Expecting a surge of patients suffering from severe cases of COVID-19, the disease caused by the novel coronavirus, state and federal officials are trying to marshal emergency resources and supplies to Washington state.
The state could soon have up to 1,000 additional emergency hospital beds supplied by the federal government, Gov. Jay Inslee said Tuesday afternoon. State officials also are trying to stock up on essential medical gear like masks, gloves and ventilators from new sources. And health care centers are beginning to open new drive-through testing centers for the public, widely seen as one of the most effective means to understanding the outbreak’s scope here.
More than 1,000 people have tested positive for the virus in Washington state, and 55 people have died as of Tuesday afternoon.
Meanwhile, hospital systems report that testing of their own employees indicates the virus has infected more than two dozen workers, a sign of further stress on the medical system, and a concern that could constrain its ability to deliver service and respond to the crisis.
Eighteen UW Medicine employees have been infected, testing shows, according to a spokeswoman for the hospital system. Eight EvergreenHealth employees have tested positive for the virus, according to the hospital system.
The positive tests highlight a critical challenge for health care administrators as they struggle to keep employees healthy amid an outbreak that could reach them not only at their workplace at the spearpoint of the crisis, but also at home with their families or during routine activities, like grocery shopping or commuting.
More beds, $200 million in state aid
Some area hospitals were running near capacity before the outbreak, and an expected influx of COVID-19 patients has top officials searching for additional capacity.
A U.S. government program known as the Federal Medical Station will provide the 1,000 emergency hospital beds Inslee said will soon be available, Washington Military Department spokeswoman Karina Shagren said. The U.S. Department of Health and Human Services (HHS) runs the program.
Shagren said Washington state National Guard members who were in Yakima on a prescheduled drill last weekend helped unload some of that equipment, which contained supplies for 250 of the 1,000 emergency beds, according to Shagren.
Inslee on Tuesday also said he has spoken with the U.S. Secretary of Defense about additional help, fearing a surge of patients.
“They have a variety of resources to use to stand up medical hospitals,” Inslee said, adding later: “And I would predict that we’ll be getting some real help from the Department of Defense. And that will be necessary.”
Inslee’s remarks came after the governor signed a bill into law that authorizes using $200 million in state budget reserves to fund the state’s response. Most of that money will go to help state and local health offices.
Meanwhile, to stock up on badly needed medical equipment, Inslee said the state is looking to acquire more ventilators and other medical gear through the private market.
“We are in the midst of procuring a whole host of medical equipment, from ventilators to masks to gloves,” he said.
In related developments, the governor said Tuesday that President Donald Trump has agreed to change how medical equipment distribution is prioritized from the federal stockpiles.
Previously, that medical gear – such as protective masks and gloves for health care workers – was given to states based on their population, Inslee said.
But the change will help prioritize Washington and its severe COVID-19 outbreak, Inslee, said, which will help the state replenish its stockpile for masks and gloves.
Health care workers test positive
Front-line health care workers are at greater risk of contracting COVID-19.
More than 2,000 workers in Wuhan, China, became sickened by the virus, according to a report from the World Health Organization, and most became ill early in the outbreak when supplies were low and when the disease was less understood. Some workers likely contracted the virus outside of work, too.
In the U.S., “we are dependent on our health care workforce,” said Julie Fischer, an associate research professor in the Department of Microbiology and Immunology at Georgetown University Medical Center. “They’re our scarcest commodities.”
That’s why it’s so important to limit the virus’ spread in health care communities and why many health care facilities have prioritized testing for employees.
Susan Gregg, a UW Medicine spokeswoman, said on Tuesday that the healthcare system had tested about 700 employees, and 18 positive cases had been found.
EvergreenHealth said in a statement that eight employees have tested positive for COVID-19. A total of 139 employees had been tested as of March 17 and 28 tests were pending.
The Seattle Times reported Sunday that an emergency department doctor in his 40s at EvergreenHealth Kirkland had been diagnosed with COVID-19 and was in critical condition.
At Overlake Medical Center system, “no one has tested positive,” said Morgan Brice, a spokeswoman.
A Swedish Medical Center spokeswoman said the hospital system could not comment on whether Swedish hospital workers had tested positive for COVID-19.
Anne Piazza, of the Washington State Nurses Association, said reports of more positive tests of nurses were concerning.
“We are anticipating a surge, we need every one of our nurses to be protected, so they can continue to work safely,” Piazza said.
Some workers frustrated over testing
Access to testing has become a frustration to some area health care workers.
Two health care workers at EvergreenHealth told The Seattle Times they felt they had to fib about symptoms to get tested. Both workers said they did not want to be named because they feared reprisals from EvergreenHealth, which sent staffers an email March 9 telling them not to speak with the media.
“I had a cough. I had a headache. They told me I had a head cold and I couldn’t get tested. They told me I didn’t qualify,” said one of the health care workers, who reported working with COVID-19 patients. “I called back and said I had a temperature, and that’s when they first agreed to test me.“
About a week after the onset of symptoms and days after a test, the worker said the test came back positive.
“I feel like I was gaslighted and unsupported in just trying to get a test,” the worker said, adding that the criteria for testing was too rigid.
“If you don’t fit in this box, we’re not going to test you. This virus is not a box, and I’m fearful that some people are going to die as a result.”
A second EvergreenHealth worker said she and other colleagues also fibbed to get tested when they didn’t have a fever, but were experiencing other symptoms.
“… Our response has continued to adapt to and be flexible with new information, including recommendations for screening and who ought to be tested,” EvergreenHealth said in a statement.
A March 11 hospital system guidance says health care workers with symptoms including new fever, cough, shortness of breath, sore throat and diarrhea should be referred for COVID-19 testing after receiving clinical evaluation and flu testing.
The first health care worker, who reported testing positive, said the initial days of scrambling to react as patients from the Life Care Center of Kirkland flooded into EvergreenHealth left some employees at risk of infection.
“I saw chaos, and it was a controlled chaos. But, what you saw was everyone being very overwhelmed,” said the worker, adding that many procedures could aerosolize the viral pathogens. “I had a feeling, at some point I was going to get exposed.”
About a week after the onset of symptoms, and several days after receiving a test, the worker said the test came back positive.
Having COVID-19 has felt “like 10 different flus combined, hitting your body,” the worker said.
The second health care worker who spoke with The Times said she worked with the first two patients diagnosed with COVID-19 at EvergreenHealth. She said Evergreen staffers likely exposed to the virus around the time of the outbreak’s discovery were not given clear guidance from administrators.
“I found out they were COVID positive on Friday night. I found out through word of mouth, not officially through the hospital,” the health care worker said, referring to the first two patients. The worker said she prepared to go into quarantine for 14 days, which was the Centers for Disease Control and Prevention advice at the time. Hours later, managers said as long as workers were asymptomatic, they could continue in their jobs.
“I was working. I was out in the community. And now, I’m showing symptoms,” she said.
EvergreenHealth said in a statement late Tuesday:
“As the first healthcare organization in the U.S. to test and provide care for COVID-19 positive patients, we have followed the immediate guidance provided by the CDC and local health authorities when available and sometimes led the way in setting standards alongside these expert partners, which were deemed as appropriate responses to our local situation. This included our response for quarantining staff.”
The hospital system added that it has adjusted policies after additional guidance.
The health care worker said EvergreenHealth top administrators had presented a rosy picture of what had happened in the early days of the outbreak to multiple media outlets, including The Seattle Times, but had not been sufficiently transparent with workers or the public.
“I’m scared to go back into work,” she said. “I’m looking forward to going back to work and to helping, but I want to feel safe when I’m doing that and I want to feel like I’m not just a number or a set of hands, that there’s consideration towards the fact that we’re people and we have families at home.”