The only metrics keeping King County from fully going to Phase 2 of Gov. Jay Inslee’s re-opening plan is its testing capabilities. Image courtesy King County

The only metrics keeping King County from fully going to Phase 2 of Gov. Jay Inslee’s re-opening plan is its testing capabilities. Image courtesy King County

DOH to Enumclaw: We are ‘committed’ to a county-by-county approach

COVID-19 activity in Enumclaw is low, but the state wants whole counties to move forward through Gov. Inslee’s reopening plan.

Although King County has moved forward in Gov. Jay Inslee’s plan to reopen Washingtons economy over the weekend, there’s still a long way to go before the state returns to “normal”.

But some small cities are hoping they get permission to move forward with re-opening faster than larger cities in the county; the Enumclaw City Council sent a letter to Inslee earlier this month with their request, arguing that larger cities have more resources to fight the economic fallout from the COVID-19 pandemic than they do, and that some local businesses are on the brink of disaster.

It doesn’t appear Inslee’s administration is seriously considering this idea at this time, though Dr. Kathy Lofy — State Health Officer and Chief Science Officer for Washington state at the Department of Health — did leave some room for minds to be changed down the road.

“When we started talking about re-opening, we originally thought we would re-open as a state,” Lofy said in a March 26 phone interview. “[We] quickly realized that with so much heterogeneity (differences) in COVID activity from county to county that staying together as a whole state didn’t really make sense.”

For example, King, Pierce, Snohomish, and Yakima counties account for the vast majority of coronavirus cases and deaths, whereas 22 of Washington’s 39 counties had less than 100 cases, and several with zero deaths.

It actually wasn’t until earlier this month that Lofy learned smaller cities in larger counties were becoming concerned that they would be held back from re-opening their economy because of the county’s more populated areas.

“We haven’t really discussed moving to the city level. That does really complicate things, logistically, because it even hard to keep track of 39 counties and what stage everybody is in,” she said. “We’re really committed to the county approach. Last week was the first time I actually heard there being concern about cities, particularly cities that are on county boarders.”

For the first 10 counties that applied to move to Phase Two, “we used a very strict criteria that was no cases for three weeks. And really, only our smallest counties were able to qualify,” Lofy said.

“Then when we let the next group of counties apply… we decided to use a threshold that’s used by the CDC in their guidance documents that supports the work the White House is doing. That document does use a threshold of less than 10 cases per 100,000 [for a ] two week period,” she continued. “Moving forward for the rest of the state, we’re not necessarily using that same criteria. We’re actively discussing what that criterion should be.”

In fact, on May 29, the state again revised its requirements for when a county is able to move to a new phase, increasing the number of positive cases per 100,000 people from 10 to 25. This allowed King County to apply on Monday, June 1, to re-open to Phase 1.5.

Like Phase 2, Phase 1.5 will allow additional construction, gatherings of five or fewer people, and restaurants to open at 50 percent capacity, the Seattle Times reported. Unlike Phase 2, Phase 1.5 limits retail businesses to 15 percent of building capacity and a time limit of 30 minutes, as well as limited pet grooming, real estate, and professional services.

ENUMCLAW, COUNTY DATA

It’s unclear how individual cities would be able to show the state that they are safe to re-open using the same metrics counties are using.

However, it appears Enumclaw is farther along than larger cities in reducing the number of COVID-19 cases and deaths.

The Seattle Weekly reported on April 15 that Enumclaw had a total of 63 positive cases, whereas the city was at 80 on June 1, meaning the city experienced an additional 17 cases over 44 days (an average of one case every 2.6 days).

Additionally, the Courier-Herald reported on May 7 that the Enumclaw Health and Rehabilitation facility reported a total of 23 deaths, which matches up with the total number of deaths reported in the 98022 ZIP code on June 1, indicating no additional coronavirus deaths occurred for at least 20 days.

It seems likely that this data would meet the state’s current criteria of less than 25 cases per 100,000 people in a two-week period, and Mayor Jan Molinaro appeared hopeful.

“Enumclaw has not recorded any new deaths since May 6 and there have not been any new positive tests since May 13,” Molinaro wrote in a May 28 email, before the state once again revised Phase 2 metrics. “This is a strong indication that reopening [the city] to Phase 2 should be granted and would be similar to the current guidelines placed on counties wishing to file an application to reopen.”

However, like King County overall, another sticking point that may prevent Enumclaw from moving on to Phase 2 before other cities may be linked to testing capabilities, of which the city likely has little, if any, data.

To get the whole county into Phase 2, King County must show the state that it is able to test at least 50 people for every one person who tested positive for the coronavirus for a straight week. As of June 1, King County was able to test 40 people for every positive test.

Additionally, the county must show the state that it is able to test people two days or less after they appear to be sick; as of June 1, it was taking King County four days to test people after they start showing COVID-19 symptoms.

Another concern the state has about opening cities before counties is travel. In an interview with the Snoqualmie Valley Reporter, Molinaro said that the state asked how cities like Enumclaw would potentially prevent people from other communities (especially communities with high-COVID activity) from coming to the city to shop or eat at recently-reopened retail stores and restaurants.

In response, Molinaro said he asked for the same guidance that large stores like Costco and WalMart have received on how to remain open and apply it to small businesses in town.

“I have yet to receive an answer,” he said.

PHASE 2 METRICS ALMOST MET

As of June 1, the state reported a total of 24 of the state’s 39 counties have moved to Phase 2, and another three are eligible to apply.

King County’s goal was to reach Phase Two by June 1, but Executive Dow Constantine had some doubts about achieving that.

“We are not approaching the numbers — the benchmarks that are set out under the most recent state orders,” he said in a May 27 interview with NPR. “So unless the rules are going to change, which they of course could, I can’t foresee that happening.”

As mentioned, one of those “benchmarks” was showing the state that King County is experiencing less than 25 positive COVID-19 cases per 100,000 people, but also includes showing the state that its county health care systems are able to handle a surge in cases, that testing is widely available, that there are contact tracing system in place, and that high-risk populations are extra protected, according to the May 5 “Safe Start Washington” plan.

King County recently published a new online dashboard showing where the county has met that positive case threshold.

Additionally, the state wants to see the “reproductive number”, a.k.a. how many people one person will infect, shrink below one in the county. Currently, the county estimates 0.6 people are being infected for every one person with the virus, though the estimated range is between 0 and 1.3 people.

Additionally, the rate of hospitalization and deaths have fallen below target rates and appear well on their way to do so for 14 days in a row.

The county has also met its occupied hospital bed goals, with only 71 percent of the total number of beds in the state being occupied (the county was shooting for less than 80 percent.) King County is also showing only 5 percent of hospital beds are being occupied by COVID-19 patients (their goal was 10 percent or less).

The metrics the county continues to struggle with is testing capacity.

The county’s needs to test at least 50 people for each positive result, and to meet that goal for seven consecutive days. Currently, King County is able to test 40 people for each positive test.

The county also wants to shrink the number of days between the onset of symptoms and a COVID-19 test, with the goal of less than two days. Currently, it is taking the county a median of four days between symptoms and testing.

Reporter Aaron Kunkler contributed to this story.


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