We’re likely to be living with COVID-19, and the limitations required to fight it, for months if not years, Grays Harbor Public Health and Social Services Director Karolyn Holden said Tuesday at a forum presented by Greater Grays Harbor Inc., the region’s chamber of commerce and economic development group.

She started off by giving a timeline of the pandemic. “Back in March we were watching the COVID-19 outbreak in localized pockets all over the globe, starting in China, and at the very beginning of February we realized we had a case in Washington,” she said.

Holden said in early March the belief was that outbreaks could be surrounded and contained.

“It became apparent because of outbreaks across the state that was not the case,” she said. “They were not related to travel, we had a different animal on our hands.”

The number of cases in Grays Harbor County has gone up significantly related to the phases of the state’s safe start phased program to reopening.

“In mid-March the county was in Phase 1 and at the beginning we had one case and no deaths. On May 22 we were approved to go into Phase 2 of the safe start plan and we had 16 cases and no deaths,” said Holden. “Then in the middle of June we got approved to move into Phase 3, and at that time we had 21 cases, and four to five weeks into Phase 3 our case counts have jumped up to 60 and we had one death confirmed.”

As of Tuesday, the case count stood at 86, 46 of them in July. There is one death attributed to COVID-19, and another possible COVID-related death under investigation, awaiting autopsy results as the cause of death was not immediately clear.

Holden talked about lags in case reporting between state and county numbers. For example, Tuesday the Department of Health had two deaths listed, but the county isn’t including it until it’s known COVID was the cause of the second.

“We reached out to them and said our health officer isn’t sure how that death occurred,” she said. “They don’t have the feet on the ground that we do or the level of details about each case.”

Public asking for details

“I’m reluctant, ethically, even though there’s been an outcry for details to be shared in terms of perhaps city of residence, age, are they hospitalized,” said Holden. “When you have a small community and a small number of cases the likelihood of someone’s privacy being breached by saying I have a new case and it’s in Montesano, or it’s in Ocean City,” is high. She used the city names as examples only.

With the larger number of cases, reporting more details without violating federal patient privacy laws becomes more possible, and the county has started providing details like age, race/ethnicity, and sex. Holden, however, has no immediate plans to start providing details about where cases are located within the county.

“I don’t think that knowing where cases are makes you safer than not knowing,” she said. She said because 25% or more of cases are asymptomatic – not showing symptoms of COVID-19 — “knowing there are cases here and there may give you a false sense of security there aren’t any cases there, and that’s not the case.”

When there is an outbreak, like the one recently traced to Charlie’s Sports Bar in Montesano, the public is informed more widely to make sure those individuals know the potential for exposure and to get access to testing.

One notable number in her mind is that four out of 10 cases recently have been identified in young adults, since testing has been focused more on more vulnerable groups, generally people 60 and older. “When you look at fatalities, about 90% are people over the age of 60,” said Holden.

Holden was asked why the county is not reporting active versus recovered cases. She said it’s because the terms “active” and “recovered” have not been clearly defined. Just what is the meaning of “recovered,” does that mean no symptoms, how many clear tests, how long without symptoms? And “active,” does that mean in isolation, or quarantine, or hospitalized? Without clear definition the county will not be releasing those numbers as other health officials in the state have done.

She said the “meaningful data” is how many people are in quarantine or isolation, and those numbers may be available soon.

Restrictions

A few questions taken by Holden revolved around the current face mask requirements and how businesses are allowed to remain open. Holden said there is no local enforcement policy on the state-mandated mask requirement, but there are avenues through the governor’s website to report violations, and employees of businesses who feel they aren’t being protected by employers can file complaints with the state Department of Labor and Industries.

Holden was asked if it’s enough to restrict to large gatherings while businesses remain open.

“There is no right answer,” said Holden. “There are 8 million wrong answers but no right answer to the situation we see ourselves in.”

She said people are fearful for their own health, while others are fearful of loosing their livelihoods. Some of the further restrictions put forth by the governor in recent days can help, and she expects further changes to requirements depending on the path the pandemic takes in the coming weeks and months.

One participant of Tuesday’s forum expressed concern about the large amount of traffic going through Aberdeen and Hoquiam heading for the beaches and the recent spike in positive cases, and if anything could be done to stem the influx of non-local traffic to the county.

“Officially, counties in Phase 1 and Phase 2 should not be traveling to a Phase 3 county. That is the point of the phasing,” said Holden. She said she and other public health officials are “pleading” for a “structured, consistent statewide approach” to pandemic containment. She said she felt it was a step in the right direction when the governor recently rolled back some Phase 3 restrictions, but agreed that a more targeted statewide approach could help further.

The long term

“We’re very concerned about the position we find ourselves in at this moment,” said Holden about the recent spike in cases. She said the county did a “great job of flattening the curve” early on at no little sacrifice to the community economically and socially. As the economy has reopened, cases have surged.

“Now we’re trying to walk a tightrope for the level of public interaction we can have,” said Holden. “We are going to be living with this for months, if not years. The end game for this is to develop adequate immunity to where it doesn’t spread like wildfire or get a vaccine.”

Holden said her staff is working weekly securing testing supplies and finding labs that can get results back rapidly. She said that would help her staff more accurately determine the extent of the pandemic locally and maintain the state recommended threshold of 50 tests administered to every positive reported.

Another key factor is availability of hospital beds for COVID-19 patients. Holden said her staff works daily with local hospitals to make sure there are some available if needed. Chris Majors, a spokesman for Grays Harbor Community Hospital, told those listening in that it had 15 available beds as of Tuesday based on current staffing. “If we increased staffing we could increase that number if we needed to,” he told Holden.

For now, social distancing and face masks are the key, as is avoiding large social gatherings as directed by state and local public health authorities.

The forum was sponsored by Grays Harbor Unders, a base layer manufacturer located in Hoquiam. The company switched production early in the pandemic to produce and distribute face coverings, neck gators and surgical gowns.