On Thursday, all eight Clark County mayors sent a letter with an urgent message to Gov. Jay Inslee’s office.
The letter said COVID-19 testing supplies in Clark County are severely low. The county needs more swabs for specimen collection. It needs more viral transport media to transport the swabs. And it needs more personal protective equipment, or PPE, including masks and gowns to keep staff safe and help them collect specimens for tests.
Clark County health care providers have less than a 48-hour reserve of testing supplies and PPE, according to the letter — and another letter sent by the Clark County Council. The letter stated that local medical directors believe the county needs to start testing in its long-term care facilities within 48 hours, but can’t do that without testing reinforcements.
“Clark County is at a critical tipping point in our ability to respond and mitigate the spread of the virus in our community,” the letter reads.
What’s happening in Clark County is happening across the state and nation. After an initial delay in getting laboratories set up to test specimens, testing capacity has ramped up. Washington has tested more than 20,000 people, more people per capita than any other state, according to state epidemiologist Dr. Scott Lindquist. At least 195 of those tests have come from Clark County, according to Clark County Public Health.
But as lab capacity improves, another problem has emerged. Washington counties outside the Puget Sound area are in serious need of supplies to collect specimens for tests, and protective gear to keep medical workers safe and healthy. Some counties don’t have any swabs and transport media, Lindquist said.
“There simply aren’t enough supplies around,” he said. “There needs to be more testing. We need to push our federal government for more supplies.”
On Thursday, the Washington Department of Health announced that it received more than 8,000 test packages, which include swabs, transport media and personal protective equipment. The supplies are being sent to King, Snohomish and Pierce counties, where about 81 percent of the state’s confirmed cases reside.
No way to measure
Officials in Clark County are concerned that a lack of testing supplies here means there’s no way to properly gauge the local outbreak. According to county documentation, Clark County has requested more than 52,000 testing supplies and PPE from the state and received nothing. Those supplies include test swabs, surgical masks, latex gloves, disinfect wipes, N95 masks, safety goggles, splash protection gowns and hand sanitizer.
Clark County Public Health Officer Dr. Alan Melnick said he understands the demand in Puget Sound, but doesn’t want the outbreak to worsen in other areas because counties are left hanging.
“Whatever minimal supply they’ve gotten from the federal government, I wish they had sent a little bit of it to Clark County,” Melnick said.
While Clark County is the fifth-largest county in the state, there are only six confirmed cases here. Three of those patients have died.
Vancouver Mayor Anne McEnerny-Ogle said that on the surface, Clark County appears mostly spared from the pandemic. That’s because it can’t test enough people to unearth the real data. At any time, the county could start experiencing a surge in sick patients.
Clark County mayors sent the letter to Inslee because they are concerned about Clark County being left behind during the outbreak, McEnerny-Ogle said. She’s worried the county’s proximity to Portland will leave it forgotten.
“It’s the epicenter up there (in Seattle),” she said, “but we need the governor to understand he has more than one child.”
Lindquist said the state wants to help more counties, but is in need of at least 100,000 swabs and viral transport media from the federal government.
The governor’s office passed off a request for comment to the Department of Health. An emailed statement from department spokeswoman Jessica Baggett said the state health department is working “tirelessly” with the federal government to get more personal protective equipment.
Supply chain issues have begun to bubble up across the U.S. Lack of test supplies and PPE appear to be next the big problem areas after faulty testing kits delayed state’s ability to test.
Drive-in clinics in Minnesota have closed because they don’t have enough test supplies, according to CNN. South Dakota ran out of testing supplies earlier in the week, and had to temporarily stop processing tests, but has now resumed, according to a CBS affiliate in South Dakota.
These shortages in Washington and across the country have manifested in frustrations on the ground.
Over the last week, The Columbian has received a handful of calls and emails from residents who feel they should be tested. A 51-year-old Ridgefield flight attendant who believes he was exposed on a plane had to make multiple long phone calls to get tested. A 33-year-old Vancouver woman showing COVID-19 symptoms, who works with high-risk populations, was told she was “too young” to get a test on Monday, before a doctor eventually administered a test Tuesday.
Dr. Lawrence Neville, the chief medical officer for PeaceHealth Southwest Medical Center, said he shares concerns about testing, and said PeaceHealth has to be selective about testing at the moment.
“We’ve had to make decisions about testing folks on a more limited basis, where we would like to open the doors to test more widely,” Neville said.
A lack of testing will hinder attempts to stop the virus from spreading, because many carriers of COVID-19 are not sick enough to be hospitalized.
“It’s not that people aren’t getting tests,” Lindquist said. “It’s that the limitation on supplies are hurting people who aren’t the priority for who the lab wants.”
At times, the federal government has made it sound like anyone is eligible for COVID-19 testing, Lindquist said. It’s up to a provider’s discretion, but providers across Washington don’t have nearly enough supplies to test people who have symptoms, but aren’t a high risk. In some cases, high-risk populations such as the elderly are still waiting for tests.
“Our providers have restricted testing mostly to hospitalized patients, and it has been difficult, if not impossible, to test long-term care facility residents and other high-risk populations with COVID-19-like illness,” the mayors’ letter reads.
‘Severely low’ on masks
Dr. Alfred Seekamp, the chief medical officer with the Vancouver Clinic, said Vancouver Clinic is “severely low” on supplies, particularly gloves and face masks. Vancouver Clinic can administer 50 COVID-19 tests per day right now, Seekamp said, but if staff doesn’t have personal protective equipment they can’t safely test or treat patients.
Seekamp said his hospital is particularly low on N95 masks, which fit to the face and efficiently filter out airborne particles. They are ideal for providers doing COVID-19 testing. The CDC has recommended that providers use homemade masks such as bandanas and scarves if protective gear is unavailable.
“Right now the limiting factor is the availability of tests, but soon the limiting factor could be masks and gloves,” Seekamp said. “We want to have enough supplies to take care of our patients, and keep our staff safe.”
Cassie Gabriel, an anesthesiologist with Columbia Anesthesia Group, who does work at Legacy Salmon Creek Medical Center and PeaceHealth, said medical providers are concerned about the shortage of personal protection equipment.
She said providers don’t want to contract the virus because of a shortage in PPE. That could result in two problems: a shortage of providers because they are sick and can’t work. And the potential to pass the virus to patients, who are receiving treatment for another medical complication.
“Right now we are rationing,” Gabriel said. “There are some instances where we feel like we are going to become spreaders to the people who come to see us. We need to be protected now.”
Legacy Health spokeswoman Vicki Guinn said Legacy Health has adequate supplies of PPE across its system, but knows a surge in patients could impact its supplies.
Melnick said Clark County’s population — the state’s fifth-largest, behind King, Snohomish, Pierce and Spokane counties — indicates a surge of cases could happen soon, possibly along with Spokane, which has nine confirmed cases.
“I see us as the next likely area where the numbers are going to increase rapidly,” Melnick said.