Hot Topic #49 | A COVID-19 update, and looking at the road ahead

COVID-19 updates from San Juan County around subjects on the minds of islanders

||| FROM BRENDAN COWAN for DEPARTMENT OF EMERGENCY MANAGEMENT |||

This Hot Topic is going to provide updates on current local COVID news and attempt to look ahead to what the rest of 2021 might bring. There is a lot of info below, so if you want the short and sweet, here it is:

• San Juan County is leading the way with vaccination rate
• Get your shot
• Mass clinics are no more, look for a more targeted vax effort going forward
• Kids are at risk, hopeful that ages 12 and up will be able to get vaxed in mid-May
• Cases in WA are still high, but hopefully dropping soon
• COVID can cause significant long term health impacts- about 30% of those with “mild” cases
• Precautions around masking and other safety measures are starting to loosen, but be patient
• End is in sight, but not there yet. Nice work, islands.
• Remember, there’s a whole world out there that’s not in such good shape

VACCINATION RATE IN SAN JUAN COUNTY
As of May 5 th , over 65% of San Juan County residents (registered with a San Juan County address) have initiated their vaccination. This means that of those who are eligible (16+), the vaccine initiation rate is approximately 75%. Actual numbers are expected to be a bit higher due to recent clinics, some local providers catching up with data-entry, and not all mainland shots being included in WA DOH reporting.

This the highest vaccination rate in Washington and is one of the highest in the nation. No matter how you look at it, this is remarkable and welcome news. It indicates a real willingness on the part of islanders to step up and protect themselves, their community, and help the islands move closer to normal this summer. It also reflects the incredible work put in by some local healthcare providers, the San Juan County Vaccination Team, and countless volunteers and local organizations to do the work required to get us to where we are.
That said, there are still about 4,000 islanders over the age of 18 who have not been vaccinated. While our progress is admirable, there is more to be done.

VACCINATION OFFERINGS GOING FORWARD
The days of mass vaccination clinics are over. Recent open registration windows on all islands have remained unfilled – including almost 1,500 unused slots for the recent National Guard clinics (unused vaccine was transferred to other jurisdictions in need). Vaccine is no longer in short supply.

At this point, it is helpful to identify some general groups who have yet to be vaccinated:

• Those who are morally or philosophically opposed due to issues of trust and/or belief.
• Those who are apprehensive and uncertain.
• Those who lack access or awareness due to language, scheduling, or other limitations.
• Those who are willing to be vaccinated but need it to be right in front of them, with a minimum of planning required.

There is a cost & benefit to reaching each of these groups, but some general strategies going forward are:

• Encouraging and supporting local healthcare providers to ensure that vaccinations are an easily accessible and well-advertised service they offer to the communities they serve.
• Providing walk-up, no cost vaccinations in the near-term.
• Regular walk-up vaccination clinics at a set time, schedule, and location. This will likely be weekly or bi-weekly offerings at times that allow those who are unable to leave work during the day to attend.
• Mobile vaccination offerings, attempting to connect with islanders where they gather. Supermarket parking lots, youth sports events, busy times at high-visibility locations.
• Ongoing direct outreach to islanders for whom access may be a challenge.
• Ensuring there are experienced public health communicators at all clinics to help answer questions and concerns.
• Supporting local businesses and organizations who want to encourage and facilitate their staff to be vaccinated.

Given the already high rate of vaccination in San Juan County, it is expected that the San Juan County vaccination efforts will last through June, after which the responsibility will fall to local healthcare providers.

VACCINATIONS FOR CHILDREN
At the moment, island kids are our greatest exposure risk. They’re highly social, traveling with families, and vaccine has not been available to those under the age of 16. In many cases to date, children have been asymptomatic or experienced only very mild symptoms; however, there is evidence that expanding variants are impacting children more severely than previous strains of COVID. Also, there is increasing evidence that the long-term physical health impacts of COVID are impacting up to a third of those with “mild” COVID, regardless of age.

Fortunately, indications are that the Pfizer vaccine will shortly be approved for use in children 12 and up. The County Vaccination Team is making plans to bring a large volume of the Pfizer vaccine to the islands that will serve youth between the ages of 12 and 17. Assuming approval and supply is in place, Pfizer clinics will start in mid-May, with second shots being given three weeks later in June. Stay tuned for more details.

There is no concrete information on vaccine availability for those under 12 but fall of 2021 would be soonest that approval can be expected.

Adults whose children are living, traveling, or working in high-interaction situations, including schools, are highly recommended to get their kids vaccinated. Local public health experts will be messaging in advance and making themselves available to answer questions from parents who may have concerns.

Adults who choose to be unvaccinated and have close interactions with children should be especially careful about their risk of exposure.

CASE TRENDS IN WASHINGTON
While things are very much looking up nationally, cases continue to be relatively high in Washington. However, in recent days there have been encouraging signs that cases are plateauing. Hopefully that trend continues, and cases begin declining soon. That said, cases in some neighboring counties, in particular Whatcom are still increasing. For those who
chose to be unvaccinated, please remember that the number of cases out there are still as high as they have been over the course of the pandemic, other than the spike that occurred in January and February of this year.

In the islands, the outbreak of cases from early April seems to have declined. Our high vaccination rate should result in keeping case rates low. Going forward, case surges that occur should be smaller in scale and primarily limited to unvaccinated children and adults.

LONG COVID
We need to understand that even “mild” cases of COVID can lead to long lasting and debilitating symptoms. Even those whose symptoms pass quickly are experiencing an array of complex issues weeks or months later. This doesn’t happen in all cases, but as time goes on, it is becoming clear that a significant percentage of those infected are suffering long-
term.

Bottom line: no one should take COVID lightly. For all ages, healthy or not, COVID can be a big life change, and there are islanders whose fight with COVID has been prolonged and difficult. Getting vaccinated is the best and only protection against getting COVID and the potential long-term consequences that come with it.

SAFETY PRECAUTIONS AND REOPENING
San Juan County remains in Phase 3. At this time there is no indication of what Phase 4 will look like, or when a move to Phase 4 might occur.

There have been many questions in the community about masking and what the current protocols are, particularly for those who are vaccinated. For now, there have been no changes to the Governor’s requirements around masking.

Guidelines for specific industries and events continue to evolve and are available online here.

Note that the CDC recently released guidance that allows for those who are vaccinated to relax their masking precautions in some situations. While this guidance has not yet been fully incorporated into all WA State regulations, the approach makes sense and will likely become recommended practice in WA before too long.

Masking up indoors in San Juan County business remains a requirement, vaccinated or not.

We’re entering a period of transition, and with that will come some inconsistencies and delays as things progress. This will be a time when patience is required. With luck and attention positive progress will continue and a steady ongoing reopening will occur as we head into summer. Until then, common sense and caution should be the guiding principle of our collective decision making.

OVERALL
Clearly the past 14 months have been full of uncertainty and anxiety. At every step of the way community concern has helped to shape our collective response. While the crisis it not yet over, the islands can be proud of where we are.

At the risk of jinxing ourselves:

• Not a single COVID fatality to date
• One of the lowest infection rates in the nation
• One of the highest vaccination rates in the nation
• An informed and proactive population, willing to do the right thing, and whose collective actions have led the way

Clearly the impacts on our economy and many small businesses have been enormous. The prolonged closures of our schools have taken an immeasurable toll on island kids and their families.

It would be wrong to say that there aren’t things we have learned and things we would have done differently, but the overall response of the islands has been something we should all be proud of.

It is too soon to say we’ve reached the finish line, but the end is in sight. For good reason so many of our concerns have been local and self-focused- but the world is still suffering. We need to stay focused just a bit longer yet can start to shift our gaze to parts of the world with far fewer resources and who are still very much in the fight.

Thanks all.