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COVID-19 ripped through communities east of the Cascades, killing people at twice the rate of Western Washington

SOAP LAKE — For months, McKay Healthcare and Rehab staff kept its elderly residents safe from COVID-19. But in late October, the virus slipped into the center’s 8-decade-old building.

By mid-December, 15 of the 31 residents had died from the disease.

In the struggle to fight the virus, some staff members worked 24-hour shifts to cover for co-workers who tested positive and had to stay home.

As Christmas approaches and wreaths decorate the center’s long narrow hallway, the outbreak is over. But most of the beds are empty. So McKay’s administrator, Erica Gaertner, says she is forced into an economic reckoning, and must reduce hours or pay of some of the employees with whom she joined in the searing struggle to save lives.

“These are hard conversations. The very people who got us through this are the very ones I have too many of,” Gaertner said.

The death toll at nonprofit McKay, located in a farming community of fewer than 1,500 people at the edge of a remote mineral-rich lake, is stark evidence of the long reach of COVID-19 across Central and Eastern Washington.

The virus, in its early days in Washington, largely cut a swath of illness through the Puget Sound region. The first casualty east of the Cascades — an elderly resident in Quincy who died March 7 — was a disturbing new development. As the year crawls to an end, COVID-19 has killed more than 1,000 residents east of the Cascades, a per capita rate double that of Western Washington counties, according to a Seattle Times analysis of state Department of Health and county statistics.

The deaths were part of a broader surge of illness that has hit much of rural America this fall.

In Grant County, more than half the 73 deaths reported as of Dec. 16 happened within the past six weeks. This month, infections have climbed so sharply that public health workers have largely given up on comprehensive tracing of cases.

Vaccines have arrived at a Moses Lake hospital, offering the prospect that 2021 will be a much better year. But here, as elsewhere in America, the rollout to the broader population will take months during a winter in which COVID-19 will continue to kill. In a part of Washington where skepticism runs high over lockdowns — and even the severity of the threat — it is still uncertain just how many people will opt to get vaccinated.

One hopeful sign for the future is how Grant County residents, at times have come together to fight the virus as a common foe. Earlier in the year, for example, Quincy-area farmers developed a plan to stagger workers’ pay days and bus trips into town, to ease crowding in stores that residents feared could accelerate the spread of the infection.

“Our town really stepped up,” said state Rep. Alex Ybarra, a Republican lawmaker and son of farmworkers who reached out to growers to help forge the agreement.

A divisive presence

Some residents continue to rail against the statewide restrictions that have once again shut down indoor restaurant dining. Others, though their numbers are dwindling, still shrug off wearing masks, angering Allen Dearie, the Latino owner of Central Market.

Dearie says he has repeatedly endured tense moments asking maskless customers, most of whom are white, to cover-up. He put some of the blame on President Donald Trump, who won nearly 66% of the Grant County vote last month and has failed to embrace masks.

“They got an attitude and they get mad,” Dearie said. As he spoke, he eyed a maskless construction worker who had stopped to order lunch from the store’s to-go counter that features tacos and burritos. “If I get sick, I have to shut down my store,” Dearie said.

Another flashpoint in the Grant County pandemic saga has been the nearly 50 cases of the virus traced by public health officials to a Nov. 7 wedding with some 300 guests in adjacent Adams County. Eleven of the guests worked in the Moses Lake School District.

Wedding guests also included employees of a Moses Lake long-term care facility, Lake Ridge, that subsequently got hit with an outbreak that killed at least 16 residents. The Grant County Public Health District determined staff went to work “while contagious and before they knew they were ill,” but reported “it will not be known” which deaths are directly tied to them. The county also is investigating possible links to wedding guests at another long-term care center where at least nine deaths have occurred.

This wedding, labeled by media as a super-spreader event, triggered an angry backlash that hit even the McKay staff, none of whom attended the wedding and whose coronavirus outbreak began more than a week before the Nov. 7 gathering.

“I was not prepared for that. It was just nasty, hurtful, rude, misinformed comments,” Gaertner said of the social media fervor. “It was just devastating.”

Such online assaults have added more challenges to the already daunting work of public health officials as they reach out to people who may have been exposed to the coronavirus. Even some people showing symptoms, or living with those who have tested positive, are now declining requests to get tested.

“I think that we have moved on from ‘It’s a hoax,’ to ‘It’s not as big a deal as we think it is,’” said Theresa Adkinson, the administrator of the Grant County Public Health District, who has spent weekends assisting her staff in contact tracing. “In a lot of the phone calls, people are angry and they want to yell ... We are not here to judge ... We are working insane hours to keep them safe and dealing with constant confrontation.”

A hospital’s grim battle

In March, Samaritan Healthcare, Grant County’s largest hospital, put elective surgeries and other nonessential services on hold to prepare for a spring surge in COVID-19 cases that never arrived. Instead of an influx of county residents infected with the virus, the 50-bed hospital suffered a 40% decline in patient volumes and took a financial hit as revenue fell by $15 million.

In September, the number of patients with COVID-19 still remained low — averaging around five. But things changed dramatically during the next three months as the virus in Grant County — mirroring broader national trends — escalated sharply.

In December, the COVID-19 patient count — on many days — has been more than triple that of September. In a recent visit, the hospital was treating 18 infected patients, including nine in a fully occupied 12-bed intensive care unit.

If COVID-19 cases continue to climb, staff — not bed space — will be the most precious and scarcest resource. Soaring infection rates have made even temporary recruits difficult to hire.

Fatigue is another concern.

At Samaritan, this month is usually highlighted by prime-rib Friday, where hospital leaders don Santa hats and aprons to deliver the meals in a morale-boosting cafeteria service that extends deep into the night.

The event was reluctantly scrapped, and some staff are picking up extra 12-hour shifts to cover for those who have tested positive or had to quarantine. Julie Nishida, a registered nurse and supervisor, says that she runs to reduce stress but that the stress never ends. “Every day, you have to actively tell yourself to keep going,” she said.

In the hospital’s intensive care unit, the COVID-19-positive patient rooms are marked on doors with red paper wheels, and registered nurse Sandy Martin adds goggles and a face shield to her protective wear before she goes inside. The 73-year-old Martin has worked for 45 years at the hospital and has been one of the stalwarts on the ICU this fall.

“This has probably been the worst thing in my whole career,” Martin said. “Retirement is looking a little bit better.”

The big majority of the COVID-19 patients cared for by Martin and other Samaritan staff eventually go home. So far, there are fewer than a dozen deaths among the more than 100 infected patients who have received care at the hospital.

This reflects, in part, the transfer of some higher-risk patients with underlying conditions to larger hospitals with more specialty care. That has helped the patient census at Samaritan to trend toward younger patients, mostly under 65, and many in their 30s and 40s, who have a better chance of surviving the disease.

Staff also cite improvements in care — with less of the intrusive intubation and more use of the drug Remdesivir, an antiviral, as well as steroids and anticoagulants to prevent blood clots.

The hospital marked another step forward as it became a regional center for coronavirus vaccination. The first shipment of 975 Pfizer-BioNTech doses arrived last week. Deliveries are expected to continue on a weekly basis well into 2021.

Some 75 hospital staff with the highest priority were selected to be given the first of the two-dose vaccine last week along with other front-line medical workers.

Martin won’t be among the first to get shots. Though undaunted by the risks of 12-hour work shifts during the pandemic, she is wary of the vaccine. “With my age, I just would like to see how it’s going in the general public before I jump right in and get it,” Martin said.

When the virus gets in

In the Puget Sound region, long-term care centers were hit hard early on with dozens of deaths that warned the nation of the staggering risks of COVID-19 in such facilities.

In Grant County, there were only a few reports of such outbreaks through the spring and summer, and The Cambridge in Quincy has been able to reach December without any staff or residents testing positive for coronavirus. One firm rule: Residents who visit family return to 14-day quarantines.

“We’re not going to take any chances, and they are prepared for it,” said Linzi Michel, the Cambridge administrator.

In five other Grant County long-term care centers, the virus has turned deadly, killing 42 people — mostly this fall — with another six deaths expected to be confirmed in the days ahead, according to Adkinson, the public health district administrator.

At McKay, Gaertner describes the initial attempts to limit the number of infections in a building — initially built as a hospital back in 1937 — that lacks modern ventilation and still has up to three beds in rooms. Even in the best of circumstances, this can be tough duty with some patients suffering from dementia or in an end-of-life situation requiring extensive bedside help.

When the virus struck, much of the 42 staff got infected, including Gaertner, who still has a cough and suffers from shortness of breath. So as the outbreak intensified, only a skeletal crew was available to help move coronavirus-positive residents to isolation quarters.

“We just worked until we couldn’t anymore,” said Gaertner, whose husband at one point moved a cot into her office so she could catch a few hours of sleep.

By the first week in November, the infection had overwhelmed the staff, and the decision was made to evacuate 24 patients — many of them with deep family roots in the Soap Lake region — more than 90 miles to a Pasco center that has a unit designated by the state to assist in caring for the elderly with COVID-19. That effort took four days. Vans filled with McKay residents in wheelchairs traveled south past the fields and sagebrush lands.

Most of these men and women would never make it back to Soap Lake, according to Gaertner. They died in Pasco, away from loved ones and the McKay staff who had cared for them. The county as of last week had reported 11 deaths at the care center, with one more pending review. Gaertner said she can confirm 15.

Seven who survived the virus have returned to McKay, where the staff has hung a banner just inside the main entrance. “Welcome home, we missed you,” it said.


Local
centerpiece
Warming fires increase as it gets colder in Wenatchee Valley

Local
As temperatures dip into the 20s, Wenatchee Valley’s homeless still have no cold-weather shelter

WENATCHEE — A Wenatchee Valley cold-weather shelter is expected to open in early January, about a month later than last year and as overnight temperatures have already dipped into the 20s.

The delay in getting a shelter was caused by COVID-19 complications, said Glen DeVries, Wenatchee Community Development director. The challenge was “the ability to find a location given the pandemic,” he said.

As city and nonprofit officials work to get the shelter open, firefighters have been called to several warming fires in the past week. Those calls included one early Wednesday in a parking lot by the Salvation Army where a small group of people burned cardboard to keep warm and a fire that got out of control Wednesday along the Apple Capital Recreation Loop Trail.

Of the cardboard warming fire, firefighters do not cite people for these types of fires, they just let them know it’s illegal, said Kay McKellar, spokesperson for Chelan County Fire District 1 in Wenatchee.

The Chelan-Douglas Homeless Housing Task Force, a group of city representatives from Chelan and Douglas counties, helped set up two severe weather shelters last December. This winter, they are only funding one and it should open in January.

Temperatures dropped to the 20s in the last week and snow is expected Christmas night. Last winter’s shelters opened on Dec. 1 and 19.

The Task Force voted Wednesday to fund the People’s Foundation to set up a shelter at the Gospel House in Wenatchee. The shelter will cost $58,200 to run through the winter.

The Task Force contracted with the People’s Foundation and the Women’s Resource Center on Oct. 7 to use the same buildings as last year for shelters but they were unable to use those spaces, he said.

Not having a space is the reason the Women’s Resource Center, which previously housed people at First United Methodist Church in Wenatchee, was not able to make it work this year, he said.

Gary Steele, who runs the People’s Foundation, said when he was looking for a possible shelter location, churches were very limited on the number of people they could bring in.

COVID-19 has made this a real difficult situation, he said. He added, “We want to be safe, but on the other hand, we want to have our doors open.”

Guests at the shelter will stay upstairs in a room at the Gospel House, each in their own tent, he said. Workers at the shelter will use a forehead thermometer to check new arrivals for COVID-19. Face masks will be required.

The plan is to open up no later than Jan. 1 and be open 12 hours, from 7 p.m. to 7 a.m., he said.


Education
Washington high school seniors set graduation rate records this year

SPOKANE — Despite the COVID-19 pandemic but partly because of it, Washington’s high school seniors graduated at record rates last spring.

The Office of Superintendent of Public Instruction reported this week the 4-year graduation rate reached 82.9% .

That’s an all-time high, and 2 percentage points higher the previous record.

“The Class of 2020 completed their senior year in a manner unlike all of the graduating classes before them,” said Superintendent of Public Instruction Chris Reykdal. “I’m proud of the way our educators, school staff, and families came together to support our seniors in reaching the finish line despite the challenges they faced.”

Every student group saw an increase in their 4-year graduation rate compared to 2019. Native American students and English learners saw the largest gains, with their graduation rates rising by 8.1 and 6 percentage points, respectively.

In Chelan County, Chelan High School led the way at 97%, with Manson High School not too far behind (93%), and followed by Cascade High School and Wenatchee High School (both 91.7%), Cashmere (89.8%) and Entiat (76%).

In Douglas County, Eastmont registered 91.5%, followed by Waterville (90%) and Bridgeport (86%).

Graduation rates rose partly because of relaxed standards put in place during the pandemic and the quick move to distance learning.

To help push students to graduate, the Washington State Board of Education created an emergency credit waiver program to support students who had been on track to graduate on time when the pandemic first closed schools last spring.

On the other hand, the class of 2020 was the first group required to meet the new “graduation pathway” requirement by showing that they were ready to take the next steps after high school .

OSPI and State Board of Education are analyzing how the credit waivers and graduation pathway programs impacted graduation rates. They hope to have that data available next month.

“I’m pleased to see that gaps are closing, and I believe it’s important to celebrate that progress,” Reykdal said. “However, the work can’t slow down. We will continue our focus on closing gaps and ensuring all of our students have the supports they need for graduation and beyond.”

The state’s largest district, Seattle Public Schools, had a graduation rate of 85.8%.

Wenatchee World reporter Pete O’Cain contributed to this report.


Coronavirus
Logistical hurdles lower use of monoclonal antibody treatment in the U.S. — and in Wenatchee

WENATCHEE — Faced with logistical concerns, Confluence Health has returned around 100 doses of a newly approved drug that treats coronavirus-positive people with a high risk of hospitalization.

The treatment uses monoclonal antibodies, which are laboratory-made proteins that mimic the immune system’s ability to fight off viruses, according to the U.S. Food and Drug Administration. The treatment received widespread attention in October after President Donald Trump received a dose, along with other medications, shortly after contracting the virus.

Two similar versions of the treatment have been authorized for emergency use by the FDA. One is manufactured by Regeneron, which is the version Trump received, and the other is made by the company Eli Lilly, which is the version that was allocated to Confluence Health by the state Department of Health.

But the treatment has seen relatively low use by health care organizations across the country — including Confluence Health — partially due to the logistical hurdles of administering the doses.

Confluence Health chose to return its doses to be used in other hospitals and instead is focusing on the all-hands-on-deck effort to roll out vaccinations in the area, Confluence Health Chief Medical Officer Dr. Jason Lake said Wednesday.

“This was occurring at the same time we were going through our vaccine planning stages,” he said. “So ultimately we had to decide what would provide our community with the best benefit and we chose to put most of our efforts into planning the vaccination rollout and to ultimately not utilize the monoclonal antibody therapy.”

The issue is the very short window of time needed to identify patients who could benefit from the drug and then administer it.

Monoclonal antibody treatments are meant to treat people who are at high risk of having a severe case of COVID-19 or needing hospitalization. But they must be administered soon after a person contracts the virus and before they’re hospitalized, according to the FDA.

“From a logistical standpoint — where we’re getting sometimes over 100 positive patients a day through our drive-thru testing station — you can imagine the process of fully vetting the risk factors of all these patients that were positive and trying to figure out which ones would benefit the most from that therapy,” he said.

Once identified, the COVID-positive patients would then need to come into a clinical setting to receive the drug intravenously. When administered to at-risk patients with the right timing, the treatment’s effect has been promising, according to data from the companies.

But finding enough staff members, who are already in short supply, to manage the program was also a concern, Lake said.

“Logistically, it was going to be very, very challenging to try to figure all that out,” he said.

But Confluence has started using other medications to treat the most severe COVID-19 cases once the patients are hospitalized, including steroids and the antiviral medication remdesivir. Those improved treatments have helped lower the number of hospitalized patients who have needed ICU admission, Lake told The Wenatchee World in November.

The concern around the monoclonal antibody logistics — especially in conjunction with the vaccine rollout — has been mirrored across the country. The federal government has on hand nearly 532,000 doses of the monoclonal antibody treatment, according to The New York Times. Around 55% of that has been shipped out.

“But early data collected from hospitals by the federal government suggest that they have given only about 20 percent of their supply to patients,” The Times reported.

Some health care organizations that are offering the treatment have also found significantly less demand from people than expected, according to The Times.


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