FAQ: Coronavirus in Washington

Q: How many test kits are available in Washington state to test for the coronavirus, and how many people are projected to become infected in the next one to three months?

It’s difficult to determine the precise availability of coronavirus testing in Washington state, but Washington state Department of Health’s Danielle Koenig said the afternoon of Friday, March 6 that the state public health lab has the capacity to perform up to 200 tests a day, and the University of Washington Virology Lab can perform up to 750 a day.

That capacity seems to be expanding quickly. A tweet from UW Virology, which is handling testing for the University of Washington, said the same day that it has the capacity to perform 1,000 tests per day; that it had performed 400 tests to date finding a 5% to 7% infection rate; and that it’s “able to meet all current testing demands.” The next day, March 7, the lab said it performed 400 tests that day. 

According to Hilary Karasz with Public Health — Seattle & King County⁠, the majority of swabs for testing are taken in health care providers’ offices and then sent to labs for analysis. “Public Health has been triaging whose tests were conducted based on CDC guidance when there was very limited testing capacity,” Karasz said Friday. “Now that there appears to be increasing numbers of labs being able to test, we will expect providers to conduct the tests and not consult with us.” 

While Koenig said “there is no way to know how many people will become infected in the future,” people are making projections.

On March 10, Gov. Jay Inslee said that 64,000 Washingtonians could become infected with COVID-19 by May without containment. The next day, he announced a ban on certain gatherings larger than 250 people through the end of March in three Washington counties. 

Harvard University epidemiologist Dr. Marc Lipsitch told CBS News that he projects between 40% and 70% of the global population will ultimately become infected — to differing degrees of seriousness.

Q: What are early symptoms? Do they vary across age groups?

As with many illnesses, the symptoms can vary by person. The main symptoms are fever, cough and shortness of breath and appear two to 14 days after infection. Other agencies and outlets say symptoms tend to appear five or more days into infection, and also include fatigue, a dry cough, and production of sputum (a mixture of saliva and mucus). 

There are many similarities between coronavirus, the flu and the common cold ⁠(also caused by a strain of coronavirus), making it difficult to distinguish among them. As Public Health works to stop the spread of the virus, it recommends that anyone who is sick stay home. 

More on this topic: What are symptons of cornovirus? reported by the New York Times.

Q: When will broad-scale, same-day testing be available in King County?

It’s unclear. The Department of Health's Koenig didn’t say when broadly available, same-day testing would be standard, but did say that “we are running multiple test runs a day, so tests may be performed the same day we receive them, if we are undercapacity for the day.” 

However, there are many signs that testing is becoming more available. The University of Washington was recently given the green light to provide testing; initially, only the Centers for Disease Control and Prevention, and then state labs, were able to provide testing. 

The Bill & Melinda Gates Foundation announced over the weekend that, through the Gates-funded Seattle Flu Study, it would allow Seattleites to apply online for in-home coronavirus tests deliverable within two hours and intends to process thousands of tests daily. But it’s (again) unclear when that initiative would start.

There are people trying to make testing more accessible ⁠— including a locally led group of DIY biologists working on an open-source test protocol ⁠— but testing is still managed by health care providers and state and local health departments.

Q: What are local retailers like Bartell Drugs and Fred Meyer doing to restock shelves with 90% alcohol, disinfecting wipes, etc.? Are they shifting supplies from distribution centers out of the area? How do local customers assure they can get these items in a timely way?

After Public Health recommended people use alcohol-based hand sanitizers to disinfect their hands when away from handwashing facilities, many local drugstores and markets ran out of product. Alex Fryer, communications director of King County's Office of the Executive, didn't comment on whether the county has discussed the issue with local businesses but did say, “Our facilities department is ordering extra supplies, which are in demand across the country.” 

“I do not have information on this,” said Department of Health’s Koenig. 

For what it’s worth, states like New York are responding by producing their own lines of hand sanitizer, with the help of prison inmates. 

The good news is that things like soap are still readily available. So while sanitizing your hands on the go may be more difficult, tried-and-true methods like handwashing remain easy and effective. And if you wind up quarantined, you won’t need mobile-ready hand sanitizer to stay clean.

A tip from Bartell Drugs:

Q: What is the University of Washington, especially the medical center, doing at this point?

The University of Washington and UW Medical Center are both heavily involved in reducing the outbreak. UW’s Department of Virology is assisting in the processing of coronavirus tests, and people across the university, like Dr. Deborah Fuller, are involved in the creation of vaccines.

Hospitals such as Harborview have been working closely with Public Health to monitor and contain the outbreak. The hospital set up a mobile testing team to visit patients suspected with the illness at their homes instead of asking them to come to Harborview at the risk of infecting others. UW Medical Center Northwest is providing employees with drive-through testing. 

You can also get updates from the medical center's news updates web page.

Q: I want to know how the COVID-19 tests will be paid for. People will not want to get tested if they have to pay thousands of dollars to do so.

The Department of Health’s Koenig said she’s unsure right now how much each test costs. There are reports from across the United States of people receiving large medical bills as a result of coronavirus testing and care. Washington state recently committed to making tests free to uninsured populations, and free of deductibles and copayments for insured populations. 

Last week, state Insurance Commissioner Mike Kreidler required insurance companies to allow one early refill of prescription medications and to waive prior authorization requirements for testing. 

“Consumers are rightly concerned about prevention, testing and possible treatment,” Kreidler said in a press release. “My emergency order provides guidance to health insurers and should help reassure the public that we will take all necessary steps to protect them.” 

Have you received a high bill related to coronavirus testing or care? Get in touch. 

Q: If schools close, how will the children who qualify for free and reduced lunch be fed? Will food banks do deliveries?

Many schools in Washington state have been closing to clean facilities and limit the outbreak; the University of Washington has gone to all-online classes. 

According to Katy Payne, director of communications of Washington’s Office of Superintendent of Public Instruction, local food banks would make their own decisions about the delivery of food to needy students in the event of closures. “So far, it isn’t a model that we have been able to explore. Our plan is to work with school districts individually as the need arises, as each district’s situation is different,” she said. 

Meanwhile, she said schools have options under state regulations to provide students with meals during unanticipated closures. If individual schools are closed but a district is operational, the district can still feed students through a sack meal service. For completely closed districts, Payne pointed to how schools handle meals over the summer. The unanticipated school closure option of the Summer Food Service Program allows districts to feed students ages 0 to 18 at no cost to families if the district is in a high-need area (50% or more of the student population qualifies for free or reduced-price meals). But Payne said this program requires students to gather and be served in one designated place, recreating the high-risk conditions school closures are designed to fight. 

The superintendent's office submitted two waiver requests last week to the U.S. Department of Agriculture’s Food and Nutrition Services, Payne said. One yet-unapproved waiver would allow districts that don’t qualify as high-need to also serve food during districtwide closures. The other waiver, approved March 6, allows grab-and-go meal service for qualifying high-need districts instead of requiring students to eat together in one place.

While Seattle Public Schools remain open, district communications specialist Tim Robinson said the district has an emergency plan that’s being finalized. “As in the past, we will provide sack lunches prepared by our central kitchen. If all schools are closed, we intend to have an established drop off point. We may distribute from school campuses, neighboring schools or in partnership with the community centers and the city of Seattle. Our approach is similar to supports provided during the summer,” he said.

Q: Who is the motel that the city is purchasing for? Who is supposed to recover there? Everyone? Homeless? Only people who require hospitalization?

King County recently announced that it would be purchasing an Econo Lodge motel in Kent for COVID-19 quarantine. King County’s Fryer said the people who’d use the hotel are the “same as [those using] modulars,” referring to modular housing units recently announced by the county as isolation and quarantine sites. 

“So there's really two segments of the population that [it] is designed for,” King County spokesperson Chase Gallagher said. Both segments of people are those for whom home quarantine isn’t an option. “One would be if you're someone that needs to self-quarantine, but maybe you have a family member at home that may be at higher risk or a pregnant spouse, or something like that,” he said. “The other one would be if you were a homeless person, and you normally would go into a shelter during a cold weather event or something like that.”

Gallagher said the motel isn’t in use yet, as officials finalize the purchase and make sure it’s a safe space for people to recover.

Q: If someone does get sick from the virus, and then recovers, is that person now immune and can not get sick from it again?

It’s unclear whether people can get re-infected — but it’s unlikely. STAT News’ Helen Branswell, a veteran health journalist, backs this up with her reporting.

"People probably aren’t being re-infected after recovery,” Branswell writes. “There has been concern on social media about reports of people getting infected, recovering, and then later developing symptoms again. Some scientists from China have suggested the virus is able to re-infect people after a very short time.”

“In fact, it would be unusual if an immune system that had just fought off a viral invader would forget how to recognize it and fend it off within a period of days or a few weeks.” Instances where people seem to test positive again, she reports, are likely indicative of how testing was done rather than how the infection has actually progressed. 

Q: What age group was most affected by COVID-19 in China?

While testing that would confirm COVID-19 diagnoses has lagged in the United States, China’s testing program has been able to account for more than 80,000 infected persons, with at least 61.8% confirmed cases. Researchers from the Chinese Center for Disease Control and Prevention evaluated data on more than 72,000 of those cases in mid-February to identify who was getting infected and suffering the worst. 

The analysis found that the majority of infections ⁠— 86.6% ⁠— occured in people between the ages of 30 and 79. Where the mortality rate hovered around 3.4% at the time, the elderly were more likely to die, with people over 80 experiencing a 14.8% fatality rate. “By contrast,” notes STATNews’ Helen Branswell, “the fatality rate was 1.3% in 50-somethings, 0.4% in 40-somethings, and 0.2% in people 10 to 39.” The majority of people who developed the most severe symptoms, which resulted in the highest likelihood of death, had an average age of 61.

People still aren’t sure why more children aren’t being infected, or whether those infections are going unaccounted for. A recent Johns Hopkins University study based on infections in Shenzhen, China puts forward that children are just as likely to be infected as adults, but simply don’t get as ill. That has implications for how health care professionals work to reduce the likelihood of infection elsewhere in the world. If kids are just as likely to be carriers of disease as adults, the researchers told Wired, “closing schools might be an important thing to do to prevent onward transmission.”

Q: What precisely have the causes of death been for those in Washington who have died after being diagnosed with COVID-19? There has been discussion of co-morbidities and underlying health conditions, but nothing else.

Until King County’s medical examiner makes that information public, we’ll be officially in the dark.

“The state does not post individual medical information, only total case counts,” says DOH’s Koenig.

But thanks to a World Health Organization analysis of deaths in China, we know that risk increases when the disease moves into the lungs, where it can lead to respiratory failure and occasionally septic shock.
 

Q: With school nurses spread so thinly among thousands of students, what back up plans do school districts have for assessing ill students when the nurse is out sick? Or quarantined?

“It is true that our K–12 schools experience a shortage of state-funded nurses. During a public health outbreak like this, we anticipate that districts are including the possibility of temporarily losing access to their nurse as part of their contingency planning,” says OSPI’s Payne. Per OSPI organizational protocol, schools are required to have one professional nurse for every 1,500 students. 

At Seattle Public Schools, Robinson says nurse input “isn’t necessarily always part of the process when it comes to addressing some instances of student health.” Funding limitations, he says, mean that some schools don’t have nurses, though school staff are trained to look for signs of all variety of illness. 

“That said, we have been sharing basic information: If you’re sick, don’t come to school. See your health care provider,” Robinson says. Students exhibiting symptoms at school will be quarantined until parents can pick them up. 

Read Crosscut’s previous coverage of coronavirus in schools: Coronavirus has Puget Sound schools prepping for 'an ongoing risk'

Q: If a person with the virus on their hands touches a doorknob, how long will the virus be active?

It depends on the surface and factors like temperature and humidity. It’s not certain but the World Health Organization says COVID-19 “seems to behave like other coronaviruses.” That would mean germs could last a few hours to several days. You can clean surfaces with mild disinfectants or soap and water to help mitigate the virus lingering on surfaces.

Q: Can a person transmit the virus to a pet such as a dog or cat?

That doesn’t seem to be absolutely known at this point, but experts don’t seem to be concerned about a pet outbreak of the illness. The Washington Post reported on March 5 that a dog had “low-level” infection and the animal’s owner was hospitalized with COVID-19, but the dog, which is quarantined, has no symptoms. Read the full story.

Q: What are immune-compromised people over 50 supposed to do?

The general advice for older people and those more vulnerable to catching illnesses is to stay home as much as possible. Department of Health has more ideas to help you hunker down, if needed:

• Make sure you have contact information for your regular healthcare providers handy. 
• Ask your healthcare provider to write prescriptions for extra supplies of medications to save the refill trips to the pharmacy.
• Make a phone tree or social media group with people who can help you if you need extra assistance. Ask them to check up on you, too, but make sure they understand not to drop by for visits.
• Consider stocking up on extra food or personal hygiene products to avoid needing frequent trips to the store.
• If you’re not feeling well, make sure you take your temperature before you take any medications. Write down your symptoms and note when they appeared, and write down any medications you’ve taken to treat them (including over-the-counter products).
• Before going to any kind of medical center, call your healthcare provider first. They might be able to give you advice or instructions that will save you a trip or help you avoid exposure to other immune-compromising situations.

Dr. Tania Busch Isaksen, a senior lecturer with UW’s Department of Environmental and Occupational Health Sciences, points to two sites for safety tips for older and immunocompromised people: Public Health’s first-person guidance on making recommendations to at-risk loved ones during an outbreak, and the above DOH guidance to high-risk individuals.

Q: What are King County Exec. Dow Constantine and King County Council doing to address the previously reported issues of insufficient money, masks and personnel in our area? They have recommended we wash our hands, but I've not seen them address any contingency plan for bridging these identified gaps.

On Friday morning, a group of public officials updated the state on the process of emergency funding to support state and local efforts. King County Exec. Dow Constantine, Gov. Jay Inslee, Rep. Suzan DelBene and Rep. Derek Kilmer announced that the state has spent more than $2.5 million on the response, with health districts like King County spending about $100,000 a day to fight coronavirus.

With encouragement from officials like Sen. Patty Murray, the Trump administration recently signed a $8.3 billion supplemental funding bill to stem the national spread of coronavirus. Rep. Kilmer says that $950 million will be available to state and local health agencies, with at least half to be distributed within 30 days. $11.5 million will immediately be distributed to Washington state, he says. 

The funding includes a general provision to reimburse state and local governments for costs that they’ve incurred since the beginning of the outbreak, he says, and to help improve preparedness and response. The government has committed “nearly a billion dollars for medical supplies and healthcare preparedness and medical surge capacity,” he says, with about half of that funding meant for procuring pharmaceuticals, masks and personal protective equipment “which can be distributed to state and local governments dealing with shortages.” The funding will also help support further training of healthcare responders. 

Inslee says Washington is passing an appropriation of $100 million to help “a whole variety of these efforts,” and says the state is pursuing ways to compensate first responders and other health care workers. 

“The State Legislature increased funding. So did U.S. Congress. We have an appropriation request in front of County Council,” King County’s Fryer said Friday, citing the county’s recent $27 million funding request. 

Q: Pollen allergies are also kicking up for a lot of people. How can we tell the difference between allergies and the coronavirus? What about the flu?

It’s hard to give a definitive answer for how to tell the difference between the seasonal flu and coronavirus. Both share many of the same symptoms, according to John Hopkins Medicine, including fever, cough, body aches, fatigue and sometimes vomiting and/or diarrhea. Both can manifest as mild or severe cases in different people.

But there are key differences. Itchy, watery eyes are not a listed symptom of the common flu or coronavirus, according to advice from the Mayo Clinic. Allergies also don’t cause body aches and rarely cause a fever — a main symptom for both the common flu and coronavirus. 

Q: What are airports and airlines doing to keep passengers safe and healthy?

The Port of Seattle, which is in charge of the Seattle-Tacoma International Airport, says on its website that it follows protocols provided by multiple state and federal agencies, including: 

• The Centers for Disease Control and Prevention
• U.S. Customs and Border Protection
• The United States Coast Guard
• The Washington State Department of Health
• Public Health-Seattle & King County

According to the Port’s website, the airport has more hand sanitizer available in more places; and they’ve increased cleaning practices, particularly in “high-touch” places like handrails, escalators, restroom doors, etc.

SeaTac is one of 20 airports in the United States with quarantine stations, according to the Port’s website. It also notes that, “Public health staff will also proactively monitor for signs of ill passengers who present signs and symptoms of disease at SEA. This screening builds on established infectious disease protocols, which includes reviewing information received from pilots, flight attendants, or crew who are trained to spot and report symptoms.”

Several major airlines announced they’re waiving some or all change fees for customers with existing tickets booked for the next few weeks. 

If you have upcoming travel plans, check the CDC’s guide for updates on risk assessment and travel restrictions.

Q: Are there any small, portable UV zappers to kill the virus on door knobs, handrails, surfaces? Do they work?

Plenty of news outlets have been sharing information about supposed ‘UV zappers’ that clean phones, laptops, and other screens known for carrying germs. Even CNN has promoted something called the ‘PhoneSoap,’ calling it “the phone sanitizer you didn’t know you needed.” 

However, UV lamps should not be used to sterilize hands or other areas of skin as UV radiation can cause skin irritation, according to the World Health Organization.

Dr. Busch-Isaksen says “I would recommend against their use. The inappropriate/untrained use of high intensity UV bulbs can result in non-trivial injuries to the skin and eyes.” 

High-touch surfaces should be cleaned daily, as should any surfaces that come into contact with blood, stool, or bodily fluids. The best tool for the job is a household cleaning spray or wipe, used safely according to its instructions. 

“I don’t know about that item but you can find cleaning recommendations here,” DOH’s Koenig said via email, pointing to the CDC’s cleaning tips webpage. 

Q: I'm wondering what King County is doing to help protect the homeless population from coronavirus. For those living on the street, handwashing can be challenging. Further, many are living close together, and chronic diseases are common, which could increase their risk.

Sherry Hamilton, communications director for King County Department of Community and Human Services, says the county is working with its provider network and outreach teams to continue shelter services countywide and launch a few activities specific to COVID-19. 

Focus areas include how to respond to cases of COVID-19; providing hygiene and sanitation services; and setting up shelters for quarantine, isolation and recovery in partnership with the City of Seattle. Hamilton says modular units will be placed at one site in White Center and one in North Seattle, in addition to the motel in Kent and the recovery center in Interbay. The total capacity for the four sites is 213 people. 

Hamilton says more than 200 people (including city planners, homeless services providers and others) have joined weekly conference calls about updates and training opportunities around COVID-19. The county co-launched a web-based, recorded hygiene and sanitation training module Friday, and scheduled six Q+A webinars for homeless service staff over this week “and will add more if needed.”

Update: This article was updated with answers to additional questions at 6 p.m. on Tuesday, March 10; the question about projected infections in Washington state was updated at noon on Wednesday, March 10 to reflect Gov. Jay Inslee's projection. 

Anne Christnovich contributed to this report.