As the number of COVID-19 cases in Grays Harbor County continues to rise, so does the number of cases for which public health can’t determine a specific source of infection.
“I have been watching the proportion of our cases that are due to what we call community transmission, which means we cannot illicit a likely exposure source,” Grays Harbor Public Health Director Karolyn Holden said at a briefing Friday. “That’s been pretty consistently going up over the last month and certainly the last several weeks.”
Two weeks ago, community transmission accounted for about 28-30% of confirmed cases, said Holden. “Now it’s closer to a third of the cases not being related to a known source of exposure,” she said. “So what that tells us is not only are we having a lot of cases, but we’re seeing an increase in cases where we don’t know where they are getting infected.”
Community transmission cases are concerning because, without a good idea of how those cases contracted the virus, efforts to stem the spread further are made difficult. Details on how the virus is spread allow public health to “figure out how to intervene to interrupt transmission with as minimum an impact” as possible, said Holden. “We like to be as precise about those things as we can be,” calling the increase in community transmission “highly concerning.”
Friday, public health updated transmission numbers for the last week, describing how the virus was spread: 60% contact, 35% community, and 5% travel.
Numbers posted Friday show that in the past week, the case count grew by 94 — 25 new cases Nov. 5, 37 Nov. 8, nine Nov. 9, 17 Nov. 11, and six Nov. 12. The county total was 840 as of Friday.
There are 55 active cases still under isolation or quarantine, with 123 active contact investigations; the total number of case investigations was at 1,358 with the updated Friday figures.
Epidemiologist Hillary Booth said out of the last 20 “clusters” the county has investigated, “only two were related to private gatherings or multi-family situations. The other 18 were related to workplaces.”
A “cluster” is not to be confused with an “outbreak.” An outbreak is a situation where more than one case can be traced to a specific place and time. A cluster “indicates we need to follow up and get more evidence,” said Booth.
Public health does not reveal those workplaces unless it determines there is potential for widespread exposure outside of those workplaces. Instead, the agency does “the best it can” to identify those clusters to keep the virus from spreading, said Booth.
With the growing number of cases, the rising number of those cases where a specific point of infection can be determined, and the holiday season coming up, Holden is concerned about potential exposure caused as families get together for Thanksgiving and Christmas celebrations.
“Given the epidemiological curve we’re looking at right now, I’m really concerned about how we engage in holiday gatherings and celebrations,” said Holden. “We understand that people probably need now more than ever to be together and celebrate together, to have some sense of normalcy, but we are not in a normal situation.”
Holden mentioned Gov. Jay Inslee’s Thursday press conference about the recent large-scale surge of cases statewide. The governor imposed no new restrictions, but a plea was made for people to maintain their social distancing and masking, and to avoid larger gatherings. Even if stronger restrictions were put in place ahead of the holidays, “we wouldn’t see the benefits from that for two or three weeks because of the incubation period off the virus,” said Holden.
As difficult as it may be, Holden encourages everyone to consider modifying their holiday gatherings this year.
“Please, please, please consider different ways to be together during the holidays,” she said. That includes considering if anyone at a gathering of any size is in a high risk category – for instance, elderly or with pre-existing medical conditions. It also may mean a pre-celebration quarantine of sorts.
“If you feel like you’ve been out and about and may be incubating, you’re increasing the safety of your family if you’re choosing not to risk community exposure in the two weeks up to the holiday,” said Holden.
“We have had the National Guard down here for the last several weeks, and over those weeks 2,623 people were tested,” said Holden. “Out of those folks, 94 positives were identified, a rate of just over 3.5%.”
That’s above the 2% ceiling public health wants to see on the rate of positivity for tests being administered, said Holden.
“The feeling is that if we have 2% or less it is likely we are doing enough testing to surmise what is occurring in the course of the outbreak,” she said. “If the positivity rate is higher, that perhaps suggests we’re still not getting the people in who need to be tested in order to provide us with a full picture.”
The National Guard testing did improve the overall testing rate in the county and lowered the positivity rate “substantially, so it was definitely a good move, I’m very glad we did it,” said Holden.
Public health as also purchased a trailer so it can set up a pop-up kind of testing site in the community if needed, without having to bring in the National Guard, already in high demand across the state, said Holden.
As of Thursday, there were 59 COVID-19 cases actively monitored in isolation, and 55 being actively monitored in quarantine, said Holden.
Construction continues on a county-owned isolation and quarantine facility on Eighth Street in Hoquiam, next to City Hall, which will have 15 beds, 10 for quarantine, five for isolation, said Holden. Completion is still several weeks out, as it has been delayed several times over the past few months.
In the meantime, the Sweet Grass Hotel in Ocean Shores continues to serve as a place where anyone can isolate or quarantine if they have no other safe options. Since July, the Sweet Grass has had 25 “guests” who have used the facility, which is owned by the Quinault Indian Nation, for a total of 190 overnight stays.