HomeMy WebLinkAboutResolution 20-048-CCBOARD OF COUNTY COMMISSIONERS
Grant County, Washington
RESOLUTION TO MOVE GRANT RESOLUTION No. 20- U `t�-CC
COUNTY TO PHASE 2 OF THE
GOVERNOR'S REOPENING PLAN
WHEREAS, on February 29, 202 Governor Inslee declared a State of Emergency in
response to the COVID 19 Pandemic; and
WHEREAS, On March 13, 2020 the Grant County Board of County Commissioners
declared an emergency regarding the COVID 19 pandemic; and
WHEREAS, By various emergency proclamations the Governor has severely restricted
economic activity to deal with the pandemic; and
WHEREAS, The Governor has announced a four phase approach to re -opening the
economy; and
WHEREAS, Grant County has met the criteria announced on May 19, 2020 to move to
phase two of the recovery plan; and
WHEREAS, On May 22, 2020 Dr. Alexander Brzezny, Grant County Health Officer,
submitted a letter to the Grant County Board of Health with his recommendation to apply for the
phase 2 variance per "Safe Start Washington".
WHEREAS, This recommendation is based on Dr. Brzezny's assessment of Grant
County's decreasing COVID-19 transmission, increased access to COVID-19 testing, Public
Health's robust capacity of timely isolation of positive cases and quarantine and contact tracing
of close contacts, and
WHEREAS, The Grant County Health District and the medical infrastructure in Grant
County are sufficient and prepared to move to phase 2.
THEREFORE, BE IT RESOLVED that Grant County shall submit its request to the
State to move to phase 2 of the recovery plan and move to phase two as cnnn ne nuffinA—f- i
received from the State.
A A
N:\Staft\BVasquez\Resolution-Ordinance\Phase 2 .docx
-x
DATED this<,' � day of , 2020.
BOARD OF COUNTY
COMMISSIONERS
Yea Nay Abstain G1j,ANT COU , WASHINGTON
Ti
, &
❑ ❑
mdy r, C it
ATTEST:
9 ElElTaylor, Vice- air
�ck
)y // �
Barbarau / ❑ ❑ -
Clerk oft r [�' Richard Stevens, Member
N:\Staff\BVasquez\Resolution-Ordinance\Phase 2 .docx
GCHD
GRANT COUNTY HEALTH DISTRICT
RESOLUTION 20-5
1038 West Ivy, Suite 1
Moses Lake, WA 98837
A RESOLUTION OF THE BOARD OF THE GRANT COUNTY BOARD OF RESOLUTION TO APPLY FOR A
VARIANCE TO PHASE 2 OF THE GOVERNOR'S COVID-19 RECOVERY PLAN.
Section 1. RECITALS
The Board of Health finds that:
1. WHEREAS, on March 5, 2020, the Washington State Department of Health (DOH) confirmed
the first case of the novel coronavirus (COVID-19) in Grant County, Washington, and the Grant
County Health District and the Washington State Department of Health have since worked to
identify, contact, monitor and test others in Grant County potentially exposed to COVID-19 in
coordination with the US Centers for Disease Control and Prevention (CDC); and
2. WHEREAS, COVID-19, a respiratory disease that can result in serious illness or death, is caused
by the SARS-CoV-2 virus, which is a new strain of coronavirus that had not been previously
identified in humans and can easily spread from person to person; and
3. WHEREAS, the CDC identifies the potential public health threat posed by COVID-19 both
globally and in the United States as "very high," and has advised that person-to-person spread
of COVID- 19 will continue to occur globally, including within the United States and Grant
County; and
4. WHEREAS, on January 31, 2020, the United States Department of Health and Human Services
Secretary Alex Azar declared a public health emergency for COVID-19, beginning January 27,
2020; and
S. WHEREAS, on February 29, 2020, Washington State Governor Jay Inslee proclaimed a public
health emergency for COVID-19, beginning February 29, 2020; and
6. WHEREAS, on March 2, 2020, the Grant County Health District activated its District Operations
Center to manage their response to the COVID-19 cases; and
7. WHEREAS, on March 12th, 2020, the Grant County Health Officer proclaimed a countywide
public health emergency (Per RCW 70.05.070) for COVID-19; and
8. WHEREAS, on March 13, 2020, the Grant County Board of Commissioners declared a State
of Emergency in Grant County, beginning March 13, 2020; and
9. WHEREAS, on March 23, 2020, Board Chair Massa, Health Officer Brzezny, and Administrator
Adkinson issued a Declaration of Emergency, declaring COVID-19 pandemic to be an emergency
in Grant County pursuant to Section 38.52.010 RCW, Chapter 70.05 RCW, and other relevant
provisions of state, local, and federal law.
Phone: 509-766-7960 0 FAX 509-766-6519 0 granthealth.org lu
AzblicHeaIth
10. WHEREAS, on May 21, 2020 Grant County Health District was notified of their opportunity to
apply for a variance to Phase 2 of the Washington State Governor's COVID-19 Recovery plan
due to the downward trend in COVID-19 cases in Grant County.
11. WHEREAS, on May 22, 2020, Health Officer Alexander Brzezny presented to the Grant County
Board of Health and the Grant County Commissioners his recommendations to apply for the
Phase 2 variance based on his evaluation of the current COVID-19 data, increased testing
capacity, and robust disease investigation and contact tracing abilities within Grant County
Health District and its partners.
12. WHEREAS, on May 22, 2020 Grant County Health District has demonstrated in the variance
application the required expectations of the Washington State Department of Health.
13. WHEREAS, on May 22, 2020 all Grant County Hospitals submitted letters to Grant County
Health District indicating their 20% surge capacity and 14 -day surplus supply of PPE as required
for the variance application.
Section 2. RESOLVED
NOW THEREFORE, BE IT RESOLVED, by the Board of Health of the Grant County Health District,
Grant County, Washington, that:
The Grant County Board of Health accepts Grant County Health Officer's letter regarding the phased
approach to COVID-19 recovery.
Be it resolved by the Board of Health of the Grant County Health District here by directs the Grant
County Health District to apply for a Phase 2 variance in the Governor's COVID-19 Recovery Plan.
Section 3. BOARD OF HEALTH MEMBERSHIP VOTE
Board Members Present:
Board Members Who Were Absent:
Board Members Who Made the Motion and Seconded:
Board Members Who Pass this Resolution by a vote of Yay:
Board Members Who No Not Pass this Resolution by a vote of Nay:
Section 4. BOARD OF HEALTH MEMBERSHIP VOTE
This resolution shall take effect on May 22, 2020
PASSED BY THE GRANT COUNTY BOARD OF HEALTH AND SIGNED BY ITS CHAIR ON May 22, 2020
Tony Massa, Chairman of the Board
ATTEST:
Theresa Adkinson, Administrator
1038 West Ivy, Suite 1
GCHD
Moses Lake, WA 98837
GRANT COUNTY HEALTH DISTRICT
May 21, 2020
Grant County Board of Health
c/o GCHD
1038 W Ivy Ave #1
Moses Lake, WA 98837
Phone: 509-766-7960; Fax: 509-766-6519
RE: Recommendation about a variance to implement Phase 2 per "Safe Start Washington"
Dear Chairman Masa and members of the Grant County Board of Health,
Based on the Washington State Department of Health notification about Grant County's eligibility to apply for a
variance to the Governor's "Safe Start Washington" received by me today, I am providing my assessment of
SARS-CoV-2 activity in Grant County, its health system capacity and Grant County Health District's (GCHD) level
of preparedness and response to "COVID-19". I am also including my recommendation about the Grant County
variance request.
1. Cases of SARS-CoV-2 ("COVID-19") in Grant County have decreased and then stabilized during May.
a. As of 05/20/20, a total of 193 confirmed cases of COVID-19 were reported in Grant County since
February (rate 190.5 /100,000), with a peak in mid-April and a gradual decline, except for a spike in
cases in early May related to a COVID-19 cluster in H2A housing setting (Fig 1. Epi Curve).
FIGURE 1. Epidemiologic Curve
Confirmed Case Counts
*Confirmed Cases • Data are incomplete for the most recent dates.
10
8
6
4
2
0
Feb 2020
11
Mar 2020 Apr 2020
Date of Illness Onset
May 2020
b. Confirmed cases of COVID-19 have declined to an average of about 5 cases per week during the last
2 weeks for a Grant County's population of approximately 98,740 (OFM 2019 population data;
excluding undocumented or migrant populations; Fig. 2. New Cases).
Phone: 509-766-7960 0 FAX: 509-766-6519 • granthealth.org 10
Public Health
FIGURE 2. Grant Countv, WA, New Cases
Ori
Q�Ps _I- �
c. During a two-week specimen collection period between 05/05/2020 and 05/18/2020, there were on
average 0.71 newly diagnosed cases per day for a crude rate of about 0.7 cases /100,000 /day. This
remained the case for the two-week time period ending 05/20/2020, according to the most recent
count (with additional tests pending).
d. If Grant County's undocumented residents and migrant farm workers were included in the population
count, a daily incidence would be below 0.7 /100,000 /day during the last 3 weeks. However as is the
case with any rural agricultural county, even a few additional individuals with COVID-19 or one outbreak
among farm workers can dramatically impact the statistics in the opposite direction.
e. Grant County cities of Quincy and Mattawa have experienced a disproportionately higher number of
COVID-19 cases, while central and northern cities of Ephrata, Moses Lake, Soap Lake, Electric City
/Grand Coulee have seen a protracted period of proportionately lower activity (Fig. 3. Communities). It
is estimated that migrant housing communities (located mostly in the southern and western part of the
county) will continue to pose a challenge to local statistics, presently essential to the variance
determination and without any extenuating circumstances provisions in the current variance eligibility
calculus.
FIGURE 3. Communities, Grant County, WA, Cumulative Case Count
I Communities
0 -
cc cry ,Ev, C-C « var3n 1e.— e; Rrn. a, � S., U,e mm
f. There have been no outbreaks of COVID-19 in long-term care facilities or other congregate living or
institutional settings in Grant County since late April, when a cluster of individuals with the novel
coronavirus was investigated in a congregate H2A housing near Quincy.
2. Number of SARS-CoV-2 positive tests is declining, while the total test numbers remain steady.
a. The number of individuals with COVID-19 positive test has been generally declining during the last 3
weeks.
b. The rate of increase in cases has slowed from the April's peak of 10% a day at the beginning of the
month, about 5.3% during mid-April, to 0%-2.13% per day during the last 15 days (Fig. 4. New Positives).
c. During May 2020, there were 713 tests performed in Grant County to date, with a total of 22 positive
tests. This means that it took on average 32.5 tests to discover one new confirmed COVID-19 case in
May. However, during the last two weeks a total of 450 test were performed with 9 positive tests: it
took about 50 tests to discover one case (FIG. 5. Testing).
d. The proportion of positive tests vs. all tests performed per week has also been declining: a month
ago, about 9.3% of tests were positive per week, 2 weeks ago that number declined to about 2%. During
the last 2 weeks, exactly 2% of all tests were positive for COVID-19.
e. The number of tests performed in Grant County has remained steady at about 32 tests per day
during the last 2 weeks, which is close to the average of about 34 tests per day during the same period
of time a month ago, while the number of positives has declined fourfold.
FIGURE 4. Grant County, WA, New Positives (% vs. prior day total)
70
ea
FQ
40
8
s
a
20
20
10
0
t3'4*"00
70
0, aha► at 0 'Y ► w
Dee
_%1fl-Sve`.__
FIGURE 5. Grant County, WA, Testing (n
U"
Pa4tve - `:e,a:.e M Pen&V
3. Healthcare facilities in Grant County have sufficient and available capacity, per their assessment.
a. Emergency Room visits have declined substantially since March in all four public hospitals in Grant
County, showing only mild rebound unrelated to COVID-19 care recently.
b. Grant County's four public hospitals report occupancy below 50% of all available beds during the last
4 weeks with a bed surge capacity to >120% available if necessary. In addition, Samaritan Hospital in
Moses Lake reports an action plan to stand up a respiratory care /ventilator unit for >10 beds if
necessary, with a potential to surge this capacity further (assuming an additional ventilator availability).
c. So far, local hospitals did not experience a surge in COVID-19 visits or hospitalizations. A total of six
Individuals with COVID-19 were hospitalized for at least some period of time In Grant County
(Samaritan Hospital, Moses Lake) mainly during March and early April. In total, 21(10.9% of all cases)
Grant County residents required hospitalization for COVID-19 since the beginning of this
emergency, most of them placed in a regional center in Wenatchee.
d. A total of four Grant County residents died from COVID-19 since beginning of this emergency (2.1%
of all cases): two passing away in a regional hospital (neighboring county), one out of state, and another
at home.
e. According to WATrac, referral hospitals in Spokane and Wenatchee continue to possess additional
capacity to accept patients from Grant County if needed.
f. Hospitals in Grant County are reporting more than 14 days of PPEs on hand.
g. Local surge ventilator capacity in Grant County is not optimal. Previously obtained and delivered
ventilators from the National Stockpile had to be returned back. At that time, verbal reassurances were
provided by DOH that, if needed, state -resourced ventilators would be made available.
4. Public health investigations of individuals suspected or confirmed for COVID-19 and tracing of their contacts
is aggressive, its results reassuring, and the capacity to test very good and increasing.
a. GCHD has always aimed for all individuals suspected or confirmed for COVID-19 to receive an
investigator call within 24 hours to assure an immediate isolation. In addition, GCHD is now contacting
all confirmed individuals daily. GCHD has responded within 24 hours of the initial report to 99% of all
COVID-19 confirmed cases.
b. GCHD has been in contact with a large proportion of all tested Individuals BEFORE their test result.
c. Most contacts are reached within 24 hours; more than 90% of known contacts are reached or have an
attempt to be reached recorded within 48 hours.
d. Arrangements have just been finalized for an Isolation and quarantine facility.
e. GCHD has 1,500 test kits ready for use in case of large outbreaks. The largest public hospital
(Samaritan Hospital, Moses Lake) has the capacity to perform 100 tests per day through their test site
and is preparing an outdoor screening /drive through unit capable of handling even greater number of
tests per day. All municipalities in Grant Count possess testing capacity, with public hospital districts
conveniently located in key parts of the county. Mobile testing team for remote locations could be
assembled utilizing healthcare staff within 24 hours with a testing capacity of hundreds of cases per day.
S. Greatest threat to Grant County's COVID-19 caseload comes from a large number of congregate settings
associated with agriculture and from a recently observed informal relaxing of physical distancing and masking
standards in our communities.
a. While H2A housing -associated cases of COVID comprise a low proportion of all cases so far, at least
one cluster of individuals with COVID-19 has already been investigated at a H2A housing community,
with a large proportion of asymptomatic individuals testing positive. .
b. Approximately 8,000 individuals are expected to reside in Grant County's H2A housing units by the
summer, with additional non-H2A-housing temporary farm workers arriving by that time.
c. GCHD has taken additional steps to prevent occurrence of outbreaks in congregate setting associated
with essential agricultural production by working closely with the farms and the housing communities,
by developing specific farm housing guidance, by prepositioning testing capacity, and by working closely
with and learning from neighboring counties with similar challenges.
d. Even though a greater risk of clusters and outbreaks in these congregate settings exists, the
individuals residing in this setting are predominantly young and healthy, their activity in the community
at large is generally low, their risk for hospitalizations is also low, while the capacity for their
sequestration away from the community at large is good (assuming early cases identification).
e. In addition, recent mobility data demonstrated an increase in activity community -wide.
Anecdotal reports of reduced voluntary mask use and relaxation of physical distancing have been
received by GCHD. Out -of -county visitor numbers have also been observed as increasing.
f. In response, and to improve public awareness about integrating physical distancing and disease
surveillance into our daily life, GCHD has recommended its own "COVID-19 SMART" business guide
suitable for a county -wide implementation in this and any subsequent phase of the "Safe Start
Washington".
While the presence of COVID-19 in our county demands a continued vigilance and a readiness to re -impose
more stringent community -wide mitigation measures in case of a disease surge, it is my assessment that Grant
County is presently experiencing an objective decrease in local SARS-CoV-2 activity with additional favorable
mitigation indicators. However, with the aforementioned risks unique to Grant County, it is my plan to issue
additional directives to the county residents including a face covering requirement at indoor or confined public
settings (when within 6 feet of another person with whom they don't live) should this Board decide to move
forward with a variance request and become successful.
Ultimately, as a result of my review, including the assessment of county's existing healthcare capacity supported
by a robust public health response, I recommend requesting a variance to implement all Phase 2 modifications
per the Governor's "Safe Start Washington".
Respectfully Submitted,
Alexanderl�H, FAAFP
Grant County Health Officer