Wahkiakum case load increases; contact tracer goes to work
June 25, 2020
Another Wahkiakum County resident tested positive for covid-19 on Monday morning, bringing the total of confirmed cases to five.
Wahkiakum Health and Human Services has contacted the individual and a case investigation is ongoing, Director Chris Bischoff said.
As of Tuesday night, there had been 177 tests conducted in Wahkiakum. In neighboring Cowlitz County, the number of positive cases had risen to 149, with 19 people currently hospitalized. There are 13 confirmed cases in Pacific County. Across the river, there have been 47 cases reported in Clatsop County and 26 in Columbia County.
In fact, the number of positive cases is on the rise across Washington state, according to Bischoff. Earlier it appeared that it was just happening on the east side of the state, but data is showing that it is happening in western Washington as well.
“Tests per day have been going up,” Bischoff said, “but what is troubling and is not nice is that cases per day have been increasing rapidly as well. In March, we averaged 193 new cases a day. In April we averaged 288, which was our big month for quite awhile. In May, we felt like we were getting things under control and that’s when the phased approaches started happening. I would comment that since the phase reopening has started, we have not been doing as well. We are 20 days into June, and we are significantly higher than our highest month on a case per day average. On Saturday we reported 624 new cases in the state of Washington, which is the highest since April 3.”
Yakima County continues to struggle, with 26 percent of their tests turning up positive for covid-19.
“That’s insane,” Bischoff said. “The state average is about 6.5 percent. There was a period of time in King County when their tests were averaging around 14 or 15 percent.”
“They have a massive problem,” he added. “People are either blaming others for it or not taking it seriously. People are still having parties and doing all those things and they should not be, especially in that county.”
Hospitalizations are trending upward as well.
“So most hospitals around the state are doing okay,” Bischoff said. “Some are in very good shape. I know St. John, our closest relevant hospital, is doing very well for all the things they need. Yakima County has exceeded their capacity, however. I think they have 25 covid-19 patients that are housed outside of the county. They have no ICU beds left and have no non-ICU beds left. Two of the counties close to them are experiencing similar issues, where they are close to being at full capacity. This becomes your worst case scenario where you have folks who can’t get the treatment they need and succumb, not just to covid-19 but we’ve seen that people can’t get the treatment for other things they need either, because all the beds are taken.”
“Right now we’re able to deal with it because of some of the other bigger counties that we can move patients to. They can take up the surge, but it becomes troubling as more counties start approaching the max for their hospitals beds. You start running out of places to send people,” he added.
There are now over nine million confirmed cases worldwide, with nearly 500,000 deaths.
“There was a thought that we were starting to tackle this worldwide,” Bischoff said, “but there were 183,000 new cases on Sunday. The highest we’ve ever had in this entire pandemic. It outpaces any other disease we know of.”
“People are still trying to compare this to the flu,” he said. “It’s ridiculous. At this point, it’s well beyond that. It’s a serious issue. It’s not over and it continues to get more serious even as people try to talk it less and less seriously.”
Phase 4 and the summer months
“If it’s available and we qualify, I will go after that,” Bischoff said. “I know that’s the will of a lot of folks around here.”
Still, he expressed some concerns.
“It’s summertime,” he said. “We want to do more things, it’s natural. We want to go out and visit friends and go do other activities that put us in proximity to a lot of people. We need to be cautious. We’re in Phase 3 and we can do a lot more things than other counties can.”
He has witnessed a lack of concern in neighboring Cowlitz County, where numbers are rising. On a recent drive, he saw a number of churches and restaurants operating well above capacity.
“Many people are doing whatever they want anyway,” Bischoff said. “This is a problem that is going to get bigger unless we take it seriously. Covid-19 has not been shown to be significantly diminished by warm weather. So the assumption that just because it is summer we can go out and behave how we want is a bad one.”
“This is for me very troubling, the national trend of misinformation causes me significant concern,” Bischoff said. “I don’t understand the issue with masks. I don’t like wearing them, certainly. I’m asthmatic. I’ve had a hard time breathing my entire life. I hate a mask, but I wear it when I go out in public, when I go to the store because it is about me saving somebody else’s life, not about my inconvenience.”
Process of contact tracing
After WHHS received a fax on Monday notifying them that a local resident had received a positive result from a test conducted by a health care provider outside the county, the public health nurse, Danelle Barlow, immediately contacted the individual to find out if they had been notified and to begin an investigation.
She asked a standard set of questions, considered best practice across the state.
Barlow, like any contact tracer, wants to learn when the test was conducted, why the individual got tested, and where they had been when they were most likely exposed in order to determine when they became able to spread the virus.
“Generally, you are not shedding the virus the day you contract it,” Bischoff said. “It is usually within two to three days. Symptom onset is right around that seven to nine day period, so if the person started having symptoms, we can dial that back to when we think they contracted covid-19 and then look at all those contacts in there.”
Armed with that information, the contact tracer, or Barlow in this case, begins asking about anyone the person may have been in contact with during that time frame.
“It takes some coaxing for some people,” Bischoff said. “They don’t want to rat out their friends and neighbors. Then we begin contacting those close contacts. If it spills over into other jurisdictions we will ask those counties for help in contacting those folks.”
They ask everyone to self-quarantine for 14 days, and anyone who was in close enough proximity to have a test done.
“Once we’ve got that all under control and figure out how far reaching this is,” Bischoff said, “then someone from the health department will be making daily contact with the confirmed cases or strongly suspected cases to make sure that their symptoms are not increasing, that they are not leaving the house, and if they have any issues with getting food or anything else. We will try to work that out with them, and we have several ways to do that locally, thankfully, to make sure they don’t need to leave their house for any reason.”
The health department will not ask for your birthdate or social security number, Bischoff warned, and there are fraudsters trying to take advantage of the situation. If you are contacted by someone claiming to be from the health department and you become concerned, ask for the person’s name, say you are going to hang up, and call the health department.
“That way you know it’s legitimate,” Bischoff said.
“The intention of testing is not to drive up data on numbers,” Bischoff said. “The intention of testing is monitoring the disease’s progression so that we can react appropriately. We’re trying to get rid of the damn disease. Getting data is how we do that. Any suggestion that we should just stop testing is ludicrous, dangerous, and reprehensible.”
“As a scientist before the pandemic, I could have told you that. We’re not making that up, that’s not new,” Bischoff said.
On Tuesday, Governor Jay Inslee announced a statewide mandate requiring everyone to wear a mask when out in public.
“The mask wearing is not about you,” Bischoff said on Monday. “It’s about the people around you, whether you like them or not, it’s not up to you to kill them, so please wear your mask. We know masks are not a hundred percent, but if you and the other person are both wearing your masks then we are seriously knocking down that transmission rate.”
And just because you are wearing a mask? It doesn’t mean it’s a good idea to have a bonfire at the beach with 100 of your closest friends.
Bischoff encourages everyone to continue to wash their hands, practice social distancing, and wear masks.
“Please take it seriously along with me and my staff and we can get through this,” he said.