— from Michael Riordan —

Image: Centers for Disease Control and Prevention (CDC)

Thanks to a vigorous response to the coronavirus outbreak by the county health department led by Public Health Officer Frank James, M.D., San Juan County has thus far been spared the worst effects of the pandemic sweeping through the state and nation. But the anticipated influx of tourists coming to our islands this summer may undermine that success and will likely increase our risks substantially.

On May 19 the County passed the thousand mark for Covid-19 testing but had registered only 15 positive cases — and absolutely no deaths. That’s a “positivity rating” of just 1.5 percent, on par with South Korea. (For Orcas Island, this number is slightly higher, about 1.8 percent.) For comparison, Washington state had a positivity rating of 6.7 percent and the entire United States a woeful 12 percent as of May 22.

Why does this matter? And why are we doing so well?

Low positivity ratings indicate high levels of testing — in our case, about one of every 16 year-round county residents. It also helps when public-health officials quickly track down and confine infected individuals and their close contacts, to limit as best as possible any further spread of the disease. That is what happened in South Korea.

But it’s also likely that some actual Covid-19 cases were overlooked in the early testing — for example, symptomatic individuals under age 65. This would mean that the 15 confirmed cases may be an undercount.

After a slow start in March, when testing supplies were scarce and testing-lab access difficult, county public-health officials have been testing a lot of “asymptomatic essential workers” in addition to people with flu-like symptoms. According to Dr. James, such individuals could be unduly and unwittingly exposed — for example, health-care workers, first responders, grocery clerks, pharmacy employees and ferry workers.

“Covid-19 testing is certainly making a big difference, together with early case identification and isolation of infected individuals,” Dr. James told me. This aggressive testing program has helped identify infected individuals rapidly — before they have much chance to expose others — keeping case counts down. That knowledge guides subsequent contact-tracing activities, which can therefore be kept manageable.

The high number of negative test results hereabouts suggests that less than 1 percent of islanders have been infected. For comparison, Skagit County has recently been seeing Covid-19 infection rates of 3 to 4 percent in its testing program. But our success rate has an unfortunate down side: over 99 percent of island residents remain vulnerable.

The success of the county effort has been due in part to the limited number of new people coming on island since late March, when Governor Inslee’s “Stay Home — Stay Healthy” order went into effect. Apart from a “spike” of four positive cases on one day in early April, at most two cases per day have been recorded, and only one in the last 35 days. At that level, the all-important follow-up activities of contact tracing, isolation and disease surveillance have been kept manageable with the limited public-health staff.

In addition to about 16,750 year-round county residents, there are a number of second homeowners who have come to the islands since March to shelter in place. On Saturday, March 28, for example, an unusually large number of vehicles came to Orcas Island on morning ferries from Anacortes. Such in-migration would increase the effective county population and lower the fraction testing positive.

“It appears that the vast majority of second homes in the islands are currently occupied by their owners,” said County Emergency Manager Brendan Cowan in a May 22 press release. While that may be an exaggeration, we can reliably guess that perhaps half of the county’s second homes have been occupied by off-islanders sheltering here (which would explain all the strange faces being seen at Island Market). That would bring the effective county population to 22,900 and lower our fraction of positive cases to 1 in 1527, compared with 1 in 365 statewide.

One such couple I know who live in the Seattle area came here bringing sufficient food and supplies to self-quarantine for two weeks. We can expect that other, similar second homeowners feel a strong connection to Orcas Island; they are valuable members of the community, despite having their primary addresses on the mainland. This is the case for the couple I mentioned above. Orcas is indeed their second home.

But unfortunately there are others for whom second homeownership is mainly a commercial enterprise. Thanks to Airbnb and VRBO, these owners can market short- term, transient accommodations here for hundreds of dollars a night and earn substantial profits. According to the Vacation Rental Working Group, there are now 1038 permitted short-term rental properties in the county — 469 of them on Orcas Island, about half owned by off-islanders. These owners and the tourists they attract care much less about the Orcas community.

The public-health activities of testing, contact tracing, and isolation will become far more complex and difficult as tourists arrive, some of them likely carrying the virus. If diagnosed, any such infected individuals will not have residences here where they can be quarantined. And an asymptomatic tourist could arrive, infect islanders, and be long gone before anyone here experiences symptoms.

This is a serious concern that needs to be taken seriously. We risk another Covid- 19 outbreak unlike anything witnessed in late March and early April — given how vulnerable we remain and the potential deadly impact on our many aged residents.

Since tourism has become essential to the islands economy, county leaders and public-health officials now face a choice between lives and livelihoods. Perhaps they — and we as citizens — need to reassess the actual “value” of tourism here. Has tourism swollen to a level that has become unsupportable and is now putting islanders at undue added risk? And are its economic contributions worth that risk?

I submit that we initially need to take a long, hard look at the short-term rental properties, especially those owned and operated by off-islanders, for which 90 percent of the gross income leaves the county.

This summer may give us a valuable glimpse of our coronavirus future.

Michael Riordan writes about science, technology and public policy from his home in Eastsound.

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