FRIDAy, MARCH 27 , 2020. THE WASHINGTON POST EZ SU A
Politics & the Nation
BY ROBERT KLEMKOKIRKLAND, WAsh. — The subur-
ban hospital that handled the
first onslaught of coronavirus pa-
tients weeks ago — a crush of
seriously ill and dying nursing
home residents that signaled the
beginning of the national health
crisis — is now offering cautious
optimism to people across the
United States who are searching
for an end to the springtime
nightmare: They believe they
might have flattened the curve
here.
At EvergreenHealth Medical
Center, two miles from the shut-
tered Lifecare nursing home
where 35 patient deaths were
linked to the virus, officials say
their rate of new covid-19 cases
has remained steady for two
weeks, leveling off at a trickle. On
some days, doctors here see just
one new case and haven’t seen
more than four in a single day
since mid-March. Few need ad-
mission to the intensive care unit,
which is now half full, two weeks
after overflow necessitated trans-
fers to nearby hospitals.
“We don’t know if this last two
weeks has been a calm before the
storm or if the social distancing
and all those things that are being
practiced are working,” s aid Ever-
greenHealth CEO Jeff Tomlin,
whose hospital has handled 40 of
Washington state’s more than 130
virus-related deaths. He said the
hospital is no longer over-
whelmed, though it still lacks
needed supplies.
“You will never hear me declar-
ing victory at a ny p oint of this,” h e
said. “But I can tell you we’re
making sure we have enough sup-
plies, beds and ventilators as we
can. I’d say we’re gearing up just
in case a surge does happen like in
New York or in Italy.”
In the state that saw the na-
tion’s first confirmed covid-
case on Jan. 31, and the first
recorded coronavirus-related
death on Feb. 29, initial dire pre-
dictions of massive spikes have
waned even as testing has in-
creased rapidly. While the num-
ber of cases in Washington state
grew by as much as 28 percent in
one day on March 15 — i t has since
slowed significantly statewide, as
have hospitalizations and deaths.
State authorities said there
have been 2,580 positive cases
and 132 deaths, and as testing in
Washington has ramped up, the
percentage of positive cases has
remained low — holding at about
7 percent.
“We know this is still a dire
challenge, we know we have not
turned the corner and we are not
even close to the end of this battle,
but we do think there is some
evidence that our community
mitigation strategy — to close
schools, restaurants and theaters,
to prohibit gatherings — w e think
these things have slowed the rate
of increase in King, Snohomish
and Pierce counties,” Inslee said
during a news conference Thurs-
day, pointing to a graph showing
Washington’s rate of new cases
beginning to flatten while most
other states trend upward.
While cases continue to surge
in metropolitan areas in New
York, Michigan and Louisiana,
Inslee’s take on what is happen-
ing in the Pacific Northwest could
signal that there is a way out, if
people continue efforts to keep
from spreading the disease by
limiting contact. Cases also are
flattening in China and South
Korea — where authorities
ramped up testing and used strict
social distancing — and research
indicates that social distancing
can delay a surge in cases so
severe they require intensive
treatment and overwhelm hospi-
tals.
“It is a glimmer of hope,” Inslee
said. “This is suggestive that some
of the things we’re doing together
is having some very modest im-
provement. The things we did two
weeks ago are now appearing in
our hospitals.”
At Overlake Hospital in Belle-
vue, about seven miles south of
Kirkland, doctors have seen a re-
cent uptick in cases, with about
20 to 30 positive tests a day, what
they believe to be due to viral
spread throughout the region be-
fore strict social-distancing poli-
cies took effect two weeks ago.
David Knoepfler, Overlake’s chief
medical officer, said his hospital
has about 70 covid-positive cases
— or people they are working to
rule out — and that patient traffic
has been “much higher and accel-
erating quickly.”
But Knoepler also said he be-
lieves strong social-distancing
policies could lead to an immi-
nent decline.
“What we are seeing now is a
result of delaying the social dis-
tancing until 1-2 weeks ago,” he
said. “I am hopeful that in anoth-
er week we will see some leveling
off.”
‘A military operation’
In the beginning of March,
when the coronavirus had
touched only this state, Chief Jo-
seph Sanford stood in the middle
of Central Way and Lake Street,
Kirkland’s busiest intersection,
and took a picture in each of four
directions. No cars. The city was
in panic. Sanford was attending
multiple covid-19 task force meet-
ings per day and was managing a
swelling list of firefighters under
quarantine after potential expo-
sure to virus-carrying patients.
People were dying, and the
spread of the virus was both inevi-
table and terrifying.
To day, while traffic has re-
sumed at a tempered pace, the
chief and his counterparts in local
government have begun to take
stock of what worked, and what
they might pass on to other com-
munities. New York, with its pop-
ulation density, is an outlier, but
fire and EMS leaders from com-
munities like Aspen, Colo.; Roch-
ester, Minn.; and Ta os, N.M.; call
several times per day seeking ad-
vice on how to respond to a virus
just beginning to make an impact
on those communities.
Sanford is an especially good
person to ask: Out of 95 EMS
personnel, just one has tested
positive for covid-19, despite Kirk-
land officials having no expecta-
tion of encountering the especial-
ly contagious virus in this subur-
ban enclave east of Seattle.
Rather than enter a potentially
infected nursing home, Kirkland
first responders asked staff to
bring patients out into the fresh
air to reduce risk.
They stripped the back of the
ambulance of unnecessary equip-
ment and separated the front and
back compartments with thick
transparent plastic shields, to
speed up the decontaminationprocess. They used electrostatic
foggers to lay down disinfectant
in big coats. The tweaks took the
cleaning process from 40 minutes
to five.
“There was no example to fol-
low,” S anford said. “We were first.”
EvergreenHealth officials this
week have been drafting a release
on best practices, to be released
late this week, in an effort to
educate hospitals around the
country on what worked in Kirk-
land. A spokesperson for Ever-
greenHealth said the h ospital was
uniquely positioned to deal with
an infectious disease outbreak,
owing to its s tatus as one of Wash-
ington’s highest-rated hospitals
and t he presence o f Francis R iedo,
the hospital’s Johns Hopkins-
schooled and CDC-trained medi-
cal director of infection control.
Their cheatsheet for hospitals
will include a host of procedural
items a nd a few examples of social
engineering. For example, Ever-
greenHealth advises the s trongest
feasible limits on visitors at the
outset — banning them — until
the situation allows for family
members t o safely enter the hospi-
tal. That way, the hospital never
has to walk back less-stringent
policies.
“The other thing we learned
right away was how much you
have to communicate and how
much you have to be present,”
To mlin said, noting that people
need to hear a consistent voice of
leadership. “It does begin to feel
very much like a military opera-
tion in terms o f logistics and o per-
ations and communications.”‘Unseen enemy’
While the medical community
continues to urge caution, many
Kirkland residents have begun to
look beyond the virus to the loom-
ing economic threat to the 6,small businesses that call the city
home. Those concerns multiplied
this week as a recommended shut-
down of “nonessential” business-
es became a mandated one, Inslee
threatening potential police ac-
tion should businesses defy it.
The clash playing out here —
between economic forces and
medical concerns — l ies ahead for
thousands of American commu-
nities that lag weeks behind Kirk-
land in their coronavirus time-
lines. It also mirrors the debate
happening inside the White
House, a s President Trump has set
Easter as a target for the United
States to — in his words — “have
the country opened up and raring
to go.” This is a projection that
defies expert medical projections
on his own coronavirus task f orce,
but echoes sentiments swirling
from coast to coast that t he nation
might not be able weather societal
shutdown f or an extended period.
Although new covid-19 cases
have plateaued locally in the Kirk-
land area, Mayor Penny Sweet
said she is getting an influx of
requests for economic assistance,
as business owners b egin to calcu-
late how long they can last with-
out revenue.
“What has not slowed down for
me is the deluge of calls and emails
I’m getting from community
members who are panicked about
the e conomics o f it all,” S weet s aid.
“I’m glad the governor made the
call to shut the state down, but I
got a lot of calls today saying
they’re picking winners and los-
ers, and small businesses will be
the losers unless we take action.“The really scary consequences
are yet to happen.”
Seeing no clear path to solven-
cy, Scott Holm, owner of Chain-
line Brewing in Kirkland, is one of
many who have written to Sweet
for help. Like others who have
contacted the mayor this month,
he asked for an order similar to
the one just issued in Seattle man-
dating a moratorium on commer-
cial evictions. All the city could
offer came Wednesday afternoon
in the form of a link on the Cham-
ber of Commerce website to apply
for seed money from Google, a
$250,000 relief fund.
“The fund is pretty much small
potatoes compared to what peo-
ple really need,” Sweet said. “But
it’s a start. It’s not going to pay
anybody’s rent.”
The best-selling beer at Chain-
line is Tune Up IPA. It, along with
the six-year-old company’s name
and several of its beers, is a nod to
Holm’s previous career in bicycle
sales. His “pride and joy,” though,
is the “Polaris Pilsner,” w hich won
a silver medal at the 2016 Great
American Beer Festival.
He’s not bottling any more for
the time being, and he’s moving
what stock he has out the door as
soon as possible, because while
the state allows him to sell the
beer during the shutdown, he
can’t serve it in the taproom.
Holm, 42, said he has had to lay off
most of his staff during the out-
break as he prepares to pay two
rents: One for the current brew-
ery, soon to be demolished to
make room for Google’s expand-
ing campus, and the other for thenew location, still being fitted.
“We could last a few weeks into
the shutdown,” Holm said. “We
could sell through the inventory
we have, assuming the landlord
doesn’t evict us. Then we’re done.
Like many small businesses, we’re
leveraging quite a bit, and our
house is our collateral. So if this
business fails, we lose the house.
That’s the reality.”
Making matters worse, Scott’s
wife, Michelle, is an ER physician
at EvergreenHealth.
Scott is now watching their
6-year-old son, Cade, because
schools are closed and none of
their friends and family in the
neighborhood will pitch in, fear-
ing Michelle could be exposed to
the virus at work.
“They try to be nice about it,
but ultimately nobody wants to be
around her or me or our son,
because of this unseen enemy,” he
said.
A resistance among some small
business owners was evident in
the city’s busy shopping district
the day Inslee put out the man-
date as some stores remained
open, including a massage spa.
Daniel O’Malley defended his
decision to keep open Epicurean
Edge, a specialty knife store, as a
necessity to avoid layoffs.
“I think that this is such a big
thing for everyone that emotion-
ally it’s important to keep things
moving as much as we can while
being safe,” O’Malley said.
Kellie Stickney, the city’s com-
munications manager, said the
desire to get back to normal is
misguided. “It’s becoming very
difficult to convince people that
we are not out of this thing yet,”
she said. “We don’t see disasters
here. We d on’t s ee tornadoes, hur-
ricanes, earthquakes. The most
people get here is a lot of snow, so
it’s hard for people to understand
what it is to be in disaster mode.”
Holm understands the medical
necessity for Inslee’s order, but it
doesn’t make it any less devastat-
ing. To add insult to injury,
friends on social media with pay-
ing jobs during the shutdown ap-
pear to be treating the days off as
“one big vacation.”
“Their main concern right now
is boredom from being forced to
stay h ome, which I just can’t q uite
square,” Holm says.
The virus chews up his busi-
ness by day, a nd in the evenings, it
chews up his wife. Most nights
she comes home in street clothes,
having left her scrubs at the hos-
pital, part of her new routine.
Cade, who is learning to write,
leaves illustrated notes for her
arrival: “I love you mommy.” She
clings to order and cleanliness in
the home, Scott says, as a means of
coping with shifting hours and a
deadly disease at work.
Though hopeful that this will
pass, that Kirkland will return to
normalcy before too long, he is
trying to stave off bankruptcy
while dealing with stress, anxiety
and uncertainty.
“Some of us are fighting for our
lives,” Holm said. “I don’t see a
clear path forward.”
[email protected]In Washington state where U.S. outbreak started, there’s ‘a glimmer of hope’
JOVELLE TAMAYO FOR THE WASHINGTON POST
Scott Holm, center, founder of Chainline Brewing in Kirkland, Wash., speaks with taproom manager Jake Hoveland on Thursday. Holm,
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