Over the course of four days, five new cases of COVID-19 were identified on San Juan Island.
On July 13, San Juan County announced it had been alerted of three new cases over the weekend. In performing contact tracing, the county discovered “well over” 20 close contacts those patients had recently.
“Lots of work going on there and lots of potential for additional cases as a result of that activity,” San Juan County Health and Community Services Manager Mark Tompkins told the County Council during its July 14 meeting. “Our testing efforts are well underway.”
An additional two cases were identified through testing close contacts of the three people who had previously tested positive.
The county has also been performing asymptomatic testing of frontline workers who have the most interaction with the public. During the week of July 6-10 the county had performed 61 of those tests, Tompkins said, one of which was one of the three recent positives. On July 14, Tompkins said more than 200 tests would be performed by the end of the week.
A dilemma arises from how long the tests are taking to return to the county, San Juan County Health Officer Dr. Frank James said. According to James, test results are taking six-to-eight days to return. One of the positive cases was tested on July 6 with the county receiving results on July 12.
“The delay of getting test results is a very significant issue,” James said. “People are optimally infectious in the 48 hours prior to developing symptoms … We’re starting at a disadvantage in that respect.”
On a statewide level, Tompkins said hospital beds are still relatively uninhabited currently, even though case numbers have been rising.
“Which is extremely good news,” Tompkins said. “It doesn’t mean it’s going to stay there.”
Tompkins added that cases will rise first, followed by hospitalizations. He said younger people are the ones increasing the numbers currently. A press release by the county on July 16 noted the age range is 20-40-year-olds.
With mask use estimated daily infections go down significantly and protect the health care system, Tompkins explained.
“It just really shows that a simple device as a mask goes a long way in preventing illness, infections and then associated hospitalizations and death,” Tompkins said. “I think that there’s work to be done with our younger population about gathering size, mask use and some other items that we need to look at as a system.”
Until now, most cases in the islands originated from an off-island source, or if it was someone on island infecting another, they were usually a spouse. James said we may be seeing the beginning of community spread.
“I think that we’re in a very difficult place now. We’re in a very different place than we were a week ago,” James said. “I believe that this is the beginning of community-based spread in our community. We have been incredibly fortunate not to have that in the past. The adoption of the masking program back in May has served us extraordinarily well. … I believe that’s still the most important thing that we can be doing. That’s what all the academic projections suggest.”
County Council Member Jamie Stephens questioned whether there was a need for a back-up surveillance team as the one in place is experiencing burnout, according to James and Tompkins.
“Regardless of what phase we’re in, we’re going to be doing this for a long time and to get those people a break, or something reliable,” Stephens said. “We need to have the capacity and we need to give these people a break.”
Tompkins said the county is looking at several options to deal with potential burnout including hiring additional staff. However, while several people have been trained, Tompkins added, they have not been able to shadow a current tracer. James noted that contact tracing requires skill to get people to admit places they’ve been and people they’ve been around. He added many of the tracers are well equipped to deal with patients who are reluctant to answer such invasive questions as they also deal with sexually transmitted infection tracing.
“The problem with the virus is it doesn’t care whether you’re telling the truth or not,” James said. “Everybody is going to find out what you did, you may as well cop to it in the beginning.”
San Juan County submitted its application to progress from Phase Two to Phase Three on June 25. However, on July 2, Gov. Jay Inslee announced a pause on application approvals for two weeks. He then extended it on July 14 until at least July 28.
“When we submitted our application to move to Phase 3 last week, we genuinely felt that San Juan County was prepared to respond effectively to cases in the islands,” James said in a July 2 press release. “We also understand that this is a fast-moving situation and that the governor prioritizing a safe reopening for the entire state is a logical choice at this time. Like so much in this crisis, these decisions are difficult and finding the right path is an enormous challenge.”
Because of this extended pause and the influx of cases across the country, questions arose regarding whether the county should retract its Phase Three application. The Board of Health voted to suggest to the council that it withdraw the nearly 10-page document. County Council is part of the Board of Health — Council Member Rick Hughes voted yea; Stephens voted nay; and Council Member Bill Watson abstained from the vote.
“I’m concerned about the wear and tear on our staff and that going to Phase Three which will then increase the influx of people from outside of the county as well as loosen up our own restrictions is only going to increase our COVID rate,” Watson said. “I think our recent experience has said that our limited resources are already being stretched at the current level and we haven’t even gotten to Phase Three yet. Maybe we’re at Phase Two and a half. We’re certainly getting an influx of off islanders.”
Following the Board of Health decision, the county council met and requested more information on the ramifications of withdrawing the application to be presented to it on Tuesday, July 21.
“I think several fundamental things have changed that we’ve learned, things we didn’t know before,” James said. “Our situation nationally and at the state have changed substantially as well as our own circumstance.”