“Okanogan County Hospitals Have Exceeded Capacity.”
That devastating statement came from Okanogan County Public Health on Friday (Sept. 10), in a news release that asks people to seek care at emergency rooms only in a genuine emergency. The hospitals are overburdened by people needing care for COVID-19.
All three hospitals in the county — Three Rivers in Brewster, Mid-Valley in Omak, and North Valley in Tonasket — have exceeded the capacity of beds in their emergency rooms more than once in the past week.
Not only is there no space in the county’s hospitals, but beds aren’t available in the rest of the state either, meaning there’s no place to transfer patients, they said. As a result, patients end up being cared for in emergency rooms, hallways and spare offices.
The crisis stems from a shortage of both beds and doctors and nurses, according to Public Health. This means that there are long waits for all patients to be seen, long waits to be transferred for critical care, and the inability to easily provide patients the treatment they would normally receive, Okanogan County Health Officer James Wallace said.
The hospitals are on the verge of moving into what was once unthinkable — crisis standards of care. Under crisis standards, there aren’t enough space, supplies or staff to give the best care to every patient in a hospital. As a result, providers must make decisions about who gets the scarce resources. “This means that some patients might not get the life-saving care they need,” Public Health said.
Washington residents don’t have to look far to see the consequences of the crisis — hospitals in Northern Idaho have been rationing health care for the past week. The shortage of hospital beds in Idaho has already affected Washington, since some patients have been transferred to hospitals across the border.
In addition to asking people not to go to emergency rooms, hospitals are imploring people to avoid risky behaviors and activities that could land them in the hospital, to get routine care from a primary care provider, and to protect themselves from COVID by getting vaccinated and wearing a mask.
Central Washington Hospital in Wenatchee is also overwhelmed. They were treating 54 people for COVID, including 12 in the ICU and 14 on a ventilator, as of Sept. 14. Most of those patients — 25 — are from Chelan County, and eight are from Okanogan County. But they are also caring for patients from counties across Washington, and one from Uinta County in Wyoming. Eighty-four percent of those being treated at Central Washington for COVID are not vaccinated.
Highest case rate yet
Okanogan County is facing its worst COVID crisis in the 18 months of the pandemic. “We have never been this busy with cases. It’s impacting our health care resources and many community resources across the county,” Wallace said.
Businesses, long-term care facilities and schools are all seeing high numbers of COVID cases. They’re doing an excellent job of screening people and identifying cases, and have been working with Public Health to keep the cases from spreading. “It’s an impressive display of community collaboration,” Wallace said.
Many groups and businesses are voluntarily closing, he said. The Okanogan School District closed in-person instruction for sixth grade because of the number of COVID infections among staff and students, Okanogan County Community Health Director Lauri Jones told the Board of Health on Tuesday (Sept. 14).
The Okanogan County Fair was held last week with protocols recommended by Okanogan County Public Health and the county’s emergency manager. Fair organizers posted signs at entrances and throughout the fairgrounds telling people to wear masks, even outdoors; to practice social distancing; and to wash their hands regularly.
Reports and photos from some events at the fair show almost no attendees wearing masks and people crowded together to watch events. The fair advisory committee had a good plan and compliance with protocols improved after reminders, Jones told the Board of Health.
Masks are required in all public indoor spaces in Washington. Gov. Jay Inslee expanded the requirement last week to include outdoor gatherings with 500 or more people.
Although COVID cases have been surging across the country because of the extremely contagious Delta variant, there are now effective prevention and treatment measures.
Monoclonal antibodies have proven effective at reducing hospitalization and death, and local medical providers are working to expand capacity to offer that treatment, Wallace said. Because it’s a resource-intensive therapy, it requires considerable staffing, he said.
Drugs including Dexamethasone and Remdesivir continue to be mainstays in severe cases to prevent further progression to intubation and death, Wallace said.
“The best treatment for this disease is prevention, and we know that we have high success rates in the prevention layers of vaccination, masking, and avoiding indoor gatherings and large, crowded gatherings,” Wallace said.
It’s not clear if county residents are turning to Ivermectin, an antiparasitic drug used in humans and animals, which has been touted in some circles as a treatment for COVID. But local feed stores report more requests for the drug.
Omak Feed & Supply said they’ve sold more Ivermectin than usual. They don’t ask customers how they plan to use the drug, according to the clerk.
Twisp Feed & Rental has had more inquiries for Ivermectin than normal, but they don’t typically carry a large inventory and are currently out of stock, owner Katrina Auburn said. Their supplier is also out of stock of the basic Ivermectin, she said.
Ivermectin is needed in the animal world, Auburn said. While there are other drugs to control worms and parasites in livestock, Ivermectin is “the Cadillac,” she said.
No patients have been admitted to Central Washington Hospital for issues related to Ivermectin, according to Director of Marketing & Communications Andrew Canning. “That said, it is very important for community members to know prescribing Ivermectin for prevention and/or treatment of COVID-19 is NOT recommended,” he said by email.
Confluence Health practices evidence-based medicine, and although Ivermectin in a test tube in the laboratory exhibits very weak anti-viral activity, subsequent clinical trials have failed to show a benefit, Canning said. The medicine can be potentially harmful and Confluence won’t use it to manage COVID-19 at this time, Canning said.
Wallace, who’s participated in local and statewide conversations about Ivermectin, said the drug is one of many ideas that’s been circulated as a hope for simple, safe, easily accessible and low-cost treatment that would be the “silver-bullet” for COVID that everyone desperately wants to find. It’s not a treatment that he uses for COVID and not something he would recommend for the public, Wallace said.
COVID tests are available at local clinics and hospitals and at other locations for people with symptoms or a known exposure.
If you need a test, call:
Aero Methow Rescue Service: 997-4013. Tests given Tuesdays and Thursdays from 4 to 6 p.m. and Sundays from noon to 2 p.m.
Confluence Health COVID-19 Hotline: (509) 663-8711
Family Health Centers, Twisp: 997-2011
The Methow Valley School District is offering free, voluntary testing for students with parental consent. Interested parents should contact School Nurse Adriana Vanbianchi at email@example.com or the student’s school secretary to arrange a date and time. Elementary school: 996-2186; Liberty Bell High School: 996-2215.
For more testing information and options, visit okanogancountycovid19.org/symptoms-testing.
Okanogan County statistics
Okanogan County recorded 231 new COVID infections in the week ending Sept. 13. Although that included the county’s highest daily case count ever, at 89, there were 41 fewer total cases for this week than last. There were eight cases in Twisp, eight in Winthrop, and one each in Carlton and Methow.
Still, the county’s infection rate for 100,000 population over 14 days is nearing 1,200, Okanogan County Health Officer James Wallace told the Board of Health.
That number is “through the roof” — few places in the country have rates that high, he said.
Public Health calculates the incidence rate for vaccinated and unvaccinated individuals once a week. As of Sept. 9, the rate for the unvaccinated population was 2,225 per 100,000, and for the vaccinated population, it was 293.
The county is also seeing more cases of “long” COVID, where debilitating symptoms linger for months, Wallace said.