With the rate of new COVID infections in Okanogan County nearly tripling in the past week, county health officials are bracing for a debilitating impact on health care services over the next month.
“Everything is just really stressful, with the numbers we’re seeing,” Okanogan County Health Officer James Wallace told the Methow Valley News last week.
County public health officials and health care providers are preparing for many more cases than in the summer of 2020, when the rate reached about 1,000 per 100,000 population, then the highest in the state, Wallace said.
COVID infections in Okanogan County typically lag behind neighboring counties and the rest of the state, where cases have been skyrocketing. “We’re still very early in the Omicron experience in Okanogan County. Just this week [of Jan. 10], we’re seeing a significant rise and we’ll see a sharp increase in the next three weeks,” Wallace said. He expects it will be four to five weeks before cases start to drop again.
Omicron has proven to be much more contagious than earlier COVID variants, but people generally have less severe illness and recover more quickly. Still, hospitalizations are increasing and, for people with weakened immune systems, it’s a very serious illness, Wallace said.
The biggest concern is maintaining adequate coverage in clinics, hospitals and extended-care facilities, Wallace said.
“It’s a dilemma of cascading failures,” Wallace said. If schools close or a family member is quarantined, parents can’t go to work. Then there aren’t enough people to staff clinics, so patients go to the emergency room instead. Then emergency rooms overflow, he said.
Okanogan County Public Health has been advising people not to go to the emergency room unless they have a genuine emergency. “There’s a lot of panic and fear that’s been driving people to emergency rooms,” Wallace said.
Clinics and health care partners have expanded services to keep people out of emergency rooms, but shortages are affecting some services. Aero Methow Rescue Service increased COVID testing to six days a week, but had to suspend the tests as of Monday (Jan. 17) until they get additional tests from Public Health.
To eliminate the need for trips to the emergency room, clinic staff are checking in with patients to verify their oxygen levels and providing support services like picking up groceries so people can isolate at home, Wallace said.
Although the stresses and shortages are real, “We have contingency plans to keep the lights on and doors open in health care facilities,” Wallace said. Health care providers have learned a lot over the course of the pandemic and are better prepared, he said.
Discharge bottleneck
Hospitals are already near capacity, but the situation has been exacerbated because patients who are ready to be discharged after surgery or other treatment – but who still need rehabilitation or nursing care – have nowhere to go, Wallace said.
Strict polices enacted to protect long-term care facilities mean that, if any staff or patients are exposed or sick and have to quarantine or isolate, the facility is prohibited from accepting new patients for 14 days. Even when they can accommodate a new patient, that person has to quarantine, which requires additional staffing and puts pressure on space, Wallace said.
Local hospitals are getting help from the state. Last week, Gov. Jay Inslee announced the deployment of 100 non-clinical personnel from the Washington National Guard to assist four hospitals across the state, including Central Washington Hospital in Wenatchee. The National Guard will help emergency departments with nonmedical tasks.
In addition, Inslee required hospitals to halt nonurgent procedures for four weeks. He also announced steps to assist with staffing in rehab and long-term care facilities.
Wallace and other county health officers talked with representatives from the state Department of Health (DOH) and Department of Social and Health Services last week to explore possibilities for changing rules to reduce barriers to care in nursing facilities.
Some guidelines regarding when it’s safe for people to return to work or school have changed based on what they’re seeing with the Omicron variant. Omicron appears to make people sick much more rapidly than other COVID variants. The illness comes on in the first two or three days and it’s very rare for people to get sick in the second week after exposure, Wallace said.
Health care workers who’ve been exposed to COVID – but who haven’t been infected – can safely return to work sooner, particularly because they’re accustomed to following infection-control practices, including regular screenings and masking, Wallace said.
As with other COVID variants, the most severe Omicron cases occur in unvaccinated individuals. While the highly contagious strain has been infecting vaccinated people, their cases tend to be more mild.
The vaccine is still protective, particularly when people are boosted, Wallace said.
Unvaccinated people ages 35 to 64 are three times more likely than vaccinated individuals to get COVID. Unvaccinated people 65 and older are 13 times more likely to be hospitalized and 15 times more likely to die than those who’ve been vaccinated, according to DOH.
County stats
Okanogan County Public Health reported 323 new COVID cases in the eight days ending Jan. 17, compared with 133 cases over the previous eight days. Cases have also been rising in the Methow Valley – 17 of those cases were in Twisp, 15 in Winthrop, four in Carlton, three in Mazama, and one in Methow.
Public Health reported another COVID-related death last week, a female in her 70s. That brings the total verified deaths in the county to 78.
The infection rate per 100,000 population in the county over the past 14 days has increased from 355 to 1,004. The infection rate among unvaccinated people is more than four times higher than for the vaccinated population, according to Public Health.
While the case rate is accelerating in Okanogan County, compared to other parts of the state, it is among the lowest, by far. The 14-day rate in King County was almost 2,500 per 100,000 people, according to DOH. And neighboring Chelan County, with a rate of 2,246, wasn’t far behind. Statewide infection rates are the highest in the almost two years of the pandemic.
Ferry County has the highest seven-day hospitalization rate in the state, at 50.6, almost three times the statewide rate.
The percentage of Okanogan County residents who’ve been fully vaccinated against COVID has remained virtually unchanged at 47% since Dec. 13.
Although people have been doing a better job of reporting positive results on at-home tests, Public Health isn’t capturing all new COVID infections in the county, Wallace said. Limited or inconvenient testing options may also contribute to undetected cases, he said.
People can protect themselves and others by masking – with a well-fitting N95 mask, not a cloth mask – and avoiding unnecessary travel and indoor gatherings, Wallace said.
COVID reinfections
Now that we’re almost two years into the COVID pandemic, DOH is tracking the possibility of reinfection with COVID.
“We are still learning about COVID-19 and the duration and strength of immunity following infection with this virus,” State Epidemiologist for Communicable Diseases Scott Lindquist said. “Based on what we know from similar respiratory viruses, we expect some COVID-19 reinfections to occur.”
The state’s first report, which covers September through December 2021, found a reinfection rate of 0.016%, or 4,404 reinfections out of 264,520 cases. The majority of those with a reinfection (60%) were unvaccinated.
Health officials’ recommendations for preventing reinfection are the same as for overall prevention – getting vaccinated and getting a booster when eligible.
COVID testing
Aero Methow Rescue Service: rapid tests every day but Saturday, 7:30 to 8:30 a.m., when available. Call 997-4013.
Family Health Centers, Twisp: Call 997-2011 for an appointment.
See https://okanogancountycovid19.org/symptoms-testing for more.
