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Posted on: August 3, 2020

COVID-19 Updates for Clinicians: August 3, 2020

COVID-19 Update 

COVID-19 incidence continued to increase for the sixth consecutive week through July 25, with the most recent 2-week period being 97 confirmed cases per 100K*14days (see Figure 1 below). When this metric approaches or exceeds 100, sustained and widespread community-based transmission is occurring. 

Key Observations:

  • Current incidents rates match where they in March when the hospital surge, PPE shortages, and imposition of stay home orders emerged.
  • We are well into the second of what could be multiple forthcoming waves in the coming year or two.
  • Geographically, all parts of the county are affected but the I-5/I-99 corridor from Everett down to Lynnwood remains the focus of most intense transmission.
  • Snohomish County’s COVID-19 hospital census remains stable in the mid 20s county-wide. About 30 Snohomish County residents are hospitalized with COVID-19 overall (a few are hospitalized in neighboring counties).
  • This dissociation between rising case reports and flat hospitalizations is occurring because 60% of recent cases are in the 15-39 y/o age group. Only about 5% are >70 years of age (roughly half of what we saw earlier in the pandemic), we remain concerned about increasing absolute numbers of cases in the elderly and a sustained increase in hospitalizations if this continues (see Figure 2 and Table below). Age drift from younger to older groups and increased hospitalizations are beginning to emerge in other parts of the state and also occurred in Florida’s lead up to its hospital surge (see linked Institute for Disease Modeling report).
  • We have seen a slight increase in LTCFs cases and outbreaks over the past couple of weeks (3 adult family homes, 1 assisted living facility with memory care, and 1 skilled nursing facility), but nothing yet has approached what we were seeing during March-May.
  • While there are no imminent plans for a retreat to Phase 1 in the Safe Start sequence, you may have noted the Governor’s dialing back on gatherings and discretionary activities.  Also, we are now on an indefinite hold regarding progression through the Safe Start phases, remaining in Phase 2.
  • Much of this remains in our collective hands to flatten the curve, especially the use of face coverings in public, maintenance of 6’ of distancing with non-household members, avoiding crowds and gathering greater than five non-household members, and limiting our non-household social contacts to a stable cohort of five-or-less. 
  • At the current time, a gathering of 10 people in Snohomish County currently carries an estimated risk of 5-10% that one or more infected people will attend.  If the gathering is 25, the risk increases to 12-23%.

charts for health alert 080320

table for health alert 080320

For more COVID-19 data, visit and/or bookmark the following websites:

Recommendation for remote K-12 learning to start the school year 

This wave of COVID-19 is also affecting our local recommendations for K-12 school operations. The Health District last week recommended that K-12 schools start out in distance learning mode, albeit with some limited in-person attendance for small cohorts of students with high needs or no distance learning resources.

Continued or increasing psychosocial and economic consequences for children and families are expected.

Community survey for recovery needs

Please consider responding to this survey and sharing the link. It takes about 5-10 minutes. https://www.wacoronasurvey.com/SE/1/WACorona.

The Washington State Department of Health (DOH) launched the Community Recovery-Oriented Needs Assessment, or the CORONA survey. The survey is an effort to assess the behavioral, economic, social, and emotional impacts as wells as the needs of communities across the state as a result of the COVID-19 outbreak. In order to appropriately and equitably inform recovery plans at the state and local levels, DOH is requesting residents from across Washington take part in the survey. (To take the survey by phone, call 855-530-5787—interpreters are available to assist.) The survey is voluntary and confidential.

Washington Listens Fact Sheet

https://www.hca.wa.gov/assets/program/washington-listens-fact-sheet.pdf 

Washington Listens is a 1-800 telephone service that aims to assist callers in making linkages to address concerns causing COVID-19-related stress. It is not a direct counseling or care service. It may be helpful to ancillary health care staff supporting patients in primary care and urgent care settings.    

Testing Update

You or your patients have probably heard that the Health District has stopped providing testing for asymptomatic folks unless they fall into one of these categories:

  • close contact of a confirmed case;
  • live in a congregate setting, like a shelter, group home or assisted living facility;
  • work in a location that has had a case;
  • are part of a family or social network that has had a case;
  • work in healthcare, EMS, law enforcement or other fields where work settings have a higher risk of catching or spreading COVID-19; or
  • belong to a racial or ethnic group disproportionately affected by COVID-19 (e.g., Pacific Islander, LatinX, Black, Native American/Alaska Native).

We realize this retreat from widespread asymptomatic testing includes some pre-procedure testing and is likely to contribute to the bottleneck that may be occurring there, but with the deterioration in commercial laboratory turnaround times, intermittent supply and reagent shortages, and rising demand for symptomatic testing, the Health District must prioritize its safety net testing for those people more likely to be of disease control significance.

Health District drive-through testing website:

https://www.snohd.org/drive-thru-testing

Insurance Commissioner Extends Billing Rules for COVID-19 Testing

  • Insurance Commissioner Mike Kreidler extended his emergency order protecting consumers from receiving surprise bills for lab fees related to medically-necessary diagnostic testing for COVID-19 until August 27. His order applies to both in-state and out-of-state laboratories, when a provider orders diagnostic testing for COVID-19.

https://www.insurance.wa.gov/sites/default/files/documents/extension-of-emergency-order-20-06.pdf

  • Commissioner Kreidler also extended to August 27, his emergency order requiring health insurers to waive copays and deductibles for any consumer requiring testing for coronavirus (COVID-19).

https://www.insurance.wa.gov/sites/default/files/documents/emergency-order-number-20-01-extension-4.pdf

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