Hello Thurston County!
We, like many other counties in Western Washington, are experiencing a fall surge in COVID-19 cases. As a county, we are currently in the high transmission range with transmission rates being above 75 cases per 100,000 population over 14 days. As of October 26, our transmission rate is 86.8 per 100,000 population over 14 days. While some of this increase is due to the cases we are seeing as a result of COVID-19 outbreaks in long-term care facilities, there is increased transmission in our community. This is especially important to think about when deciding how to interact with people outside of one’s household.
As I work with people throughout our community, I am hearing people talk about their “quarantine bubble” or the group of people they exclusively socialize with outside of their immediate household on a regular basis. Many bubbles of people don’t wear a mask or physically distance when they are together. This is risky behavior because each member of the bubble is at risk of contracting COVID-19 while out in the community, at work, or from other social contacts who may not share the same behaviors towards COVID-19 preventative measures. If one member of the bubble gets sick each member of the bubble is at high-risk for getting sick. They would likely be considered a close contact and would need to quarantine for 14 days. The key to staying safe is maintaining physical distance, wearing a mask, avoiding gatherings of more than 10 people, and meeting outside when possible.
Halloween is coming up this Saturday. Celebrating Halloween in a pandemic can be done safely. The safest ways to celebrate include scavenger hunts at home with household members, online costume and pumpkin carving contests, or movie marathons with household members. If your family chooses to trick or treat, wear a cloth face covering that covers your nose and mouth, maintain a distance of 6 feet or more with non-household members, and practice frequent hand hygiene. If you would like to give out treats, it is safest to place them in treat bags on a table away from your door, or on a table in your yard or driveway. Place markers indicating 6 feet so trick or treaters can maintain distance if multiple household groups arrive at once. Please read our flyer for more tips for a healthy, happy Halloween. Halloween this year will be different, but it can still be fun!
I have been getting questions about whether or not Thurston County would go back to Phase 2 since we are in the high transmission range. When Thurston County received the letter from the Washington State Secretary of Health John Weisman approving the application to move into Phase 3 on June 24, 2020, our county transmission rate was less than 25 cases per 100,000 over 14 days and fewer than 2 percent of COVID-19 tests performed in our county were positive. In addition to transmission rates and access to testing, hospital surge capacity, personal protective equipment supply, public health capacity for case investigations and contact tracing, as well as facilities for quarantine and isolation for people who could not do so at home, were elements of the approval process.
Since our approval in June, transmission has increased in our county and around the state. In Thurston County, our hospitals have had the capacity to accommodate a surge in medical needs thus far. The county has also worked with community partners to assist with ensuring organizations in need of personal protective equipment have access to it. Thurston County Public Health and Social Services Department has increased our capacity and brought on many talented people from our community to assist in our COVID-19 response and have a quarantine and isolation facility which can be used by people who have COVID-19 and need a place to isolate away from home or who meet the definition of a close contact and need to quarantine away from home. Any decision to move phases would be undertaken with consultation with the Secretary of Health, Department of Health, and the Governor’s Office. At this time, no county in Washington State has moved backwards in the phases.
I have also received many questions about why we are concerned about our case increase and whether there was an accompanying increase in deaths. While nationally the death rate (case-fatality rate) has been dropping, which is likely due to multiple factors, here in Thurston County our death rate is rising in large part due to outbreaks in our long-term care facilities. The improvement in our national numbers may be due in part to a shift in the people who were becoming infected with COVID-19 who were on the whole significantly younger than those who became sick at the beginning of the pandemic and fewer people who became sick had comorbidities which would make severe illness more likely. Additionally, health care providers developed techniques to help severely ill patients have the best chance of survival, including delaying the use of ventilators and having people lie on their stomachs rather than their backs to promote oxygenation. The use of medications like dexamethasone, a strong steroid, can be helpful when given to certain people who meet treatment criteria. A recent study which looked at COVID-19 patients treated at NYU Langone Hospitals in New York between March 1 and August 31 showed a decrease in deaths in people who were hospitalized from 25.6% to 7.6% thought to be due at least in part to these reasons.
In Thurston County, the majority of COVID-19 cases have been in working aged people 20-59 with the 20-29 age group being the most affected. Since we have been having outbreaks in long-term care facilities, many people who are older and more medically fragile have become sick. I am carefully watching our hospitalization and death rates. Even though overall death rates have come down, we are learning more about the long-term effects of COVID-19 in survivors including persistent symptoms of cough, fatigue, and shortness of breath. Because so much is unknown at this time about the long-term consequences of COVID-19, it is important for all of us to remain diligent in preventing spread. I look forward to partnering with all of you to reduce transmission rates in our county, until then, wear a mask, keep your distance, cover your cough, and wash your hands!
Please submit your questions for my letter next week to firstname.lastname@example.org.
Wishing you the best of health,
Dimyana Abdelmalek, MD, MPH Thurston County Health Officer