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

Knowledge is the best tool to fight against fear. A wise person chooses to be informed so they can make sound decisions. To join the fight against COVID misinformation, you can share this update through your social media platform of choice.

[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.

Thank you

Thank you to our new subscribers and those of you who have made one-time contributions. On behalf of the entire team, thank you for helping us keep the lights on!

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.

Malcontent News

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

Taking the day off

DoH COVID data has been broken since August – local and national update for September 24, 2021

Knowledge is the best tool to fight against fear. A wise person chooses to be informed so they can make sound decisions. To join the fight against COVID misinformation, you can share this update through your social media platform of choice.

[KING COUNTY, Wash.] – (MTN) Worsening problems with data from the Washington State Department of Health is hobbling efforts to understand the current situation and forecast the future. In counties where 40% or more of the total population is vaccinated, the number of cases per 100,000 people is down. Hospitalizations are up among people under 35 and have declined for individuals over 49. There is very little else that can be said with certainty.

Confirmed COVID cases between students and faculty at Bothell High School in the Northshore School District have grown to 12, with 100 more in quarantine. School officials in Eatonville moved its middle school to remote learning at least until mid-October due to an unspecified number of cases.

If you qualify for a Pfizer booster shot, we checked area pharmacies and grocery stores – they’re available now.

The Washington Department of Health data and reporting problems, which started in August and has only gotten worse, have become problematic. The new Modeling and Surveillance Situation Report, released by the DoH today, expressed uncertainty in the ongoing COVID situation because critical data is missing. Choose your path wisely over the next two months based on what is in the report. The first option makes for a harsh winter while the second path forecasts a sixth wave.

The City of Seattle has reached an agreement with three more unions today over modifications to the vaccine mandate. The Seattle Fire Department agreed to the compromise plan and incentives. The Seattle Police Officer Guild was absent from the negotiations.

Anti-vaccination advocates are becoming more desperate and violent. Hospital workers were threatened and attacked in multiple states this week, and the anti-vaccination group Waking Up Washington has resorted to telling their followers not to go to hospitals. The same group is planning an anti-vaccination “town hall meeting” at a Woodinville restaurant tomorrow. If you’re planning to attend, be sure to bring $20 cash and be ready to pay at the door.

Idaho and Alaska are still operating under “crisis standards of care,” and Alaska, in particular, is getting much worse. If you want to feel your blood pressure rise and have veins bulging out of your neck, please, read the Idaho section. We recommend not having anything breakable nearby. In Helena, Montana, where the city’s hospital is operating under crisis standards of care, state legislatures debated whether things are really that bad.

The situation in the Pacific Northwest is so deranged reporting Oregon has 60 available ICU beds statewide is now considered good news.

This update uses the latest data from the Washington State Department of Health (WSDOH), released on September 24, 2021.


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Washington State Update for September 24, 2021

Washington state COVID update

Data continues to show improvement across Washington, particularly in most of the highly vaccinated counties. 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 803.4 per 100K, statistically unchanged from yesterday. The Central Hospital Region, which represents King County, is 258.7, a slight drop from yesterday.

Percent of Total Population Fully VaccinatedAverage 14-Day New Case Rate (unadjusted)
50.00% or above (13 counties)464.5 (down)
40.00% to 49.99% (17 counties)683.3 (down)
28.10% to 39.99% (9 counties)755.8
14-Day New COVID Cases per 100K average by Vaccination Rate, Not Adjusted for Population

Through September 23, Washington’s statewide 14-day rolling average is 446.4 COVID cases per 100K – the change is “statistically insignificant,” but it’s worth noting the margin was 0.4 cases!. Counties in the 1,000.0 to 1,399.9 range include Lincoln (1,257.9), Franklin (1.127.5) and Stevens (1,115.0). Counties in the 800.0 to 999.9 per 100K range include Adams, Benton, Garfield, Grant, Grays Harbor, Okanogan, and Pend Oreille.

New cases by age group are statistically unchanged. Hospitalizations were up for people under 35 years old and down for individuals over 49 years old.

Age Group7-Day Case Rate7-Day Hospitalization Rate
Ages 0-11193.41.3
Ages 12-19201.41.5 (up)
Ages 20-34193.45.0 (up)
Ages 35-49196.89.9
Ages 50-64135.414.7 (down)
Ages 65-7997.621.7 (down)
Ages 80+94.933.3 (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 has not been updated since yesterday. The state of Washington is not reporting the percentage of positive cases.

COVID reports from the Washington Department of Health providing fewer details

As Washington state entered what local officials called the fifth wave, the state provided fewer details on the Washington State Department of Health COVID-19 Data Dashboard. Between August 30 and September 24, the state removed or has delayed granular information, including:

  • Total number of staffed adult acute care beds available
  • Total number of adult acute care beds occupied
  • Total number of staffed adult ICU care beds available
  • Total number of adult ICU beds occupied
  • Staffed acute care and ICU beds available by Hospital Region
  • Number of COVID patients in acute care and the ICU by Hospital Region
  • Percentage of positive COVID cases detected by daily testing by county and state – accurate data hasn’t been available since August 27, and all data stopped updating last week – there will be no reporting until November 1

Some metrics, particularly hospital occupancy, number of people in the ICU, and number of people on ventilators, have gone through multiple revisions. When these issues have occurred in other states, they became the subject of national attention.

Suppose you compare the quality and quantity of data from the DoH to other states such as South Carolina. In that case, it exposes a breakdown in the region’s ability to gather and analyze COVID information.

South Carolina reported 2,602 confirmed new cases and another 889 probable cases today. The state had 111 confirmed COVID-related deaths and another 11 probable fatalities under investigation. The state processed 36,766 PCR tests, and 9.4% were positive. Currently, 8,511 acute care beds are being utilized, 86.4% of staffed beds in the state. Of those patients, 2,196 have COVID, with 533 in the ICU and 369 on ventilators. There was 223 hospital admission for COVID patients, and 28 hospitals in the South Carolina are experiencing staffing shortages.

We were able to write that in five minutes. The analysis in the first section of the state update took over half an hour and required processing raw data in Excel.

Last year, Washington state moved quickly to create detailed reports during the start of the pandemic. The state was the first to have a confirmed COVID case, a confirmed COVID death, and the first super spreader event. EvergreenHealth in Kirkland and the Kirkland Fire Department literally wrote the books for hospital COVID response, initial case management, and EMS response to potential COVID cases.

The lack of data, while Washington is in the worst COVID surge to date, is glaring, considering these tools were once available. We once led the nation in the capacity to process PCR tests and report the data. It erodes public trust when the number of skeptics is declining, and the remaining are increasingly radicalized. Doctors and nurses in the United States are being assaulted, stalked, and getting death threats. Anti-vaccination organizations are now advocating for people not to go to hospitals and, in a few cases, have attempted to remove people, including ICU patients, on BIPAP and ventilators.

Finally, current reporting does not track pediatric hospitalizations or pediatric acute care, NICU, or PICU resources despite weeks of promises that information would be shared.

We are disappointed that other larger media organizations are not highlighting these issues, especially when you consider the number of headlines generated by the actions of Florida, Georgia, Iowa, and Nebraska.

Department of Health issues updated modeling and surveillance situation report

The latest SitRep report from the Washington Department of Health highlights data fidelity problems, a shortage of testing capability statewide and provides one pessimistic outlook for the coming months.

Testing shortages create uncertainty in how many active cases are missed as hospital admissions spiked to a level 60% higher than the peak in January 2021. At the end of August, the statewide R0, the rate of transmission, dropped below 1.0. It has since increased to 1.3 and was showing an exponential growth curve. The report estimates that 1 in 106 Washingtonians are experiencing an active COVID case, the highest rate recorded since August 2020.

Statewide immunity to COVID is estimated at just over 60%, with 1 in 5 having some degree of natural immunity. With 40% of the entire population exposed, the Delta variant has a significant number of new hosts it can infect. Unvaccinated residents are ninefold more likely to be hospitalized than unvaccinated.

The state has two forecasted models. The first is based on the R0 at 0.9, which would support a declining number of new cases. Under that model, daily hospital admissions for COVID would return to levels seen outside of surges, less than 40 people a day statewide.

The second model assumes R0 doubles to 1.8 due to the Thanksgiving holiday and the state population becoming fatigued with mask wear. If this scenario becomes a reality, December daily hospital admissions will increase to 141 to 240 per day by the end of the year.

Neither scenario predicts that hospital occupancy will drop below the spring 2021 surge. The current IHME forecast model paints a similar picture, with the current projection supporting the first, more optimistic scenario.

Eatonville Middle School moves to virtual learning due to COVID outbreak

Officials in Eatonville announced that Eatonville Middle School was moving to remote learning through October 11 at the minimum. The district didn’t release any specific information on the number of infected students, staff, or if there is significant transmission within the school.

Located between Olympia and Mount Rainier in Pierce County, the town had 3,000 residents. According to the DoH, only 47.9% of county residents are fully vaccinated.

Letter to parents announcing Eatonville Middle School is moving to remote learning

Seattle reaches agreement with major public employee unions over vaccination mandates

Mayor Jenny Durkan announced the City of Seattle had reached a tentative agreement with the Coalition of City Unions, Fire Fighters Union Local 27, and IBEW Local 77 regarding vaccination requirements for City employees.

“Since the pandemic touched down in Seattle, our officers, firefighters, and frontline workers have worked day in and day out to provide nation-leading testing, vaccination, and relief programs for our residents. Those efforts are a key reason we have one of the highest vaccination rates and lowest cases and hospitalizations of every major American city,” said Mayor Durkan.

The agreement is expected to be ratified, provides 8 hours of paid time off for any employee who submits a vaccination form by October 5 and is fully vaccinated by October 18. Employees can begin the vaccination process by October 18 and not face termination. They will have to use their available accrued time off while going through the vaccination process, which can last from two to six weeks. Finally, each employee will receive 40 hours of supplementary paid leave for COVID-related reasons. Employees who are fully vaccinated by October 18 will receive an additional 40 hours of supplemental leave for a total of 80 hours.

“Worker safety and certainty are of paramount importance, and the unions involved with these negotiations centered those concerns throughout a complex and time-sensitive process,” said Shaun Van Eyk, PROTEC17 Union Representative and Coalition of City Unions Co-Chair. “We believe that these two tentative agreements honor the essential, public-sector workers whose work could not be performed remotely and create clear, transparent, and equitable pathways for all City workers with respect to the vaccine mandate. While both agreements took a great deal of time and effort to reach, the outcome is unquestionably worth it for the health and safety of our union members, their families, and our communities.”

The city has now reached vaccination agreements with six labor unions. The Seattle Police Officer Guild, SPOG, was not part of the agreement. The city indicated they were still negotiating with police union leaders.

Almost 90 local, county, and state employees sued Washington state to try and block vaccine mandates earlier this month. One of the plaintiffs claimed up to 150 City of Seattle firefighters were ready to resign. In August, SPOG Union President Mike Solan said up to 200 officers were prepared to quit.

Anti-vaccination activist groups calling for the sick to “avoid hospitals”

As part of a national trend, the activist group Waking Up Washington is telling its followers to “avoid hospitals” because “they’ve fired many of their free thinkers.”

In a video posted today by Palmer Davis of La Center, Washington, she suggests that up to 15% of the medical workforce has been terminated or will be terminated by October 18. Nationally, no single medical system has come close to those numbers, with 97% to 99.5% of all employees choosing to get vaccinated.

Ms. Davis is a central figure in the Washington state anti-vaccination movement, which has seen its numbers dwindle since the summer months. She told her followers to go to another website for medical treatment plans. The site includes access to an online doctor for prescriptions of medications, with a $149 fee for a consultation for Ivermectin. According to WebMDRx, 10 pills cost between $23 and $56.

The site also links to the discredit organization America’s Frontline Doctors and the FLCCC. We have elected not to link to that website as it provides dangerous medical advice.

Suggested treatments include hydrogen peroxide nebulization and taking dandelion, pine needle, and eucalyptus supplements. Neublizing hydrogen peroxide can be fatal, and none of these supplements have any therapeutic value. The website DNS is provided by Google, according to a whois search.

This trend isn’t unique in Washington, with other groups recommending “vigilante treatments” in unchecked Facebook groups and shared through Tik Tok videos. Hospital workers have been assaulted in Alaska, Massachusetts, Texas, Georgia, Idaho, Washington, and Canada in the last month.

Anti-vaccination “town hall meeting” in Woodinville tomorrow at local restaurant

Tomorrow, the same group is holding a “town hall meeting” at Rooster’s Bakery and Cafe in Woodinville. The event touts legal resources to fight vaccine mandates and “expert testimony” about “rigged statistics.”

To attend, you are required to pay a $20 fee in cash at the door.

Editor’s comment: Nothing suspicious about that.

Anti-vaccination event flyer for Woodinville tomorrow

Rooster’s Bakery and Cafe has multiple complaints on Yelp for not following COVID guidelines. The cafe’s Facebook page hasn’t been updated since the fall of 2020.

Travel Advisories

We recommend avoiding all travel to Spokane, Yakima, Klickitat, Benton, Franklin, and Walla Walla counties, along with Alaska, Idaho, and Montana. Hospital resources in these regions are constrained, and you may receive inadequate care if you experience a medical emergency.

Thank you

Thank you to our new subscribers and those of you who have made one-time contributions. On behalf of the entire team, thank you for helping us keep the lights on!

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

No update

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.

Malcontent News

Hospital Status

According to the DoH COVID Dashboard, 22.0% 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 89.5% of capacity statewide, with 33.9% of ICU patients fighting COVID. There has been a slow decline for all data points over the last week.

The 7-day rolling average hospital admission rate for new COVID patients was unavailable today. The Department of Health reported 1,436 COVID patients statewide on September 23 and 233 on ventilators. We aren’t confident that these numbers are accurate. Hospital occupancy rates don’t support this much of a decline, and the state dashboard noted, “The “hospital admission rate” metric on the Healthcare System Readiness tab was not updated today due to an interruption in our data systems.”

Harborview Medical Center is only at 113% capacity, which is an improvement from last week when the Level I trauma center was at 117% capacity.

KCPQ in Seattle reported that almost half of nurses in Washington are ready to leave the profession. The issue isn’t vaccine mandates. Nurses are burned out from the trauma of 19 months of death, harassment, and vanished community support.

Chelsey Roos, a registered nurse who works at St. Joseph’s Hospital in Tacoma, spoke with KCPQ.

“You get into your car after work, and you just want to cry.”

“Not only do we have roughly 50% more cases than we had during the December surge, but we’re caring for all of those patients with fewer staff, because it’s been so challenging for particularly our nurses, that people are choosing to leave healthcare because of how stressful it’s been,” says Dr. Steven Mitchell, the medical director of Harborview Medical Center’s Emergency Room.

It’s a perfect storm, the stress of the job causing many to leave-which then leaves the remaining nurses with an even heavier workload.

“It burns people out, its burning people out so easily, we can’t seem to keep enough nurses working or wanting to work in acute care or a hospital, it’s just becoming too much, and I think people are wanting to reprioritize things in their lives,” says Roos.

Providence Hospital in Spokane reported an increase in the number of pediatric patients in a press briefing today. Station KXLY quoted Providence Sacred Heart Medical Center Chief Medical Officer Dr. Daniel Getz.

“I don’t know what my daily census is today, but this is really the first time in the COVID surge this last week where we’ve seen an increase in children that have been admitted for the care of COVID.”

KREM reported the number could be as high as 10, but we have trust issues with their reporting after the Medical Lake report.

Back to School

School DistrictStatusLess than 10 Active Cases10 or More Active Cases
BellevueYELLOW– Bellevue (1)
– Big Picture (1)
– Chinook (1)
– Eastgate (1)
– Enatai (36)
– Interlake (2)
– Lake Hills (13)
– Puesta del Sol (2)
– Wilburton (3)
None
Lake WashingtonYELLOW– Alcott Elementary (2*)
– Ella Baker Elementary (3*)
– Community School Elementary (7)
– Dickinson Elementary (2*)
– Eastlake High (1*)
– Einstein Elementary (1*)
– Evergreen Middle School (1*)
– Finn Hill Middle School (1*)
– Benjamin Franklin Elementary (2*)
– Robert Frost Elementary (9)
– Inglewood Middle School (3*)
– Juanita Elementary (2*)
– Juanita High School (1*)
– Kamiakin Middle School (4* – see below)
– Helen Keller Elementary (1*)
– Peter Kirk Elementary (2*)
– Kirkland Middle School (1*)
– Lake Washington High (1*)
– Lakeview Elementary (1*)
– Muir Elementary (1*)
– Redmond Elementary (2*)
– Redmond Middle School (1*)
– Redmond High School (1*)
– Rose Hill Elementary (1*)
– Rose Hill/Stella Schola Middle School (2*)
– Thoreau Elementary (4)
– Mark Twain Elementary (3*)

NorthshoreRED– Arrowhead Elementary (13)
– Canyon Creek Elementary (24)
– Canyon Park Middle School (8)
– Cottage Lake Elementary (16)
– Crystal Springs Elementary (47**)
– East Ridge Elementary (24)
– Fernwood Elementary (13**)
– Frank Love Elementary (28)
– Hollywood Hills Elementary (17)
– Inglemoor High School (7)
– Innovation Lab High School (9)
– Kenmore Elementary (15)
– Kenmore Middle School (39**)
– Kokanee Elementary (50)
– Leota Middle School (5)
– Lockwood Elementary (8)
– Maywood Hills Elementary (14**)
– North Creek High School (21**)
– Northshore Middle School (10**)
– Ruby Bridges Elementary (7)
– Secondary Academy for Success (10)
– Shelton View Elementary (18**)
– Skyview Middle School (82**)
– Sunrise Elementary (21)
– Timbercrest Middle School (28)
– Wellington Elementary (64)
– Westhill Elementary (10)
– Woodin Elementary (9)
– Woodinville High School (21)
– Woodmoor Elementary (21**)
– Bothell High School (12*/100)
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.

We had a parent-reported confirmed COVID case at Kamiakin Middle School on Tuesday. Because the Lake Washington School District updates its dashboard weekly, we don’t know if this is in addition to the 3 cases reported on Monday or if any of those earlier cases have returned to class. We have set the number to 4.

The number of positive cases between staff and students has swelled to 12 at Bothell High School, with another 100 students 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, they are the only school district of the three we are following that is performing weekly universal COVID testing.

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

Kirkland-Bellevue-Woodinville

Booster shots for eligible individuals are now available in the Kirland-Bellevue-Woodinville area. 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.

We canvased area drug and grocery stores to check for availability. Walgreens, Rite-Aid, Bartell’s, and CV are all offering booster shots immediately. Booster shots are also available at the CVS located within the Target store at 17,700 NE 76th Street in Redmond. Additionally, the QFC at Kirkland Urban is providing booster shots.

Most locations require an appointment that can be set up online. The Kirkland Urban QFC was already completely booked through the weekend.

National Round-Up

Johns Hopkins University Cumulative Case Tracker is reporting 128,731 new cases and 3,157 deaths nationwide.

Alaska

Alaska continues to operate in crisis standards of care as the situation in the vast and remote state continues to deteriorate. Officials reported 1,793 new cases and a staggering 41 deaths (yes, we know the headline says 1800 cases and 44 deaths – if you read the story, it says 1793 cases and 41 deaths, talk amongst yourselves – we’re over it) in the state of just over one million people. The numbers included hundreds of older cases due to a data entry backlog.

The state had a record of 217 COVID patients hospitalized. The statewide 7 day moving average for new COVID cases is a staggering 976 per 100K people, and currently, 9.2% of all COVID tests are coming back positive.

The state now has 20 ICU beds available, an improvement from yesterday, and 74 residents on ventilators.

The Guardian reported Soldotna’s Central Peninsula Hospital spokesperson Bruce Richards discussed worker burnout and frustration with the crisis, particularly because it was preventable. “The evidence speaks for itself,” Richards said. “It’s very clear that a vaccine will help keep you out of the hospital.”

Soldotna’s Central Peninsula hospital, about 150 miles from Anchorage, is operating at 133% capacity. Richards is worried about what will come next. “We all know that hospitalizations lag following these high-case days, so I don’t know what’s in store for us.”

The situation has become so desperate that medevac aircraft that would typically fly patients to Anchorage or Seattle are moving patients from Anchorage to rural hospitals.

The goal is to make more room at the busy Anchorage hospitals, which offer more intensive care and other services, especially sick patients that rural hospitals can’t support.

This practice is known as “load leveling,” and it’s done more regularly between hospitals in urban areas, where patients can be moved by ambulance. It’s far rarer in rural Alaska, though, since most hospitals in those areas aren’t connected by road and can be hundreds of miles apart.

“Once you start involving learjets and medevac companies, it gets infinitely more complicated,” Brunner said in an interview Thursday.

Patients that don’t need critical care are flown to acute care hospitals in rural areas. For many rural hospitals, the patients they receive are sicker than they usually see, straining staff. Worse, patients are separated from family and friends and face potential air ambulance bills in the tens of thousands of dollars.

In the 6,000 resident town of Bethel, Alaska, half the police force is threatening to resign over a recent vaccination mandate. The remote city is only accessible by boat or airplane during the warmer months, and ice road in the winter. The city is experiencing one of the highest COVID case rates in the state and country and doesn’t have the resources to deal with the surge. City officials decided to mandate vaccinations.

“The city had no choice,” James Harris, Human Resource Manager, told The Daily Beast. “We had to react.”

Resistance to the vaccine from police in Bethel is endemic of opposition the vaccine has seen from police departments across the country. Many officers have refused vaccine mandates, filed unsuccessful lawsuits, and decried the measures as unconstitutional.

But in Bethel, some say police have gone a step further, dangling the possibility of increased violence over remote residents’ heads if the city were to push half of the police force out of a job.

Among other highlights, Police Chief Richard Simmons baldly told KYUK earlier this week that the small city was “one of the most violent communities in the nation” and needed every one of its officers.

Available data shows that Bethell has a high crime rate but not one of the highest in the nation.

Alaskans have been abusive to health care workers who ask them about COVID-19 or discuss the disease in public, according to health officials. 

Alaska Chief Medical Officer Dr. Anne Zink, who also works in a hospital emergency department, said many retail pharmacists have stopped asking customers if they’d like the vaccine because of the fury it triggers.

“We see many triage nurses in the emergency department also afraid to ask that question,” Zink said, “because patients have been violent towards them in the emergency department when asking the question if they’re vaccinated or if they have COVID-19.”

Idaho

Idaho reported 1,646 new COVID cases and 34 new deaths on Friday. The state continues to operate under crisis standards of care. Unlike states such as Alaska, Oregon, and Washington, which use “load leveling” to maximize resources, Idaho hospitals can go it alone.

While people are dying in hospital waiting areas in the Panhandle, hospitals in the eastern part of the state are operating under “contingency care.” Both Oregon and Washington are running on “contingency care protocols,” which give medical providers options to defer certain treatments and take other steps to maximize resources.

Editor’s Note: It is unconscionable that parts of Idaho are stacking bodies in morgues, storing corpses in unrefrigerated areas, and placing them in railroad cars while people are dying in waiting rooms, that any hospital could have the audacity to speak about available resources publicly. If Idaho has unused resources, maybe Washington state should be less generous in its support.

The Idaho State Journal reported  Portneuf Medical Center has been operating near capacity amid a surge in COVID-19 cases, but CEO Jordan Herget is confident the hospital has ample resources to avoid crisis standards of care.

While hospitals in the Magic and Treasure valleys and Northern Idaho have added beds in conference rooms, cafeterias, and other available spaces, Herget believes PMC should have adequate traditional bed capacity heading forward.

On Monday, Herget said PMC would open a special care unit with nine rooms equipped with negative pressure technology to treat patients with contagious upper respiratory diseases, such as the coronavirus.

“Older adults are facing serious risk of discrimination, resulting in death,” because of Idaho’s crisis standards, Justice for Aging attorneys wrote in their complaint letter. Symptomatic breakthrough cases are overwhelming among people over 70 years old.

Boise State University opted to tell the doctors and nurses trying to save lives to get bent, halting its plan to require fans to show proof of vaccination for COVID-19 or test negative for the coronavirus before attending a football game at Albertsons Stadium.

The school wrote in a statement on Friday, “In light of our declining campus positivity rates and high vaccination rates, the university will shift from testing all ticket holders in the student section to random sample testing of that population before next week’s football game.”

According to the Idaho Department of Health and Welfare, the percentage of Idaho’s eligible population (12 and older) fully vaccinated is just 51.5%.

We’re sure that Dr. Ashley Carvalho, completing her residency training in Boise, appreciates this decision. A family member of a COVID patient under her treatment threatened to shoot her last week, and police had to be called to the hospital.

Photo credit – Dr. Ashley Carvalho – photo after being a family member of a patient threatened to shoot her

“I received a slew of verbal abuse from a patient’s family members who called me an incompetent doctor, threatened me with physical violence, and demanded I give them my name and medical license number so they could sue. This was because I refused to prescribe Ivermectin, which is not proven to treat COVID-19 and is recommended only in clinical trials at this point, and hydroxychloroquine, which current research suggests is not effective or safe in treating COVID-19. My patient was struggling to breathe, but the family refused to allow me to provide care. A call to the police was the only solution.”

But wait, there’s more. In Coeur d’Alene, police had to fend off anti-mask and anti-vaccination protesters who attempted to storm the school district’s board of trustees special meeting on Friday. Yes, the story is from KREM, and yes, we were roasted, but KREM has receipts in the form of videos of the incident (feel free to talk amongst yourselves).

Several physicians from Kootenai Health were slated to speak during the meeting as the hospital hit two milestones this week: its highest number of COVID-19 inpatients and the highest number of COVID-19 ICU patients at 43. The hospital in Coeur d’Alene typically only has 26 ICU beds.

The group was described as a “mob” of 200 people who were “extremely hostile.”

Editor’s Note: We remind you again, our state is supporting Idaho’s bad choices. In the coming weeks, it is likely at least a couple of the people in this “mob” will be begging the doctors who had planned to speak today to save their lives.

Wait – there’s more. Andy Grover, the executive director of the Idaho School Administrators Association, told the Idaho Board of Education that workers are leaving Idaho schools “for hiring bonuses and higher wages in fast food.”

“When there’s that kind of things to compete against, we don’t have a chance,” he said. “We just don’t have employees. We’ve seen from 2 or 3 classified staff, all the way to 60 classified staff, that districts are missing across the state.”

He said three school districts were closed Friday, two due to staffing shortages and one because of COVID-19 cases among students. He said open schools are also struggling with lower than normal attendance.

Montana

Montana reported 1,326 new COVID cases across the state where officials aren’t reporting unvaccinated versus vaccinated cases. The state has 395 people hospitalized with COVID and didn’t share how many are on ventilators.

In Billings, the city’s largest hospital reported running out of “hallway space” to put patients while the ICU is operating at 160% capacity.

According to KHN, Billings Clinic said it might soon implement “crisis standards of care” that would force staff to save provisions for patients they can most likely save.

Yellowstone County is seeing the worst of the surge. The Montana Department of Health and Human Services reported 2,461 current active cases there, as much as the next two counties combined.

Another county health officer resigned in Montana. Blaine County public health nurse Jana McPherson-Hauser said her resignation would take effect October 15 because of the “constant negativity, pushback, disregard and lack of support” that health officials have faced throughout the coronavirus pandemic.

And in Helena, where a hospital is operating at crisis standards of care, state lawmakers questioned health officials on the severity of the situation.

During Wednesday’s meeting, Rep. Jane Gillette, a Republican from Bozeman, disputed concern over the jump in new cases.

“I’m not sure I would feel really dismayed about the rate increase when you just think of it really mathematically,” Gillette said. “… Just put in simple terms, if you had two (cases) at one point and you increased to four, you’d increase by 50%, so you just kind of have to put it in … more broad terms and not … lose the other data. So, for instance, when we look at the number of COVID cases per 100,000, we’re pretty much just middle of the pack normal.”

If being the sixth-worst in the United States is “middle of the pack,” Montana is competing with its neighbor to the west in a race to the political bottom.

Oregon

Another 2,113 new confirmed and presumptive cases were added, bringing the state total to 320,990.

There were 855 COVID-19 hospitalizations, 30 fewer than the previous day, and 268 patients in ICU beds, which was an increase of five. There were 60 available adult ICU beds across the state of Oregon, which is an improvement from two weeks ago.

The OHA’s latest COVID-19 forecast shows a slowing in the decline of daily cases and hospitalizations through mid-October. The report estimates 495 cases per 100,000 people, or an average of 1,480 daily cases and 81 hospitalizations for the two weeks between September 29 and October 12.

In our neighbor to the south, new COVID cases among children now outnumber those among the elderly.

In another sign that the anti-vaccination movement isn’t as big as it presents itself, a little more than 5% of Oregon’s 42,000 state employees have applied for vaccination exemptions. About 90% of the 2,284 requests come from people seeking religious exemptions. So far, almost half of state employees have provided proof of vaccination.

Misinformation

Taking the day off

Local and national COVID update for August 20, 2021

Knowledge is the best tool to fight against fear. A wise person chooses to be informed so they can make sound decisions. To join the fight against COVID misinformation, you can share this update through your social media platform of choice.

[KING COUNTY, Wash.] – (MTN) Multiple sources reported to us today that the state of Washington is considering a plan to place renewed restrictions on gatherings within public indoor spaces, as hospitalizations reached a new record. There is some evidence that the growth of new cases may be slowing down, as more hospitals report they are running out of resources.

There are reports out of Washington D.C. that the Pfizer and Moderna vaccine may receive full FDA approval next week. Trials for both the vaccine started more than a year ago, while the Johnson & Johnson vaccine was released later, requiring more data.

Bonadventure Senior Living is under fire after a recruiter for the company in Oregon posted a video on Tik Tok called for unvaccinated nurses to work for the eldercare company in Oregon, Washington, and Colorado. That story took a much darker turn today with new allegations of criminal activity.

This update uses the latest data from the Washington State Department of Health released on August 19, 2021.


vaccinationhospitalsschoolslocalnationalmisinformation

Washington State Update for August 20, 2021

Are new COVID restrictions coming?

Governor Inslee is considering setting capacity limits for indoor public venues, according to several people we spoke to today. The plan being considered would not return Washington state to the phases used during the spring of 2021 but would put limits on the number of people who can gather in one place in specific public settings. No specific date was given, but there were indications if the plan is implemented it would happen end of August or early September.

On August 13, the National Terrorism Advisory Bulletin from the U.S. Department of Homeland Security expressed concern over the growing threat from domestic extremists groups due to the rise of COVID cases.

“Extremists may seek to exploit the emergence of COVID-19 variants by viewing the potential re-establishment of public health restrictions across the United States as a rationale to conduct attacks.  Pandemic-related stressors have contributed to increased societal strains and tensions, driving several plots by domestic violent extremists, and they may contribute to more violence this year.”

The report did not mention any specific threats and is a broad assessment of the risk of terrorism, foreign or domestic, at a national level. A large anti-vaccination rally is planned to happen on Saturday in Olympia from noon to 3 PM.

Washington state COVID update

COVID continues to spread through Washington at levels not seen since December of 2020. Through August 12, the 14 day rolling average Washington grew again to 455.8 COVID cases per 100K. This breaks the record high that was set yesterday. The USA Today COVID Tracker indicated that on Thursday, Washington reported over 3,900 new COVID cases. New cases continue to grow exponentially, with the epidemiological curve showing signs that things are slowing.

Washington State Newly Diagnosed COVID Cases per 100K During the Prior Two Weeks Through August 12, 2021

The Washington State Department of Health reports a data backlog for test positivity, with the published number 14 days old. According to Johns Hopkins University Medicine, the positivity rate for the last 30 days is 11.69%, and over the previous 7 days, 12.69%. We continue to see widespread transmission in the state, with another small decrease in the 7-day average.

The 7-day moving average for COVID-related deaths has increased again to 8 per day and the USA Today COVID tracker reported 33 deaths in Washington state Thursday. It is important to note that fatalities are a trailing indicator that usually increases two to four weeks after hospitalizations begin growing. The growing number of fatalities would align with the spike in hospitalizations that started two weeks ago.

Are changes coming to the Evergreen State Fair?

In a KOMO News report, Jeremy Husby of Snohomish County Parks & Recreation expressed concern about the upcoming Evergreen Fair. Husby said that capacity limits were already in place, but they were expecting between 18,000 and 24,000 people to attend. According to the Washington State Department of Health, Snohomish County hospitals have reached the same utilization level as early 2021. “When we know we are at a capacity where we can’t not serve the public and we can’t provide a safe space,” Husby said. “We need to make that call to shut down the fair,” Husby told KOMO.

Bonadventure Senior Living

On Monday, TikTok user @thisdaneshguy reposted a recruiting video made by Bonadventure Senior Living employee Shanya Hall, which went viral. Bonadventure, based in Salem, Oregon, manages senior living facilities in Washington, Oregon, and Colorado. In the video, Hall says, “I just wanted to tell you that if you are a nurse, a caregiver, a tech, and you now need a new job because of this, hit me up. I’ll hire you. I need nurses, caregivers, med techs, in Washington, Colorado, and Oregon.”

The video was taken down on August 9, the same day Governor Jay Inslee announced that healthcare workers would be required to get vaccinated against COVID. The Salem Reporter ran a story on Tuesday where they interviewed Hall. In the interview, she said she made the video on July 29, and it had been viewed more than 50,000 times before it was taken down.

When asked what she would say to families who are concerned about unvaccinated health workers caring for their family members, she said protecting residents is the number one priority for Bonaventure.

“I get being concerned or being scared but we are taking precautions,” she said. “We wouldn’t want to put anybody in the way of danger.”

In the same story, Jeremiah Gray, divisional director of operations at Bonaventure for Oregon, stated that they could not require vaccines for their staff because of an Oregon law. However, that was only partially true while the recruiting video was still on TikTok. On August 5, 2021,  the Oregon Health Authority filed a final temporary rule requiring COVID-19 vaccination or weekly testing for individuals who work in healthcare settings.

In a since-deleted Facebook post, Gray responded to the TikTok video on the Bonadventure, defending the company, and again stating that they are prevented by Oregon law to require vaccinations. That point became moot, with the federal nursing home vaccine mandate issued earlier this week. Today, in another video posted on TikTok by @thisdaneshguy, the creator claims that multiple employees of Bonadventure have shared internal e-mails with him about directives made by the company that put residents and patients at risk. Among the claims made, eight current and former employees are accusing Bonadventure of falsifying federal issued COVID vaccination cards, including in Washington state. That information has been turned over to The Statesman Journal, which ran a deeper story about Bonadventure yesterday.

Data from the United States and Israel indicates that the majority of COVID breakthrough cases that lead to severe cases are among people over 70 years old with multiple comorbidities. This was on of the key drivers for the United States to make the controversial decision to provide booster shots to recipients of mRNA vaccines.

The University of Washington Medicine is allegedly denying organ transplants to patients who refuse to get a COVID vaccine. In an interview with Jason Rantz, Sam Allen of Monroe claims he was removed from the heart transplant waitlist for refusing to get the COVID vaccine. Allen claims he had a “dispute” with his cardiologist over wearing a mask, and then was called.

“The cardiologist called me and we had a discussion, and he informed me that, ‘well, you’re going to have to get a vaccination to get a transplant.’ And I said, ‘well that’s news to me. And nobody’s ever told me that before.’ And he says, ‘yeah, that’s our policy.”

Allen was removed from the waitlist on June 7. Although post-transplant organ rejections are less common, and the medications to prevent the condition have dramatically improved, organ transplant patients face a lifetime of being immunocompromised. University of Washington Medicine would not confirm if this was a policy or part of evaluating how viable an individual patient is for a transplant.

Etcetra

Gig Harbor announced they are canceling all remaining summer events including Summer Sounds at Skansie and Movies in the Park.

Yesterday it was widely reported that WSU football coach Nick Rolovich, had agreed to get a COVID vaccine. The Seattle Times is reporting that when pressed, Rolovich would not clearly state that he would.

Former University of Washington wide receiver Lamarr Mitchell died of COVID after a 10-day battle. Lamarr was part of the 1991 Rose Bowl team and was described by his family as healthy and fit. He was unvaccinated and went from being on a ventilator to kidney failure in 24 hours. His family was called at 4 AM to come and say their final goodbyes but became stuck in traffic and did not get to the hospital in time. Lamarr’s parents are appealing for people to get vaccinated.

“We got to get the message out there we have to get the message out there; this is real. This is real,” she pleaded.

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Last month, 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

There are multiple reports tonight that the Food and Drug Administration will issue full approval of the Pfizer COVID vaccine as early as Monday. Pfizer started Phase I trials of the COVID vaccine in May of 2020. Researchers used development efforts to create a vaccine for SARS and MERS as a foundation for the COVID vaccine. COVID or SARS-Cov-2 is similar to the original SARS strain, which appeared in 2003, and MERS which appeared in 2012.

Phase III trials were completed in November enabling the FDA to issue an emergency authorization for the vaccine. Distribution began on December 14, 2020, to tens of millions of Americans. Pfizer would be the first to receive full approval because it was the first vaccine to complete its trials in the United States.

Washington state is providing COVID vaccine booster shots for moderately and severely immunocompromised residents. People who received an mRNA vaccine are eligible for the booster. People who received the Johnson & Johnson vaccine do not require a booster at this time.

Almost two million Washingtonians who are vaccine eligible remain unvaccinated. The group Find a COVID Shot WA can assist anyone who needs help making an appointment. The group of 75 volunteers has been operating since the beginning of 2021 and offers support in 20 languages.

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King County, Washington is over 80% vaccinated, and Washington state is over 70%. The highest rates of positivity are in areas with low vaccination rates statewide. The FDA is expected to provide full approval to the Pfizer vaccine next month.

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.

Malcontent News

Hospital Status

On August 19, 86.4% of available adult staffed acute care beds in Washington state have patients. The data indicated there were 1,211 acute care beds available statewide and 210 in King County. The Northwest, South Central, and East Regions were over 80% utilization and the Central and West Regions are now over 90%. According to the Washington State Department of Health, there are 1,221 COVID patients in acute care, an increase of 16 since yesterday, which is 13.7% of all acute care patients.

Washington State Hospital Acute Care Beds Occupied by Patients – August 19, 2021

Statewide ICUs were 85.9% occupied with 171 staffed beds available, 52 located in King County. Although the number of COVID patients statewide in the ICU dropped to 327.

Washington State ICU Patients with COVID – August 19, 2021

Washington state continues to have a critical shortage of blood, with a less than 24 hour supply for five out of eight blood types. The situation has deteriorated since August 3. There will be a blood drive in Kirkland on August 30 and 31. We will publish additional details when they become available.

The West Region, which includes Tacoma, is down to 9 available ICU beds and the East Region, which includes Spokane, has 10 ICU beds available.

PeaceHealth St. John Medical Center in hard-hit Cowlitz County issued a statement on Facebook that the hospital, “is now at maximum capacity.” The facility appealed that, “only people who are experiencing true medical emergencies come to our E.R. for care.”

In another comment, PeaceHealth stated, “We are experiencing an exceptionally high number of caregivers unable to work due to COVID-19, and we have great concern that – as patient demand continues to surge – we will be faced with a corresponding increase in the number of caregivers unavailable to help.”

The hospital is no longer doing COVID testing and advised people to use urgent care facilities. People were suggesting other locations to get a COVID test but frustration was boiling over.

Barbara Anderson wrote, “The only urgent care center in Longview will not see u unless u are a current Peace Heath [sic] patients [sic]. Where should the rest go?”

You can listen to a podcast with Cherelle Montanye, Chief Administration Officer for PeaceHealth St. John, and Cathrine Kroll, Director for Infection Prevention.

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Back to School

No update

Kirkland-Bellevue-Woodinville

No update

National Round-Up

Johns Hopkins University reported over 138,400 new cases and 908 deaths. Nationwide, 11.36% of COVID tests are coming back positive.

The CDC issued a warning tonight for older adults, and people in high-risk groups not to take cruises, even if they are vaccinated. The new guidance applies to older adults, people with certain medical conditions and pregnant and recently pregnant people. Prior to Friday’s announcement, the agency recommended that only people who were not fully vaccinated against COVID-19 avoid cruise ships.

Alabama

Former President Donald Trump is holding a rally in Cullman, Alabama tomorrow, forcing the city to declare a COVID state of emergency. Alabama added 3,800 new COVID cases on Wednesday and the state ran out of ICU beds the day before. The declaration of the State of Emergency allowed the city to provide the additional personnel and equipment for this weekend’s political rally after it was requested by Cullman Regional Hospital, which is overwhelmed with patients.

Florida

The Sunshine State only releases COVID data once a week on Friday’s and the data indicates that it may be hitting its COVID peak. New cases were flat week over week for the first time in over two months. However many state residents are complaining they can’t get tested. Of the 150,118 new cases reported, 20,331 were children under 12 years old. Florida has 16,973 people hospitalized with COVID, a new record.

Pictures taken by Louie Lopez at a monoclonal antibody treatment center recently set up by Governor Ron DeSantis went viral late this week. The images show people lying on the floor, barely able to move or breathe, and moaning waiting for treatment. The lobby only had two chairs according to Lopez, and one patient laid on the floor for almost 30 minutes before someone came with a wheelchair. A spokesperson for the city confirmed that according to organizers at the site, the woman in the picture was waiting to be treated with Regeneron.

Regeneron is only effective if given within the first 96 hours of the first sign of COVID symptoms that are mild to moderate. Ron DeSantis has fought against any entity that has attempted to mandate vaccines or masks, and has only loosely promoted the COVID vaccine. The announcement that he was creating Regeneron clinics raised eyebrows when it was revealed that his top political contributor is also a major investor in Regeneron Pharmaceutical Inc.

Mayor Buddy Dyer of Orlando appealed for residents to conserve water due to a shortage of oxygen. The Orlando Utility Commission treats the city’s water with liquid oxygen and supplies that ordinarily go toward water treatment have been diverted to hospitals for patients suffering from the virus, Mayor Dyer said.

“We acknowledge that the No. 1 priority for the liquid oxygen should be for hospitals,” Dyer said at a news conference.

The city-owned utility typically goes through 10 trucks of liquid oxygen a week but its supplier recently said that it would be cut back to five to seven trucks a week to accommodate hospitals, said Linda Ferrone, OUC’s chief customer, and marketing officer.

Hawaii

Yesterday we reported that hospitals on the island of Oahu were on the brink of having to implement disaster plans. City officials in Honolulu made a “disaster area” declaration today. At Queen’s West Hospital, a rush of new COVID patients overwhelmed the hospital, on top of many already waiting for beds in the emergency room. The City set up a disaster area and tents.

Hawaii also appealed for traveling nurses, with more than 500 expected to arrive next week. Honolulu having to potentially move to “black tag triage” is coming at the same time that flooding rains are expected this weekend.

This disaster is happening at the same time that the state’s 1,200 first responders are fighting a court battle against Hawaii’s COVID vaccination mandate.

Hawaii has the strictest entry rules of all 50 states, but people are attempting to circumvent them using fake vaccination cards.

Mississippi

Seventy-three Mississippi hospitals have asked for a combined 1,450 healthcare professionals to supplement their staff, as the state’s hospital system teeters on the brink of collapse. Efforts that are described as “last-ditch” to shore up the system included support from the federal government and building two field hospitals in a parking garage.

Mississippi State Department of Health Reported a sharp spike in calls to their Poison Control Center due to Ivermectin poisoning. State officials sent out a health alert warning to health care providers about the use of the horse dewormer. Although Ivermectin is used in humans to treat scabies, it is highly concentrated for livestock. At least 70% of the calls into poison control have been for Ivermectin poisoning.

Mississippi also reported that the fastest-growing group infected with COVID is children from 5 to 17 years old. The state is seeing 20 to 30 pediatric patients hospitalized on any given day, with 3 to 5 needing ventilators.

There are so many COVID cases in the state, officials made an emergency order allowing school districts to offer hybrid and remote learning options through October 31.

New Hampshire

New Hampshire COVID test positivity has reached the highest level since January with 82 people hospitalized.

Oregon

There is no good news coming out of Oregon today. COVID hospitalizations have set a new record every day since August 10, in the Pacific Northwest State. In the last 30 days, cases have increased 500% putting the hospital system on the brink. Oregon is requesting outside help to come to the state including 35 physicians, 35 advanced practice providers, 300 registered nurses, 10 paramedics, and 100 respiratory therapists.

In Roseburg, a COVID patient died in the Emergency Department because there wasn’t an available ICU bed at CHI Mercy Health.

“A COVID-positive patient was in our Emergency Department, within our four walls, waiting for an open Intensive Care Unit bed to receive life-saving care. It had been several hours because other COVID-positive patients had filled those beds. Even after expanding ICU care onto other floors, there weren’t any beds available for this patient. We didn’t have enough. This patient died in the Emergency Department waiting for an Intensive Care Unit bed.”

Texas

Lt. Governor Dan Patrick blamed “Black Texas” for the surge of COVID in the Lonestar State. During an interview on Fox News Patrick said, “The Democrats like to blame Republicans,” Patrick said. “Well, the biggest groups in most states is African Americans who are not vaccinated. Last time I checked, over 90 percent of them vote for Democrats in their major cities and major counties.”

Blacks make up 12% of the population of Texas – a state where only 45% of all people are vaccinated. Black vaccination rates in the state match that among white Texans.

State officials previously were blaming undocumented immigrants for the spread of COVID in the state, but mostly backed away from the claim after the City of McAllen declared a state of emergency. Of the 586,000 undocumented immigrants processed in the city in the first seven months of 2021, 7,500 were COVID posted after testing – a rate under 2%. The state of Texas is at 19.8% positivity as of this Friday.

Georgia

The Peachtree State has the fourth-highest number of pediatric patients with COVID in the United States, just three weeks after school started. Children’s Hospitals are reporting ICUs are at 70% to 90% capacity and cases are continuing to grow.

“We haven’t reached that critical moment yet where we’re unable to provide that care,” said Dr. James Black, medical director of emergency services at Albany’s Phoebe Putney Memorial Hospital. “We’re doing everything we can to stay just ahead of that, but it’s a race and a race that most of us are losing.”

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Misinformation

An ongoing piece of misinformation is the COVID vaccine has microchips in it. Typically the needle used to vaccinate an adult is 28 gauge and has an outer diameter of 1/3 of an mm. The inner diameter is about 1/6 of an mm (0.184 mm). That’s about thick enough to pass a human hair through with a touch of room to spare. The smallest 5G chip available today is about the size of your fingernail. That’s just the 5G chip, not the microprocessor to run it, not an antenna that can transmit through your body to the nearest 5G tower. It doesn’t include a power source and most critically, it doesn’t include having a heat sink or other way to regulate the temperature.

The RFID chips they inject into pets such as cats and dogs are about the size of a grain of rice. They provide no way to track, only identification with a scanner. The 12 gauge needle used to insert an RFID chip into a dog is almost 3 mm (and anyone who has had a large-bore IV can tell you, needles that big are very unpleasant). Additionally, they are passive RFID chips that don’t require a battery and are incapable of transmitting any data, let alone to a 5G cell tower.

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