison Berry 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.

The following is a summary of the presentation during the Public Health briefings at this week’s Board of County Commissioners meeting made by Jefferson and Clallam County Public Health Officer Dr. Allison Berry, along with Dr. Tom Locke, who has stepped back to serve as Deputy Public Health Office. Also Willie Bence, Director, Director of Emergency Management, gave a report. The summary was provided by and used with the permission of Jefferson County Government.

Note: The next scheduled BOCC meeting will be held Tuesday, September 7 beginning at 9am. The COVID-19 briefing by County Health Officer Dr. Allison Berry and Department of Emergency Management Willlie Bence will begin at 9:45am.

Jefferson County Health Officer Dr. Allison Berry this morning announced that the Food and Drug Administration (FDA) granted full approval to Pfizer-BioNTech’s coronavirus vaccine today, August 23. This is the first full approval for a COVID-19 vaccine in the U.S. The full approval for Pfizer-BioNTech includes people 16 years of age or older, but children ages 12 to 15 can still receive the vaccine under emergency authorization. Moderna has also applied for full approval, but Johnson & Johnson has not yet applied (both have emergency use authorizations).

“Now is a “great time to go out and get that vaccine,” Dr. Berry said. She emphasized that besides getting vaccinated, the biggest thing you can do if you aren’t is to wear a mask. “Wearing a mask really does make an incredible difference in reducing transmission of COVID-19,” she said. “We don’t see breakthrough infections in that kind of context and we don’t actually see any infections in that kind of context. We’re still not seeing cases where masked people are spreading COVID-19 between each other. “It really makes a huge difference in reducing transmission.”

Dr. Berry clarified indoor versus outdoor transmission probability. She said we are still not seeing transmission under normal circumstances in outdoor spaces, “It’s very safe to be outside,” she noted. “The only times that we’ve seen outdoor transmission is in these really packed, close spaces — so mosh pits and  large festivals where people were really really close together outside. Otherwise, we really don’t see outdoor transmission, so your standard outdoor gatherings are very safe.” That changes when the event comes indoors.

“It can get really risky,” Dr. Berry warns.”So the biggest thing to think about if you’re planning an outdoor gathering is making sure there is no point in the day, where it becomes an indoor gathering.”

Jefferson County’s current COVID-19 case rate is 263 per 100,000 — the highest we’ve ever experienced, according to Dr. Berry. “Our total number of cases is 640 — that’s 84 actually, just in the last two weeks,” Dr. Berry explained. “It kind of gives you an idea of what we’re looking at. The numbers in Jefferson are always a little tricky to break down because we have a small population, and blessedly a small number of COVID cases, because we are so well vaccinated and Jefferson County residents have been doing a really good job, by and large, with following pandemic protocols.”

She said key takeaways are that we’re seeing the highest rates of viral transmission in our community are exclusively the Delta variant in our sequencing at this point. Now is “a really risky time to spend a long time in indoor spaces, especially if you are unvaccinated.” If you are vaccinated, she said it is important to know we have never seen transmission between vaccinated people in an indoor space with masks on. “It’s still very reasonable to put on a mask, go to the grocery store, do those kinds of things. But if you are unvaccinated I would highly encourage you to get vaccinated right away,” she said.

“The biggest thing that we all can do besides getting vaccinated if you aren’t, is wearing a mask,”Dr. Berry said.” Both parties wearing a mask really does make an incredible difference in reducing transmission of COVID-19. We don’t see breakthrough infections in that kind of context and we don’t actually see any infections in that kind of context. We’re still not seeing cases where masked people are spreading COVID-19 between each other.”

Director of Emergency Management Willie Bence said the vaccination clinic scheduled for Quilcene today was cancelled due to lack of interest. Bence said he’s seen a number of polls that cite the most often cited reason for not getting the vaccine was lack of FDA approval. With today’s announcement regarding the Pfizer vaccine, Bence hopes it will spur those to get vaccinated. 

If there is an uptick in demand, the EOC number 360-344-9791 can be reached for help in finding a place to be vaccinated. There are a few private clinics that have been scheduled for employers who have a state-mandated deadline. 

Bence estimates that booster shots for the immunocompromised could be as high as 5%, which would be about 1,500 people. “We’re looking and seeing how many folks are going to their health care provider, how many folks go to the pharmacies, and then we’ll have as many two to four large mass clinics, typically for immunocompromised folks. And those would likely be the beginning of September.” Bence also is planning for booster shots for the entire population. Doses would start September 20 and they would go right on down the line, eight months after you received your your second shot. It started out with health care workers, certain older Jefferson County residents, and other high-risk populations, and then it would go through that prioritization process that we experienced earlier this year.

He said vaccinations will be busiest through November, December, and January, and DEM is starting to plan for what those clinics and what those numbers look like in preparation.

Submit your Public Health questions to Dr. Allison Berry and to Willie Bence 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.

The following is a summary of the presentation during the Public Health briefings at this week’s Board of County Commissioners meeting made by Jefferson and Clallam County Public Health Officer Dr. Allison Berry, along with Dr. Tom Locke, who has stepped back to serve as Deputy Public Health Office. Also Willie Bence, Director, Director of Emergency Management, gave a report. The summary was provided by and used with the permission of Jefferson County Government.

County Health Officer Dr. Allison Berry this morning told Commissioners that “the news is not getting better” regarding COVID-19. “There are a few key things for the public to know,” said Dr. Berry. “We are seeing really incredible rises in cases, really unprecedented numbers in our region. We’ve never seen anything like this before – 80% of the virus we send through sequencing now comes back as Delta variant, which is dramatically more transmissible than the COVID-19.”

She said it is also more severe. “We’re seeing younger people get hospitalized,” Dr. Berry said. “And we’re seeing a higher proportion of people who get infected getting hospitalized. We’re also seeing just a shocking amount of disease.”

Testing capacity at Jefferson Healthcare is increasing to meet the surge in demand which has risen six-fold. There are some supply-chain issues, however, with delays in shipments of tests from the state. Of COVID-19 tests in Clallam County, the present positivity is 10%. She said she doesn’t have those numbers today for Jefferson, but estimates one in 10 people who go to get tested are positive.

Jefferson Healthcare has its drive-through testing open, and is offering tests for pick-up. The County Health Department will also be offering test kits in Port Townsend as well as in South County soon.  As of this morning, Jefferson’s case numbers are 235 per 100,000. We’ve crossed the 200 mark, and have up to 597 cases so far in this response. Dr. Berry explained, “There are two main tools that we have to use: one is getting vaccinated and the other is wearing a mask, and so that is why, on Friday, I issued a mask mandate for Jefferson and Clallam counties for all indoor spaces, regardless of vaccination status.”

With the Delta variant, six feet of social separation may not be enough both indoors or outdoors or if “people are screaming or yelling or singing.” She said in adults, the variant is spread across six feet in indoor spaces.  “Just being six feet apart from someone else is not enough,” Dr. Berry said. “We’re truly seeing aerosol spread. We’re seeing large-scale viral loads when we look at the church outbreaks that we’ve seen; we’re seeing it travel far beyond six feet in those places. 

“Having some space between you and other people makes a difference,” she continued. “Having a mask on makes a difference. Airflow makes a difference. If you need to go into an indoor environment where people are going to be closer together, really think about ventilation; think about opening windows. There is nothing that is 100% safe, except for staying in your own household, but I do think we need socialization in our life to be healthy. And so what I would recommend, if you’re fully vaccinated: you can gather indoors with other fully vaccinated people.”

Director of Emergency Management (DEM) Willie Bence reported that the community masking program is being revitalized. The county’s mask makers are back sewing again, helping to build up the stock of cloth masks. They’re available yet again through DEM, grocery stores, small businesses, and wherever you might be. Bence said not to hesitate to reach out. “We’re happy to drop those off and make those available. This helps protect the stock of N95 surgical masks that are on hand.”

Cloth masks and hand sanitizer are also available through the Jefferson County Chamber of Commerce (you don’t have to be a member). The Quilcene School Vaccination Clinic will be held Monday, August 23 from 11am to 1pm. It’s the Pfizer vaccine, available for kids 12 years and older. It’s open to anyone but it can be targeted at students in the south county area – both Quilcene and Brinnon. Appointments are available by calling: 360-344-9791. The Quilcene clinic is a partnership between DEM and the Tri-Area Pharmacy.

More clinics are being scheduled later this month and at the beginning of September. Bence also emphasized that if anyone has any questions about COVID-19 or testing, the COVID-19 Information Line is still up and running: 360-344-9791.

Submit your Public Health questions to Dr. Allison Berry 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.

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(BOCC) meeting.

Please note that the Board of County Commissioners (BOCC) will not be in session next Monday, May 31 due to the Memorial Day holiday. They will meet the following week on June 7 to provide the public health update from Dr. Tom Locke and Willie Bence at the usual time, 9:45am here at KPTZ.

Today, May 24, 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 indicates improvement with a continued decrease in new COVID-19 cases, dropping 38% from the previous two weeks, with hospitalizations dropping as well. The average new cases diagnosed nationally is 30,000 a day, which is the lowest average since the early summer months, about 11 months ago.
• Washington was recently considered a hot zone, being one of the top ten states with increasing cases and hospitalization rates. Dropping from 10th nationally to 15th this past two weeks demonstrates a 47% decrease in new cases and the exponential decay seen near the last phases of a pandemic as the suppression of the virus continues. Washington is reporting a case rate of about 200 per 100,000 population, along the I-5 corridor, with Pierce County at a high of 300 new cases per 100,000, far above the metric that would allow restrictions to ease.
• Hospitalizations, however, have not significantly decreased. The past two weeks only saw a 7% drop. This new face of COVID-19 hospitalizations are primarily among younger persons, who are encountering the increased presence of the variants of concern, primarily the UK variant which is more easily transmitted. It is considered the”bully” form of COVID-19 infections. Washington State continues to see about 12 of it’s residents die each day from this virus.
• Jefferson County continues to see new case rates drop, with only 8 cases diagnosed in the last two weeks, giving us a new case rate of approximately 25 per 100,000 population. This makes our county among the lowest for new case rates per 100,000 in the state, as well as meeting the state metrics for successfully suppressing the virus and presents the eventuality of reducing restrictions.
• Neighboring counties continue to improve suppression of the virus as well. Clallam and Kitsap County currently have 71 and 145 new cases respectively per 100,000 population.
• Vaccinations have slowed statewide, currently about 47,000 inoculations a day, which exceeds the state goal of 45,000 a day, but is down from a higher number seen a few months ago. About 48% of residents in Washington have received at least one dose, with 39% fully vaccinated. By contrast, Jefferson County has 63% of its residents with at least one dose, while 57% are fully vaccinated. When considering those residents eligible in this county (16 years of age and older), 71% have at least one dose and 64% are fully vaccinated. This places our county in a good position to remove most pandemic restrictions by the end of June, if not before, in keeping with the intent of our Governor to end restrictions in this time period.
• Vaccine hesitancy remains the challenge. Although realistic about the likelihood of reaching 70-80% full vaccinations, health officials know there are still those residents who may not be able to be persuaded to get the vaccine. About 13% may consider the inoculation after watching and waiting for any risks the vaccine presents, with about 7% who may face an issue of access. About 14% of COVID-19 skeptics will not likely get the vaccine. To truly lessen the threat of any other waves, the desired goal of herd immunity needs to be 80% or higher.
• Masking, after the release of the CDC guidelines, continues to be confusing. Many counties statewide have individual masking mandates, especially for indoor public spaces. These mandates prevent unvaccinated, susceptible residents from congregating indoors in public spaces to prevent the further spread of the virus. As there is no practical way to consistently verify vaccination status for businesses, many counties will leave these masking mandates in place. Masked and unmasked within a closed indoor public space is more problematic than just having everyone mask up when indoors for the time being.
• Labor and Industry standards for public spaces and businesses were published this past week, providing more guidance. They allow fully vaccinated employees to drop the masks, when in spaces not accessible by the public. The business must verify vaccination status of all employees and keep records available for inspection.
• Dr. Locke pointed out the concern for those with a poor response to the vaccine, such as immune compromised, those receiving cancer treatments, taking a medication that suppresses the immune system, which comprises about 4% of the total population. Dr. Locke is currently evaluating indoor settings with no public access as to when and under what circumstances they can forgo masking.
• The statewide standard for relaxing pandemic restrictions requires 70% of those eligible to be fully vaccinated. Restrictions on indoor public spaces include masking as residents continue to get the vaccine, thus further slowing the spread of the virus. The benefits of more residents vaccinated is shown by the dramatic drop in new case rates. Infections will still be expected among those unvaccinated.
• Locally, Dr. Locke will be considering metrics for eliminating indoor masking in the next few weeks, gathering recommendations from King County health officials, as well as any concerns with our typical upcoming tourist season. He estimates masking will continue for the next 4-5 weeks, with guidance for specific situations outlined as we also try to encourage the hesitant to be vaccinated. He does not expect masking to continue in public access sites beyond June 30 for our state or local jurisdiction, except in high-risk environments like jails, long-term nursing homes, medical facilities, any form of public transportation, and schools. Labor and Industry standards allow the right of business owners to retain masking, even when state and local mandates have been discontinued.
• Incentives can play a role for those who are unvaccinated. Everything should be considered at this tipping period. Polling surveys reveal that a small portion of the unvaccinated will respond to incentives, especially when employers offer time off if a vaccinated employee has side effects from the inoculation. The risk to businesses is greater when there’s an outbreak such as reduction in staff availability, lost income, and disability among some employees who may have residual effects from a serious infection.
• Vaccination cards may well be a passport for certain activities in the near future. Dr. Locke recommends making copies of the CDC card and laminating the copy, as we will likely need boosters in the future to be recorded on the original card. Other avenues for documentation include a statewide program called MyIR.net, where a person can register their vaccination and keep a link to the website on smart devices. Labor and Industry have also promoted ways of acceptable verification of vaccine status, such as sworn statements, CDC vaccination cards, or alternate/replacement cards through the local health department, should you misplace or lose your card.

KPTZ listener’s questions:

• A commonality among the 5 local breakthrough cases was being over the age of 60 years, and mild symptomatic or asymptomatic COVID-19 infections. Statewide, 832 breakthrough infections have been diagnosed, with 10% hospitalized, all over the age of 60 years and predominantly mild disease course. Breakthrough cases have been discovered among recipients having received each one of the three vaccines available. The proportion of cases attributable to each vaccine may only reflect volume of use at this point in time. It does not indicate which one actually has the most breakthrough cases based on the manufacturer, as the nation is early in the use of all the available vaccines.
• The University of Washington is currently scaling up to conduct a surveillance study of antibodies for the state of Washington. It will begin soon and will ask random residents , through a postcard mailing, to volunteer for a simple blood draw, measuring antibodies acquired by natural infection or vaccination. The first round will include a mailing to 7,000 residents, followed by subsequent mailings. Jefferson County has been selected as part of the counties to receive postcard mailings.
• For those who opt for the Johnson & Johnson one-dose vaccine, once you are 3 weeks post vaccination, the risk for possible development of blood clots is negligible, with most serious cases developing within one week of the inoculation. It is still not known if this vaccine may be the cause of this blood clotting condition, but it is suspicious in relation to the timing of receiving the vaccine and will be continually studied.
• The Johnson & Johnson manufacturer ran a clinical trial in South Africa and it was determined to protect against this variant of concern. It was found to have about 80% protection from a serious disease course. With continued mutations possible, future booster shots are expected to provide additional protection to account for the divergence of the original SARS-Cov-2 virus and will most likely target healthcare workers who were the first to receive these vaccines late last year.
• When schools have new COVID-19 infections, there are currently three models for handling the quarantine schedules, with associated risks. Schools with a 7-day requirement of quarantine, with a negative test, still have a 5% risk of having the infection spread. Schools with a 10-day period of quarantine and a negative test are considered adequate to really reduce transmission. Schools which have a 14-day period of quarantine with no test have the lowest risk of transmission, with under 1% of transmission.

Willie Bence, Director, Department of Emergency Management:

• Jefferson Healthcare ran its first dose clinic for 12-15 year-olds this last Wednesday, with about 200 doses given. The final dose for these residents will occur three weeks later.
• Onsite school clinics also were able to give 45 doses to students at Chimacum and Quilcene Schools this last week.
• Chimacum Saturday clinics gave 140 second doses on May 22 in the morning and 54 Johnson & Johnson doses in the afternoon. Traffic signs announcing walk-in opportunities for vaccines appear to have increased the convenience factor for some residents.
• This next Saturday a second-dose clinic at Brinnon is also offering either appointments or walk-in opportunities for the Johnson & Johnson vaccine. We are looking for help in getting the word out about this upcoming event, as it may be the last time we will coordinate a clinic in this south county area.
• On June 5, we will coordinate a vaccine clinic at the local Farmers market in uptown, as well as have medical staff available to answer questions and concerns for those who may be hesitant to get the vaccine.
• The Department of Emergency Management and partners have currently served all those residents to date who wanted the vaccine, but were homebound. Mobile outreach could still be available to serve additional homebound residents if they call the Vaccine Phone Line to be placed on a list for a future clinic. Area residents should advise homebound residents of this opportunity and help them call 360-344-9791 to be placed on a list. When at least five residents in a close geographical area have been established, a clinic will be scheduled for a vaccination in their home with medical staff.

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(BOCC) meeting.

Today, May 17, 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 indicates a continued decrease in new COVID-19 cases, dropping 33% from the previous two weeks, with hospitalizations dropping by 17%. Death rates have also dropped by 13%.
• While the trend in metrics for new cases, hospitalizations, and deaths are decreasing nationwide, our state is dropping at a slower rate, ranking us higher on the list of states compared to others. Due to the slower decrease, we are now ranked 6th in the nation, with only an 11% decrease in new cases and a 5% drop in deaths per 100,000 population. That amounts to 10 Washington residents still dying every day.
• Washington’s case rate is 244 per 100,000 population, with the greatest number of cases along the I-5 corridor, in King, Pierce, and Snohomish counties.
• Of note, this week the CDC announced the results of several studies which continue to demonstrate the efficacy of the vaccines. These studies reveal the vaccines continue to prevent serious disease, hospitalization, and nearly 100% protection from death. Those who do contract the infection tend to have a mild course of the disease or asymptomatic infections, with a lower viral load and hence less risk of transmission to others. These infections are called “breakthrough infections” and are expected, as the vaccines are designed primarily to protect you from the most serious consequences of COVID-19 infections. With little risk of severe outcomes and the added benefit of significantly reducing transmission to others when fully vaccinated, new guidelines regarding restrictions and masking are possible at this point in time.
• While the research supports new guidelines, every state and local health officer will be evaluating their mandates.
• To this end, Governor Inslee announced Wednesday that all counties, subject to continued decreasing case metrics, will be able to be in Phase III of the RoadMap to Recovery plan by June 30, if not before. Another metric signaling progress toward fewer restrictions and less masking will be our collective efforts to have at least 70% of those eligible for the vaccine to be inoculated with at least one dose of the vaccine, as well as having 10% capacity or more in our ICU units.
• With the announcement from the CDC pronouncing that those fully vaccinated do not need to wear masks, with certain exceptions, the Governor will now re-evaluate the current mandates in place for this state. Current mandates require masking inside stores and restaurants, denial of service without a mask, and capacity limitations. Each state and territorial health officer will now evaluate their local mandates in light of the research findings. They will take into consideration their local epidemic, as well as labor and industry organizations in trying to rewrite new guidelines and mandates in line with the most current research findings.
• Jefferson County will maintain the required mandate issued one year ago (May 28, 2020) for masking indoors, as there is no viable way for store owners to reliably check the vaccination status of patrons. Dr. Locke will also update the types of masks that provide the greatest protection from infection.
• After consultation with other area health officers, Dr. Locke will likely suspend using masks when outdoors as increasing herd immunity rises and new data suggests fewer transmissions occur outdoors, whether vaccinated or not. He added that when there are gatherings indoors among fully vaccinated persons, no mask will be required, with the onus on the hosts to verify the status of attendees. The advantage to those fully vaccinated can be seen as masks and social distancing are not required when attending spectator events outdoors as well no masking and social distancing for smaller indoor gatherings.
• Deciphering what activities under specific conditions where mask wearing would not be a problem remains a challenge, as not all residents can take vaccines or are currently eligible. We continue to diagnose cases weekly, with segments of our residents hesitant to get the shot, as well as safety and efficacy trials still in progress for children 12 years and younger. It is not currently safe for those still unvaccinated to gather indoors without a mask. It will simply prolong the pandemic if we all dropped masking at this point.
• Our current challenge is getting vaccination rates increased, as we are not at the finish line yet. Polls regarding incentives for getting the vaccine do not rely on perks for the fully vaccinated crowd, but rather personal incentives, whether they be access to a medical advisor, monetary incentives or prizes, or simply having the vaccine available at your local drinking establishment, or a discount on your groceries if you get the vaccine. So the goal is now to provide new opportunities for vaccinations with advice from trusted family, medical or faith leaders joining the efforts. This pandemic will not be over until 80-85% of all residents are vaccinated, including children who could remain the reservoir for infections.
• Jefferson County continues to maintain one of the lowest case rates in the state at 50 cases per 100,000 population, down from 63 cases per 100,000 the prior two week period. Neighboring Clallam County is at 109 cases per 100,000, while Kitsap has declined to 177 cases per 100,000.
• Vaccines rates have been rising slowly, however, and demand has dropped, even with ample supplies of the vaccines. Jefferson County is nearing suggested herd immunity with nearly 70% of eligible residents fully vaccinated.
• The mRNA vaccine platforms appear to be protective against the variants of concern (VOC). There is not, at this time, data addressing the Johnson & Johnson vaccine with regard to the vaccine’s protection against the VOC’s.
• Dr. Locke responded to one of the inquiries made by a constituent regarding allowing children to play together in an outdoor setting. He stated this is not really problematic and interacting outdoors is safer than previously believed, even among unvaccinated children.
• Dr. Locke also mentioned the expectation of breakthrough infections (new infection 14 days after full vaccination) among a NYC baseball team with 8 cases among fully vaccinated players. Unlike most populations, sports teams are regularly tested for COVID-19, otherwise most of the time, these infections would not be detected, as they are mild or an asymptomatic disease course. Small outbreaks do not justify specific restrictions, as the risk to others is not zero, but low, and not a public health threat. Jefferson County has documented 5 cases of breakthrough infections among fully vaccinated persons.

KPTZ listener’s questions:

• The new CDC guidelines maintain that masking will remain necessary on all modes of public transportation, in hospital settings, clinics, and long-term-care facilities. Those fully vaccinated do not require masks when outside. While indoors, continue to follow all state and local mask mandates. We will essentially stay masked until we have sufficient protective herd immunity.
• An employer can inquire as to an employee’s vaccination status and with permission post the percent of employees vaccinated. Employees are not under any obligation to respond to the request. As an example, the public health staff in Kitsap County under Dr. Morrow has posted that 90% of employees have been fully vaccinated.
• Home testing kits for COVID-19 are available and cost about $20 for a package of two tests. Compared to the gold standard PCR test, these home kits are about 64% accurate when you have symptoms and about 34% accurate in the absence of symptoms. The manufacturer’s literature states it’s correct 80% of the time. These types of tests are not useful as a screening tool, but may be the most helpful when you are experiencing COVID-19-like symptoms. Results from these tests are not reported to the local health department, but you are advised to contact public health for advice and management of symptoms.
• The connection of the blood clotting cases with the Johnson & Johnson vaccine have been reported among one man and 27 women sometime after receiving that vaccine. This is a rare occurrence in the general public, rare among 8.7 million doses of the vaccine given to date, and is connected to a drug called heparin, used to thin blood when a person develops blood clots. Some people experience the reverse reaction, and the blood clots more from an unwanted immune response after receiving heparin. A pause in the use of the vaccine allowed the manufacturers and the FDA to issue new guidelines for use in certain populations who may experience this reaction.
• Another point of misinformation: there is no need to isolate when you receive any vaccination for COVID-19, as there is no virus in any of the vaccines to cause an actual infection, so you will not be “shedding” any virus. As the vaccine begins to make antibodies, you are actually safer to be around. The vaccine simply induces your immune system to make antibodies to the coronavirus as a practice run. We know this is true because those who receive the vaccine do not test positive for the coronavirus.

Willie Bence, Director, Department of Emergency Management:

• Last Saturday, Jefferson Healthcare held a drive-thru clinic for 12-17 year olds to get the Pfizer vaccine. This came after Pfizer was granted Emergency Use Authorization from the FDA last week for 12-15 year olds, creating a huge demand. Another Pfizer clinic will be held this week on Wednesday through Jefferson Healthcare for the same age group. Appointments can be made online or by calling the COVID-19 Vaccine Phone Line at 360-344-979, M-F from 9-5pm. Jefferson Healthcare will continue their clinics for 2nd doses, and will discontinue this operation site soon. They may keep the site available for clinics as new age groups periodically become eligible.
• Additional clinics targeting this age group will occur sometime in May in Chimacum, Brinnon, and Quilcene. On May 29, Brinnon will be the site for second doses with the Moderna vaccine. It is expected that the J & J vaccine will also be available for that day.
• Second doses continue to be given at Chimacum Schools in the morning, with a large clinic held this past Saturday and another scheduled for May 22. J & J will be available in the afternoon by appointment or as walk-ups. Medical consultation has been added as a feature of these clinics for residents who would like to speak with medical staff when considering getting a vaccination.
• Moving forward in June will involve sites through new community partnerships, which would for some residents improve access, along with incentives. These sites may include the Saturday Farmer’s Market, a site in the south of the county, and other businesses.
• If you have any questions or want to know where to get a vaccination, please call the COVID-19 Vaccine Phone Line at 360-344-9791, M-F from 9-5pm and a volunteer will assist you. Leave a message if you are not able to speak with the volunteer staff.
• The community mask makers are still producing masks and can be picked up at several community sites. Thank you to Jane, who leads this effort, as well as all the mask makers and other volunteers. Our masks are still needed to protect employees who work indoors, until more residents are vaccinated.

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 10, 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 indicates a cresting and decrease in the recent wave of new cases, dropping about 30% from the previous two weeks. Hospitalizations are also dropping due to the diminishing cases in hard hit states like Michigan and Minnesota.
• Washington continues to see new cases, hospitalizations, and deaths. We rank 10th in the nation for new case rates per 100,000. We experienced a slight decrease (4%) in cases for the last two weeks, but also saw hospitalizations increase 7% and a 22% increase in deaths. This suggests that a cresting for our state may occur near the second or third week of May and hence the reason for holding off on any decision to return as many a ten counties to Phase II of the RoadMap to Recovery Plan by Governor Inslee. If we are about to hit the peak of new cases for Washington, in conjunction with more of the state’s population initiating or completing their vaccine series, we may be able to avoid any additional economic or social restrictions.
• Jefferson County ranks among the lowest in new cases at 62.7 per 100,000, remaining stable from the previous two weeks. We have had 20 new COVID-19 cases in the last two weeks, with three cases seen in younger children. These cases in children were infected by an adult member of the household who had tested positive. Going forward, Dr. Locke said this is likely the future epidemiological picture with higher attack rates, among persons infected when exposed to household members, especially pediatric cases.
• Greater transmissibility among variants of concern also contributes to higher attack rates, particularly with younger children, as has been seen in Clallam County after three large outbreaks. Clallam remains stable with 108 new cases per 100,00 and Kitsap has neared the threshold for the RoadMap to Recovery plan at 196 per 100,000 population.
• On the vaccine front: locally, statewide, and nationally the number of doses delivered into arms has subsided from an average of 3.5 million a day down to about 2 million a day. One-third of the nation is fully vaccinated and 46% have received at least the first dose, meaning that supply is beginning to outpace demand. Washington ranks 17th in the nation with 51% fully vaccinated. Now is the time to begin outreach to (1) populations who find it problematic to schedule a vaccine appointment due to job and family commitments, (2) those who are still trying to weigh the risks against the benefits of getting vaccinated, and finally (3) those who have a specific objections or a political perspective that would not likely be influenced by anyone.
• To this end, the strategies for delivering shots needs to change. Currently, Jefferson HealthCare will not be scheduling any more drive-through clinics, but continuing those clinics for second doses only. Teens will have more opportunities for vaccinations in the coming weeks, with recent clinics onsite at Chimacum and Quilcene school sites. Mass vaccinations at Chimacum Schools continue this weekend with completion of second doses and an afternoon (1-2:30pm) clinic for Johnson & Johnson.
• Homebound residents have been able to get the vaccine through the assistance of a mobile clinic supported by the state. The mobile clinic continues to seek residents who can not easily leave home. Call the COVID Vaccine Phone Line (360-344-9791) to place these residents on a list to receive the vaccine in their homes.
• Multi dose vials will continue as there is a worldwide shortage of the specialized glass that is required for vaccine vials. This also poses the problem of needing at least 10 to 14 individuals to receive the vaccine when a diluent is added in preparation for administration. If not used within a specified time, the vaccine is wasted. Single-use vials are not practical at this time due to the glass shortage, so the strategy will begin to focus on small clusters of unique populations with more convenient times and settings to achieve the herd immunity goal of 70% fully vaccinated residents. As we near this goal, health care facilities may be less impacted, as well as a drop off of disease activity. Gatherings will likely increase with fewer restrictions, but pose a problem for those who remain unvaccinated.
• A long-awaited announcement this week by the CDC and WHO has formally acknowledged the airborne transmission of this virus. This has ramifications for any public indoor space which allows groups of people for activities. It may require indoor public spaces to revamp indoor ventilation measures as infectious respiratory particles as small as 100 microns can travel easily within that space and beyond. Normal conversational activities and socialization when someone is infected can easily spread indoors and expose those unvaccinated. So when masking and social distancing are discontinued, the unvaccinated will face the greatest risk of exposure and infection without significant adaptations of the ventilation systems for indoor public spaces.
• Jefferson County is the first county statewide to exceed 50% of its residents being fully vaccinated, with 61% receiving at least one dose. For those actually eligible – 16+ years and older – 67.2% are fully vaccinated. Dr. Locke thanked all the organizations and volunteers who supported this effort.
• The FDA and APIC are expected to endorse the Emergency Use Authorization for 12-15 year olds for the Pfizer vaccine this week. As soon as the endorsement is made public, this county will begin plans for clinics and sites to vaccinate this new population. This age band constitutes approximately 1,000 residents and the county is eager to get them vaccinated to ease the return to an in-person educational experience. It is unlikely that the western area consortium for vaccine review will delay this process of getting the vaccine into arms, as they usually work quickly to review the safety data independently.
• The coronavirus is expected to be endemic worldwide, never really disappearing. It will be treated like influenza as it correlates with winter infections and thrives best when humidity is low and most residents retreat indoors in crowded spaces. With a higher percent of vaccinated residents, outbreaks will not require economic or social restrictions. It is expected that fully vaccinated persons will face fewer restrictions than unvaccinated persons.

KPTZ listener’s questions:

• India’s situation was catastrophic and preventable, when leadership failed to understand the severity and seriousness of this disease and thus failed to act.
• With anticipation of more in-person family visits, what safety practices to use depends on the vaccination status of those gathering. Exclude members who are ill or recently exposed to a known case. And if someone has recently traveled, make use of the home tests currently available before meeting in person. If everyone is fully vaccinated, there is little reason to use any precautions like masking or socially distancing. If relatives or friends travel, include extra days before gathering to monitor health for 5-7 days and use the home tests to rule out active infection. Outdoor gatherings are safer with precautions if time is limited for the visit.
• Vaccination rates among health care staff are less than ideal (under 80%) at this time, however, mandatory vaccinations may be instituted when vaccines become fully approved by the FDA in the near future. Local numbers of vaccinated health care staff are not available.
• Asking your dentist and staff if they are vaccinated is a reasonable question, as their status could impact your health. They are not required to answer your inquiry, however. If they continue to use full precautions, this is still a safer environment to receive services.
• If you have family members who are refusing to get vaccinated, don’t give up. Instead, emphasize the positive aspects that come when more of the community is fully vaccinated, such as: greater choices for travel, protection for others, escaping serious infection and hospitalization, and solid safety data with millions receiving a variety of vaccine platforms. Long-term information can’t be given for a pandemic only 15 months old, with new vaccines, but there is no reason to doubt our experience with other vaccines.
• Vaccinations for persons with a recent infection of COVID-19 should ideally wait 28 days after resolution of the infection before receiving an inoculation. If you choose a two-dose vaccine, be sure to get both doses on the schedule recommended.
• Dr. Locke is of the opinion that the notion that this vaccine affects one’s menstrual cycle may be a way to scare women, as we have no data to suggest this phenomenon. This question was not part of the vaccine drug trials. It is known that the uterus is connected to the immune system, as is every organ which might become infected. Short-term changes in your menses can be observed from stress and lack of appropriate nutrition, but studies are lacking regarding any impact on fertility. What IS known is the risk to pregnant women who experienced COVID-19 infection. It is a serious disease, with women experiencing complications at a much higher rate than women who are not pregnant. Women can safely get vaccinated during pregnancy, the sooner, the better.

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

• This week, the Department of Emergency Management (DEM) conducted vaccination clinics for 16 and 17 year olds at Chimacum and Quilcene school sites using the Pfizer vaccine. Students this age will have other opportunities soon to get this vaccine as additional clinics will be planned.
• DEM is partnering with the state’s Mobile Clinic staff to offer vaccinations to those housed at the American Legion and the Fairground homeless residents. Selection of the type of vaccine will be determined by each resident based on their preference for either the one-dose or two-dose series.
• DEM and JC Public Health staff continue to serve up second doses at Chimacum Schools on Saturday, May 15 and May 22 in the morning. Johnson & Johnson vaccines are available by appointments or on a walk-in basis this Saturday from 1-2:30pm at Chimacum Schools.
• Transition to walk-in clinics versus appointments has been complicated by strict guidelines not to waste doses of the limited supply of vaccines early in this process. At this time, wastage is less of a priority than getting shots into arms, so movement toward more walk-in and point-of-service availability is becoming the norm.
• As we await approval from the FDA for 12-15 year olds for the Pfizer vaccine, plans are being made to inoculate this new age band. A host of ideas are being looked at to meet residents at gathering places such as churches, watering holes, and points of common gathering, with the assistance of Main Street, business contacts, and community events.
• Anyone with questions or having trouble finding or securing an appointment should call the DEM COVID Vaccine Phone Line at 360-344-97912 for assistance.

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 Chimicum 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 Chimicum 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.

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, April 26th, 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 15% from the previous two weeks. This trend is driven by the decrease in new infections among the states in the upper Midwest, as well as the states along the Atlantic seaboard. However, Oregon has seen a 51% increase of new infections within the last two weeks, making it the 17th highest case rate among those states experiencing a rise in new cases. 
• Washington continues to see new cases increase (26%) the last two weeks, as well as hospitalizations (42%).  Hospitalization continues to occur among younger residents who are ill enough to be admitted, with improved survival rates.
• New case rates for the state now exceed the Governor’s threshold for Staying in Phase III of the RoadMap to Recovery at 202 per 100,000 population.  These higher case rates and hospitalization rates are primarily driven by counties experiencing a surge of a fourth wave, such as Pierce and Yakima, at 325 per 100,000 and 218 per 100,000 per population, respectively.  
• The state will evaluate phase status for all counties on May 3 and most likely will place some counties back into Phase II restrictions, to further mitigate the spread of the virus. This of course means that many businesses such as restaurants and gyms will need to reduce capacity to control the spread of infection.  Although many of the clusters of new infections occur within households, new infections are likely the result of travel outside the community, friends and family visits into a community from another area and variants which are more infectious and transmissible.  Individual and household behavior have a widespread effect on the business life of the community and its ability to stay in the less restrictive phases of recovery outlined by the Governor. 
• Jefferson County has reported 19 new cases in the last two weeks, bringing our case rate to 60 per 100,000 population.  This may be recalculated as of this reporting due to the arrival of lab results conducted over the weekend.  Clallam County remains at 108 per 100,000 and Kitsap has risen to 190 per 100,000. 
• Washington continues to receive and distribute vaccinations (5 million to date), with approximately 40% of the population having received at least one dose and 27% completing the vaccine series and now fully vaccinated. 
• Jefferson County continues to lead other counties with nearly 57% of residents having received one dose and 45% fully vaccinated. Removing the proportion of younger residents who are currently not eligible to receive the vaccines in Jefferson County at this time (11%), 62% of adults 17 years and older are fully vaccinated, with at least 50% receiving their first dose.  This progress toward widespread community immunity may begin to blunt the fourth wave of this pandemic in our region. This progress would not have been possible without the extraordinary support from Jefferson HealthCare, the Department of Emergency Management, area pharmacies and an army of volunteers.  Much of our county was eligible as a priority for the vaccine due to our unusual population distribution of older residents and our readiness to receive and deploy the vaccines.
• This is a critical juncture for communities, as supplies have now caught up to the demand for vaccinations.  New strategies are needed for harder-to-reach populations and those with hesitancy about receiving the vaccine.  This last weekend at the Chimacum School clinic, 308 second doses were given, but only 147 of 300 first doses available were given.  The successful Chimacum School clinic will continue with 2nd doses for the next 2 weeks, but first dose clinics will now target smaller communities south – like Brinnon – for the first weekend in May, as well as a clinic for the predominantly Spanish-speaking population next Sunday at St. Mary’s Catholic Church in Port Townsend.  Walk-up clinics, as well as mobile clinics, are also being planned, with support from the state.  Homebound residents figure prominently in this change in outreach, since the current model of mass vaccination sites do not serve all residents.  It is estimated that at least 20% more residents of Jefferson County need these barriers to be removed in order to get a vaccination and achieve community immunity.  A caveat remains that once a vaccine vial is opened it must be used within a specific time frame, so wasted vaccine doses are still a concern.
• Vaccine hesitancy remains a challenge, further eroded by the recent suspension of the Johnson % Johnson vaccine due to a rare blood clotting disorder discovered among women under 50 years old of child bearing age. This vaccine was a popular choice for younger populations, with only one injection required. The FDA and CDC remain confident about this vaccine’s safety and efficacy; however, some residents who favored this vaccine are now more hesitant. Between one fourth and one third would still get it.  It will be important to encourage other vaccine options in this population.
• For those who start with a two-dose vaccination series, about 8-10% are failing to come back for the second dose.  Although the first dose confers good protection, it is not the protection one could receive when two doses are administered.  The second dose primes your immunity with a higher supply of antibodies necessary to protect you further from variants.  Employers are being engaged to support employee vaccinations with paid time off for the second dose, if recipients experience side effects, and to talk about the benefits of returning to a more socially safe working environment, as well as a more normal social life. 
• Will there be an effort in the public realm to limit access to a venue when a person is not fully vaccinated?  Dr. Locke stated that some organizations may do this, especially airlines and educational institutions, particularly private businesses. The limited Emergency Use Authorization status is a changing landscape as both Pfizer and Moderna have applied to the FDA for final approval of their vaccines, thus changing the possibility of required proof of vaccination for participation in certain venues. This may also support incentive toward more residents getting fully vaccinated, as voluntary vaccination progresses to mandatory. 
• Dr. Locke will modify his order for specifications for open meetings to now align with Governor Inslee’s requirements. The Chair of each body will remain responsible for adhering to the recommendations and assure that a plan is in place to comply with the proclamation.  Dr. Locke stated that this fourth wave is expected to peak in May and then drop off. With prevalence in some parts of the state still high, exposure opportunities are still high, so it is best to have the public remote when having meetings as specified in state standards at this time.  A website link to the open meeting capacity and best practices will be placed on the Jefferson County website.

KPTZ questions:

• The capacity of a Physical Therapy clinic is not specifically addressed by state standards like businesses, industry or commercial space guidelines.  It is ruled by healthcare facility standards and should adhere to the CDC recommendations of distancing, ventilation, masking, health screening and sanitation guidelines.  This is balanced by the population coming to the clinic in terms of access while maintaining their health during a pandemic. Phase II and Phase III do not apply to healthcare facilities.  It then becomes a personal assessment of your risk in exchange for the health benefits you may need. 

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

• This last week, Chimacum clinic delivered 455 doses of the Moderna vaccine, with 308 first doses delivered and 147 of 160 scheduled first doses, with 13 no shows. 
• This next weekend, there will be 100 first doses available at a pop-up clinic in Brinnon.  Those needing assistance in scheduling appointments need to call 360-344-9791 at the DEM Covid Vaccine Phone Line, M-F from 9am to 5pm. 
• This Sunday there will be a Spanish-speaking pop-up clinic at St. Mary’s Catholic Church in Port Townsend.
• DEM is seeking partnerships with organizations and entities who can identify under-served populations for vaccinations for the purpose of planning strategies for additional vaccination outreach and clinics. 
• Thanks go out to all who have been involved with this massive vaccination effort.  For the meantime, however, Mr. Bence has suspended recruitment of volunteers as the mass vaccination sites transition to smaller, more unique populations still needing vaccines, such as homeless populations, congregate living settings or home bound residents with the mobile clinics. 
• Dr. Locke stated that the Labor and Industry standards still apply to meeting indoors within office spaces, with masks to a question submitted by the public to DEM.  It is not appropriate at this time to have fully vaccinated persons take off their masks in an office setting when all are fully vaccinated.

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, April 19th, 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, new COVID-19 cases have slowed, but continue to increase, with a five% rise over the previous two weeks, with an average of 67,000 reported cases a day. The true number is most likely double the number of confirmed cases. The hot spots remain in the upper midwest and east coast, with Michigan reporting exponential numbers out of 26 states reporting increased cases.
• Washington reported a 38% increase over the last two weeks, with hospitalization also increasing by 41%, primarily among 40-50 year olds. The case per 100,000 population now stands at 191, nearing the RoadMap to Recovery threshold for reverting to Phase II, if suppression of the virus is not driven downward. Death rates have increased by 42% compared to the previous two weeks, which means about 8 residents die each day, which is higher than the rates from a year ago in the same time period.
• As of this report, Jefferson County had 10 cases each for the last two weeks, raising our new case rate up to 62 per 100,000 population and 374 cases to date. Clallam and Kitsap have also seen new case rates rise, 114 per 100,000 and 147 per 100,000, respectively. The increases are driven by the continued spread of more infectious variants from California and the UK, with confirmed cases of the UK variant in Kitsap and Clallam. This wider spread of the variants impacts transmission within households, schools and work sites and has health department staff on alert. Genetic sequencing is occurring on about 5% of all nasal swabs and this figure is used as a basis for modeling the approximately incidence of these new variants in circulation. What used to take about three weeks to sequence, now takes about a week.
• One 60-year-old resident, with co-morbitities, died this last week at Jefferson Healthcare from COVID-19 complications.
• Increasing new case rates means that exposure to the virus increases, particularly in dense urban areas, with a proportion of cases stemming from the more infectious strains. The trend is that more cases are being diagnosed among younger residents. The greatest increase is among the 20-39 year age group. The settings that pose the most risk continue to be indoor dining and sporting events, fitness centers, and gyms – worksites as well as large gatherings in poorly vented indoor spaces among unvaccinated or incompletely vaccinated persons.
• Vaccination progress continues, with 4.4 million Washington residents receiving at least one dose and 24% fully vaccinated. Jefferson County residents receiving at least one dose stand at 54%, with 40% fully vaccinated. If all residents under 18 years of age (3,776) are subtracted from the total population, then the adult population eligible and receiving at least one dose stands at 61%, with 45.2% fully vaccinated. This progress toward herd immunity could mitigate the magnitude of a fourth(4th) wave for this community.
• Caution still needs to be practiced when considering activities which mix non-household members together. When the adults are fully vaccinated, they still may have young people in their family who can not yet get the vaccine, so continue to practice masking and distancing when in a closed setting for a brief period, or for longer periods when you can gather outside.
• The Johnson & Johnson vaccine remains on hold. The CDC and FDA are meeting to determine recommendations, as the hold may soon be reversed with some restrictions for use in those with clotting disorders. It is anticipated that the two other vaccines currently approved will be a substitute vaccination choice. Even with the temporary hold, many individuals are preferring to wait for the J&J vaccine.
• Pfizer recently made an application for an Emergency Use Authorization (EUA) after initial results showed efficacy and safety in a clinical trial for 12-15 year olds. It is expected if an EUA is granted by the FDA, this age band will be able to be vaccinated during the summer. Moderna is also in trials for this age group and expects to seek EUA status soon. Children 11 and younger can expect completion of clinical trials later in the year or the first quarter of 2022 and vaccine availability soon after this time frame.
• Jefferson Healthcare and QFC Pharmacy have Pfizer vaccines for 16 and 17 year olds in anticipation of special clinics for this age band. Check their websites for appointment availability as well as special clinic times.

KPTZ questions:

• Following CDC guidelines, for those with full vaccination status, indoor gathering of a small book club can resume without masking. However, remember that 1 out of 20 fully vaccinated individuals may not have benefited from the inoculation and still pose a risk to others if infected. Breakthrough infections after full vaccination series have been documented and continue to pose a risk. When among the general public, indoor settings, and crowds, continue to follow CDC recommendations for everyone’s safety.
• Anyone can register for a CDC national program called VSAFE. Anytime after a vaccine, a person can register and report side effects to a database intended to track the experience you had with your vaccinations and invites feedback from a population standpoint versus a clinical trial. This is especially important as the new methodology of vaccine development aggressively prompts your immune system to respond without an actual COVID-19 infection.
• Those fully vaccinated can also ride in a car together unmasked. It is still a good idea to get ventilation to avoid other infections as well.
• If you enter an indoor space which allows up to 50% capacity, but see that the capacity is higher than that, you may need to refrain from entering and leave. Although under Phase III, capacity at 50% may be permitted, it may not mean it is actually safer, especially in the light of greater spread and infectiousness of the newer viral strains. Currently there is no enforcement of these guidelines, unless an employee makes a complaint to the state labor board.
• Past recommendations for rigid surface cleaning, washing fruits and vegetables are not the primary transmission route for the COVID-19 virus. Transmission by fomites (inanimate objects) is less likely than respiratory droplets. Cleaning and sanitizing highly touched surfaces by multiple persons still is advisable to prevent other infections.
• A condition called ”long hauler” syndrome occurs after a COVID-19 infection leaves a person with prolonged and sometimes debilitating effects of an initial infection, even if that person initially tested negative. Early in the pandemic, testing was limited, so even if you wanted the test, it may have not been available. Nearly 30% of those hospitalized with COVID-19 continue to experience a range of symptoms related to long hauler syndrome. It is more likely than not to have antibodies to COVID-19, no evidence of a positive PCR, yet report long hauler symptoms long after the initial infection.
• Even with a known COVID-19 infection, which may confer limited immunity, all individuals should be vaccinated.

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

• The Jefferson County Public Health and the Department of Emergency Management (DEM) vaccination clinic at Chimacum Schools this past Saturday provided vaccines for 662 residents. Second doses were given in the morning and first doses in the afternoon. There will be another clinic again this next Saturday, April 24, with nearly 200 first doses available to be scheduled at this reporting, as well as the Jefferson Healthcare drive-thru clinic during the week. Go to the Jefferson County Public Health website for information on where and how an appointment can be made. Residents can also call the DEM COVID-19 Vaccine phone line at 360-344-9791 for assistance, Monday-Fridays, 9-5pm.
• Volunteers are continuing to staff all the clinics sites and are greatly appreciated by the community. Volunteers are still needed for traffic control and need to be able to be on their feet for several hours as well as being willing to work in any weather

Today, April 12, 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: 

• The national picture continues to demonstrate a steady increase of new infections, with a daily average of 69,000 new cases reported each day. This current peak is higher than the peak in new cases last summer, demonstrating a failure to significantly lower the circulation of this virus. The states hardest hit are midwest and eastcoast states. Hospitalizations are increasing as well, with a 32% increase from the previous two weeks. Those hospitalized are younger residents between the age of 40-50 years, a departure from the morbidity seen among older residents in the beginning of the pandemic – clearly a protective effect from vaccinations among this older age group. This translates into a decline of the death rate of 27% over the last two weeks.
• The recent rise in new cases in Washington is driven by the presence of variants of concern, primarily two homegrown strains from California, B.1.427 and B.1.429, circulating within this state since November and December of 2020, respectively. These strains account for 50% of the new cases in this state. The UK variants continue to circulate here, accounting for nearly 34% of cases sequenced, doubling every 12 days, and expected to account for the majority of the new cases by the end of April.
• All the new strains pose a challenge to containing this pandemic as is evidenced with outbreaks recorded in British Columbia to our north. Although the US/Canada border is closed to recreational travel, commercial travel still continues to be a potential for further spread into our state of these variants of concern. All the newly documented strains are more infectious as well as being able to evade the vaccine’s effectiveness.
• Jefferson County recorded 10 new cases last week; including 7 cases the previous week, this brings our new case rate to 53.29 per 100,000 population, which doubles our rate from the previous two weeks. Our case positivity remains below 1%, most likely an artifact of less testing among residents of this county. This does impact surveillance efforts, thus the need to repeat recommendations isolate and to seek COVID-19 testing after 7 days of the onset of any respiratory symptoms, as well as seeking testing 3-5 days after travel to an area with increasing new case rates.
• Surrounding counties are recording increased new cases as well. Clallam is reporting 87 new cases per 100,000 population with 5.4% positivity of those seeking testing. Kitsap has risen to 144 new cases per 100,000 population and reports 6.1% new case positivity.
• The RoadMap to Recovery used by the Governor to move forward with our economic recovery relies on two metrics that signifies the collective containment of this virus, as well as our capacity to manage and contain outbreaks and clusters of new infections. Both new case rates and hospitalizations are assessed every three weeks for all counties. Failure to meet the thresholds for large and small county metrics may push some counties back to the previous phase for a temporary period. Currently, any county failing either of these two metrics may expect to be pushed back to a prior phase, however, many health officers are asking that failure of both metrics be the standards from this point forward. This current method, they believe, unfairly impacts smaller counties, putting thresholds so high, so as to have the local spread get out of control before thresholds are met and state restrictions are imposed. Other states, like Michigan, have seen outbreaks coinciding with increased capacity at sporting events and indoor dining, placing residents at risk of infection, especially those who are unvaccinated. A group of Health Officers from smaller counties is sending a letter to Governor Inslee regarding this issue. The fact remains that the authority to impose restrictions to control the spread of new cases lies with the local county health officer, under current laws.
• This is a critical issue of timing, with about two more months of intensive efforts to get more residents vaccinated before returning to more activities indoors or large group gatherings as allowed in Phase III, thus preventing widespread transmission of the coronavirus. With daunting logistical measures, Washington has given more than 4 million doses of vaccine, with nearly a third of residents receiving one dose and 21% fully vaccinated. Jefferson and Clallam remain among the counties with the highest efficiency of getting their residents vaccinated. Jefferson has 51.6% of its population receiving at least one dose and 36.7% fully vaccinated. Clallam ranks second in these efforts.
• Vaccine dose supplies will remain flat for the next few weeks, although our capacity to vaccinate residents exceeds our current allocations. The Johnson&Johnson vaccine experienced a manufacturing error at a plant pending FDA approval and has delayed delivery of 65 million doses, so states can expect a nearly 80% reduction in expected supplies. These doses were expected to be used for pop-up clinics in many counties, so these clinics will be on hold until supplies increase.
• The targeted pop-up clinic in Quilcene this past weekend provided 123 vaccinations to its residents, with more specific geographical areas slated for the future, such as Brinnon. These clinics are all staffed by volunteers and can provide about up to 300 doses in about three hours. These special clinics are likely to be planned for the time period when greater numbers of vaccine supplies are coming in May.
• Don’s Pharmacy is receiving about 100 J&J doses as they join the organizations giving vaccinations. TriArea Pharmacy and Jefferson Healthcare continue to provide Moderna for their clinics, as well as J&J allotment to the S’Klallam Tribe now being shared with Jefferson Healthcare for their drive-thru clinics. The J&J vaccine is especially favored by younger residents, who like the convenience of just one shot. Additional clinics in Port Angeles and Sequim are scheduled in an inter-county effort to get the Olympic Peninsula upwards of the needed 70-80% fully vaccinated rates which would confer herd immunity. Residents are encouraged to get vaccinations in either county as soon as appointments are listed.
• An additional clinic is scheduled this week with the Pfizer vaccine approved for persons 16 and 17 years old. Although counties are not receiving Pfizer vaccine supplies at this time, a supply of vaccines has been stockpiled as extra doses are being put into vials and they have been reserved for this age range. This company was the only manufacturer to use this age range in their clinical drug trials.
• More young persons will be able to get vaccines over the summer as more manufacturing companies conduct clinical trials for younger age groups and begin to apply to the FDA for Emergency Use Authorization for these younger subjects. Preliminary results show the same safety and efficacy data seen in the adult clinical trials. It is critical to get this population vaccinated with the necessity of students to return to school in person and the increased circulation of more transmissible viral variants.
• Today at 2:30pm, Governor Inslee will announce the plans for any rollback to Phase II for those counties who do not meet the adjusted metrics. Dr. Locke reminded us that we have one chance to respond to rising metrics, and if we wait, we have to take more drastic measures to bring down high case rates, which just prolongs the pandemic. He praised the Governor for his leadership, given the complications of this pandemic. Washington has fared better than other states given his leadership and recommendations from public health officials.
• Vaccine hesitancy continues to be an issue for our state’s efforts to reach herd immunity, with outreach to those who are waiting outcomes for those who have received the vaccine. Messages need to target those who have reservations. Research shows that trusted medical staff are good persuaders for the hesitant. For those whose world view intertwines vaccinations with other life views, persuasion is less useful, no matter where it comes from. This tends to be 5-10% of the population.
• Dr. Locke reminded us of the phenomenon of “long haulers” – those with long-lasting, troublesome aftereffects of COVID-19 infections. This is an important reason to get the vaccine as this is not benign illness. Some people – 10-30% – experience debilitating symptoms, such as cardiac complications, from getting a COVID-19 illness. Vaccines can prevent this and have been deemed better protection than getting the disease naturally. In general, preventing the disease is better than getting the disease. If we prevent infection and disease, long-hauler incidence will also decrease, relieving further suffering.
• Dr. Locke mentioned a KPTZ program he recorded this past weekend to be aired this coming week, so check the KPTZ website for opportunities to listen to the recording.

Willie Bence, Director, Department of Emergency Management:

• Mr. Bence stated that the Quilcene pop-up clinic this last weekend served 123 residents with the J&J vaccine supplied through the TriArea Pharmacy and staffed by volunteers. More of these types of clinics are planned for Brinnon and areas with a high concentration of Spanish-speaking residents. The mass clinic scheduled for this coming weekend at Chimicum Schools on April 17 has about 19 slots left for first-dose vaccinations. Second doses will be given in the morning, with first doses given in the afternoon. Call the Emergency Management COVID-19 Vaccine Phone Line to schedule -360-344-9791.
• Volunteers are still being recruited, as the effort to vaccinate everyone who wants a vaccine will take more months to accomplish. Currently, over 250 volunteers, medical and non-medical persons staff all the clinics. To get these vaccinations accomplished, a huge reserve of volunteers are needed to prevent exhausting anyone and taking turns to staff clinics.
• Still needed are medical staff who once had a license in Washington, active or inactive. Non-medical volunteers are needed for traffic control, computer experience, logistics, set-ups, customer service, or the vaccine phone line. Commitment for a few months is important as this is a monumental task and requires regular attendance when you sign up.
• Currently, background checks are being conducted on those who recently applied and the DEM is trying to catch up, so please be patient with the process. But you will be needed for this massive task.