COVID-19

SITUATION REPORT # 32
WA DOH Incident Management Team

OFFICIAL USE ONLY
Date:

Friday,
February 21,
2020

IMPACTED AREAS
County/Regions:
CURRENT
SITUATION
(new information
highlighted)

Time:

Contacts:
Email: doh-pio@doh.wa.gov
Phone: 253-512-7100

1600

Snohomish County, WA
Please contact the Poison Control Call Center at 1-800-525-0127 for further information
related to this outbreak. Please contact the DOH Duty Officer at 360-888-0838 or
hanalert@doh.wa.gov for question regarding incident management or emergency
preparedness and/or response.

Washington Confirmed Cases

COVID-19 Washington confirmed cases by county in 2020
County
Cases to date
Last Changed
Snohomish
1
1/21/2020
Total
1
1/21/2020

Persons Under Investigation–Updated 2/21/2020
Total Persons Under Investigation in Washington*: 1
*Includes non-Washington State residents
COVID-19 Washington Test Results-Updated 2/21/2020
Positive (confirmed)
1
Negative
25
PUIs Pending Results
1
Total Tested
27
Washington Close Contacts Being Monitored-Updated 2/21/2020
Counties
Close Contacts
N/A
0
Total
0
Total Persons under public health monitoring – Updated 2/21/2020
Total: 793

Prepared by: Adam Rovang, SITL

Approved by: Chrystin McLelland, PSC
1

Last updated: 2/21/2020

 FOR OFFICIAL USE ONLY
Executive
Summary

As of the release of this SitRep, only one case of novel coronavirus (COVID-19) has been
confirmed, and that individual has recovered. IMT Epidemiologists continue to monitor
potential contacts and reach out to travelers. Operations staff are focused on building
communications to promote community engagement, and establishing safe and scalable
isolation capabilities.

Current
Operations

Currently the DOH IMT Operations section is engaged in the following activities:
Overall Operations
Background:
- All groups worked on adjusting operations based on evolving CDC guidance and
situational awareness around quarantine planning and operations.
- Support and coordination with 4 patients transferred to Spokane.
Epidemiology Branch Operations
Background:
- Provided guidance documentation for travelers entering Washington via SeaTac
Airport or cruise ships on COVID-19, social distancing, and symptom monitoring.
- Packaged and sent letters to travelers identified through EpiX.
- Continue to utilize TIMS. Washington State is the first to use this system. Responses
to TIMS forwarded to JHLs for more information.
Updates:
- One negative test received. Waiting on one additional test result from CDC for
remaining PUI.
- Continuing to draft Enhanced Surveillance Report.
- Cleared backlog of TIMS records into WDRS.
Public Health Laboratory (PHL) Group
Background:
- Gained EUA for COVID-19 testing capabilities with approval from FDA and CDC.
- LIMs lab data entry module is running and staff are being trained.
- Onboarded 5 UW SEAL students on lab systems as testing support, allowing for
surge capacity when needed.
- Staffing 2 microbiologists for surge capacity testing at PHL.
Updates:
- Support and coordination for the COVID-19 tests heading from Spokane to the CDC.
Community Engagement Task Force
Background:
- Identified working components of task force:
o Public Health Policy, Guidance, and Communication
o Diversity, Equity, Inclusion (DEI)
o Community Relations

Prepared by: Adam Rovang, SITL

Approved by: Chrystin McLelland, PSC
2

Last updated: 2/21/2020

 FOR OFFICIAL USE ONLY
-

Provided guidance for pathologists, medical examiners, and coroners who may
perform autopsies on patients with COVID-19.
Provided and translated guidance documents for LHJ and local healthcare providers.
Sent out school guidance documents for schools and daycare centers.

Updates:
- Conducting Equity and Cultural Sensitivity review.
Community Mitigation Branch
Background:
- Established basecamp website for LHJs, including infection prevention guidance,
and additional guidance from DOH.
- Completed and distributed WATrac guidance for updating airborne infection
isolation rooms.
- Developed home health kits for impacted public health partners.
- Developing a Home Assessment Team (HAT) for specimen collection and how best
to implement this team.
- NIOSH and OSHA reviewing masks that are older than five years for emergency use.
- Worked on improving NPI and mitigation strategies based on updated leader’s
intent.
- Hosted webinars on infection prevention with Harborview for healthcare partners,
and COVID-19 patient movement support plan.
- Continuing support and coordination with 4 patients being transferred to Spokane.
- Secured staffing to develop strategic guidance for public health preparedness.
Updates:
- Developing/augmenting guidance for PPE resource conservation.
- Received comments on 13 NPI recommendations from agency executives. Currently
incorporating comments.
Isolation and Quarantine Group
Background:
- Finalized plan for quarantine site to receive and monitor individuals, plans for nonlife-threatening transport of any potential COVID-19 patients to a specific DOH
quarantine site, and tear-down and transition plans for quarantine site.
- Secured two additional RVs and staff for isolation site to deploy, if required.
- Continue to conduct safety assessment for isolation site, including ensuring site is
ADA compliance.
- Continue to conduct tabletop exercises for quarantine staff groups in preparation
for additional quarantine needs.
Updates:
- Preparing for the requirements of establishing a secondary isolation facility.
- Worked to acquire water connections for the isolation site.

Prepared by: Adam Rovang, SITL

Approved by: Chrystin McLelland, PSC
3

Last updated: 2/21/2020

 FOR OFFICIAL USE ONLY
Public Information
Background:
- Continually responding to constituent, legislator, and media information requests.
- Conducting daily LHJ coordination call.
- Posted mental health resources on website.
- Drafted and approved social media messaging.
- Coordinated press release for the 4 patients transferred to Spokane.
Updates:
- Coordinated NY Times interview with Secretary of Health, and KUOW interview
with Dr. Kathy Lofy and Cynthia Harry.
- Reached out to media regarding individual quarantined in Shoreline.
FEMA Region 10
- Washington: Activation level 1. One COVID-19 case. One PUI.
- Oregon: Activation level 2. No cases.
- Idaho: Activation level 3. No cases or PUI.
- Alaska: Activation level 3. No cases or PUI.
Literature
Situation Report

This is not official guidance from the CDC and is based on a Department of Health literature
review. Reports can be found here:
https://www.doh.wa.gov/Emergencies/Coronavirus/Resources
Background:
- Researchers estimate that cases in Wuhan may be under-detected by seven fold.
- Using data on Japanese travelers evacuated from Wuhan, researchers conclude that
as many as half of all COVID-19 cases may be asymptomatic.
- A pooled estimates indicate an R0 of 3.1, with likely values ranging from 2.1-5.7.
- Calculated CFR for hospitalized patients range from 0.7% for mild cases to 9.5% for
patients with risks factors.
- Incubation period estimates the majority of persons developing symptoms within 5
- 11 days. A small number (<1%) extend beyond 14 days.
- Home isolation of sick persons may be the most effective way to limit transmission,
based on findings from pandemic influenza.
- Shortage of essential personal protective equipment and other medical supplies in
China is limiting epidemic prevention and control of COVID-19.
- Study suggests that oral swabs may not be as effective at identifying COVID-19 at
later stages of disease progression.
- Studies highlight potential effectiveness of Chloroquine phosphate as a viable
treatment option for COVID-19-associated pneumonia.
- More research is needed to assess the possibility of fecal-oral transmission.
Updates:

Prepared by: Adam Rovang, SITL

Approved by: Chrystin McLelland, PSC
4

Last updated: 2/21/2020

 FOR OFFICIAL USE ONLY
Key Messages
from Public
Information
Officer

•
•
•

•
•
•

Preliminary evidence from hospital-based studies indicates that kidney impairment
and acute respiratory distress syndrome are associated with a greater likelihood of
death among hospitalized COVID-19 patients.
Researchers seem to be converging on the theory that while bats are the most likely
origin of 2019-nCoV, pangolins are the most likely intermediary host.
A new survey of roughly 1,000 Chinese residents indicates that perceived unclear
communication from government officials regarding COVID-19 is associated with
increased anxiety.
The Department of Health is coordinating with local, state, tribal and federal
partners on efforts to protect public health and prevent the spread of COVID-19.
While this situation poses a serious public health threat, the immediate health risk
to the general public remains low in Washington.
There are steps people can take to reduce their risk of getting any viral respiratory
infection. These include:
o Wash your hands frequently.
o Avoid touching your mouth and eyes.
o Cover your coughs and sneezes.
o Stay away from people who are sick.
o Stay home when you are sick.
For the latest information please visit: www.doh.wa.gov/coronavirus
If people are concerned or want to learn more about COVID-19, we have a call
center open. Call 1-800-525-0127 and press #.
Media inquiries should be directed to doh-pio@doh.wa.gov or 253-512-7100.

Washington State COVID-19 news: 2/21/2020

DOH mentions/ Quotes
From China to Sea-Tac to Shoreline: How screening for coronavirus works, and what happens to ‘high
risk’ travelers (Dr. Scott Lindquist quoted, Seattle Times)
Four coronavirus patients receive treatment in isolation rooms at Sacred Heart (DOH mentioned; KREM,
KING 5)
Doctor answers questions about coronavirus patients in Spokane (DOH mentioned; KREM)
WA State
Hospital in Spokane receives coronavirus patients; doctors say risk to public 'very low' (KEPR TV, KIMA TV,
KOMO)
‘No risk’ of contracting coronavirus from 4 patients in Spokane hospital, says official (SpokesmanReview, Seattle Times)
Spokane mayor on treating coronavirus patients: 'We have to do our part' (KREM)
Why was Spokane's Sacred Heart chosen to treat coronavirus patients? (KREM)
National
Thousands of Americans voluntarily self-quarantine after returning from China (NBC News)
First US patient has fully recovered from coronavirus in Washington state; nearly 800 still under watch
(USA Today)
Prepared by: Adam Rovang, SITL

Approved by: Chrystin McLelland, PSC
5

Last updated: 2/21/2020

 FOR OFFICIAL USE ONLY
11 US cruise ship passengers test positive for coronavirus (KING 5, AP)
Coronavirus-infected Americans flown home against CDC’s advice (Washington Post)
16 cruise ship evacuees being moved to US hospitals (AP)
AP-NORC poll: More Americans worry about flu than coronavirus (Washington Times)
College investigating reports of coronavirus-themed party (AP,Yakima Herald)
Global
Coronavirus Live Updates: Fears of Global Spread as Cases Accelerate in Iran and South Korea (New
York Times, AP)
Japan to let off last healthy cruise travelers, isolate rest (AP)
Iran reports 2 more deaths, 13 new cases of new coronavirus (AP)
China’s leaders say nation yet to turn corner in virus fight (AP)
China's changed how it counts virus cases three times now. Here's why (CNN)
Experts say confusion over coronavirus case count in China is muddying picture of spread (STAT,
Washington Post, Seattle Times)
Once widely criticized, the Wuhan quarantine bought the world time to prepare for Covid-19 (STAT)
Restrictions And Rewards: How China Is Locking Down Half A Billion Citizens (NPR)
Shadowy Church Is at Center of Coronavirus Outbreak in South Korea (New York Times)
‘No More Hugging, No More Kissing.’ At Home in Hong Kong With 2 Frontline Doctors. (New York
Times)
There's still a 'fighting chance' to contain coronavirus but time is running out, world health leader says
(USA Today, Reuters)
Diamond Princess quarantine is over, but Americans are still in limbo: 'I feel ill-used by my country'
(USA Today)
11 questions about the Covid-19 coronavirus outbreak, answered (VOX)
Could warmer weather help contain the coronavirus? (Reuters)
Stress, rumors, even violence: Virus fear goes viral (AP)
Coronavirus infects hundreds in China's prisons as global markets take hit (Reuters)
With selfie, Ukrainian health minister joins coronavirus evacuees in quarantine (Reuters)
Virus shows plight of China's overstretched doctors (Reuters)
Why the Coronavirus Seems to Hit Men Harder Than Women (New York Times)
Coronavirus: 81% of cases are 'mild,' study says (Medical News Today)
Coronavirus cruise ship to undergo major cleaning before April sail (CNN)
Research/ Viewpoints
Genetic engineering company says they have created a coronavirus vaccine (KREM)
New Research: Bats Harbor Hundreds Of Coronaviruses And Spillovers Aren't Rare (KUOW)
What's spreading faster than coronavirus in the US? Racist assaults and ignorant attacks against Asians
(CNN)
Fake Facts Are Flying About Coronavirus. Now There's A Plan To Debunk Them (NPR)
Awful online coronavirus hoaxes keep popping up (VOX)
US stocks fall as new virus cases spike outside of China (AP, Yakima Herald)
Prepared by: Adam Rovang, SITL

Approved by: Chrystin McLelland, PSC
6

Last updated: 2/21/2020