By Jason Kravarik and Sara Sidner
“Chaos” was how Dr. Kevin Hanson described his emergency department at EvergreenHealth hospital in suburban Seattle.
Nearly 20 coronavirus patients were coming in every day. Staff members were running out of personal protective equipment. Even one of the doctors became severely ill with the virus.
“It’s very sobering,” Hanson said. “It gave us all a lot of pause, saying ‘are we doing the right thing?’”
But that was a month ago. Now, Hanson strolls past room after room with empty beds. The lights are off. The waiting room is nearly empty.
Chaos has turned into quiet.
Hanson’s hospital is a testament to what has changed in Washington. Once leading the nation in deaths and considered a hot zone to avoid, Washington state now ranks number 17, with 870 deaths from the novel coronavirus as of May 7.
How did it happen?
With a unified approach, say local officials and scientists who spoke to CNN.
Even before stay-at-home orders became part of the American vocabulary, Amazon and Microsoft, both headquartered in Washington, encouraged their tens of thousands of Seattle-area employees to work from home.
It was not by chance.
“We included (the tech giants) in our plans and conversations from the beginning,” Seattle Mayor Jenny Durkan said. “The first phase of having people telecommute and not come downtown really started breaking the back of the virus.”
That took thousands of people off Seattle’s streets just three days after Washington recorded the nation’s first known death at a time from COVID on Feb. 29.
That same day, Washington Gov. Jay Inslee declared a state of emergency.
“This was an all-points bulletin,” Inslee told CNN. “And I think it was successful because it set the public up to be willing to do things very, very rapidly.”
Eleven days later, Inslee banned gatherings of 250 or more in the most populous counties, and by March 13, he ordered community centers and schools to close.
Restaurants soon followed.
A grim discovery
A few floors above Hanson’s emergency room at EvergreenHealth hospital in Kirkland, Dr. Francis Riedo made the discovery that sent many of Washington’s public officials and the Centers for Disease Control into overdrive.
In late February, before the U.S. learned COVID-19 had escaped in its communities, Riedo randomly selected two patients for a coronavirus test. Neither had been out of the country; yet, both tested positive.
It proved community spread was already happening.
“It was a moment of recognition that everything had changed,” said Riedo, director of infectious disease control at EvergreenHealth. “Over the next five days we tested 42 more and found 32 more patients who were positive.”
Many of those came from the Life Care Center down the street.
More than 100 cases and at least 35 deaths were eventually linked to the nursing home, and the nation watched in horror as a macabre parade of ambulances took one patient after another to local hospitals.
Dr. Isaac Weisfuse, a former deputy commissioner with New York City’s department of Health and Mental Hygiene who is also a professor at Cornell University, said he believes that played a role in how Washingtonians responded.
“(Washington) went through the crucible of having a really difficult initial outbreak that in other places wasn’t quite that bad or as evident at that moment,” he said.
The Life Care case was an early stumble in the Washington response.
Not only were patients dying, a third of the staff fell ill and was unable to return to work. It took more than a week for a federal government medical team to arrive and offer hands-on help.
The governor said the operators of the nursing home share some of the blame for that.
“This corporation had a responsibility for the medical care of their patients,” Inslee said. “And to some degree we couldn’t just walk in on day one without some coordination with them to really understand the circumstance.”
A Life Care spokesman said nursing homes have been held to a different, unfair standard compared to hospitals.
“No hospitals were blamed for deaths that occurred there after being hit with the virus,” said Tim Killian, a Life Care spokesman. “The virus happened to us when there was still confusion over how contagious it was and how it spread.”
The nursing home was struggling to get enough testing and PPE for its staff, Killian said.
That was, and continues to be, an issue statewide, Inslee said.
“We did not have enough PPE for nurses and many facilities, and to some degree still don’t,” he said.
But he says the federal government has ramped up production and some supplies are coming in. Washington has even been able to return some government-provided ventilators since flattening its curve.
Testing and contact tracing
Now, Inslee has started opening things up in his state, but at a cautious pace.
State parks are open, some construction is allowed again, as are limited in-person car sales. Boeing, the state’s largest employer, has workers back on the lines.
By the end of this month, the state may let people return to dining in restaurants with restrictions, and curbside retail may begin.
Science and data will dictate the pace, Inslee said.
“This is very important because as we move away from the blunt instrument of social distancing towards the smart weapon of testing, contact tracing and isolation,” he said, “we have to have that capability up and running.”
Jason Kravarik and Sara Sidner are reporters with CNN. This story is part of the SoJo Exchange of COVID-19 stories from the Solutions Journalism Network, a nonprofit organization dedicated to rigorous reporting about responses to social problems. Today, we examine some steps being taken in Seattle, which could provide some answers in our fight against the coronavirus.
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