Childhood Vaccines

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We are already experiencing a pandemic. We can’t afford to experience a vaccine-preventable outbreak too.

If you’re like me, you’ve skipped your yearly wellness exam and dental cleaning due to COVID-19. Most of us will not suffer any long-term consequences from putting off these routine healthcare visits, but young children face additional risks that most of us older folks don’t have to worry about.

(REMEMBER! If you’re feeling unwell, call your doctor! Serious health conditions don’t stop during a pandemic. Don’t put it off! Hospitals have protocols in place to keep you safe.)

Children are blank slates, capable of learning anything, but also susceptible to a lot of diseases that are vaccine preventable, some of which can be devastating. In March, many healthcare clinics shuttered their doors to save personal protective equipment for hospitals dealing with COVID-19 patients. As a result, the CDC has noticed a sizeable reduction in the number of vaccinations given to children. This leaves children vulnerable to new disease outbreaks, especially as social distancing measures begin to relax.

The Washington State Department of Health reported in a May 8 news release that providers in the state vaccine program administered 30% fewer vaccines in March of this year compared to previous years. “In April, preliminarily we are seeing a 42% decrease,” DOH said in the statement.  

While we deal with this pandemic, the last thing we need is an outbreak of a vaccine-preventable illness, like measles, whooping cough, or rotavirus.

For a while, it may have been difficult for parents or guardians to schedule immunization appointments for their children. Amie Tidrington, Correctional Health Manager with Skagit County Public Health, spent nearly 18 years as the Immunization Clinic Coordinator, overseeing vaccination clinics for children and adults. She knows first-hand how important vaccinations are to a child’s health, and also experienced the difficulty in scheduling an appointment for an infant.

Amie’s infant granddaughter was due for her six-month appointment and immunizations at the end of March, but due to COVID-19, the appointment was cancelled. Her daughter waited a few weeks and called to make an appointment, only to be turned down. A few weeks later, Amie called to make the appointment for her granddaughter, and, again, was turned down.

“I was bothered by it because if you’re not going to vaccinate because of COVID-19, those other diseases still exist. We’re just going to have another outbreak like meningitis or measles,” she said. “We risk an outbreak of childhood diseases that can be very serious.”

Amie’s granddaughter was finally able to get vaccinated at the beginning of May. The DOH is asking providers to prioritize newborn care and vaccination of infants and children up to age 24 months if possible.

“Even in these days, when COVID is the priority on everyone’s mind,” it’s still important to vaccinate children, Amie believes. “If we don’t keep the vaccination rates up, other diseases will use this as an opportunity to come back in our lives. We don’t have the capacity to deal with that, nor do we want our children to suffer through what are preventable diseases.”

If your child is overdue for immunizations, call your child’s healthcare provider and make an appointment. Hospitals and clinics are taking extra measures to keep patients safe from COVID-19.

There’s a lot of information out there about immunizations. Here are some reliable sources:


Don’t delay your healthcare: a message from Connie Davis, MD

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Health Care is a Basic Need 

As always, pandemic or not, healthcare providers are keeping a watchful eye on our community. I must say, although people are following most advice, there is one thing that I have noticed from the front line; some people are waiting far too long and are arriving at our healthcare facility doors very late and very sick. 

People have told us they are avoiding coming to doctor’s offices, urgent care clinics and emergency departments. I have seen patients and heard stories of people delaying their concerns about chest pain, then finally arriving at the hospital with very serious heart attacks that could have been prevented by coming in earlier. Patients have tolerated abdominal pain and come in with a hole in their appendix after it ruptured and now requires prolonged surgery. Likewise, I know of a pregnant woman who developed a medical issue and showed up late for fear of catching COVID-19 in the hospital. And I have heard from other physicians that people are not going for their important blood thinner testing. I am afraid people are putting themselves at risk because of COVID-19 fear.

Clinic Spaces are Kept Safe

I and my fellow healthcare providers want to make sure you know we are keeping our spaces safe. We screen all people coming into our clinics and hospitals, we offer telemedicine visits you can join from home, we stood up Acute Respiratory Clinics to keep people with symptoms separate from those without, we boosted our already strict cleaning procedures to be super clean and designed separate areas in our hospitals to care for those with COVID-19. We are a safe place to come when you need care. 

My ask is that you call us, use the telemedicine options to connect for regular appointments and discuss the importance of maintaining your screening program (such as mammograms, blood testing, etc.) with your doctor. If you have a chronic illness, stay on the rhythm of appointments and tests as you normally would. If you are experiencing new or worse symptoms, you must quickly connect with your doctor, or go to urgent care or the hospital.  We want to make sure that you visit a healthcare provider for the same level of care you would expect at any other time.

I value the trust that you put in our teams to provide for your health and well-being.  You can trust us now, more than ever, with your care.

Connie Davis, MD

Chief Medical Officer

Skagit Regional Health

Connie Davis, MD
Skagit Regional Hospital


Fresh Air Exercise

Fresh air: Is it safe to exercise outside?

Reading Time: 3 minutes

By now, everyone knows Governor Inslee has extended Stay Home, Stay Healthy through May 4.  Non-essential workplaces and schools have closed. We are staying home and using social distancing when we need to venture out for staples like groceries.  But the Stay Home, Stay Healthy order does not ban all outdoor activities. We know getting exercise and fresh air is healthy—strengthening our bodies and brightening our moods. But how do you safely exercise outside in Skagit County?

Physical Distancing

First, it is important to maintain social distancing, also called “physical distancing.” This means keeping space between yourself and other people outside of your household. As you have surely heard, you should stay at least 6 feet away from other people, avoid gathering in groups, and do your best to stay out of crowded places.

Source: https://www.nrpa.org/about-national-recreation-and-park-association/press-room/NRPA-statement-on-using-parks-and-open-space-while-maintaining-social-distancing/

We are lucky to live in Skagit. Our county is filled with true gems – open space, walking trails, and great parks.  But before you go out, you should be aware that some parks are closed or partially closed.  At this time, Skagit County parks are open for hiking. Again a reminder – when hiking, make sure that there is space for social distancing. Picnic shelters, sports courts, play structures, and other facilities at all Skagit County parks are closed.

Brian Adams, the Skagit County Parks and Recreation Director has the following advice for Skagit County residents looking to get outside:

  • A good option for a walk or a hike is a park or a trail within walking distance from your home.
  • If you don’t have a park nearby, you should consider walking on your neighborhood streets and sidewalks.
  • If that is not an option, Adams recommends you visit some of our large open spaces where you can see people approaching in advance and be prepared to maintain social distancing
  • If  people do drive to trails or parks, they should avoid stops or using restrooms in order to minimize physical contact during your trip.

Adams said that Skagit County residents seem to be doing a good job so far:  “Most people, more than 90% are complying with the closures.  From what I’m seeing people are doing a good job.”

Adams said they haven’t seen large crowds yet at any county parks, but that traffic at some popular trails is more in line with July than the usual April traffic. “The kind of things you see in on the news with crowds and problems in more urban areas like Seattle’s Green Lake — Skagit County hasn’t experienced anything like that,” Adams said.

Here are some outside dos and don’ts to stay safe and prevent the spread of COVID-19

DO

  • Prepare before you visit: confirm park is open, including bathroom facilities, bring anything you need with you
  • Visit parks and trails that are close to your home
  • Stay at least 6 feet away from others (“social distancing”) 

DON’T

  • Don’t visit parks if you are sick or were recently exposed to COVID-19
  • Don’t visit crowded parks
  • Don’t use playgrounds
  • Don’t participate in organized activities or sports

Source: https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/visitors.html

One other important piece of staying safe is avoiding injuries while you are outside.  Our hospitals and first responders are under increased pressure. It is up to us to preserve these limited resources for those most in need. And now is not the time that you want to go to the Emergency Department! That means don’t try out your child’s hover board or tear down the mountain on a bicycle that you have not ridden for years.  Be sure to follow common sense safety procedures — bring extra water on a hike, wear your bike helmet, obey rules of the road, and tell someone where you’re going and when you expect to be back.

In short, outdoor exercise, when following these dos and don’ts, keeps you safe and healthy. Fresh air can ward off cabin fever and brighten your day. Just be safe out there!


Important Message COVID-19

Recovered from COVID-19 – Important Message

Reading Time: 5 minutes

A very important message from the first Skagitonian diagnosed with coronavirus.

In life, we generally want to be first. Get that gold medal, be the valedictorian, hold the world record. Like most of us, Susanne had never been first before. Until March 10, 2020.

Susanne, 49, is a recent transplant to Skagit County, having moved here from Enumclaw in January. She decided to live fulltime in her 37-foot-long RV with her rescue dog. On March 10th, Susanne became the first person in Skagit County to be diagnosed with COVID-19.

She began feeling symptoms on Saturday, Feb. 22nd. It’s just allergies, she thought. She’d been through this every year and this time didn’t feel any different. This was weeks before Governor Jay Inslee announced the “Stay Home, Stay Healthy” order and things started shutting down. Weeks before most people began taking the pandemic seriously. Susanne continued to live her normal life, as we all did. Her story could be any one of ours.

As an avid square dancer, she drove south for a square dancing lesson, followed by a square dance. “I felt crappy enough that when I got halfway down to Lynnwood, I thought that if I have a fever when I get down there, I’m going home. If I don’t, I’ll toughen up,” she says. “I didn’t have a fever.”

“I was really sick the next day. The dog was really concerned about me. I didn’t want to get out of bed, I was getting dehydrated,” she says, crediting the dog with making sure she drank and ate. “But by Monday morning, I felt fine.”

On Tuesday, she went down to her 81-year-old mother’s house in Enumclaw and was cleaning stuff out. Luckily, her mom wasn’t there. On the way back, she ran errands, making stops at several stores, as we all used to do before the outbreak. She had contact with many people along the way.

“I had a long day and my allergies were really flaring,” she says. “At that point, I realized that I’m not going to manage to make dinner, so I stopped at a drive thru and picked something up.”

She was looking forward to a square dance coming up on Sadie Hawkins day, February 29th. As a lifelong allergy sufferer, she knew the feeling of her allergies working their way into her chest, causing pneumonia. She thought, with some rest, in a few days she’d be better.

“At this point, I’m like 99.9% sure that I’m not contagious. It’s just allergies,” she says. “There was no fever, all the drainage was clear. That’s an allergy, not an infection.”

However, she thought she better not go to the dance. Plus, “nobody wants to be around mucus girl!” she joked.

By March 2nd, she could hardly get out of bed. She certainly couldn’t make anything to eat. She didn’t even feel like making herself tea, so she picked up a few iced teas at a drive thru to keep herself hydrated. At 11:15pm, she got back to her RV site and checked her email. Sitting in her car, she read the news. One of her square dancing friends had been hospitalized and died. He had been diagnosed with COVID-19.

She knew she had to get tested. She drove to Overlake Hospital in Bellevue, arriving at 1:08 am, March 3rd, less than two hours after she found out about her friend.

“I drove south because they had people down there who had [COVID-19], so they would be prepared. And they were,” she says. Hospital staff immediately handed her a mask and placed her in a negative pressure room. While she waited to be seen, she turned on the TV.

“I don’t normally watch TV, but in like 5 minutes, I was concerned that I had been out in public and giving this to other people,” she says. “Just five minutes of TV and I was like … ‘Holy crap, no wonder people are freaking out.’ I shut it off.”

They took a chest x-ray and tested for non-COVID-19 respiratory viruses. The results came back quickly – all negative. The x-ray revealed what she already knew – bilateral pneumonia.

But still, she had no fever so she didn’t quite fit the COVID-19 testing criteria at that point in time.

“My symptoms weren’t what we were hearing,” she says. All of her square dancing friends who ended up testing positive had different symptoms, “and none of them were what you had to have to get a COVID-19 test. The one thing we had in common was that there was a time when we all were feeling better so we went out and did things. And then we crashed harder.”

Knowing she had been exposed and a friend had died from COVID-19, hospital staff decided to test her. She was told the results would be available in 24-48 hours. They gave her a box of masks to wear in public and sent her home.

Other friends were also tested on March 3rd and their results were in by March 6th. Of five friends tested, four came back positive, but Susanne was still waiting on her test. On Sunday, March 8th, she got a call from Skagit County Public Health, which had also been waiting to receive her test results. There had been problems processing her test. So Public Health arranged with Skagit Valley Hospital to have her retested early the next morning.

Approximately 24 hours after the retest, she got the call she was dreading. She had COVID-19. She spent the next hour and a half telling Public Health every place she’d been in the last 30 days. Fortunately, she lets her GPS run and it keeps track down to the minute.

Susanne spent the following two weeks in isolation. Once cleared by Public Health, she went out to enjoy some fresh air. From about 30 yards away, she had her first physical conversation with someone in weeks. She asked a man how he was doing, and his response left her astonished:

“Fine, not really doing anything because of this COVID-19. I think it’s a hoax. I don’t know anybody who had it or died from it,” Susanne recalled.

“Well, I’ve had friends die from it,” she responded. “And, hi! I just got out of isolation today!”

Later that day, while doing five-and-a-half weeks of laundry at the laundromat, she had a nearly identical conversation with a woman there.

“How are there still people who don’t think this is a thing?” she wonders. “They’re still denying it. That was kind of horrifying to me.”

She wants everyone to know that they can get this disease, even young people and those who do not have underlying health conditions that make them more susceptible to deadly complications.

“You’re not immune, you’re not special. You can still get it and you can still spread it,” she says.

She has hope for the future and is confident that with accurate, scientific information, the community will come through this.

“Life is never going to be quite the same. We’re going to be aware of things we weren’t aware of before,” she believes. “And that’s a good thing. Knowledge and growth are a good thing. “


Steve saved lives.

Recovered from COVID-19

Reading Time: 3 minutes

One man’s struggle through coronavirus


Steve woke up one day and just didn’t feel right (Steve isn’t his actual name in order to protect confidentiality). He had a bit of a fever and felt rundown in general. He recently went through a divorce and had been drinking. He thought it might just be withdrawal symptoms. But, just in case, he made a trip to Skagit Regional Health.

He had a fever of over 100 degrees and a cough. Hospital staff tested him for COVID-19 in a tent set up outside the hospital. His blood pressure and temperature were elevated. He had nausea and a headache. A doctor put a stethoscope to his chest and Steve coughed. The next thing he knew, his test results for coronavirus came back positive.

“I’ve been travelling so much, it’s really a tough call,” Steve said, regarding where he may have picked up the virus. “I stayed in a lot of hotels, so whoever had been there before, depending on how well it was cleaned, or it could have been food I picked up at the grocery story. There’s just a lot we don’t know about the virus.”

In 2015, Steve had a stint placed in his heart, putting him at higher risk of complications from COVID-19. At the same time as his COVID-19 diagnosis, he was diagnosed with MRSA, another potentially life-threatening infection. He spent about a week and a half in the hospital fighting off both diseases. At least five of those days were in total isolation.

“Everyone in the hospital was wearing state-of-the-art protection equipment,” he said. They had sealed facemasks with ventilation so their masks wouldn’t steam. I could hear the motors running. For the most part, I saw spacemen and women. You see that kind of stuff and you think, ‘Wow, this is pretty serious.’ You don’t normally see your nurses and doctors looking like they’re walking on the moon.”

Steve grew up in Washington. These years here included the best of his life. So, after his divorce he returned from out of state back here to a place of good memories with hopes for a brighter future. He hasn’t yet found a permanent place to live, so once he was well enough to be discharged from the hospital, Skagit County Public Health provided him a hotel room. This temporary housing allowing Steve to remain isolated from others until he had fully recovered and could no longer spread the virus to others.

“There’s not much to do in 20 feet of space,” he said. “When I get sad or lonesome, I get online or talk to friends or family on the phone and they’re sad and lonesome too. And I watch TV. What else are you going to do?”

When I spoke with him, Steve was preparing to leave the hotel the next day. He had been cleared by Skagit County Public Health nurses. He spoke highly of the hotel staff and Public Health nurses who have been working with him over the last two weeks. They picked up prescriptions for him and ensured that he had meals delivered daily.

He’ll be heading back into his small community soon, which seemed a ghost town to him before his hospitalization.

“They shut down all the restaurants and bars. They shut down just about every public facility except for grocery stores,” he said. “I just pray and feel for all my friends who are suffering and have lost their jobs.”

Watching the news, he feels some stories are sensationalized for ratings, but he wants people to know that this outbreak should be taken seriously and that it is not a hoax or conspiracy.

“There are death tolls,” he said. “People are dying. People are very sick. There are people on death’s door. I’ve seen them. I’ve seen the hospital. I’ve seen people walking around in space suits. This is not a hoax. That is absolutely ridiculous.”

For now, Steve is just happy to be healthy and out of isolation.

“Today was the first day I got to go outside and felt sunshine on myself,” Steve said. “I feel great. I can breathe. I don’t have a headache. I don’t feel nauseous, I don’t have a fever. It was so nice to just walk outside.”

He hopes that this national crisis will help people forget their politics and come together.

“As much as people can connect with each other, that’s gonna help beat this thing,” he said.


Tiffany's "home". She Sleeps in the driver's seat while her fiance sleeps in the back.

Homeless in the Time of COVID-19

Reading Time: 3 minutes Reading Time: 3 minutes

For the first time in a year and five months, Tiffany Holien has a bed to sleep in and a private bathroom. She’s not sleeping upright in her truck or on a mat at the cold weather shelter, just feet from someone else, without access to a shower and with no privacy.

Tiffany lost her housing in November 2018, less than two months after she lost her mother to heart disease. With just her own income, she was no longer able to pay rent and began living in her truck with her cat. Ever since then, she’s been homeless.

But almost two weeks ago, an opportunity for housing opened up, even if it’s only temporary. Tiffany now has a motel room. She can finally sleep lying down. It’s one bright spot during a global outbreak that has killed tens of thousands.

“If I was living in my truck, I’d probably already be gone,” Tiffany said. “Because I’d be around other people all the time.

During the COVID-19 outbreak, grant funds from the state Department of Commerce is enabling Skagit County to pay for motel vouchers for people experiencing homelessness who are a high risk of complications from COVID-19, including those over age 60, and those with underlying health conditions. Tiffany, at age 39, falls into the second category.

In fact, she was just in the hospital in mid-March. Tiffany’s fiancé, who lived with her in her truck, took her to the ER when she became ill to the point of deliriousness. It wasn’t COVID-19, it was pneumonia. And while she’s on her way to recovery, some days just walking about her room is difficult.

“I know that my immune system just got beat to hell. Staying in the motel, I don’t have to worry about that as much. In my truck, the basic foot traffic downtown could take me out. All it takes is one person walking by me coughing and I’m doomed, she said.

Currently, Tiffany and her fiancé are leaving their motel room only for necessities, such as grocery shopping or going to the food bank. Tiffany knows that she has this motel room only because of the outbreak. Even with an influx of state and federal money, there’s only enough funds to cover about 50 motel rooms through April. The need far exceeds this capacity. There are dozens of Skagit County residents left outside in the cold with no ability to “Stay Home, Stay Healthy.”

“It’s bittersweet,” she said. “It’s great that we’re being put into motel rooms so we have a place to sleep and stay warm and everything, but it’s a bitter pill to take that it takes people dying to get this for us. While we’re appreciative of this, we also feel guilty because we’re getting something at the cost of other people’s lives. We watch the news and we feel relief, yet are bothered that people are dying in order to get us these motel rooms.”

Tiffany

Those of us with a roof over our head, well, we might feel frustrated about being told not to leave our home except for essential activities. We’re just so bored! And it’s spring and we want to go out and have fun! But we have to remember there are people, like Tiffany, who are grateful to have a small room they can’t leave, a warm bed to sleep in, and a sink to frequently their wash hands. Because it wasn’t that long ago that she didn’t have these things, and she knows that, for her, it’s only temporary. And then she’ll be back to living in her truck, wishing she had a home to be safe in.

Want to Help?

If you are in a position to help others in dire housing situations, considering donating to:


Social Distancing: People with Developmental Disabilities

Reading Time: 3 minutes Reading Time: 3 minutes

Answers for people with developmental disabilities – as well as a call for us to be there for our neighbors

We are staying home and staying safe to protect our loved ones and our neighbors throughout Skagit. We know our seniors are at high risk for COVID-19. We worry about elders when they are isolated at home, and worry about them when they live in group settings. But often our neighbors with developmental disabilities are overlooked.

Many people with developmental disabilities have medical conditions that put them at higher risk from COVID-19. Much like seniors, they may now live somewhat isolated at home or in group housing which can increase physical contact with others. Children and adults with developmental disabilities rely heavily on caregivers and service agencies in their day-to-day lives. Key in-person support has been disrupted during this time of social distancing.

People with developmental disabilities have jobs and enjoy social activities. But employers are closing, group homes can no longer accept visitors, and community events have been cancelled. The resulting isolation can create creates loneliness, depression, and anxiety.  Many adult children have long and proudly lived on their own. Now COVID-19 forces them to move back into their parents’ homes to stay safe.

So, what can be done? Know a family in your neighborhood who has a child with a developmental disability? Reach out by phone, text, email or more than 6 feet away. See if they need anything. Check out local group homes and give the agency a call to see if there are ways you can support their residents. There’s been a burst of creativity in Skagit over the past weeks as we all learn to socialize in different ways. Let’s see if we can spark that creativity to keep this group of people connected!

One example of a creative idea is #PandemicPals, created by Rex Huppke of the Chicago Tribune. #PandemicPals is a way for people to reach out  through social media. Rex created an example you can just copy and paste into their social media page to start these conversations:

“I’m worried about seniors and people with disabilities feeling isolated because of coronavirus restrictions. If you know someone feeling that way, I’m happy to call or write that person. Message or email me at (YOUR EMAIL ADDRESS) and let’s set something up! #PandemicPals.”

The idea of #PandemicPals is to break down the isolation caused by COVID-19. We can all think of someone in our lives who is lonely.  It’s an easy way to connect with those people in need.

If you have family members with developmental disabilities at home, there are a lot of creative, engaging ways to maintain connection. Below is a list of a few:

  • The Mighty, a website for individuals with disabilities, is hosting daily interactive online activities plus a blog to share how people are dealing with the COVID-19 outbreak. Check out: https://themighty.com/ 
  • The Arc of King County has:
    • Two online art group meetings, one for young adults and one for adults
    • Coffee Hour for Parents to give some support to parents struggling with COVID impacts
    •  A phone buddy system if you’re experiencing loneliness and want to talk with someone. Just call (206) 829-7053 or email at ask@arcofkingcounty.org  

In Skagit, Heather Milliren serves as the county’s Parent to Parent Coordinator. Heather has her finger on the pulse of families in our community. Overall, families are adapting to these strange times. But their most common concern is how to access the resources needed to provide care to their loved ones. Heather wants to emphasize, “The good news is that most parents of individuals with developmental disabilities and/or complex healthcare needs are amazingly RESILIENT. We have to be since our loved ones are counting on us to be advocates for their needs every single day.”

Let’s see what the rest of us can do to support families of people with developmental disabilities. Let’s show them Skagit will do what we can to help them during this trying time.