Pierce tied to King, Snohomish now when it comes to COVID phases. Is that good or bad?

Pierce tied to King, Snohomish now when it comes to COVID phases. Is that good or bad?
FILE - In this Dec. 17, 2020 file photo, Washington Gov. Jay Inslee talks to reporters at the Capitol in Olympia, Wash. State lawmakers across the country will be convening in 2021 with the continuing COVID-19 pandemic rippling through much of their work — and even affecting the way they work. After 10 months of emergency orders and restrictions from governors and local executive officials, some state lawmakers are eager to reassert their power over statewide decisions shaping the way people shop, work, worship and attend school (AP Photo/Ted S. Warren, File) (Ted S. Warren)

Local officials this week spent time parsing what new reopening plans for the state mean for Pierce County, which still is struggling with high rates of COVID-19.

Not everyone has the same takeaway.

Under the new “Healthy Washington — Roadmap to Recovery” plan, counties are grouped into eight regions based on health system resources. All are now considered to be in Phase 1 of a two-phase plan, which goes into effect Jan. 11.

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Pierce County is grouped with King and Snohomish counties in the Puget Sound region.

In short, COVID-19 data will have to be improving regionwide, not just a single county, for the counties involved to move ahead in a phase for reopening.

While health officials argue it streamlines the process and saves labor on applying for advancement, Pierce County’s executive made clear during a recent business roundtable call he thinks it’s coming at the expense of local control.

“If we’re in a better position, can we break off from that region? I will be making that argument all day, every day,” County Executive Bruce Dammeier said on the call Wednesday. “I want to get our folks, as soon as they can in a safe way, opened up. I want to get them open.”

THE NEW PLAN AND CRITICISM

The four metrics that will be tracked include:

▪ Two-week rate of COVID-19 cases per 100,000 population.

▪ Two-week rate of new COVID-19 hospital admission rates per 100,000 population.

▪ ICU occupancy (total: COVID and non-COVID).

▪ COVID-19 test positivity rate.

In order to move to Phase 2, the region needs to show:

▪ At least a 10 percent decrease in the two-week rate of cases per 100,000 people.

▪ At least a 10 percent decrease in the two-week rate of new COVID-19 hospital admissions per 100,000 people.

▪ A total ICU occupancy of less than 90%.

▪ A test positivity rate of less than 10 percent.

Once advanced to Phase 2, the region could be moved back if there is not a decreasing or flat trend in the case rate and COVID-19 hospital admissions or if ICU occupancy goes above 90 percent and test positivity rises above 10 percent.

Officials with the Tacoma-Pierce County Health Department this week applauded the streamlined approach.

In a blog post Thursday, Nigel Turner, director of communicable disease for the Tacoma-Pierce County Health Department, wrote: “Measuring the region as a whole makes sense. Disease rates and hospitalizations usually move in the same direction at roughly the same rate across our region.

“You might remember when we moved from Phase 1 to Phase 2 of the Safe Start plan last summer, the state required us to submit a lengthy application. Our staff worked quickly, but the application still prolonged the time it took to move closer to normal. We believe the new, simplified system will allow us to progress quickly.”

Not everyone in the county was as optimistic.

Concern emerged during Wednesday’s weekly Economic Development Board for Tacoma-Pierce County’s COVID-19 call that the grouping will bring more confusion, not only about who’s in charge but by once again adding new rules as to what’s allowed.

“Candidly, that was part of my frustration when I was providing feedback, was why are we changing now? I mean, we can kind of see the end coming. Changing now is just going to confuse people. But obviously that view did not prevail,” Dammeier said in Wednesday’s call.

“On the positive side, I do believe the governor sees the need and is trying to find ways to loosen some of the restrictions,” he added. “So I think his intent is to loosen some of them and get as much back as soon as we can. I think this is an interesting way to go about it. ... And we’ll have to go to the state Department of Health website to determine the data for purposes of moving forward in phases.”

He added, “I don’t really understand or appreciate why he made this regionalization decision when everything was already set up around a county.”

The current part of the Tacoma-Pierce County Health Department’s Safe Start modules will convert into reflecting the new metrics, to be calculated by the state and updated each Friday.

Each region’s metrics will be available on the state’s Risk Assessment Dashboard on Fridays.

The health department will continue to report local numbers for the county as it does now.

In the latest figures from each county, King County had a rate of 277 cases per 100,000 over two weeks, Snohomish County had 350 and Pierce County had 406.

If the county at some point starts doing markedly better than King and Snohomish with lower disease activity, Dammeier said he would argue for splitting off.

“But right now, (Gov. Jay Inslee) has made a decision to link us to King and Snohomish, so I’m not sure he’s going to be willing to unlink that. But if we’re doing better, I’m going to be arguing as hard as I can to get us the flexibility that I think we should have had, you know, that we should be continuing now,” he said.

HEALTH DEPARTMENT’S VIEW

Dr. Anthony Chen, director of the local health department, later Wednesday addressed concerns about the plan at the Board of Health’s study session.

“This is not regionalization in a structural way,” Chen said. “This is really more about data collection epidemiology in a region. So it’s not unlike what California has. In California, they color code their counties, and most recently with the big surge, they kind of said, ‘Well, all the purple counties have to be in these restrictions.’ So that’s what it is — it’s really more way of keeping track of, you know, rather than on a county-by-county level, in a regional area.

“My understanding is that they were trying to reach some kind of alignment in terms of hospital resources,” he added.

“Originally, there was some conversation about using the EMS regions, which would have put us in the same region with Grays Harbor and Pacific County ... to the west, which makes no sense in terms of hospital resources. And so it actually is an improvement from the original plan for us to be in the same region as King and Snohomish.”

He likened it to the first restrictions unrolled early in the pandemic.

“If you remember in the spring, when they started implementing the restrictions on public gatherings and school closures, it also was a three-county region,” Chen said. “So I do not see a significant issue for us.”

Levels of coordination still need to be figured out, Chen noted, but he still considered it an improvement from the earlier Safe Start phased guidance, which put a lot of time-intensive work on the county to apply for a phase, which was then hard to roll back in the speed of a surge.

“When we hit a surge in the summer, and then again, in the fall, there was not a quick way for us to move backwards,” he told the board.

The new system, he noted, would simplify much of that work, with those determinations now on the state’s watch.

“The original Safe Start was, in my mind, a more optimistic approach to progressing forward, and then there really wasn’t anything about moving backwards. So the current proposal is more dynamic,” Chen said. “They will review it. And then if you’re doing well, you move forward. If you’re not doing well, or things are getting worse on two or four indicators, you will get moved back.”

Nigel Turner, the department’s director of communicable disease, agreed the three health jurisdictions were already comfortable working together.

“There is a lot of coordination that already goes on with our partners,” Turner said. “And also in terms of health care response planning as well, there’s a regional planning structure around that.”

In a statement sent to The News Tribune on Thursday, he added: “Department of Health’s regional approach with the new Healthy Washington approach creates a more stable and realistic approach to assess disease levels in the region, which will drive decisions on opening businesses and restrictions on social interactions.”

This story was originally published on The News Tribune.