Home / Health / Where the coronavirus outbreak began in the state of Washington, officials see hope as cases seem to be leveled

Where the coronavirus outbreak began in the state of Washington, officials see hope as cases seem to be leveled

At EvergreenHealth Medical Center, two miles from the closed Lifecare hospital where 35 patient deaths were linked to the virus, officials say their frequency of new covid-19 cases has remained steady for two weeks. On some days, doctors here see only one new case and have not seen more than four in a single day since mid-March. Few need posts on intensive care, which is now half full, two weeks after the flood that required transfers to nearby hospitals.

“We don’t know if the last two weeks have been a calm before the storm or if the social distance and all the things being worked out,”

; said EvergreenHealth CEO Jeff Tomlin, whose hospital has handled 40 of Washington’s more than 130 virus-related deaths. He said the hospital is no longer overwhelmed, although it still lacks the necessary supplies.

“You will never hear me declare victory at any point of this,” he said. “But I can tell you that we make sure we have enough supplies, beds and fans that we can. I would say we are getting ready just for a wave to happen like in New York or Italy. “

In the state that saw the nation’s first confirmed case of covid-19 on January 31, and the first recorded coronavirus-related death on February 29, the first hard predictions of massive spikes have diminished even though testing has increased rapidly. While the number of cases in the state of Washington increased by as much as 28 percent in one day on March 15 – it has since slowed down significantly, as have hospitalizations and deaths.

State authorities said there have been 2,580 positive cases and 132 deaths, and as tests in Washington have increased, the proportion of positive cases has remained low – holding about 7 percent.

“We know that it is still a difficult challenge, we know that we have not turned the corner and that we are not even near the end of this struggle, but we believe that there is some evidence that our strategy to reduce society – to close schools, restaurants and theaters, to ban gatherings – we believe these things have slowed the rate of growth in King, Snohomish and Pierce counties, “Inslee said during a news conference Thursday, pointing to a graph showing Washington’s rate of new cases beginning flattened while most other states trend upward.

Judy Layton and her son are praying for coronavirus victims at the Lifecare Center in Kirkland earlier this month.
Judy Layton and her son are praying for coronavirus victims at the Lifecare Center in Kirkland earlier this month. (Mason Trinca / for The Washington Post)

While cases continue to grow in metropolitan areas of New York, Michigan and Louisiana, Inslee can take on what is happening in the Pacific Northwest that could signal a way out if people continue efforts to not spread the disease by limiting contact. The cases are also planned in China and South Korea – where the authorities extended tests and used strict social distancing – and research indicates that social distancing can delay a powerful force in cases so severe that they require intensive treatment and overwhelm hospitals.

“It’s a glimmer of hope,” Inslee said. “This indicates that some of the things we do together have a very modest improvement. The things we did two weeks ago are now shown in our hospitals. “

At Overlake Hospital in Bellevue, about seven miles south of Kirkland, doctors have seen a new uptick in cases, with about 20 to 30 positive tests a day, which they believe is due to viral spread throughout the region before strict social-distancing policies entered into force two weeks ago. David Knoepfler, Overlake’s chief physician, said his hospital has about 70 cases that were positive – or people they work to exclude – and that patient traffic has been “much higher and faster on the road.”

But Knoepler also said he believes that strong social distance policy can lead to an imminent decline.

“What we are seeing now is a result of delaying the social distance up to 1-2 weeks ago,” he said. “I hope that in a week we will have some leveling.”

“A military operation”

In early March, when the corona virus had only affected this state, Chief Joseph Sanford stood in the middle of Central Way and Lake Street, Kirkland’s busiest intersection, taking a picture in each of four directions. No cars. The city was in a panic. Sanford participated in several Covid-19 workgroup meetings per day and managed a quarantine list of firefighters under quarantine following potential exposure to virus-carrying patients.

People die, and the spread of the virus was both inevitable and scary.

Today, while traffic has resumed at a temperate pace, the manager and his colleagues in local authorities have begun to find out what worked and what they can convey to other communities. New York, with its population density, is an overlying, but fire and EMS leader from communities like Aspen, Colo .; Rochester, Minn .; and Taos, N.M .; Call several times a day for advice on how to respond to a virus that is just beginning to affect these communities.

Sanford is a particularly good person to ask: Out of 95 EMS staff, only one has tested positive for covid-19, although Kirkland officials have no expectation of encountering the particularly contagious virus in this suburban enclave east of Seattle.

Instead of going into a potentially infected nursing home, Kirkland asked first responders to take patients in the fresh air to reduce the risk.

They removed the back of the ambulance with unnecessary equipment and separated the front and rear compartments with thick translucent plastic covers to expedite the cleanup process. They used electrostatic dimmers to put disinfectants in large layers. Tweaks took the cleaning process from 40 minutes to five.

“There was no example to follow,” Sanford said. “We were first.”

This week, EvergreenHealth officials have prepared a release for best practices, which will be released late this week, in an effort to educate hospitals around the country about what worked in Kirkland. A spokesman for EvergreenHealth said the hospital was uniquely positioned to manage an infectious disease outbreak, due to its status as one of Washington’s highest-rated hospitals and the presence of Francis Riedo, the hospital’s Johns Hopkins-trained and CDC-trained medical director of infection control.

Their cheat sheets for hospitals will contain a variety of procedural items and some examples of social engineering. For example, EvergreenHealth provides advice on the strongest possible limits for visitors from the beginning – banning them – until the situation allows family members to safely enter the hospital. In this way, the hospital never has to go back to less strict policies.

“The other thing we learned right away was how much you have to communicate and how much you have to be present,” Tomlin said, noting that people need to hear a consistent leadership voice. “It is starting to feel very much like a military operation in terms of logistics and operations and communications.”

Scott Holm, founder of Chainline Brewing, talks to taproom manager Jake Hoveland in Kirkland, Wash., On Thursday. Holm, 42, says he has been forced to lay off most of his staff during the coronavirus outbreak.
Scott Holm, founder of Chainline Brewing, talks to taproom manager Jake Hoveland in Kirkland, Wash., On Thursday. Holm, 42, says he has been forced to lay off most of his staff during the coronavirus outbreak. (Jovelle Tamayo / for The Washington Post)

“Invisible enemy”

As the medical community continues to call for caution, many Kirkland residents have begun to look beyond the virus at the looming financial threat to the 6,000 small businesses that call the city home. These concerns were multiplied this week because a recommended shutdown of “non-essential” companies became mandated, Inslee threatens potential police action would companies defy it.

The conflict that plays out here – between economic forces and medical problems – lies in front of thousands of American communities, weeks after Kirkland, in its coronavirus timelines. It also reflects the debate that is taking place in the White House, as President Trump has set Easter as a goal for the United States – in his words – “to have the country open and rare to go.” This is a projection that defies expert medical forecasts for its own coronavirus working group, but echoes feelings that swirl from coast to coast that the nation may not be able to weather the community shutdown for an extended period.

Although new covid-19 cases have plateau locally in the Kirkland area, Mayor Penny Sweet said she is receiving an influx of financial aid requests, as entrepreneurs begin to calculate how long they can keep without income.

“What hasn’t slowed down for me is the flow of calls and emails I get from community members who are panicked about the whole economy,” Sweet said. “I’m glad the governor called for the state to close, but I got a lot of calls today that say they choose winners and losers, and small businesses will be losers if we don’t take action.

“The truly frightening consequences have not yet happened.”

Scott Holm and his wife, Michelle Holm, with son, Cade, 6, at the family brewery band in Kirkland.
Scott Holm and his wife, Michelle Holm, with son, Cade, 6, at the family brewery band in Kirkland. (Jovelle Tamayo / for The Washington Post)

Seeing no clear path to solvency, Scott Holm, owner of Chainline Brewing in Kirkland, is one of many who has written to Sweet for help. Like others who contacted the mayor this month, he asked for an order similar to the one just issued in Seattle mandating a moratorium on commercial drafts. All the city could offer came Wednesday afternoon in the form of a link on the Chamber of Commerce website to apply for seed money from Google, a $ 250,000 aid fund.

“The fund is pretty much small potatoes compared to what people really need,” Sweet said. “But that’s a start. It will not pay any rent. “

The best-selling beer on Chainline is Tune Up IPA. That, together with the six-year-old company name and several of its beers, is a nod to Holm’s previous career in bicycle sales. His “pride and joy”, however, is “Polaris Pilsner”, who won a silver medal at the Great American Beer Festival 2016.

He no longer loses at the moment, and he moves whatever stock he has out the door as soon as possible, because while the state allows him to sell the beer during the shutdown, he can’t serve it in the dorm. Holm, 42, said he has been forced to leave most of his staff during the outbreak as he prepares to pay two rents: one for the current brewery, which will soon be demolished to accommodate Google’s expanding campus and the other for it. new location, still fitted.

“We could stay a few weeks before the shutdown,” Holm said. “We could sell through the stock we have, provided the landlord doesn’t let us out. Then we are ready. Like many small businesses, we utilize quite a lot, and our house is our security. So if this business fails, we lose the house. is the reality. “

Exacerbates Scott’s wife, Michelle, an ER doctor at EvergreenHealth.

Scott is now looking at their 6-year-old son, Cade, as schools are closed and none of their friends and family in the neighborhood will look up in fear that Michelle could be exposed to the virus at work.

“They try to be nice with it, but in the end no one wants to be around her or me or our son because of the invisible enemy,” he said.

Beer pickup tent outside Chainline Brewing. Taproom is closed, but the brewery sells its products in a pick-up area without contact.
Beer pickup tent outside Chainline Brewing. Taproom is closed, but the brewery sells its products in a pick-up area without contact. (Jovelle Tamayo / for The Washington Post)

A resistance among some small business owners was evident in the city’s lively shopping area the day Inslee laid out the mandate as some stores remained open, including a massage bath.

Daniel O’Malley defended his decision to keep open Epicurean Edge, a specialty knife business, as a necessity to avoid layoffs.

“I think this is such a big deal to everyone that it is emotionally important to get things moving as much as we can while we are safe,” O’Malley said.

Kellie Stickney, the city’s communications manager, said the desire to return to normal is wrong. “It will be very difficult to convince people that we are not out on this issue yet,” she said. “We do not see disasters here. We do not see tornadoes, hurricanes, earthquakes. Most people who come here are very snowy, so it is difficult for people to understand what it is to be in disaster mode. “

Holm understands the medical necessity for Inslee’s order, but it doesn’t make it any less devastating. To offend against injury, friends on social media who pay jobs during the shutdown seem to treat vacations as “a great vacation.”

“Their main concern right now is the sadness of being forced to stay home, which I just can’t really dry,” says Holm.

The virus chews up its business during the day, and in the evenings it chews up his wife. Most evenings, she comes home in street clothes, after leaving her scrub at the hospital, part of her new routine. Cade, who is learning to write, leaves illustrated notes for his arrival: “I love you mom.” She sticks to order and cleanliness at home, says Scott, as a way to deal with changing hours and a deadly illness at work.

Although it is hoped that this will happen, that Kirkland will return to normalcy before too long, he is trying to stave off bankruptcy while dealing with stress, anxiety and uncertainty.

“Some of us are fighting for our lives,” Holm said. “I see no clear path forward.”

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