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Nurses threatened at Harborview – local and national update for September 27, 2021

Hospitalizations declined sharply over the previous week while tempers flare and medical workers are targeted.

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[KING COUNTY, Wash.] – (MTN) Cases moved upward while hospitalizations declined in Washington state. The number of COVID positive students in the Bellevue School District dropped significantly, while cases and quarantines expanded in Northshore, particularly at Bothell High School.

The rollout of additional monoclonal antibody clinics in Washington remains hobbled due to a tight supply and ongoing negotiations with potential locations.

Over 4,000 people joined Turning Point USA and former Washington state representative Matt Shea for a “medical freedom” rally in Spokane. An anti-vaccination rally is planned for September 30 at Swedish Hospital and Harborview Medical Center. At Harborview, staff spoke out over the weekend about getting threats from family members of COVID patients.

A 38-year old Washington State Trooper died of COVID over the weekend, leaving behind a wife and two children.

Vaccination rates in Washington climbed again but appeared to be slowing in many counties. The number of vaccinated adolescents in the Kirkland-Bellevue-Woodinville area increased dramatically last week.

Alaska and Idaho continue to operate under crisis standards of care. Help came to Montana in the form of the Veteran’s Administration opening its doors to non-veteran patients. We’ve added Wyoming to a state we’re tracking and consider it at risk of expanding crisis standards of care.

This update uses the latest data from the Washington State Department of Health (WSDOH), released on September 27, 2021.


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Washington State Update for September 27, 2021

Washington state COVID update

Data points to another plateau, following the pattern of the last three weeks. In the South Central Hospital Region, which includes Benton, Franklin, Klickitat, Walla Walla, and Yakima counties, the 14 day moving average for new cases is 797.4 per 100K, statistically unchanged from Friday. The Central Hospital Region, which represents King County, is 275.3, a slight increase. We have broken out the counties that have 60% or more of their residents vaccinated. The new case rate is 416% higher in counties that are under 40% vaccinated.

Percent of Total Population Fully VaccinatedAverage 14-Day New Case Rate (unadjusted)
60.00% or above (3)182.6
50.00% to 59.99% (12 counties)560.7
40.00% to 49.99% (15 counties)730.6 (up)
28.40% to 39.99% (9 counties)760.5
14-Day New COVID Cases per 100K average by Vaccination Rate, Not Adjusted for Population

Through September 26, Washington’s statewide 14-day rolling average is 463.9 COVID cases per 100K, indicating newly detected cases jumped over the weekend. Counties in the 1,000.0 to 1,399.9 range include Lincoln (1,257.9), Franklin (1.056,5), Okanogan (1,066.5), and Stevens (1,104.1). Counties in the 800.0 to 999.9 per 100K range include Adams, Asotin, Garfield, Grant, and Pend Oreille. Adams reported 978.0, and Grant reported 976.7 per 100K, putting the two counties just under the 1,000 threshold.

New cases were up in every age group, while hospitalizations were down for pediatric and geriatric patients.

Age Group7-Day Case Rate7-Day Hospitalization Rate
Ages 0-11231.9 (up)0.7 (down)
Ages 12-19245.8 (up)1.7
Ages 20-34234.3 (up)5.4
Ages 35-49231.7 (up)10.1
Ages 50-64160.8 (up)14.4
Ages 65-79115.6 (up)19.5 (down)
Ages 80+118.1 (up)31.5 (down)
7-day case rate and 7-day hospitalization rate is per 100K within the age group – the target for 7-day case rate is <25.0, but there are other factors such as vaccination rates within the age groups, how many total tests within the 7-day period, and the positivity rate within each age group

The USA Today COVID Tracker did not provide a number for reported deaths in Washington state. The state of Washington is not reporting the percentage of positive cases.

Expansion of monoclonal antibody treatment clinics in Washington remains stalled out

We reported last week that Washington state was dealing with a restricted supply of monoclonal antibodies, and the situation hasn’t improved in the previous week. Cassie Sauer, CEO of the Washington State Hospital Association (WSHA), fielded a question during today’s briefing.

She said that the state was still working to identify partners that could provide the early stage COVID treatment outside of a hospital or urgent care setting.

Monoclonal antibodies are lab-engineered immune system proteins developed using similar processes as the FDA-approved mRNA Pfizer vaccine. For COVID-positive patients with mild symptoms and who don’t require supplemental oxygen, the therapy has shown to be highly effective in triggering a strong immune response. However, the treatment is not recommended for symptomatic cases that have lasted more than a week with worsening symptoms.

They are not an effective treatment for people who have been symptomatic for more than a week, have moderate or severe symptoms, or require oxygen therapy. Ms. Sauer said that some people were using the treatment as a “get out of jail free card” versus getting vaccinated.

Anti-vaccination protests planned at Swedish Hospital and Harborview Medical Center

Waking up Washington plans a “Seattle March for Healthcare Workers Against COVID Mandates” for September 30. The group announced they would march through Seattle from Swedish Hospital to Harborview Medical Center during the lunch hour.

Vaccination rates for doctors and nurses are high nationwide, with 97% doctors and 88% of nurses fully vaccinated. So far, hospital systems that have mandated vaccinations have seen very little attrition among the highest skilled workers.

Staff threatened at Harborview Medical Center over COVID treatment and mask wear

KING 5 reported over the weekend that family members of COVID patients were verbally and physically assaulting nurses at Harborview Medical Center.

“At first, there was a feeling of camaraderie and people really applauding health care workers,” said Sam Conley, a neuroscience acute care nurse at Harborview Medical Center in Seattle. 

But nearly two years after the pandemic began, amid a new period of vaccine requirements, mask enforcement, and staff shortages, Conley said the strains of the job have been as difficult as ever.

“It’s the verbal and physical abuse from visitors and family members that’s been some of the most challenging aspects of providing care,” Conley said. “I’ll have to ask visitors several times, ‘Hey, I need you to put that mask back on.'”

38-year old Washington State Trooper dies of COVID

On Sunday morning, the Washington State Patrol reported that Detective Eric Gunderson, a 16-year veteran of the WSP, died of COVID. The department indicated that Detective Gunderson contracted COVID “in service to the state of Washington.”

The WSP would not comment on how long he was sick, or if he worked while COVID positive, or his vaccination status. COVID has been the leading killer of law enforcement since 2020.

According to KOIN, Gunderson became ill on a business trip. Gunderson was assigned to District 1, which serves Pierce and Thurston Counties. He left behind a wife and two sons.

The Seattle Times reported that 68% of all Washington state workers impacted by the October 18 vaccination deadline are fully inoculated and have submitted their documentation.

Turning Point USA and former state rep Matt Shea lead anti-government/anti-vaccination rally in Spokane

Turning Point USA, founded by Charlie Kirk in 2021, created an offshoot organization called Turning Point Faith, collaborated with On Fire Ministries for an anti-vaccination rally in Spokane. An estimated 4,000 people gathered at Riverfront Park to hear Dr. Ryan Cole, Ada County, Idaho health officer, Leslie Monookian of Health Freedom Defense Fund, and former state representative Matt Shea. Washington state representative Jenny Graham (R-Spokane) was expected to speak but was a no-show at the rally.

Matt Shea’s speech was about freedom. He says getting fired from your job is good because you are standing up for your “rights.” 

Ms. Monookian advocated for ceasing all doctor visits, told the crowd that they and their children would be raped and murdered soon if this continues, and shared many comparisons to Nazis.

Matt Shea recently formed his own church, On Fire Ministries, after a schism with Ken Peters and the so-called Church at Planned Parenthood (TCAPP). TCAPP, along with Covenant Church, was ordered by a judge last week to stop protests outside of the Planned Parenthood Clinic after a year-long legal battle.

Matt Shea has been a subject of controversy for over a decade. While serving in Iraq, his commander had to disarm him due to “anger management issues.” In 2018 he distributed a manifesto titled Biblical Basis for War. The Spokane County Sheriff reported Shea to the FBI and said the manifesto was racist, anti-Semitic, and based on the white supremacist ideology of Christian Identity. The group wants to create a white-ethnostate based on Christian dogma in the Pacific Northwest.

Dr. Ryan Cole is antimask, called the COVID vaccine, “needle rape,” and leads the public health efforts in Ada County, Idaho, where Boise is located.

On the same day, Turning Point USA hosted a “medical freedom” rally in Enumclaw.

The anti-vaccination movement has increasingly aligned with anti-government and white nationalist groups. Organizations like Christian Identity and the Proud Boys using the messages of government overreach and defending freedom as recruiting tools.

Travel Advisories

We recommend avoiding recreational travel to Spokane, Yakima, Klickitat, Benton, Franklin, and Walla Walla counties. If the number of new cases in the South Central Hospital Region continues to decline, we will likely lift our advisory for this region in the next 7 to 14 days. We strongly advise against all nonessential travel to Alaska, Idaho, and Montana. Hospital resources in these regions are constrained, and you may receive inadequate care if you experience a medical emergency.

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In August, King County Health Officer Dr. Jeff Duchin mentioned the N95 Project as a trusted source for N95 masks. A check on the website showed that a 50 count box of United States manufactured N95 masks are available for $40.00. We recommend wearing N95 masks indoors as they provide the best protection against COVID when properly fitted.

No promotional consideration has been given, or requested from the n95 project or any manufacturer of masks

Vaccination

Number of vaccinated Washington state residents continues to rise

The Washington State Department of Health released updated vaccination numbers for the state and its 39 counties. On Monday, 76.4% of all residents 12 and over have received at least one dose, and 69.7% were fully vaccinated.

The number of people fully vaccinated slowed down last week. All but one county, Skamania, reported at least a modest increase. With 73.2% of residents fully vaccinated, San Juan County continues to lead the state. At 28.4%, Stevens County was in last and is the only county with less than 30% of residents fully vaccinated.

The two counties have a stark difference in the number of new COVID cases. On Monday, San Juan County was down to 51.9 cases per 100K people, while Stevens County was 1,104.1.

Pfizer vaccine booster shots are now available

Booster shots for eligible individuals are now available statewide. Individuals who received both doses of the Pfizer vaccine more than 6 months ago, are 65 or older, or are immunocompromised can receive their third dose immediately.

In the Kirland-Bellevue-Woodinville area, Walgreens, Rite-Aid, Bartell’s, and QFC are offering booster shots. Additionally, the third dose is available at the CVS located within the Target store at 17,700 NE 76th Street in Redmond.

Most locations require an appointment that can be set up online.

King County, Washington is reporting over 85% of age eligible residents are vaccinated with at least one dose. The highest rates of positivity are in areas with low vaccination rates statewide. The FDA has provided full approval of the Pfizer vaccine for anyone 16 and over.

COVID vaccines are free for anyone over 12 years old, and no appointment is necessary at most locations. Lyft and Hopelink provide free transportation, and KinderCare, the Learning Care Group, and the YMCA offer free childcare during vaccination appointments or recuperation.

For information on getting a vaccination in King County, you can visit the King County Department of Public Health website.

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Hospital Status

According to the DoH COVID Dashboard, 20.6% of all acute care patients hospitalized in Washington have COVID. A hospital system caring for this many COVID-positive patients in acute care is considered to be under “severe stress.” ICUs are at 89.4% of capacity statewide, with 31.7% of ICU patients fighting COVID. The number of ICU patients dropped significantly from last week.

The 7-day rolling average hospital admission rate for new COVID patients was down to 147, which is still higher than the January 2021 peak. The Department of Health reported 1,329 COVID patients statewide on September 26 and 220 on ventilators. Monday data is typically incomplete, so expect to see those numbers change tomorrow. If that number holds, hospitalizations have dropped 15%.

The number of patients at EvergreenHealth in Kirkland dropped 26% from last week. Currently, the hospital is treating 29 patients, 78% fully vaccinated (one patient, under 12, is not eligible). The ICU is caring for 9 patients, 78% fully vaccinated, with five on ventilators – none vaccinated. Only one vaccinated patient is under 60 years old. There was no additional information on the pediatric patient.

Cassie Sauer, CEO of the Washington State Hospital Association (WSHA), indicated she was “cautiously optimistic” about the declining number of hospitalizations. However, she cautioned that the future is uncertain with the arrival of cooler weather and, eventually, flu season.

At the same briefing, Dr. Radha Agrawal with Overlake Medical Center in Bellevue said the patients she is treating are younger, sicker, and not responding to treatment. 

“Once they get on a ventilator, the rate of success has been really, really low,” she said, adding, “We’re seeing so many younger people this year. It’s tragic, and it’s tragic for the patients, and it’s tragic for the families, and it’s tragic for the people taking care of them.”

KING also spoke with Dr. Todd Freudenberger, who works at Overlake Medical Center, about the stress and burnout staff are experiencing.

“I’ve never seen anything like it,” said Dr. Freudenberger. “It’s particularly bad among our nursing staff.”

He said the start of every day involves assessing how short of staff they will be and how they will staff a constant influx of new COVID-19 positive patients. 

Unlike Idaho, Washington state has not declared what’s called ‘crisis standards of care,’ which is a decision that would force health care providers to systematically ration care because of a lack of space and resources.

“We are on a razor’s edge of that,” Dr. Freudenberger. “That would get at the very core of what we do as health care providers.”

Back to School

School DistrictStatusLess than 10 Active Cases10 or More Active Cases
BellevueGREEN– Bellevue (1)
– Eastgate (1)
– Enatai (4)
None
Lake WashingtonYELLOW– Alcott Elementary (1*)
– Barton Elementary (1*)
– Dickinson/Explorer Elementary (2*)
– Ella Baker Elementary (3*)
– Eastlake High (1*)
– Evergreen Middle School (1*)
– Franklin Elementary (2*)
– Finn Hill Middle School (1*)
– ICS (1*)
– Inglewood Middle School (2*)
– Juanita Elementary (1*)
– Kamiakin Middle School (3*)
– Keller Elementary (2*)
– Kirkland Middle School (1*)
– Lake Washington High (1*)
– Lakeview Elementary (3*)
– Muir Elementary (1*)
– Redmond Middle School (1*)
– Redmond High School (1*)
– Renaissance Middle School (1*)
– Rush Elementary (2*)

NorthshoreRED– Arrowhead Elementary (19)
– Canyon Creek Elementary (24)
– Canyon Park Middle School (8**)
– Cottage Lake Elementary (15)
– Crystal Springs Elementary (47**)
– East Ridge Elementary (22)
– Fernwood Elementary (13**)
– Frank Love Elementary (31)
– Hollywood Hills Elementary (19)
– Inglemoor High School (7)
– Innovation Lab High School (10)
– Kenmore Elementary (16)
– Kenmore Middle School (41**)
– Kokanee Elementary (51)
– Leota Middle School (5)
– Lockwood Elementary (20)
– Maywood Hills Elementary (20**)
– North Creek High School (21**)
– Northshore Middle School (12**)
– Ruby Bridges Elementary (9)
– Secondary Academy for Success (10)
– Shelton View Elementary (18**)
– Skyview Middle School (77**)
– Sunrise Elementary (20)
– Timbercrest Middle School (32**)
– Wellington Elementary (67)
– Westhill Elementary (19)
– Woodin Elementary (16**)
– Woodinville High School (20)
– Woodmoor Elementary (20**)
– Bothell High School (13*/102)
Local Districts Scorecard – * indicates positive cases only ** indicates 5 or more confirmed positive cases

We redefined the school district statuses. Information for classroom and building closures has been a challenge to obtain, both for closures and reopening. We are adopting moving any school with more than 10 active COVID cases reported into the red, and we’ve adjusted the third column to reflect this change.

The Bellevue School District moved back to green status while new confirmed COVID cases were reported in four Lake Washington schools.

The number of positive cases between staff and students grew to 13 at Bothell High School over the weekend, with another 102 students are quarantined. The NECS reports the school has 1,607 students, and the Northshore School District website reports 236 faculty. Although the numbers in the district may appear to be bad, it is the only school district we are monitoring that is performing weekly universal COVID testing.

King County COVID vaccination rates – at least one dose ages 12 to 19 – by zip code as of September 27, 2021

Vaccination rates among adolescents 12 to 19 jumped significantly throughout the Kirkland-Bellevue-Woodinville area, although the sharp divide between the northern and southern half remains. Every zip code below 80% vaccinated for the age group saw an increase of at least 5% in a week.

We recommend that parents in the Bellevue and Lake Washington School District request better transparency on their publicly facing COVID dashboards.

Kirkland-Bellevue-Woodinville

King County Public Health updated the vaccination rates by zip code, with the numbers improving throughout the region. The northern half of Kirkland, Bothell, and Kenmore, continue to lag behind the rest of the local area.

King County, Washington, at least one dose of COVID vaccine, all eligible ages, as of September 27, 2021
Zip CodePercent vaccinated, at least one dose, 12 and older
9815592.7%
9802889.5%
9801185.9%
9803484.7%
9803392.3%
9807290.4%
9805294.8%
98004>95.0%
9803993.7%
9800594.6%
9800789.2%

Vaccination rates for those 12 and older by zip code – at least one dose

National Round-Up

Johns Hopkins University Cumulative Case Tracker is reporting 30,952 new cases and 286 deaths nationwide. Most states do not provide reporting over the weekend, so a significant amount of data is missing.

President Joe Biden got his Pfizer vaccine booster shot today in a live broadcast.

“Boosters are important, but the most important thing we need to do is get more people vaccinated,” Biden said before receiving his injection.

“The vast majority of Americans are doing the right thing. Over 77% of adults have gotten at least one shot,” he said. “About 23% haven’t gotten any shots. And that distinct minority is causing an awful lot of damage for the rest of the country. This is a pandemic of the unvaccinated. That’s why I’m moving forward with vaccination requirements wherever I can.”

Life expectancy in the United States declined 1.5 years in 2020, the most significant drop since World War II. COVID deaths drove the decrease, with the life expectancy of men dropping 2.2 years.

Alaska

COVID is spinning out of control in Alaska, with the state reporting 21 COVID deaths on Monday and almost 4,000 new cases from Friday to Sunday. The state is leading the United States for new COVID cases with a staggering 7 day moving average of 1,225 new cases per 100K residents. Once the top state for vaccination, since April, it has slid to 32nd place.

Hospitals are currently treating 215 COVID patients, which is more than half of the state’s largest hospital capacity. Statewide there are only 18 ICU beds available.

The first 100 hospital workers from FEMA arrived in the state today.

Arizona

 On Monday, a Maricopa County judge struck down Arizona’s ban on face-mask mandates by school districts as unconstitutional, just two days before the ban was to have become law. 

Superior Court Judge Katherine Cooper ruled the ban on certain COVID-19 mitigation measures violated the so-called “single-subject rule” for legislation by being inserted into a state budget bill. 

“The bill is classic logrolling – a medley of special interests cobbled together to force a vote for all or none,” Cooper said in her 17-page ruling. 

Ninety minutes after the decision was released, Gov. Doug Ducey’s spokesman said the ruling by a “rogue judge” would be challenged:

Idaho

While Dr. Ryan Cole was exporting COVID misinformation in Spokane on Sunday, the Gem State set new records. The state is now treating 774 COVID patients, a new record. Among the 774, 207 in the ICU – Idaho only has 170 ICU beds.

St Luke’s Health was treating 303 COVID patients statewide and reported every ICU patient was unvaccinated.

Idaho is seventh in the nation for new COVID cases, and models don’t expect peak hospitalizations to come until late October.

Federal taxpayers have had to shell out $1.9 million in FEMA assistance to 331 families looking for aid with funeral expenses with almost 300 more applications in the pipeline.

For the week ending Sunday, the state reported another 1,516 cases involving 5- to 17-year-olds. That’s a 10% increase from the previous week, as K-12-aged children continue to account for a growing share of Idaho’s coronavirus caseload. Nine children were hospitalized with COVID-19 in the past week. 

Montana

Montana hospitals have more patients in the ICU than they did during the previous record peak over the winter. Hospitals averaged 109.3 COVID patients in the ICU per day last week, almost 15 a day higher than the previous record. Nearly half of all ICU patients are fighting COVID, and nearly none of them are vaccinated.

In Yellowstone County, 129 people are hospitalized with COVID-19. Of those, 111 are unvaccinated. Between the two hospitals, 30 patients are in the ICU, and 20 are on ventilators. Of those, all are unvaccinated.

FEMA approved the use of the Fort Harrison Veterans Affairs Medical Center for non-veteran patients.

“With more hospital beds available, hospitals now have another tool in their toolbox to treat Montanans in need of care as their systems are strained,” Gov. Greg Gianforte said Friday in a statement.

Montana has the fifth-highest rate of new COVID cases in the country, with 15% to 19% of all tests coming back positive.

New York

The deadline for 450,000 healthcare workers to get vaccinated has arrived in New York with a wide range of reports from hospital systems across the state. Statewide, over 95% of nurses and almost all doctors got vaccinated or had an exemption approved. Hospital systems are reporting a wide range of results from “total compliance” to 15% attrition. The number of clinicians that left has been reported to be low statewide.

The hardest-hit system appears to be Erie County Medical Center in Buffalo. The hospital announced it has suspended elective inpatient surgeries and stopped accepting intensive-care patients as it prepares to fire “hundreds of unvaccinated employees,” a spokesman Peter Cutler said.

In New York City, up to 11% of the 43,000 public health system employees refused to get vaccinated.

Ohio

The world-renowned Cleveland Clinic is now seeing its highest volume of COVID-19 patients since last winter, causing long wait times in Clinic emergency departments and fewer nonessential surgeries.

About 460 patients — including 135 in intensive care units — are in the Clinic’s Ohio hospitals. This is more than double the number of patients that were hospitalized with COVID-19 at the Clinic one month ago. The majority of these patients are unvaccinated, the hospital system said.

Statewide, unvaccinated people account for close to 94% of recent coronavirus hospitalizations, according to data from the Ohio Department of Health.

Oregon

To our south, Oregon has 886 COVID patients hospitalized, which is an increase of 11 from over the weekend. Almost a quarter of all COVID patients are in the ICU, and although that number declined by 25 over the weekend, most of that was due to patients succumbing to COVID.

Oregon hospitals will continue to remain under severe strain from the current surge of COVID-19 cases well into the fall, according to an updated forecast released today from Oregon Health & Science University.

The current surge, fueled by the highly contagious delta variant, is slowly beginning to abate as the virus finds fewer people who aren’t immune either through vaccination or recent infection. However, the new forecast indicates that hospitalizations will remain at extremely high levels until October 5 and will stay high well into December.

Wyoming

The Wyoming Department of Health reported an additional 854 confirmed COVID-19 cases. The number of COVID-19 patients in Wyoming hospitals fell below 200 on Sunday to 198 and dropped further to 192 on Monday, according to the WDH. The most recent peak in COVID-19 hospitalizations occurred on September 8, when there were 233 COVID-19 patients in Wyoming hospitals.

Five hospitals had zero available intensive care unit beds. Four had only one available ICU bed. While ICU beds are not exclusively used to treat COVID-19 patients, when hospitals deal with surges in these patients, that can put a strain on their ability to care for other types of critical-needs patients.

Misinformation

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