Whatcom County entered phase 2 of the state’s Safe Start Covid-19 re-opening plan on June 5, and could be eligible to apply for phase 3 on June 26. Counties must apply to the Washington State Department of Health to move to a more lenient phase, and counties must stay in each phase for a minimum of three weeks while health experts assess the impacts of re-opening.
The state department of health assesses phase applications on five metrics, which it says are targets rather than hardline measures. “Where one target is not fully achieved, actions taken with a different target may offset a county’s overall risk,” the state department of health said in a press release.
The metrics are: The number of new cases; healthcare system readiness and availability of hospital beds; the number of tests performed, testing capacity, and turnaround time for test results; rapid case and contact investigations; and protection for high risk populations.
Number of infections
The state health department’s target for new cases is 25 or fewer per 100,000 residents over a 14-day period. For Whatcom County’s population of about 225,000, according to the U.S. Census Bureau’s 2019 estimate, that means Whatcom should have less than 56.25 new cases in a 14-day period. For the 14-day period ending June 16, the state department of health reported 46 new confirmed cases in Whatcom County. Twenty-nine of those cases were reported in the last half seven days of the period, representing a slight increase in new cases. If the average from that period holds up over a 14-day period, Whatcom County would average 25.8 new cases per 100,000, just over the state’s target.
The number of tests performed in Whatcom County, however, is also increasing and that likely contributes to the increase in new confirmed cases, though it’s unclear how much testing has actually increased. Data posted on the state department of health’s website is said to be “incomplete” until it is about nine days old. Between June 7 and June 13, at least 1,616 people were tested in Whatcom County, according to numbers from the state department of health, which were incomplete at press time. That’s a 13 percent increase in testing from the previous week, when 1,430 were tested in the county.
As of June 12, the health department was investigating a series of outbreaks of Covid-19 related to “large private and recreational social gatherings,” held in Whatcom County in late May. According to a health department press release, outbreaks stemmed from gatherings both in public places, as well as parties at private residences. Partygoers and their close contacts have become infected.
The health department emphasized the risk of infection presented by large gatherings and the need to follow phase 2 guidelines.
“This investigation underscores the importance of following current guidelines for phase 2,” the press release said. “This includes limiting gatherings to five people or fewer from outside of your household per week, maintaining physical distance and wearing a face covering when in public.”
It is not yet known if the outbreaks will impact the county’s ability to remain in phase 2, according to the news release.
The state’s metric for new Covid-19 infections also requires that the number of people hospitalized with the virus be flat or decreasing. On June 16, PeaceHealth St. Joseph Medical Center in Bellingham didn’t have any Covid-19 patients and hadn’t had any for several days, said Bev Mayhew, director of marketing and communications for the hospital. At that time, the hospital also had no suspected in-patient cases of Covid-19, she said.
Healthcare system readiness
The health department assesses healthcare system readiness by the amount of licensed hospital beds available and the percentage of beds occupied by suspected and confirmed Covid-19 cases, two metrics where Whatcom County is succeeding.
At PeaceHealth, about 71 percent of beds were filled on June 16, Mayhew said. That’s well within the state’s ideal target of less than 80 percent. On that day, no beds were filled by Covid-19 patients; the state’s target is for less than 10 percent of beds to be occupied by Covid-19 patients.
Counties should be testing 50 people for every new confirmed case, according to Safe Start guidelines, and the percentage of total tests that come back positive should be two percent or less.
Between June 7 and June 13, the latest seven-day period for which testing data was available from the state department of health, 2.1 percent of tests in Whatcom County came back positive. That figure is based on data that is incomplete, according to the state department of health.
Whatcom Unified Command, (WUC) the multi-agency organization responding to Covid-19 in Whatcom County, didn’t respond by press time to questions about whether that organization or the health department is working to increase the amount of testing in Whatcom County, or about the turnaround time for tests – another metric the state health department looks at for assessing applications to move phases.
Whatcom County wasn’t hitting the state’s target of 2 percent when it moved from phase 1 to phase 2. At that time, 3.1 percent of tests were coming back positive, according to the county’s phase 2 application.
For this and other metrics, the state also takes additional information that is harder to quantify, such as the geographic spread of testing sites in counties and the availability of testing supplies, said Jessica Baggett, spokesperson for the state department of health.
Case and contact investigations
In its application for phase 2, Whatcom County was meeting one of four targets for case and contact investigations. Ninety percent of confirmed cases should be contacted within 24 hours of a positive lab test report, according to the state’s guidelines. Whatcom County was contacting 94 percent within 24 hours.
The county fell short of the state’s target of reaching 80 percent of an infected individual’s contacts within 48 hours. In the early June application, Whatcom County was reaching 70 percent of contacts within 48 hours.
On two other metrics – percent of cases contacted daily during isolation (those with confirmed cases) and percent of contacts being contacted daily during their quarantine period (for those exposed to the virus who have not become sick) – the county health department provided no data in the phase 2 application, saying it was very recently made aware of the requirement but anticipated meeting it.
A WUC spokesperson didn’t respond by press time to a question about whether the county was currently meeting state criteria for case and contact investigations.
Protecting high-risk populations
To move to a more lenient phase, the state’s goal is for counties to have one outbreak for counties with a population between 75,000 and 300,000 people. Whatcom County currently has multiple outbreaks. WUC didn’t respond by press time to a question about how many outbreaks it is currently tracking in Whatcom County.
The state defines an outbreak as two or more non-household cases epidemiologically linked within 14 days in a workplace, congregate living or institutional setting. Baggett, the state department of health spokesperson, said the state looks at total outbreaks in a county, and not just the number of outbreaks in a nursing home or other high-risk population.
Whatcom County and the state as a whole have had success with stopping the spread of Covid-19 in skilled nursing facilities. Good Samaritan Society – Stafholt, a skilled nursing facility in Blaine, became Covid-19 free in May, after having 17 residents test positive for the virus earlier.
To date, Whatcom County has had 449 cases of Covid-19, and 38 deaths are associated with the virus. According to data from the county health department, just two new cases since May 28 are people who live within the Blaine school district’s boundary. To date, 32 within the district have tested positive for the virus. The district encompasses Blaine, Birch Bay and Point Roberts.
Since May 28, the number of cases in the Meridian and Nooksack Valley districts has more than doubled, to 31 and 29, respectively. The Blaine school district currently has the lowest rate of confirmed cases per 100,000 residents out of any district in the county, with 182 per 100,000.