Are playgrounds re-opening? What you need to know.

Reading Time: 3 minutes

I was scrolling through my social media newsfeed on a recent Saturday morning, when a particular post caught my eye: Mount Vernon playgrounds have re-opened. As a mom of a toddler who has been shut out of all playgrounds and splash-pads this summer, I nearly jumped for joy. My first thought was, “FINALLY! Shoes on! Let’s go!” … But then reality set in. Is it too soon? Is it safe? All the anxieties of the past six months flooded my brain and I spent the rest of the morning debating about our next move.

After quickly scoping out our nearest park, I decided that we would give it a try. My daughter couldn’t put her shoes on fast enough when I told her we could go. Before I knew it, we were walking up to her favorite twisty slide, and she looked back at me with reservation in her eyes. It felt so alien to be at a playground again, and even weirder to encourage her to climb onto the steps.  

All in all, it was a wonderful morning. She had a blast! But I was glad that I’d talked to my daughter about my expectations before we went, and about how we had to continue to be careful about keeping our distance when around others. Here are some things that I took into account before we left the house that may be helpful for you and your family.

Talk to your child about keeping their distance

Even though playgrounds may be reopening, we should be trying our best to keep a six-foot distance from others, and this can be really hard to accomplish between children at a playground! Talk to your child before you leave the house about what your expectations are, and even practice what six feet looks like. Discuss some things that your child can say if another child is getting too close, and reassure them that you will be there to help them.

Note: While you may be able to control what your own child is doing, it may be difficult to make sure other children are keeping their distance. Stay close to your child and discuss any concerns that you may have with the parents/caregivers of the other children at the playground (if it becomes problematic). If it is too difficult to keep distance, be prepared to leave.

Go during “non-peak” hours

Go to the playground when it isn’t busy, and leave (or take a snack break and come back) if it gets crowded. Though the park was empty when we arrived in mid-morning, within several minutes we were greeted by two other families. I think if we went again, I’d make a point to go earlier (since it was a sunny Saturday, after all) or maybe even a bit later in the afternoon. Keeping your distance—as mentioned above—is much easier to achieve if the playground isn’t crowded.

Take the usual health precautions

This is nothing new, but it is important to keep in mind regardless! Adults and children must wear masks when at the playground (exception being children younger than two  years old and those with health exemptions), and sanitize your hands often. Bring some hand sanitizer with you to have in your pocket, and talk to your child about avoiding touching their eyes, nose, and mouth.

Be sure to follow the signs!

Some parks may not have opened their restroom facilities yet, so make alternate plans for going to the restroom. If the facilities are open, be sure to wear your mask and try to avoid congregating in big crowds. When you are using the restroom families, take the opportunity to wash everyone’s hands! Hand sanitizer is great, but nothing beats good, old-fashioned soap and water.

Weigh the pros and cons

I had to wrestle with the pros and cons of going back to the playground and even made a few false starts before we actually made it there that morning. Even though being outdoors lowers the risks of infection, there are absolutely some risks associated with crowding and contaminated surfaces. In the end, I trust the benefits to our mental health outweigh the potential risks. That being said, I made sure to follow instructions on all posted signage, and practiced safe distancing and proper hygiene throughout our trip. I also don’t know if we will continue to go if the parks begin to get crowded. I guess I’ll make that judgment call when and if the time comes.  

Take care of yourself, and take care of others. Oh, and don’t forget the sunscreen!


Back to School: Create a Schedule that Works

Reading Time: 4 minutes

Along with Skagit school districts’ back-to-school reopening plans, each school has provided students with a schedule. While it is very important to become familiar with this academic schedule, it is also important to develop a schedule at home that will work for your student, as well as the rest of the household. Here are some ideas that may help bring a sense of clarity to your weekly routine. 

1. Compartmentalize your day

For anyone who’s been working from home the past several months, you have probably weighed the costs and benefits of compartmentalizing your day. When the work day bleeds into the work evening, then into the work weekend, it becomes really important to define your time—for your mental health, if nothing else.

The same holds true for your child! Create a routine in which your student gets up, gets dressed and has breakfast, then progresses into their school day. While it can be tempting, it is important to change out of pajamas (at least from time to time!) and put on some day-time clothing. Compartmentalize the day into natural chunks of time: morning classes, lunch, afternoon classes, and end-of-day. The late afternoon should include a period of free time to allow your child to decompress from the day and to wrap up their school work.

2. Take breaks and eat well

Along these same lines, be sure that your student takes breaks and sets aside a time to have lunch. It can be easy for kids to snack while they work, and to eat lunch at their study space. However, it is good for the mind and body to take a breather and spend some time in a different part of the house or outside.

For breaks, it may be helpful to take 15-20 minutes every few hours (or more often, for younger children). Be sure that your child knows that taking a moment to breathe, stretch, and come back to their work is extremely important (even adults need to do this!). If your child is really struggling with a project or assignment, encourage taking a quick break.

3. Get organized

It may be helpful to work with your child on reviewing their weekly academic calendar and any due dates that they may have for assignments. A planner (either paper or digital) could be a great tool for some students, while others may need something that is easily accessible and clearly visible. Just like in a school classroom, your child may find it helpful to have a whiteboard by their desk with a list of assignments, or even a large calendar with due dates clearly marked. This may also be a good thing for you, as the parent, since you can keep track of your child’s schedule from afar.

4. Get active…daily!

This is critical for your child’s physical and mental health. When the weather still permits, encourage your child to go outside to take a walk or bike ride. For younger kids, their local playground may be re-opening! Be sure to talk about keeping distance from others, even when outside, and wear a mask if in a more crowded area.

When the weather starts to turn chilly and/or rainy (or smoky), find some things to do indoors that get their blood flowing! Exercise and dance videos can be fun, and even stretching can be done in small spaces. Doing the same activities every day can get tiresome, so encourage your student to try different ways to get moving. And if you can, do it with them!

5. Encourage socialization

Your child might be excited to get back to school, even if it is remote and online. It may be the first time in a while that they have seen some of their friends and peers after a long COVID summer, and this re-engagement might be a seriously needed mood-booster. But don’t be surprised if by October your student is feeling burned out on online schooling. This kind of socialization might not be enough for many children, and it is okay to admit that!

When your child is feeling antsy or moody, encourage some socialization with friends. While it isn’t advised to schedule in-person meetups with large groups of friends, an occasional get-together between “besties” can be really good for your child’s mental health. Arrange a playdate outdoors for young children (being mindful of the 5-person per week limit), and for older students, maybe a study session outdoors? Take care to maintain social distancing and have your child wear a face covering. While it isn’t “school like usual” with the variety of opportunities to interact, a few social activities a month can go a long way to promote health and wellbeing.

6. Be flexible!

Expect the need to shake things up. A routine is awesome and a schedule is great, but sometimes things just don’t go as planned, and it is okay to modify it if necessary. There will be days that your student is rocking it and crossing off one assignment after another. However, there will also be days when PJs and a bubble bath are the most important thing. Both are okay. 

What we are asking of our youth right now is unprecedented, and we must always keep our children’s health at the forefront. If you ever feel like your child is struggling, connect with their teacher (or other school staff) and ask for some advice. You don’t need to take on these challenging times alone.


Back to School: Create A Space

Reading Time: 4 minutes

Well, folks … “COVID Summer” is almost officially in the rear-view mirror, and autumn is quickly approaching. Our local school districts have announced their fall re-opening plans, and families all around Skagit County are preparing for remote learning, at least for the foreseeable future. While these changes to normal life can feel intimidating, frustrating, and even emotional, we can take comfort in knowing that there are things we can do to support our at-home learners.

In order to help your student stay engaged this school year, there are several things to consider before school begins. Over the next few weeks, we will be posting about different topics that promote healthy, engaged, and effective learning environments for students, parents, and the family as a whole.

Today’s topic is all about SPACE!

In a typical school environment, students are given space: a desk, cubby, locker, or even a special place on a carpet. These spots are so important because it gives children a sense of belonging and purpose within their learning space. Now that students are doing the bulk (if not all) of their schooling at home, this personal space is even more crucial.

Here are some things to consider:

1. Type of Space

The type of space your child will need depends on their age. Young, elementary-age students will most likely need less structured space than an older child. Younger children will have a lot of questions, and may feel more comfortable being in a family space. While they will still need a table top for a tablet or laptop, much of their work could be completed on the dining room table (or even the floor!).

Older elementary school students and middle schoolers will require a desk with space for their laptop, as well as room for writing. These students will be required to log into virtual classrooms for longer periods of time, and may benefit from having their computer camera face a wall. That way, the student doesn’t need to be concerned about what is happening around them at home, and they can control what appears on the screen behind them.

High schoolers will need the most structured space, so a full-sized desk would be ideal. At this age, it may make sense to ask your high schooler about what type of environment would work best for them, and make a plan with their preferences in mind. For self-starters, maybe a desk in their room would work best. For social butterflies, perhaps having a space that still allows for controlled socialization would be the most effective.

2. Rotating/Flexible Space

Just like in a classroom setting, expect that your student will want to move around a bit. Elementary students are used to having different learning stations in the class, and middle and high schoolers move from room to room throughout the school day. It is okay—and even healthy—to allow for some movement at home. Maybe reading can be done on the couch, but all writing assignments should be done at the table. Maybe artwork can be done on the floor, and “class” can be moved outdoors on a beautiful, crisp autumn afternoon. Plan for some flexible learning space, and have expectations worked out with your children ahead of time.

3. Privacy and Limiting Distractions

There are so many distractions in our homes—TVs, toys, backyards, and soft couches for naps—so it is crucial to create a space that minimizes distractions and creates some privacy. For many, it may not be feasible to create an office space for each child, but there are some ways to get creative with space. An empty closet turned into a learning cubby, a strategically placed tri-fold on the dining room table, or a cute side table at the end of the hall can create “study stations” that feel purposeful—not thrown together—and keep distractions at bay.

For parents who aren’t able to be at home during the school day, talk to your students about cellphone usage during the day and make a plan about when (if at all) things like TV are allowed. Look into parental control options for TVs, smartphones, or tablets, if necessary.

3. Promote Health

Despite our best intentions, there is a good chance that our kids will end up doing a portion of their work from the couch, their bed, or sprawled out on the floor with their feet above their heads. When they are seated, try to make sure that their computer monitor and keyboard are at proper heights, and that the lighting won’t strain their eyes. Encourage your child to get up, stretch, and drink plenty of water during the day. All of these activities have been proven to help with information retention among youth.

4. Personalization

Your child may be feeling a bit bummed out about this new school year, and rightly so. By allowing them to personalize their own space, you can help to bring some of the fun and excitement back to “Back to School” prep. Not only will they be excited to use their new special space, the act of creating this space will give them a sense of ownership. Encourage your child to make the space their own, and allow them to decorate with pictures, quotes—whatever!—that makes them smile and feel good.

It is expected that there will be some bumps along the way, so if your system in September doesn’t seem to be working come October … switch it up! This year is all about experimenting, so try to have some fun with it. See you in the next edition!


Visiting Loved Ones in Long-Term Care Facilities and Nursing Homes – Latest Guidelines

Reading Time: 2 minutes

Governor Inslee recently announced new visiting rules for long-term care facilities and nursing homes, which will give some families and friends increased access to see their loved ones. We know that people who live in nursing homes and other long-term care facilities are often older adults and people with chronic health conditions—the groups who are at highest risk of complications from COVID-19. Since people live together in close proximity in these facilities, COVID-19 can easily spread within these environments, so protections were put in place to safeguard residents from the disease.

The new visiting rules will include a four-phase plan that is different from the state’s four-phase Safe Start Plan for counties that you may have heard about. Nursing homes and long-term care facilities cannot be in a more advanced phase than the counties they are in (Skagit County is currently in phase 2). Facilities will also stay in phase 1 if the local COVID case rate per 100,000 residents exceeds 75, which Skagit County currently exceeds as of August 26.

The new rules took effect on August 12, and family members should check with the facility their loved one lives in, because not every site may be able to conduct visits right away. It may take some time for facilities to work through the application and approval process with Washington State.

What will visiting look like in the different phases?

Depending on the phase, visiting access will differ. As of the time of this article, Skagit County remains in phase 1 with a high risk level.

Long-Term Care Facilities in Phase 1:

  • Indoor visits are limited to compassionate care situations. Compassionate care situations include end-of-life circumstances and for psychosocial needs (ex. distress brought on by the death of a loved one or a sudden lifestyle change).
  • Outdoor visits are allowed and limited to two visitors per resident per visit. These visits must include masking, social distancing, and appropriate hygiene.
  • Facilities may invite “window visits” at their discretion with safety protocols in place.
  • Remote visitation through technology must be facilitated.

Additional Access for Long-Term Care Facilities in Phase 2:

  • Adds ability of a designated “essential support person” to visit a resident once per day if the resident is unable to participate in outdoor visits and if remote visitation technology is unavailable.

Additional Access for Long-Term Care Facilities in Phase 3:

  • Indoor visits are generally permitted, with limitations. Facilities will establish visitor hours, visitor limits, and safety precautions. Preference should be given to outdoor visits.

Additional Access for Long-Term Care Facilities in Phase 4:

  • Normal visitation resumes.
The graduated restart plan is based off of the Washington State Safe Start Model.

Families should also know that a facility or agency must meet certain criteria before entering a new phase, including a current 28-day period without a resident or staff member testing positive for COVID-19 and having at least a 14-day supply of Personal Protective Equipment (PPE) stocked.

Questions or Need Help for a Loved One?

This can be a stressful time for family members and caregivers. Washington State has established a FamHelp Long-Term Care Phone Hotline at (888) 856-5691 that is open between 6 a.m. and 10 p.m. to answer questions about long-term care and other DSHS facilities.


Reach Out: We Can All Do Our Part

Reading Time: 3 minutes

Social distancing has impacted us all differently. For some people, it has meant spending day-in and day-out with antsy children, while others have had way too much time on their hands. Others may be experiencing unexpected financial hardship due to COVID-19, causing an increase in stress and anxiety.

For some older adults in our community, social distancing has put a lot of new restrictions on their ability to access care and resources, as well as their ability to connect with the outside world. Thankfully, there is a lot each individual can do to support the emotional well-being of our senior population. We can all do our part!

The American Foundation for Suicide Prevention has a list of ideas for reaching out to our senior population during this time:

  1. Check in regularly on your older adult friends, neighbors and family members.
  2. Call or video chat with them, since texting and social media may not be the best method of connecting. (Note: You may need to help friends and loved ones with new technology!)
  3. Seek advice from them based on their experience and wisdom. People realizing they are needed can make all the difference!
  4. Ask how they are doing during this period of time, how their routines might have had to change, and what kinds of things they are doing to cope with the stress. Encourage your loved ones to stay connected with community by reaching out to your local senior center for ideas.  
  5. Encourage them to keep doing activities that are safe during COVID for their local area, and that they identify as being most helpful for them, such as daily exercise or a walk, stretching, listening to or playing music, reading, enjoying favorite or humorous shows, puzzles, games, social activities, and meditation or prayer. Here are some activity ideas from AARP, and the National Institute on Aging. (Note: While it is still required that we keep a 6-foot distance and wear masks, there are many safe activities that can be done outdoors with loved ones that follow these requirements and minimize chances of transmission.)
  6. Help them seek medical advice or care if they are experiencing symptoms of physical or mental health decline.
  7. Offer to bring them a meal, run an errand, or walk their dog. Call Skagit County Public Health at (360) 416-1500 to get information about senior nutrition assistance.
  8. Express gratitude and appreciation for any support you get from your relationship with them. Let them know what you admire about the way they conduct their life.

All of the above ideas can be accomplished without much direct physical interaction, which is great during a time when we must adhere to social distancing requirements. It is important to remember that there is a big difference between “social distancing” versus “physical distancing.” Just because we are keeping our physical distance does not mean that we cannot still socialize. We just need to be more mindful about the ways we do it!

When connecting with loved ones, make sure to look out for possible signs of social isolation, anxiety, or depression. It is important to reach out early and often, because mental health issues—just like physical health issues—can become very serious if left unchecked.

Signs that a person might be isolated:

  • Deep boredom, general lack of interest and withdrawal
  • Losing interest in personal hygiene
  • Poor eating and nutrition
  • Significant disrepair, clutter and hoarding in the home

Where can you find support if you recognize any of the signs above?

If someone is experiencing excess stress due to COVID-19, call Washington Listens at 833-681-0211 for support and resources.

What to do if someone is experiencing a mental health crisis?

Where can you direct local seniors if they are experiencing hardship due to quarantine or isolation?

At-risk individuals who are in quarantine or isolation and find themselves in need of assistance with getting/picking up supplies or food can call the Skagit County Resource Assistance Line at (360) 416-1892 between 8 a.m. and 4:30 p.m. daily.


Health Inequities – a Further Review

Reading Time: 3 minutes

June 15, 2020, Skagit County Public Health issued a press release and a call to action on racism and health inequities. We wanted to provide some additional information and context about that call to action. Examining health disparities and inequities is not new to Skagit County Public Health or the Population Health Trust, which is the community advisory committee that guides the department’s health assessment and planning. The Population Health Trust adopted a vision for health equity that guides this work:  

“Health Equity means that everyone in our community has a fair and just opportunity for healthy living. This requires that we address and remove barriers to individual and community health that arise from poverty and discrimination (whether based on race, education, gender identity, sexual orientation, job status, housing status, or disability) that result in compromised health and powerlessness, and are often derived from lack of access to: good jobs with fair pay, quality of education, healthy housing, nutritious food, safe environments and active lifestyles, and quality health care.”

The COVID-19 pandemic has highlighted deep-seated inequities that are impossible to ignore.  We are still learning about these impacts, but four immediate examples include: a disproportionate share of COVID-19 disease burden among communities of color, unequal healthcare access, employment circumstances that disadvantage some groups compared to others, and an unequal social safety net.

  1. Disproportionate COVID-19 Disease Burden

In May, 75% of identified Skagit County COVID-19 cases were from members of the Latinx community, even though the group represents only 18% of the county’s population.  We know that there are consistently higher rates of infection in communities of color throughout Washington State and nationally. According to the Washington State Department of Health, 37% of the people diagnosed with COVID-19 are White, while 68% of our population as a whole is White.  Statewide, members of the Latinx community make up 13% of the population but represent 43% of the people diagnosed with COVID-19. This is a clear and indisputable health inequity. As is noted below, primary reasons for this inequity include unequal healthcare access, differences in employment circumstances and an unequal social safety net.    

  • Unequal Healthcare Access

Sadly, although communities of color are most impacted by COVID-19, those same communities are less likely to have health insurance and access to medical care. As the table below illustrates, the uninsured rate for Latinx adults in Washington State is nearly four times the rate of White residents. Native Americans and African Americans also are less likely to have health insurance compared to White residents.

 LatinxNative American/ Alaska NativeBlack/African AmericanWhite
Adult Uninsured Rate in Washington19%17%11%5%
  • Differences in Employment Circumstances

In Skagit County, workplaces are a major source of COVID-19 spread. Many people take for granted that their jobs offer them the ability to work from home or take time off when they are sick. Frontline workers face tough economic and health choices, and there are stark racial differences in employment situations. Many of these workers were laid off while others continued in essential services that involve a high degree of interaction with others and consequently place them at greater risk for COVID-19 infection.

Nationally, nearly a quarter of employed Latinx and African American workers are employed in service industry jobs compared to only 16% of White workers. Also, Latinx workers account for 17% of total employment but 53% of agricultural workers. In Skagit County, where agriculture is such an important part of the economy, Public Health is working with the farming community to foster safe working conditions for farmworkers. 

4. Unequal Social Safety Net    

The coronavirus crisis is not just a pandemic; it is also an economic crisis. Unfortunately, we do not have a social safety net that helps everyone equally. Many non-citizens did not qualify for the federal stimulus checks. Even citizens married to non-citizens were locked out of these payments.  Children who live in mixed immigration-status households were also penalized and no one in their family received a stimulus payment.

Millions of people lost their jobs, including people whose presence in the US is based on a temporary visa, and some workers find themselves in limbo where they do not qualify for unemployment payments and cannot seek new work. The process to receive unemployment benefits is confusing for people with limited English skills, who work non-traditional or ‘gig economy’ jobs, or for people who are self-employed. 

These are just a few of the health equity issues that have become more apparent during the COVID-19 pandemic, and this just scratches the surface of health equity issues in our community. We know there are similar inequities in chronic disease rates, educational outcomes, housing, and other economic segments of our community.

Skagit County Public Health and the Population Health Trust will continue proactively exploring these and other health equity topics. In response to the current crisis, this process will start with listening sessions where Public Health will reach out in consultation with the communities that are most impacted. 

Sources

Skagit County Race & Ethnicity Data from US Census 2018 American Community Survey 5 Year Estimates, https://data.census.gov

Kaiser Family Foundation estimates for uninsured (nonelderly) adults based on the Census Bureau’s American Community Survey, 2008-2018: https://www.kff.org/statedata/

Viruses don’t discriminate, But We Do, Washington State Department of Health, June 19, 2020: https://medium.com/wadepthealth/viruses-dont-discriminate-but-we-do-fcec9758c18f

Labor Force Characteristics by Race & Ethnicity, 2018: https://www.bls.gov/opub/reports/race-and-ethnicity/2018/home.htm  


Do Masks Make a Difference?

To wear or not to wear: Do masks make a difference?

Reading Time: 4 minutes

You’ve heard it hundreds – maybe thousands – of times over the last few months: Masks save lives! But do they? Does it really make a difference if I wear a mask when I go out in public?

Pre-COVID-19, there wasn’t a lot of research done about the effectiveness of masks. But in the last few months, out of necessity, several studies have been completed on whether masks reduce viral transmission. While there are outliers, the overwhelming consensus is that masks do help prevent the spread of COVID-19.

Every time we cough or sneeze, talk or even just breathe, we expel tiny respiratory droplets (and sometimes, embarrassingly, saliva). These droplets act as a vehicle for germs like COVID-19, helping them spread far and wide. Think of when you exhale in the winter. Your breath cloud lasts several seconds and spreads out around you before dissipating. Or think of when you’re walking near someone who is smoking or vaping. You can smell it even if you’re standing several yards away. You can see or smell the spread of these respiratory droplets.

Masks help minimize the spread of these potentially infected droplets by keeping most of them inside your mask rather than expelling them to the world, meaning if you’re infected, it’s less likely you’ll infect others if you’re wearing a mask. Additionally, studies are showing that even basic cloth face coverings can help prevent you from contracting the virus when others around you are infected.

A study, led by a Texas A&M University professor, found that not wearing a mask dramatically increases your risk of contracting COVID-19. The authors state that wearing masks prevented as many as 66,000 infections in New York City in a three-week period lasting April 17-May 9. During this time period, New York City saw approximately 93,000 positive COVID-19 cases, but without masks, this number could have been 71% higher.

One of the study’s co-authors, Mario Molina, told a Texas A&M publication: “Our study establishes very clearly that using a face mask is not only useful to prevent infected coughing droplets from reaching uninfected persons, but is also crucial for these uninfected persons to avoid breathing the minute atmospheric particles (aerosols) that infected people emit when talking and that can remain in the atmosphere tens of minutes and can travel tens of feet.”

A review of 172 observational studies from 16 countries across six continents looked at something else we have all heard about by now: social distancing. While we recommend that you stay at least six feet from non-household members, the study found that the farther you are away from someone, the lower your risk of either spreading or contracting the virus. So six feet at a minimum, but farther is better.

The same authors also reviewed 39 studies that looked at the efficacy of wearing face masks, including N95 respirators, surgical masks and cloth face coverings. They found a significant decrease in the risk of infection among people who wore masks. While N95 respirators were most effective in health care settings, cloth face coverings provide protection to the general public in non-healthcare settings. The World Health Organization (WHO) recommends that cloth masks consist of at least three layers to increase their efficacy.

The study authors stress, however, that keeping your distance from others and wearing a mask do not provide complete protection against COVID-19. The best protection is and always will be staying home as must as possible. But knowing that we can’t go on like that forever, if you do go out, these are simple ways to lower your chances of contracting or spreading the virus. But don’t forget to wash your hands or use hand sanitizer frequently!

Finally, I’m feeling healthy today. Sure, sure, I have seasonal allergies, but they’re not contagious! So why do I have to wear a mask right now? It has become clear over the last few months that COVID-19 can spread even if an infected person is feeling fine. The virus can spread for up to three days before someone is symptomatic. And even more concerning, many people never develop symptoms at all or, more commonly, have such mild symptoms that they don’t even realize they’re sick. But these people, lucky as they are, can still spread the virus, potentially to someone who will end up on a ventilator or even die.

A study out of Cambridge and Greenwich Universities in Great Britain found that wearing a mask any time you’re in public is twice as effective at reducing the transmission rate as wearing a mask in public only after you become symptomatic. Masks are an easy and cheap way to reduce the spread of the virus. Masks really do save lives.

Of course, we know that there are some people who genuinely can’t wear masks. It’s not that they find them uncomfortable or hot; it’s not that they fog up their glasses; it’s not that they don’t like the way they look; it’s not that they think they’re a sign of weakness or fear. There are people who have medical or behavioral health conditions that make wearing a mask dangerous for them or inhibit their ability to communicate. It’s incumbent upon all of us to ensure that people who cannot wear a mask are protected, even if they cannot protect themselves. When you wear a mask, you’re protecting yourself and everyone around you. Wearing a mask is a sign that you care about others, people beyond yourself. It’s part of being a community.

We’re all tired of COVID-19. We want to get on with our lives. Masks, as annoying as they are, will help us get there faster by decreasing the spread of the virus. COVID-19 will be with us for a while; no one knows for sure how long. Wearing a mask will help us get to some sense of normalcy before a vaccine is developed.

If wearing a mask means that I can go shopping, get my hair cut, or visit a friend, then I consider it a small price to pay. I’d rather the bottom half of my face be uncomfortable than be stuck at home for another three months!


A Call to Action – Racism and Health Inequities

Reading Time: 2 minutes

Skagit County Public Health is repulsed and outraged by the senseless killing of George Floyd. We wholly stand with the nationwide demand that those involved be called to justice. Systemic biases are prevalent in our society and harm people of color in numerous areas of their lives. Public Health is acutely aware structural racism impacts the health of many Skagitonians. Although health inequities often do not receive the same attention as violence against people of color, such disparities are just as deadly.

COVID-19 has laid bare the socio-economic disadvantages that people of color in our community face due to racism and inequity. Nationwide, Black Americans are dying from COVID-19 at three times the rate of white Americans. Last month in Skagit County, 75 percent of identified COVID-19 cases were members of the Latinx community.  These are just a few of many stark examples of how COVID-19 is disproportionately impacting communities of color and highlight the existing inequities in our systems.  Further, although the Centers for Disease Control and Prevention’s existing data does not indicate a disproportionate level of COVID-19 among Native Americans countrywide, there is undeniable evidence demonstrating racism severely affects the health of Native Americans. This reality is crucially important given that Samish Indian Nation, Sauk-Suiattle Indian Tribe, Swinomish Tribal Community and Upper Skagit Tribe are among the Skagit community.

Racism is a public health threat that cannot be ignored. These unacceptable injustices require action and real solutions.  We recognize and know that Skagit Public Health must intentionally strive to do better. Our mission is to serve all Skagit County residents and create positive health outcomes and living conditions for everyone.

We are making a commitment to equality, justice, and inclusion. We realize the answers to these issues are found from the wisdom and experience among our local Black, Latinx and Tribal communities.

With the support of our County Commissioners and Board of Health, we will establish an Equity Task Force lead by leaders within Skagit’s Black, Latinx and Tribal communities. Given the immediate threat of COVID-19, we will continue to focus coronavirus response efforts on assisting communities disproportionately impacted by the pandemic.

As we continue to move forward in service, we welcome guidance on ways we can do better. We ask for community feedback. You can reach us at 360-416-1500 or by email at health@co.skagit.wa.us


Person using Nicotine

Tobacco & Vapor Products “Talking Points” : COVID-19 Edition

Reading Time: 4 minutes

IMPORTANT INFORMATION FOR ALL

People who smoke may be more likely to develop serious health complications from COVID-19. Smoking weakens the immune system, making it harder for your body to fight off viral infections – especially those attacking the lungs, like COVID-19. Additionally, initial findings suggest that vaping may increase lung inflammation and exacerbate lung infections. Need help quitting? Call 1-800-QUIT-NOW or visit doh.wa.gov/quit

INFORMATION FOR YOUTH OR PARENTS OF YOUTH

To say that our kids are dealing with a lot right now would be a grave understatement. Between figuring out remote schooling, the uncertainty of schedules and daily life at home, and the rising anxieties over health and safety, the mental well-being of our youth is of pressing concern. And while our inboxes are full of tips and tricks for keeping youth occupied, there are other—perhaps more troubling—issues that may not be getting as much attention.

While it may seem like decades ago, one of the most concerning trends we were seeing at the end of 2019 and beginning of 2020 was the youth vaping epidemic. Washington Healthy Youth Survey results were showing a dramatic spike in youth usage between 2016 and 2018, and the perceived risk associated with frequent use was alarmingly low among 8th and 10th graders in Skagit County.

In the fall of 2019, national media sources began reporting on the growing number of cases of vaping-associated lung disease, and these reports were causing many lawmakers to pursue legislation that would place stricter enforcements on vapor products. On January 1, 2020, Washington State officially raised the legal age for purchasing tobacco products to 21 years of age.

The seriousness of youth tobacco usage has not waned, though we now are living in much different times. If anything, our efforts to push forward with prevention efforts is all the more important now during the COVID-19 pandemic, while youth are grappling with so many new and unprecedented struggles, and may be relying on substances, like tobacco, to cope. Experts are still trying to gauge the impacts of COVID-19 on people using tobacco, but we do know that there is conclusive evidence that smoking weakens the immune system, increases the risk of infectious diseases and respiratory infections, and is a major cause of chronic health conditions and cancer. We also know that there is growing evidence that vaping can harm lung health, and nicotine can be extremely harmful for the brain development of teens and young adults.

For these reasons, parents must be extra vigilant about monitoring the mental health and substance use of their kids. Talking to children about tobacco use can be overwhelming—even without a global crisis taking place! It is best to begin the conversation early on, and continue these messages as they grow up. Expect that your child will have questions, and be prepared to answer these with facts, not fear-driven responses. Remember that parents can have a positive influence on youth’s behavior, so long as the conversation is honest, open and understanding. In order to help guide the conversation, we have created a list of helpful information that can inform your conversations:

  • Smoking/vaping and COVID-19

Currently, experts do not yet know if there is a direct correlation between COVID-19 infection and tobacco smoking/vaping. However, this is what the World Health Organization (WHO) has to say:

“Smoking impairs lung function making it harder for the body to fight off coronaviruses and other respiratory diseases. Available research suggests that smokers are at higher risk of developing severe COVID-19 outcomes and death. … There is no evidence about the relationship between e-cigarette use and COVID-19. However, existing evidence indicates that electronic nicotine delivery systems (ENDS) and electronic non-nicotine delivery systems (ENNDS), more commonly referred to as e-cigarettes, are harmful and increase the risk of heart disease and lung disorders. Given that the COVID-19 virus affects the respiratory tract, the hand-to-mouth action of e-cigarette use may increase the risk of infection.”

  • Signs of nicotine poisoning and withdrawal in youth

With school campuses closing abruptly and families at home practicing social distancing, some kids may have increased their tobacco use in order to deal with stress, while others may be dealing with withdrawal if they can no longer get access to tobacco products. It is important to be familiar with the signs of both nicotine poisoning (if someone is consuming too much), as well as nicotine withdrawal.

Nicotine poisoning (a.k.a. “Nic-Sick”)

  • Nausea or vomiting
  • Stomachache and loss of appetite
  • Increased heart rate and blood pressure
  • Headache
  • Mouth watering
  • Quick, heavy breathing
  • Dizziness or tremors
  • Confusion and anxiety

Nicotine withdrawal

  • Having cravings for tobacco products
  • Feeling down or sad
  • Having trouble sleeping
  • Feeling irritable‚ on edge‚ or grouchy
  • Having trouble thinking clearly and concentrating
  • Feeling restless and jumpy
  • Having a slower heart rate
  • Feeling more hungry or gaining weight

To find out more about the above symptoms, visit resources such as the American Lung Association or the Centers for Disease Control and Prevention (CDC).  

  • Next steps: Cessation resources

If your child is using tobacco products, the best thing to do is to encourage them to quit, and support them throughout their journey. There are a host of resources available to youth dealing with tobacco dependence, many of which are free and easy to use without having to leave the house! Here are some great resources:

  • WA DOH 2Morrow: a free app to help teens and young adults quit vaping or smoking. There is also free cessation counseling for tobacco and vaping or marijuana dependency available
  • SmokeFreeTeen: free app services and texting services available for smoking, vaping, smokeless tobacco cessation
  • The Truth Initiative’s This Is Quitting program: text DitchJUUL to 88709 for free vape cessation support

Lastly, it is important to take care of yourself if you or your child smokes or vapes and is trying to quit.

  • Parents can text QUIT to (202) 899-7550 to sign up to receive text messages designed specifically for parents of vapers, and can find a community of support at BecomeAnEX.org.
  • Visit Smokefree.gov for a list of specialized free programs to help you quit smoking. Programs include: Veterans, Women, Moms,Teens, 60+, Spanish and others. Text, chat, and and a variety of other free supports available.

Want other “Talking Points” from Skagit County Public Health? Visit our webpage here!


Expecting

Safe at Home – Pregnancy during COVID-19

Reading Time: 4 minutes

An expecting mom anticipates the joy of her new baby in her arms while managing the anxiety of pregnancy and birth in the time of COVID-19.

It takes a village.

I’ve always heard that it takes a village to raise a child. From my own experience, I know that this is definitely true. During my first pregnancy, I woke up in the middle of the night wondering if I was ready to take on this huge new responsibility. During my second pregnancy, I nervously asked my husband if we were ready for two. There are still many days where I wonder if I’m doing this mothering thing right. But I can tell you there is one thing I know for certain: I am so glad I have a village.

When I interviewed my pregnant coworker Amber for our “Safe at Home” series, I had a lot of questions. For one, how is she handling the late stages of pregnancy during social distancing? She shared many of the same worries I had when pregnant.  But she is also facing a whole new set of daunting anxieties resulting from COVID-19.


Amber’s Story

Amber has the unusual challenge of both being pregnant and serving as an Epidemiologist performing COVID-19 case investigations for the Public Health Department. Strictly following social distancing, she works from home.  She spends the bulk of her days investigating the spread COVID-19 and taking actions to prevent further local transmission. This work is crucial to the wellbeing of Skagit. If anyone understands the importance of social distancing, it’s Amber! She sees how easily this virus can spread. So she and her husband are taking extra precautions to stay home and stay healthy.

Many people are worried about themselves and their loved ones getting sick from COVID-19. Amber also is concerned that her and her husband’s health could affect the birth experience of their child. She wondered out loud:

“If my husband shows any signs of infection when I go into labor, would he be able to be in the delivery room with me? What if I contract COVID-19? Would I be forced to isolate from my newly born child?”

NOTE: According to the World Health Organization, we don’t yet know if a sick mom can pass the virus to her unborn child or to the baby during delivery. Pregnant women who have tested positive for COVID-19, or who have coronavirus-like symptoms, should consult with their doctor. Together, they can make a birth and delivery plan to ensure safety for everyone. Medical professionals know the benefits of skin-to-skin between mothers and babies and encourage breastfeeding. Even moms diagnosed with COVID-19 or having symptoms can breastfeed and hold their baby if they practice good hygiene and wears a face mask.

The thought of being alone during labor is incredibly scary. Hospitals have a temporary restricted visitor policy. This policy allows one healthy labor companion in the delivery room of a healthy mom.  It is heartbreaking to think that so many families are having to deal with these concerns, but this what is needed to keep everyone safe from COVID-19.

So Amber’s mom won’t be able to visit her in the hospital. Family and friends won’t be able to drop to see her new baby once she comes home in order. They will need to keep everyone safe through social distancing. Thinking back to when I brought my own babies home from the hospital, it makes me sad to know Amber won’t have the same supports that eased me into motherhood—the village of family, friends, and community.  Before COVID-19, I and other moms routinely took these supports for granted.

To deal with these added stressors, Amber tries to focus on the things she has control over. She joked that she was eating lots of healthy foods because she isn’t able to go buy all the treats she’s craving. When the weather allows, she likes to take long walks. At the same time, she’s a bit weirded out by how people cross the street when they see her. But Amber is grateful people are taking the Governor’s orders seriously.

Amber finds hope and comfort knowing she will soon have her baby in her arms. She tries to remember that “there’s always something to look forward to…for the rest of her life.” Even though things are crazy right now, “there’s guaranteed joy on the way.”


Are you a pregnant or new mom?

There are many new (and free!) support services available to you during this time! Websites like WhattoExpect.com have compiled fantastic resources to help pregnant and new moms navigate this difficult time. Some of my favorites include virtual doula and lactation services, online childbirth classes through Lamaze International, and meditation apps to be used during labor.

Get connected with your local village!

Skagit County’s Welcome Baby program is unable to meet new parents at the birth centers at this time, but they are hoping to connect with Skagit families in their third trimester or those who have recently delivered. Call or text 360.922.2644 or send an email to welcomebaby@unitedwayskagit.org  For more information visit www.skagitwelcomebaby.com

Want other support services? Check out these March of Dimes resources below:

NOTE: Wonderful news! Since this interview, Amber and her husband Drew welcomed their baby daughter Isla to their family. They are all healthy and happy!

Amber – Skagit County Epidemiologist, COVID-19 Investigator, and mom to be!
Baby Isla – Born 4/13/2020!