Washington Department of Health briefs Senate on status of COVID-19

Washington Department of Health (DOH) Secretary John Wiesman briefed the Senate Ways & Means Committee in Olympia this morning on the statewide response to the COVID-19 outbreak and its projected costs.

Today marks day 42 of the official response in the state. The first COVID-19 case in the United States was identified in Washington State on January 20th when a Snohomish County man in his thirties tested positive for the virus after returning from a trip to China. There have been a total of 14 cases of COVID-19 identified between two counties – King & Snohomish – including five deaths in King and one in Snohomish.

Right now, 232 persons are under public health supervision in quarantine due to their travel patterns and exposure to high risk areas. Local public health officials are monitoring them for symptoms.

As of Friday, the state public health lab can test for the virus and get results in one day. Previously, the state lab did not have the necessary equipment to conduct the tests locally and had to send samples to the Center for Disease Control (CDC) lab.

Based on these numbers, according to Sec. Wiesman, the risk of infection in Washington is increasing. 

 

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A new development in some of the recent cases is that they do not appear to have been related to travel, but rather spread in the community.

From the perspective of DOH, Wiesman said that the primary focus has been to slow down the introduction of the virus in the state so that health care systems can respond adequately. He estimated there to be between 100 and 150 DOH staffers assigned to the response effort.

Wiesman underscored the increased demand on health care systems as a significant concern. In addition to COVID-19, there is a Hepatitis A outbreak still underway in the state. There are also cases of tuberculosis and food borne outbreaks that health care systems must contend with. 

Wiesman confirmed that many DOH staffers are being redirected away from other outbreaks to assist with COVID-19 response efforts. As hospitals attempt to grapple with the outbreak, DOH is hopeful that the spread of COVID-19 will not outpace the decline of influenza as the flu season comes to an end. 

In terms of the costs on public health systems, DOH anticipates the response measures will cost them $2.3 million, with a spending rate of $60,000 per day. 

As expected, the bulk of local costs are being felt in King and Snohomish Counties – the two counties where infections have occured. 

King County has been spending around $200,000 per week, and now the county expects the response effort to top $6 million. Snohomish county anticipates to spend about $700,000 over the next six months. 

At present, the total estimated cost for the public health system in Washington is approximately $3.5 million. However, Wiesman warned that future costs are a bit difficult to forecast as it is unclear how long the response effort will last. 

Stopping the system from getting overwhelmed remains the primary goal for DOH in its response efforts. Direct strategies for offsetting the increased burden include increasing the surge capacity of health care systems and utilizing telemedicine services to ensure that people with mild symptoms can either get diagnosed and/or receive treatment at home so that overcrowding in emergency rooms can be avoided.  

After briefing the Committee, Wiesman took questions from Senators. State of Reform has excerpted a few of the questions below.  

Questions from Senators

Sen. Keiser: Each test costs about $2500 to enact. How broad is the testing going to be in Washington? You will have to test a lot of people and that is exponential in terms of cost.

Wiesman: While the state can now test at its lab, we have the capacity to test about 100 patients per day. Research labs now have the authority to get on board. We might be able to conduct up to 1 million a week soon. When tests can be ordered by clinicians using DOH guidelines, things will be made much easier.”

Sen. Van De Wege: Are there laws in place regarding price gouging when a State of Emergency happens? And is there a declaration you can give to schools if you think they should be closed?

Wiesman: Not sure regarding laws on price gouging. We will have to consult lawyers on that matter. But part of the response effort must address scams and misinformation that are out there regarding faulty test kits. On schools, local health officers do have authority to close schools, as well as superintendents and school boards.”

Sen. Wilson: A lot of people have been buying masks and stocking up on supplies. Can you reiterate why masks are not effective in stopping the virus?

Wiesman: N95 respirator masks are the only masks that are effective, and they need to be fitted appropriately for individuals. Even then, the mask is most beneficial for those who already have the illness so that droplets don’t get out via coughing, sneezing etc.” 

Sen. Liias: I represent a strong Asian constituency. As we discuss the virus, what can we do to ensure we’re not doubling down on racial stereotypes? 

Wiesman: Viruses have no idea of what race or ethnicity you are. All of us have the responsibility to call that out. We also need to direct people to credible sources of information. We can also visit Asian businesses who are being unfairly targeted.”

Sen. Frockt: How are we mitigating risk for front line health responders and first responders? How do we do that with a contagious virus? 

Wiesman: The first thing is that when someone thinks they may have been exposed, call ahead and let health providers know. That’s what happened in the first case and it was incredibly helpful.  Next, facilities should be implementing prevention guidelines laid out by DOH and using protection equipment supplies (gloves, fitted masks etc).”

Sen. Becker: For the public, when is the time for them to think of this differently than the regular flu? What is the infection timeline given that many people are asymptomatic? 

Wiesman: We know we are having community spread and risk is increasing. There is asymptomatic infection but we don’t know how much. In those cases, we don’t know how easily transmission happens. We believe the biggest piece involved in transmission is when people are displaying symptoms because that’s how the droplets spread. The incubation period for showing symptoms is 2-14 days. Most people show symptoms before 5 days, though.” 

Sen. Carlyle: Who is most at risk?

Wiesman: Those who are most at risk for COVIF-19 are older, maybe 60 and over as well as folks who have underlying health conditions (cancer, cardiovascular disease, respiratory diseases).”

Sen. Darneille: Do you feel you are getting the support you need from the federal government? And are there investments we need to make in terms of public facilities?

Wiesman: We have had amazing support from the CDC, and we’re pleased FDA took unprecedented steps to expand emergency authorization. We are looking forward to resources coming from Congress as well. In terms of public facilities, we need isolation and quarantine facilities. That has been under-resourced. What happens now is that local health depts just find local motels/hotels willing to rent out rooms.” 

Sen. Braun: We’re headed into spring and summer, based on that when do we think we know this virus has run its course?

Wiesman: We don’t really know whether this will act like seasonal influenza, with this being a new virus. It may well be that this becomes a seasonal disease. Those are things to be determined. We will do an epidemiological curve to look at this. If we know incubation period is around 5 days we’ll be able to see whether we’re still getting cases in big clumps. There is still a lot of modeling to be done around this.”