Mask Recommendation from Skagit County’s Health Officer

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July 26, 2021

The following is a statement from Dr. Howard Leibrand, Skagit’s Health Officer.

Earlier today, several of my colleagues issued a joint statement recommending masks indoors, regardless of vaccination status. It is the goal of this recommendation to protect high-risk individuals and those who are not able to be vaccinated, including children under twelve years old.  

It is clear that masks protect individuals from COVID-19. It is never a bad idea to wear a mask in an indoor situation, particularly as we see the delta variant becoming more prominent in our communities.

With that said, I want to assure my community that vaccination is—and will continue to be—the absolute best tool we have to stop the spread of COVID-19. Local data shows that from March 1, 2021 to July 13, 2021 96% of all COVID cases were in unvaccinated individuals. This perfectly highlights the effectiveness of the COVID-19 vaccines.

It is true that the delta variant is particularly concerning. It is much more transmissible than the variants that have been circulating in our county prior to July.  Delta variant may cause more serious illness. If you are unvaccinated and not using precautions like masking and social distancing, you are at very high risk of becoming infected with delta variant and getting seriously ill in the coming days and weeks. Therefore, if you are unvaccinated, I highly recommend that you wear a mask in all crowded situations and continue to encourage your loved ones to do the same.

COVID-19 is likely going to be with us for a long time. Like many reportable diseases, there is no clear end to this health concern. I am encouraging everyone to use every tool available in their toolbelt to protect themselves. Masks will always be a great option, but getting vaccinated is most important.

In summation, the strongest recommendation that I can make as a health professional is this:

Get vaccinated today.


Dr. Leibrand has served as Skagit’s Health Officer since 1989. For more information on Skagit’s COVID-19 response, including upcoming vaccine clinics, visit www.skagitcounty.net/covidvaccine.


Overdose Prevention: Preparedness Saves Lives

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Overdose deaths accelerated in Washington State in 2020, increasing by 38% in the first half of 2020 compared to the first half of 2019. Preliminary data show 835 overdose deaths in Washington State in the first six months of 2020 compared to 607 deaths in the first half of 2019. Fentanyl-involved deaths more than doubled from 137 to 309 during that time. Most deaths involved multiple substances and many involved fentanyl. In Skagit County, a total of 143 nonfatal and 28 fatal overdoses were reported in 2020. Of those, 18 nonfatal and 10 fatal were related to fentanyl.

Substance use disorder is a disease that impacts many in our community. Overdose deaths are preventable with preparedness, education, and community care.

Illicit fentanyl is a synthetic or “man-made” opioid that is 80-100 times stronger than other opioids like morphine and heroin. In Washington state, fentanyl has been found in counterfeit pills made to look like prescription opioid pills, as well as in powders and black tar heroin. People may not be able to tell if fentanyl is present based on taste, smell, or the look of the drug. According to the WA Department of Health, people should assume that any drug not from a pharmacy could have fentanyl in it.

Everyone can play a role in saving lives in our community. If someone in your life is struggling with substance use disorder, learn the the signs of opioid overdose including; the inability to wake up; slow or no breathing; and blue, gray or ashy skin, lips or fingernails.

If you are struggling with substance use, do your best not to use alone and start slow using a tester amount to determine strength. If you must use alone, call 800-484-3731 (Never Use Alone) to ensure someone can help in the event of an overdose.

Skagit County also encourages those dealing with substance use disorders to carry at least two doses of Naloxone. Naloxone (also called Narcan®) is a safe and simple medication that reverses the effects of opioid overdose. If someone may be overdosing, call 9-1-1, give naloxone, and perform rescue breathing.

Naloxone can be administered nasally or intramuscularly. There are currently four types of naloxone available. For more information, visit SkagitRising.

Naloxone is easy to access in Washington State:

Under the statewide standing order, anyone can get naloxone at a pharmacy without seeing a doctor first.

Remember, the Good Samaritan Overdose law (RCW 69.50.315) says neither the victim nor people assisting with an overdose will be prosecuted for drug possession.

Help people struggling with opioid use disorder to find the right care and treatment. If you or a loved one want treatment or just want to learn more, see the Washington Recovery Helpline, or call 1-866-789-1511.

For information about what Skagit County is doing about the opioid and fentanyl crisis, for list of local treatment providers, or to learn how to use naloxone, go to www.skagitrising.org or call (360) 416-1500.


Confirmed Cases of Delta Variant in Skagit County: What You Need to Know

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July 15, 2021

Two COVID-19 cases attributed to the delta variant have been identified in Skagit County so far, though it can be assumed that the variant has spread more widely given that sequencing is not done on all tests.

The delta variant has been credited for dramatic increases in COVID-19 cases in other parts of the country and globally due to its increased transmissibility (meaning it spreads more easily). As of June 19, the CDC estimated the delta variant accounted for more than 30% of COVID-19 cases in the US. Two weeks earlier, 10% of cases were attributed to the delta variant.

In Washington, the delta variant accounts for about 28% of sequenced cases – that’s up from about 12% the prior two-week period. Not all cases are sequenced in Washington, so that may not represent the actual statewide proportion of cases due to the delta variant.

“While Skagit County continues to see a downward trend in new COVID-19 cases, it is vital that people continue to use precautions. The detection of these COVID-19 variants in our state proves that this pandemic isn’t over just yet.”

Jennifer Johnson, Skagit County Public Health Director

New variants seem to spread more easily and quickly than other variants, which may lead to more cases of COVID-19. An increase in the number of cases will put more strain on health care resources, lead to more hospitalizations, and potentially more deaths.

The good news is the COVID-19 vaccines are providing protection against the delta variant, particularly against severe illness leading to hospitalization and death. Some precautions to take to decrease the spread of the delta variant—and all currently known COVID-19 variants include:

  • Getting vaccinated as soon as possible if 12 years of age or older! Recent Skagit County data shows that 96% of cases since March 1, 2021 were in unvaccinated individuals. The data tells us that the vaccines work!
    • Note: Vaccination is recommended even for individuals who have already had COVID-19, as experts do not yet know how long people are protected from getting sick again after recovering from COVID-19.
  • If you are not yet vaccinated:
    • Wearing a well-made, well-fitting face mask, even with people you see regularly and in your smallest social circles.
    • Keeping gatherings outside whenever possible.
    • Avoiding any social gatherings indoors, but if participating, wearing a mask and ensuring windows and doors are open to maximize ventilation.
  • For all individuals, staying home if you are sick or if you have been exposed to COVID-19. WA Department of Health data shows that 81% of those vaccinated who experience a breakthrough case are symptomatic. If you feel sick—get tested!
  • Getting tested for COVID-19 if you have symptoms or were exposed to someone who tested positive.

If you are not yet vaccinated, it’s not too late! Visit your nearby pharmacy or medical clinic to get vaccinated against COVID-19; many locations now offer walk-up appointments! You can also call our vaccine hotline at (360) 416-1500 or text your zip code to 438829 (GETVAX) to find locations near you with vaccine available.

You can see the state Department of Health’s variant report, updated every Wednesday, here: https://bit.ly/3ehLzo7


What does the new Housing Stability ‘Bridge’ Emergency Order mean for Skagitonians?

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On June 29, 2021 Gov. Jay Inslee issued a housing stability ‘bridge’ emergency order, Proclamation 21-09, intended to ‘bridge’ the gap between the eviction moratorium and the new protections and programs enacted by the State Legislature. 

What does this means for renters and landlords?

Until there is an operational Eviction Resolution Program in Skagit County, eviction for non-payment of past due rent is not permitted. However, by August 1st, tenants must either begin paying full rent, negotiate a plan with their landlord to catch up on past due rent or apply for funds with a local rental assistance program. Public Health strongly encourages tenants to stay in their homes and housing providers not to proceed with evictions for tenants who owe rent. Tenants who leave will not be eligible for rental assistance and may have difficulty finding a new home. Landlords who evict tenants cannot then collect assistance for the back rent owed by that tenant.

What is the Eviction Resolution Program and when will it be available in Skagit County?

The Eviction Resolution Program engages both landlords, tenants, and their legal counsel to resolve any issues including but not limited to back rent issues that may cause an eviction once the moratorium has expired.

The goal of the program is to ensure landlords and tenants are connected to rent assistance, legal counsel and have an opportunity at mediation or meet and confer to resolve the housing conflicts prior to filing an unlawful detainer which may result in an eviction.

In Skagit County, there is not currently an operational Eviction Resolution Program and we will provide updates as more information becomes available.  In the interim, landlords and tenants are encouraged to reach out to and work with their local dispute resolution center (DRC) 425-789-7500 (intake) and skagitdrc@voaww.org.

Where can Skagitonians go for assistance if behind on rent?

The Skagit County Rental Assistance Program is currently active and accepting applications for assistance. Funding is available for renters or landlords who have lost income due to COVID-19 and are struggling to pay or collect rent. The program can cover rent up to 150% of Fair market value for past due rent incurred after March 13, 2020, as well as future rent. These funds can also assist with past-due utilities and other housing costs directly or indirectly due to COVID-19.

A list of local rental assistance provider is available here: English | Spanish

Renters and landlords who do not qualify for assistance will be referred to the Volunteers of America Landlord-Tenant Program. ltinfo@voaww.org 425-339-1335 ext. 4.

What should landlords do if they have tenants that are behind on rent?

Property owners can reach out to a rental assistance provider on behalf of their tenants.  A list of local rental assistance providers is available here: English | Spanish

Additional Resources:


Washington State to Reopen SOON!

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As of June 14th, more than 7,528,340 doses of vaccine have been given across the state and more than 4.1 million people have received at least one dose of COVID-19 vaccine. Washington is getting closer to its 70% initiation goal set by Governor Inslee. The state currently sits at 67.8% of Washingtonians 16 and older who have initiated vaccination, meaning they have received at least one dose of the COVID vaccine.

June 30th or when we hit 70%.

The Governor has stated that Washington will fully reopen on June 30th, though the state could reopen sooner if the 70% initiation goal is met. To reopen before June 30th, at least 70% of people 16 and older need to receive at least one dose of COVID-19 vaccine.

This is an extremely exciting time for many of us, as we begin to see things go back to normal. But with reopening comes great responsibility! It is important to remember as things open back up that we must proceed responsibly and with care and respect for those who are not yet vaccinated and for those who are at increased risk.

Reopening & what to expect:

What happens on June 30th or when we hit 70%?

The state will be open for business and recreation, and people who are vaccinated can go along with their regular lives for the most part. Unvaccinated people will need to continue wearing masks indoors. Most businesses get to operate as they did in January of 2020, with the caveat that they’re following workplace safety requirements (which come from Labor & Industries). Restaurants, bars, bowling alleys, and grocery stores are going to be fully open.

Are there any exceptions to reopening?

The one major public sector that will continue to have some limits is large-scale events that the governor just released guidance for. Events that are indoors with 10k or more people must be limited to 75% occupancy or require vaccination and follow mask requirements.

Higher risk congregant settings like healthcare, long term care facilities, or places where many people are not yet able to be vaccinated like childcare, day camps, K-12 must follow different guidance. In these settings, masking is still required, even among fully vaccinated persons.

Will unvaccinated people still need to wear a mask?

The Secretary of Health’s mask order remains in place, which means that unvaccinated people need to continue to mask in public. This helps protect not only those who are unvaccinated, but also vulnerable children who are not yet able to be vaccinated and others with auto-immune or other conditions that prevent them from being vaccinated.

Can businesses still require people to wear a mask after restrictions are lifted?

Yes, counties and businesses can be more strict and enforce masking, distancing and handwashing, etc. – whatever is appropriate in those spaces.

The situation in Skagit.

In Skagit County, 63.6% of our population 16 years and older have initiated vaccination. From data on the state dashboard, we can see that roughly 81% of our population 65+ have initiated and 64% of people 50-64 have initiated vaccination. The greatest room for growth would be amongst Skagitonians ages 12-49; the smallest percentage being those 12-17 years of age.

“We’re calling all our young adults and families with tweens and teens to get vaccinated now. It wouldn’t take much to get the state over the 70 percent threshold. We could see things reopen in the next few days if all eligible people would access their vaccine now.”

Jennifer Johnson, Skagit County Public Health Director

Getting your vaccine.

There continues to be many opportunities to get vaccinated against COVID-19 in Skagit County. Getting a vaccine is free, easy, and now—more convenient than ever!

The Skagit County Fairgrounds Clinic is still offering vaccines to anyone 12 and older, though the site closes permanently after June 26th to allow Public Health to focus on mobile outreach and pop-up clinics. To access a Pfizer or Johnson & Johnson vaccine at the Fairgrounds, drop by on Thursday from 1-7pm or Friday/Saturday from 10am-4pm.

A list of all upcoming mobile pop-up clinics can be found on Public Health’s website: www.skagitcounty.net/COVIDvaccine. All pop-ups are available to anyone 12+, unless indicated on the webpage. No appointments are required for these dates and locations.

If none of the above options suit your needs, other vaccine providers and locations can be found at Vaccinate WA or by calling the DOH help line at 1-800-525-0127.

For more information.

WA DOH: https://www.doh.wa.gov/Emergencies/COVID19/FrequentlyAskedQuestions

Governor’s Office: http://Governor’s Office: https://www.governor.wa.gov/issues/issues/covid-19-resources/covid-19-reopening-guidance

Percentages come from combining data from the Washington State Immunization Information System (IIS) and aggregate data from the Department of Defense (DoD) and Veterans Affairs (VA). To access state and county level vaccine data, go to the state Dashboard at: https://www.doh.wa.gov/Emergencies/COVID19/DataDashboard.


Get SMOKE READY this Wildfire Season

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Thankfully, we haven’t seen much smoke in Washington skies yet this year. Unfortunately though, we know that all it takes is one spark. Today—June 14th—marks the beginning of Smoke Ready Week, so let’s use this time to get prepared!

Like last year, there continues to be heightened concerns around the health impacts of breathing in wildfire smoke, and how this can worsen symptoms for those with COVID-19—or who may be at increased risk of contracting the virus. How we protect ourselves from wildfire smoke now is different than during other years when COVID-19 wasn’t a factor. Especially for those who are unvaccinated, it may be more difficult to go to public spaces where the air is cleaner and cooler than private homes may be. N95 respirator supplies continue to be somewhat limited, however not nearly as limited as last year. And we now all know from experience that cloth face coverings don’t provide much protection from wildfire smoke!-

So before we dive in, let’s discuss why getting Smoke Ready is important.

How can wildfire smoke harm your health?

Smoke is made up of gasses and microscopic particles. When inhaled, these particles bypass our bodies’ normal defenses, traveling deep into the lungs and even entering the bloodstream. Breathing in smoke can have immediate health effects, including the following:

  • Coughing     
  • Trouble breathing      
  • Stinging eyes     
  • Scratchy throat
  • Runny nose  
  • Irritated sinuses        
  • Wheezing         
  • Chest pain
  • Headaches   
  • Asthma attack           
  • Tiredness         
  • Fast heartbeat

Who is at most risk from wildfire smoke?

Inhaling wildfire smoke can be harmful to anyone, but it is especially harmful to these vulnerable groups: people with heart and lung disease, people with chronic respiratory conditions, infants and children, pregnant women and adults 65 and over. People in these high-risk groups should reach out to their healthcare provider to discuss specific ways to be prepared against wildfire smoke.

So, are you #SmokeReady? Here are 10 tips to help you prepare:

1. Plan ahead with your doctor.

If you or a family member has asthma, or suffers from heart or lung disease, have a plan to manage your condition. Children, pregnant women, and people over age 65 are especially at risk during smoke events. Learn more.

2. Get HEPA filters, recirculate your AC, and share space if able.

Use a HEPA filter in your home’s central air system or your air conditioner unit or air purifier. Learn how to turn your AC to “recirculate” in both your home and your car.

If purchasing a portable room air cleaner isn’t in your current budget, there are DIY instructions for building a “box fan filter.” These are fairly simple to assemble and cost around $50. View a tutorial to create a box fan filter.

For those who are vaccinated, you can also check with your neighbors—something we couldn’t do last year! If you or your neighbor doesn’t have good air filtration or air conditioning at home, arrange to share spaces with those who do.

3. Employers, plan ahead with your employees
.

Have a plan in place for employees who work outdoors. Consider alternate work assignments or relocation to reduce employee exposure to smoke. For staff that work indoors, ensure your air filtration system is protective for smoke. Prepare for employees to face childcare closures, home emergencies, etc. Check with Washington Labor & Industries for guidance

4. Have a Plan B for outdoor events.

Have a contingency plan prepared in case you need to cancel or reschedule. If you have children in summer camps or childcare, ask the organizers about their smoke plan. If the only viable plan B appears to be moving the event indoors, be sure to check with Skagit County Public Health before proceeding with plans. Visit the website or call (360) 416-1500.

5. Information about respirator masks.

If you have to be outdoors for extended periods of time, consider a N95 or N100 respirator. Thankfully, N95s are now a little easier to find in 2021 than last year, but the Washington Department of Health is still encouraging people to look at other options before getting a respirator.

If you do purchase a respirator mask, keep in mind that it can be difficult to find a mask that fits correctly. Test the fit and comfort of your mask before you need it. Learn more.

6. Stock up.

Stock up safely and responsibly. Have several days of water, groceries, and family needs on hand so you don’t have to go out when it’s smoky. Learn how to prepare.

7. Don’t forget your pets!

If the air quality is forecasted to be poor while you’re away from home, plan ahead to keep your pets inside or with a caregiver. Learn more.

8. Learn the air quality index numbers and colors.

During periods of poor air quality, watch for air quality alerts, pay attention to numbers and colors of air quality monitors, and know when to limit your time outdoors.

9. Make sure to get alerts.

Sign up to receive air quality email alerts for your zip code. Also, bookmark or subscribe to this blog for statewide air quality and wildfire updates.

Wildfire season doesn’t need to slow you and your family down, but proper planning is a must! Keep up to date by following the Washington Smoke Information blog. Learn more about being Smoke Ready at EPA’s Smoke-Ready Toolbox for Wildfires and Washington Department of Health’s Smoke From Wildfires Toolkit.


April is Child Abuse Prevention Month

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Post by the Skagit Valley Family YMCA

Every day, the Skagit Valley Family YMCA focuses on creating healthy activities and environments for kids to learn and grow! As part of this, each April, we join Washington State’s Department of Children Youth & Families (DCYF) in spreading awareness about child abuse and prevention strategies. Here are a few tips to help protect children in your community:

Know the signs.

Unexplained injuries aren’t the only signs of abuse. Depression, watchfulness, fear of a certain adult, difficulty trusting others or making friends, sudden changes in behavior, poor hygiene, secrecy, and hostility are often signs of abuse. Learn more about the signs here.

Evaluate if a report should be made.

Anyone who has reasonable cause to believe a child has suffered from or is at risk of abuse or neglect, should make a report. “Reasonable cause” means a person witnesses or receives a credible report alleging abuse. The report must be made at the first opportunity, no more than 48 hours after witnessing or receiving a credible concern.

Make a report.

If you witness a child being harmed or see evidence of abuse, make a report to your state’s child protective services department or local police. When talking to a child about abuse, listen carefully, assure the child that he or she did the right thing by telling an adult, and affirm that he or she is not responsible for what happened. If the child is in immediate danger, please call 911. For all other reports, call, text, or online chat the Childhelp National Child Abuse Hotline at 1-800-4-A-Child (1800- 422-4453).

Not sure about making a report? The Skagit Valley Family YMCA is here to help! All Y Kids staff are trained in child abuse prevention and reporting and our childcare centers are located across the Skagit Valley from Anacortes to Sedro-Woolley. Give us a call or visit one of our Skagit Y childcare centers.

Long-Term Effects

Child abuse has many long-term effects on children including brain trauma, PTSD, alcohol or drug use, and criminal activity. Childhood maltreatment has also been linked to life-long health problems including lung and heart damage, diabetes, high blood pressure, vision problems, and more. Fortunately, however, there is promising evidence that children’s brains and bodies may be able to recover with the help of early and appropriate interventions to decrease the risk of long-term effects.

Abuse Today

While school and childcare staff are trained to recognize the signs of potential abuse and the proper reporting procedures, COVID has limited contact that children have with trusted adults outside of their homes. With the lack of contact that trained adults have to youth due to COVID restrictions, there have been fewer reports made and a rise in hospital visits of kids who have experienced abuse or neglect. That’s why we need your help to identify and report signs of abuse or neglect. 

Get Involved

Join us for Wear Blue Day on April 2 as we kick-off child abuse prevention month! We encourage you to take photos and post them on social media using the hashtag #growingbettertogether and #CAPmonth.

Show your support by purchasing, making your own, or coloring a printable pinwheel! All proceeds from purchased pinwheels go toward Prevent Child Abuse America

Consider joining a parent group within Skagit and encourage other parents to keep an eye out for any signs of abuse or neglect. If you see something strange, you are likely not the only one. Together, you will be able to better determine if making a report is the right next step.

Prepare your Kids

Talk to your kids about what appropriate relationships look like with other adults. It may not be the right time for you to share what inappropriate behavior looks like, but by setting expectations for appropriate behavior, you provide a guide for your child to know what to expect and recognize behaviors that fall outside of the norm. It’s important for kids to know that they should trust their instincts and if something doesn’t feel right, to talk to you, a teacher, coach, or other trusted adult.

Even if your child isn’t exposed to abuse, they may know someone who is. Your kids are the best judge of any changes in their peers’ behavior and can help recognize potential signs of abuse or neglect. Consider asking your child questions such as: Did all of your friends seem happy today? Is there anyone in your class who seems left out? 

Many times, children who are abused, may repeat their abuse to other children without early intervention and support. Together, we can help stop the cycle to protect all children from abuse and neglect.


“Let’s get out of here!” Traveling After Getting a COVID-19 Vaccine

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You did it! You got vaccinated! Thank you for doing so. It helps not only protect you but the community at large. We bet that you’re ready to start returning to some of the activities you gave up in March 2020, including travel. If you are, please keep some things in mind.

The COVID-19 vaccines currently in use are highly effective.

Real world data has shown that their nearly 100 percent effective at preventing hospitalization and death amongst fully vaccinated individuals. In fact, Washington State has only observed a breakthrough rate of 0.01%, which is fantastic. Being fully vaccinated means you can do a lot of things again, such as:

  • Gather indoors with other fully vaccinated people without wearing a mask or social distancing
  • Gather indoors with unvaccinated people of any age from one other household without masks or social distancing unless one of the participants is at increased risk for severe illness from COVID-19.
  • Travel domestically, or return from international travel without getting a negative COVID-19 test or self-quarantining (Note: if you’re traveling internationally, you might still need a negative COVID-19 test to enter the country you’re visiting. Do your research before you go).
  • Unless you live in a group setting (like a correctional facility or group home), you don’t need to quarantine after an exposure to COVID-19 as long as you don’t develop symptoms.

Reminder: After receiving your second dose of the Pfizer or Moderna vaccine, or your Johnson & Johnson shot, you need to wait two weeks for immunity to build in your system. After that two week period, you’re considered fully vaccinated.

That said, COVID-19 vaccines aren’t get out of jail free cards.

There is still a risk that you could contract COVID-19 and spread it to loved ones or close contacts. This means that when traveling you should:

  • Keep wearing masks- and two if you can- especially on airplanes, in public spaces and when gathering with unvaccinated individuals from multiple households. 
  • Avoid large gatherings or events, especially when indoors, where people don’t remain in fixed locations, engage in activities that pose great risk for spread (singing, exercising, shouting, etc…) or wear masks aren’t or can’t be worn.
  •  Monitor for COVID-19 symptoms, and if any develop get tested right away.
  • Avoid visiting unvaccinated individuals who are at increased risk for poor health outcomes after traveling or being in public spaces for prolonged periods.
  • Follow your workplace guidance on quarantine when returning, which may be more strict than what is outlined here.

We’re all looking forward to increased travel and activity–but we’re not quite out of the woods yet. Please, continue to be smart and practice good behaviors. Wear your mask, practice social distancing in public or with unvaccinated individuals, wash your hands frequently (like, all the time and for lots of reasons it’s just a good thing to do).

If you’re planning a trip and are nervous about some of the circumstances, we’ve included a handy flow chart that can help guide you towards the best decision for your situation.

We’re in this together and we’ll get through this by protecting our community together.


Public Health Does What?!

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To say that it has been a weird time to work in public health would be an understatement. COVID-19 has completely shifted the day-to-day realities and priorities of health departments around the globe. And while everything has seemingly changed, the foundation of public health—what makes public health so vitally important—has remained the same despite it all.

Staff attending the Latino Health Forum (Oct 2019), pre-COVID.

As I sit here and reflect on my past three years with Skagit County Public Health, I’ve got to tell you, it has been one heck of a ride! I remember during those first few weeks learning (in astonishment!) all the things that public health is responsible for. After all, I had never worked for a government agency before. I knew that people visited their health department to pick up birth and death records or to get information about community resources, but I couldn’t have imagined the depth and breadth of the work that is done here at 700 S 2nd Street in Mount Vernon.

As I walked around the halls and met my new co-workers, I discovered the many divisions that make up our team: child and family health, communicable diseases and epidemiology, behavioral health and housing services, environmental health and food safety, senior services, and community health and assessment.

Of these, emergency preparedness and response was only one small (though critical) part of the puzzle. During a staff training one day, I learned a bit more about this division and was surprised to learn that all public health staff could be activated during times of public health crisis. At the time, I couldn’t fathom what this would look like. Now, a year into Public Health’s COVID-19 response, I can tell you exactly what this response is like!

When COVID-19 first appeared in Washington State last year, County leadership was the first to respond: Unified Command was established and plans were quickly put into place to mitigate risks associated with disease transmission.

Public Health staff working the COVID-19 Testing Site at Skagit Valley College on a foggy spring morning.

Our Public Health staff was activated—slowly at first, then almost entirely by the summer of 2020. On any given day in June or July at Skagit County’s COVID-19 testing site, you might have seen a hand-full of Public Health staff working to register people or help to administer tests—at times even jumping car batteries—whatever they had to do to get the job done.

Back at the office, a whole team of staff were called to conduct case investigation and contact tracing, conducting investigations seven days a week. Big plans for 2020 that had been on our work calendars were adjusted or put on hold to accommodate the ever-increasing demands of our COVID response.

More recently, with our vaccination initiative in full gear, we are in a much better (and sustainable) place. Our Vaccine Site at the Fairgrounds and Vaccine Hotline have been blessed by hundreds of hard-working and dedicated volunteers who show up every day to help get our community vaccinated. Our staff has also grown and changed, with an influx of new temporary and part-time staff that have been hired to conduct case investigations and to provide vaccine services at our clinic.

Case investigators staying cozy in their PJs on Thanksgiving Day.

As the numbers of vaccinated individuals in the state continues to increase, it begs the question: What will life look like after COVID? And even: What will Public Health look like if/when the demands of COVID begin to subside?

This week is National Public Health Week and is the perfect time to highlight the role of Public Health. Although our work has primarily been centered around COVID-19 this year, it is in no way all that we do.

Here is a quick look at some of the other things your local public health department does:

Behavioral Health Services

Public Health works with community organizations and coalitions, school districts, and regional partners to ensure that help is available to those in need, including access to mental health and substance use disorder treatment and recovery services. For more: https://www.skagitcounty.net/Departments/HumanServices/mh.htm.

Child & Family Services

The Child & Family Health Division works with individuals, families, and the community to assure that all Skagit County children have the healthiest possible start in life, with particular emphasis on pregnant women, infants, and toddlers. Programs include the Nurse-Family Partnership, ABCD Dental, Parent Cafes, and Skagit Bright Beginnings. For more information: https://www.skagitcounty.net/Departments/HealthFamily/main.htm.

Senior Services

Our Senior Services staff at the office are only the tip of the iceberg; this is a huge team! We have five senior centers in Skagit County and a robust Meals on Wheels and Senior Nutrition program. While many senior services have been put on hold due to COVID, the nutrition program has been instrumental to our crisis response. For more information: https://www.skagitcounty.net/Departments/HumanServices/SeniorCenters/Home/Main.htm.  

Developmental Disabilities Services

The Developmental Disabilities Program manages a variety of programs related to providing services to individuals with developmental disabilities, while also providing support for individuals and families and hosting community events and trainings to improve community awareness of developmental disabilities and inclusion. https://www.skagitcounty.net/Departments/HumanServices/DD/main.htm

Housing Services

Skagit County Public Health partners with local cities and nonprofits to provide humanitarian response, emergency shelters, rental assistance and supportive services with the goal of improving access to housing and reducing homelessness. Most recently, Public Health has made emergency funding available to those who have been impacted by COVID-19, and this funding can be used toward rental or utility bill assistance. For more: https://www.skagitcounty.net/Departments/HumanServices/HousingMain.htm.

Environmental Health Services

Environmental Health is easily the most diverse division that we have here at Public Health. From drinking water and food safety to the on-site sewage program and hazardous waste, our EH team is always super busy ensuring our residents are safe and healthy. For more: https://www.skagitcounty.net/Departments/HealthEnvironmental/main.htm.

Communicable Disease & Epidemiology

The shining star of 2020!  The Communicable Disease Program works closely with our healthcare provider partners to investigate notifiable conditions reported by health professionals, identify risk factors for disease, and provide education on how to prevent future infections. And we’re not just talking COVID-19! For more info: https://www.skagitcounty.net/Departments/HealthDiseases/main.htm.

Community Health and Assessment

Lastly, it is Public Health’s responsibility to think BIG: to analyze the data, identify the gaps, and propose new and innovative solutions. Public Health brings together a group of community leaders—called the Population Health Trust (PHT) —to solve Skagit County’s health issues that our community identifies. To learn more about the PHT, go to: https://www.skagitcounty.net/Departments/PHTAC.

If you run into a Public Health employee this week, give them a big air-five! And next time you’re wondering what the heck Public Health does, please remember—we’re so much more than COVID!

For information about Skagit County Public Health’s divisions, please visit: https://www.skagitcounty.net/Departments/Health/main.htm.

Preparing for the COVID-19 Vaccine

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We have been hearing some really positive things in the media recently about the development of COVID-19 vaccines. This news has been very exciting for the many people who are anxiously waiting for a vaccine to become available. With case numbers on the rise, it is no wonder that people are encouraged by the idea of a vaccine being approved before the New Year.

Understandably, there are those who are concerned about a new vaccine. For this reason, it is important to discuss the State’s plans for vaccine distribution, as well as what we should expect over the next several months. After all, it is important that Skagitonians have all the necessary information so that each individual can make an informed decision about the health and safety of themselves, and their loved ones.

Why is a vaccine important?

Wearing masks and social distancing help reduce your chance of being exposed to the virus or spreading it to others, but these measures are not enough. Vaccines will work with your immune system so it will be ready to fight the virus if you are exposed. A COVID-19 vaccine will help to protect you by creating an antibody response without having to experience sickness.

How are vaccines vetted for safety and effectiveness?

The speed in which these vaccines have been developed and the newness of the technology can seem scary to some. It is important to understand that safety has in no way been compromised, even with a quicker development timeline. Rather than eliminating steps from traditional development timelines, steps are being conducted simultaneously.

Clinical trials are currently underway to evaluate investigational COVID-19 vaccines. These clinical trials include thousands of study participants to generate scientific data and other information for the Food and Drug Administration (FDA). This data is then analyzed to determine safety and effectiveness.

These clinical trials are being conducted according to the FDA’s rigorous standards. If it is determined that a vaccine meets the FDA’s safety and effectiveness standards, it can make these vaccines available for use by approval or Emergency Use Authorization (EUA).

An EUA allows the FDA to make a product available during a declared state of emergency before it has a full license. So far, two vaccine manufacturers have applied for emergency use authorization, however the FDA has not yet approved a COVID-19 vaccine. If EUAs are approved, these vaccines will then be vetted by the Scientific Safety Review Workgroup, as part of the Western States Pact.

Even once a vaccine is approved for use, there are vaccine safety monitoring systems in place to track any possible side effects. If an unexpected adverse event is seen, experts quickly study it further to assess whether it is a true safety concern. Experts then decide whether changes are needed in vaccine recommendations.

When is a vaccine going to be available?

As of right now, we don’t have an exact date. The timeline is based on when an FDA-approved, safe and effective vaccine is available.However, WA DOH is hopeful that a vaccine will be available to begin administering by mid-December 2020.

There is a lot of planning taking place at the federal, state, and local level around vaccine distribution. In October, Washington State submitted its interim vaccine distribution plan to the Centers for Disease Control and Prevention (CDC) for approval. In Skagit County, the Public Health Department and its community partners are currently discussing plans for distribution—including logistics, as well as messaging.

Who will receive the vaccine when it first arrives?

Manufacturing, distribution, and administration will all take time. The availability of the vaccine, as well as local capacity to vaccinate people, will directly impact the timeline for distribution.

Washington State’s vaccination plan is tiered to focus on specific groups early on. Included in the first phase are those at highest risk. This is to ensure that these individuals will receive the vaccination as soon as possible.

Based on recommendations from the National Academy of Medicine, these high-risk individuals include: health care workers at high risk for COVID-19; first responders at high risk for COVID-19; and people with underlying health conditions that put them at a significantly higher risk for COVID-19.

The second phase would expand to include more people, including school and child care staff, as well as people of any age who have underlying conditions that put them at higher risk of severe illness.

Most healthy adults shouldn’t expect to be vaccinated until phase three or four. We expect more information for groups such as children and pregnant women to be available in the coming months.

Where can I go for more information?

There is so much information right now about the COVID-19 vaccine, but there is also a lot of speculation and misinformation. It is so crucial that we seek out credible information! Please turn to trusted sources for health information, including your healthcare provider and public health experts.

For general questions about the COVID-19 vaccine, email WA DOH at covid.vaccine@doh.wa.gov. And as always, you can contact Skagit County Public Health with any of your COVID-19 questions (360-416-1500).

Other resources:

https://www.doh.wa.gov/Emergencies/COVID19/Vaccine#FAQ

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/faq.html

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/8-things.html

https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/covid-19-vaccines