Near the end of a special meeting of the Kitsap Public Health Board on Tuesday, Dr. Gib Morrow, Kitsap Public Health District's health officer, laid out the state of COVID-19 in Kitsap County in no uncertain terms.
“This is not business as usual,” he told the board. “This is … a public health emergency right now.”
The purpose of Tuesday's meeting was to evaluate how the county should respond to the ongoing coronavirus pandemic in the midst of increased strain on the county’s healthcare system, particularly on the emergency room at St. Michael Medical Center, the hospital in Silverdale formerly known as Harrison Medical Center.
Although the board mulled the idea of implementing a requirement to show proof of vaccination to enter certain businesses — similar to such requirements in King, Clallam and Jefferson counties — the board declined, for now, to put such a requirement in place. The board will discuss the county's pandemic response further during its Oct. 5 meeting, which will include time for public comment.
At the start of Tuesday's meeting, Morrow said COVID cases in Kitsap remain high, with a seven-day county case rate, as of Sept. 19, of 215.7 per 100,000 residents, although cases appear to be starting to drop. All subregions of Kitsap County except Bainbridge Island are experiencing “high transmission” of the virus, he said.
A screenshot from Dr. Gib Morrow's presentation to the Kitsap Public Health Board.
Hospitalizations and deaths in Kitsap County are at the highest levels since the start of the pandemic, Morrow said, with a quarter of the 170 new hospitalizations occurring from Sept. 1-24 in people in their 40s or younger.
Morrow emphasized that it is disproportionately unvaccinated individuals who are feeling the brunt of the pandemic. The risk of contracting COVID-19 in the past month is 4.3 times higher for unvaccinated individuals than for vaccinated ones, he said. The risk of hospitalization is nearly 25 times higher for unvaccinated individuals between the ages of 12 and 59, he added.
John Oliver, chief of Central Kitsap Fire and Rescue, said at times he can have a third of his workforce tied up at the ER waiting to offload patients because the ER is overloaded. He noted that his agency has been working collaboratively with St. Michael Medical Center, and said, “This is a national problem. This is not just a Kitsap County problem.”
“This is a community health emergency, because multiple of my units are being tied up at the hospital for long periods of time, reducing the standard of cover that my citizens deserve and respect,” he told the board, referring to his agency’s ability to respond to emergency calls in a timely manner. “And we need to work collaboratively with the health board and [Kitsap County Department of Emergency Management], and St. Michael Medical Center, to be able to free those crews up in the surge times so they’ll better serve our citizens.”
Jim Gillard, chief of Poulsbo Fire Department, said his agency started keeping track of wait times in July after reports came in of long waits to get patients admitted to the hospital.
“We started measuring the time from our crews arriving in the emergency department until they’re able to transfer care,” he said, noting that between Aug. 21 and Sept. 21, of 1,253 reports of about 40 per day, there were 121 instances of EMS wait times exceeding 30 minutes, and 35 instances of wait times exceeding an hour.
“We all have stories with our paramedic crews with advanced life support patients, seriously ill patients, having to wheel their patients out of the emergency department, back out to their medic unit, to provide treatments,” Gillard said. “My agency had a patient with a significant cardiac issue, where there wasn’t cardiac monitoring available, and was placed in a hallway bed, and that patient went into cardiac arrest. These are the tragic stories that are happening on a daily basis to our crews and it’s really impacting our crews’ ability to then get back and provide service to our communities. And it’s impacting the patients we’re bringing to St. Michael for care.”
Dr. David Weiss, associate chief medical officer at St. Michael, said the hospital is caring for 42 COVID patients as of Tuesday morning, with 177 COVID patients being treated throughout the hospital’s network. That is down from last week, when the hospital was treating 65 patients.
“It’s hard not to look at these numbers and get lost in the numbers, but it’s important to know that each one of these patients is a member of our community that we’re here to serve, and is sick enough to be in the hospital,” he said.
One area of concern, Weiss said, is that the number of vaccinations the hospital is administering has remained flat. “I know there’s still vaccines being offered and it’s pretty readily accessible, but … I think it’s something that we could do to help our situation, and I hope to get that curve up.” He later added that, “the overwhelming majority of our patients are not vaccinated.”
Like other healthcare facilities around the country, St. Michael is experiencing a staffing shortage while also experiencing high emergency department volumes and high hospitalization rates, Weiss said.
Weiss asked the health board to continue helping to vaccinate members of the community; he said he’d like to see more than 95 percent of Kitsap County residents get vaccinated. He also encouraged people to opt for virtual care visits when possible, and to consider alternatives to the hospital, such as urgent care and primary care offices, to reduce the strain on the hospital system. Getting people vaccinated against the flu could also help relieve strain on hospitals, he said.
A screenshot of Tuesday's special meeting of the Kitsap Public Health Board.
“Vaccines work,” said Ed Wolfe, a board member and Kitsap County commissioner. “I believe this in my heart. I believe this in my mind.”
But he doesn’t like the idea of burdening local businesses with vaccination requirements. “They’re hurt too much already,” he said. “We all know about the skyrocketing costs for our businesses, and [they are] unable to find staff, and revenues are down significantly. The county is facing a serious health issue, no surprise to any of us, but I suggest to the board that we need to consider our actions carefully. Our respective jurisdictions, all of us on the board … are facing severe hiring challenges that could be further impacted by a vaccine mandate.”
Morrow noted that the health district has enacted its own vaccination requirement for employees, and said he believes that any government imposing a vaccination mandate should “walk the walk.”
“I think that putting this as a governmental imposition on small local businesses puts them in a very, very problematic position, but we’ve got a long way to go with vaccinations,” he said. “Mandates, guess what? They work. And I just want to give my own personal expression of gratitude for every armed services military member — they are required to get vaccinated and they have done that since George Washington used cowpox to inoculate soldiers of Valley Forge against smallpox.
"And I think we are asking that of our military, we are asking this of our healthcare workers, we are asking this of our teachers and staff in schools, we are asking this of state government, we have asked this of our Kitsap Public Health District employees, and virtually every one of them has taken the step and gotten vaccinated. I think we need at this point to lead by example. That would be my request.”
Morrow added, “I’ve certainly heard a lot of public input with respect to the burden that following the lead of Clallam and Jefferson and King counties might put on local businesses, but I would like direction from the board on how you would like to move things forward with respect to vaccinations, or not.”
During a discussion about whether vaccination requirements should be decided on a jurisdictional basis within the county, board member Kirsten Hytopoulos, a Bainbridge Island City Council member, said she didn’t think a mandate should be decided by each jurisdiction. The health district’s expertise and oversight is at the county level, she said. She also appeared to indicate that she was at least open to the possibility of implementing a vaccination mandate.
“This is a public health emergency and it should be guided by public health expertise and not politics,” she said. “It’s unfortunate that we’re all in this position, and even Dr. Morrow is in this position, because I think this should be coming from the state or higher. But here we are and I hope that Dr. Morrow will not be reticent in making the decisions that he thinks are appropriate.
“Any difficult public policy questions, we know, require a balancing of interests,” she continued. “And right now we have to balance the interests of the individual, the impact of individual choice, the impact on businesses. It’s a public health emergency and I think we all know — I think even we lay people know — that we have to all work together jurisdiction by jurisdiction to actually implement meaningful public health policy. So here we are, Kitsap, sandwiched between... three counties total who have been willing to take this step to require proof of vaccination for people to enter those businesses that — they don’t have to, not essential services — and honestly, I think we should go that direction if Dr. Morrow thinks that’s the right direction. I think my job, and all of our jobs, is to follow the direction of our public health officials.”
But other members of the board echoed Wolfe’s concerns about such a mandate’s potential effect on local businesses. Board member and Port Orchard Mayor Rob Putaansuu said he was “very concerned” about the impacts a mandate would have on small businesses. His internet connection cut out as he was speaking, but later in the meeting, he added, “I don’t believe that there are any easy answers, but I don’t think a mandate that shoves this down the throat of our small businesses is at all palatable to me.”
Board member Becky Erickson, mayor of Poulsbo, said, “Coercion is not going to do it, OK? It’s not going to work, right? It just doesn’t. And so what we have to do is put out information that refutes a lot of these crazy things that we’ve seen, and all the emails we’ve received.” She said she’s received probably around 400 to 500 emails about vaccines, many of which contain factually incorrect information. She suggested creating a fact sheet that would allow local jurisdictions to better respond to misinformation.
Keith Grellner, administrator for the Kitsap Public Health District, said that although the health district could try to produce a fact sheet, he wasn’t sure how effective it would be.
“There’s a lot of information out there,” he said, adding that people tend to choose which websites and resources they believe. “We can certainly take a chance and put something together. That’s going to take awhile. Right now I’m sitting on a stack of well over 1,000 emails with a lot of those claims. So a fact sheet is not imminent any time in the next several weeks, to be honest with you. If that’s what the board would like, we’re certainly willing to do that.”
Ultimately, the board declined to enact a vaccination mandate for the time being, but planned to continue discussing how to mitigate the impact of COVID-19 at its next meeting.
The Kitsap Public Health Board's next meeting is being held virtually on Oct. 5 (their meeting schedule lists the time as 10:45-11:45 a.m., but you may want to check their website to confirm the time as the meeting date nears). The link to join the meetings will be posted to the health district's website.
The health board indicated during Tuesday's meeting that the Oct. 5 meeting would include time for public comment.
