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Health officer explains reasoning behind newest Washington COVID restrictions

A general view of the stadium scoreboard at T-Mobile Park with a message promoting health and safety due to the COVID-19 pandemic on July 31, 2020 in Seattle, Washington. (Photo by Abbie Parr/Getty Images)

Governor Jay Inslee announced new restrictions Sunday for Washington to help limit the spread of COVID-19 as cases continue to rise across the state.

Gov. Inslee bans indoor gatherings and dining as part of new COVID-19 restrictions

State Health Officer Dr. Kathy Lofy joined the governor to help explain some of the rationale behind the new COVID restrictions, adding that they do not make these decisions lightly.

“The current trajectory of this pandemic has put us in a really difficult position as a state,” she said.

“We are extremely concerned about how quickly COVID-19 is spreading through our state,” Dr. Lofy added. “We have entered a phase of accelerated or exponential growth of the outbreak.”

Over the past two weeks, she explained, the number of cases reported each day in Washington has more than doubled, from about 1,000 to more than 2,200 cases per day.

If that doubling continues, Lofy says, then in two more weeks the state will see over 4,000 cases per day.

What’s especially concerning for Lofy and local health officials is that during the past week, the number of patients currently in local hospitals with COVID-19 increased by about 40%.

“This is a statewide problem,” Lofy added, as there are high disease rates throughout the state and many counties are seeing a dramatic uptick in disease activity.

“This increase is simply not sustainable,” she said. “We will eventually exceed the capacity in our hospitals to adequately care for all patients, including patients with and without COVID, and ultimately will lead to more deaths.”

“When cases are accelerating, we need to act early because the effects of the measures that we put in place this week will not be shown in the data for another three weeks,” she added.

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Rationale for specific measures

The measures announced by the governor are intended to reduce opportunities for prolonged, indoor contact with people outside of one’s household, which has been shown to be a primary risk factor for the spread of the virus.

“Over the course of the pandemic, we’ve learned a lot about how this virus is transmitted,” Lofy said. “We initially thought it was spread primarily through large droplets that only traveled a few feet in the air and rapidly fell to the ground. We now know that this virus can also spread through very small droplets called aerosols that are expelled from our mouths when we talk, cough, sneeze, and sing, and can linger in the air.”

“We also know that a primary risk factor for spreading the virus is contact with an infected person in indoor spaces,” she added. “The infection risk increases with the duration and the proximity of contact with an infected individual, with certain activities, when masks are not worn, and where ventilation is not good.”

The Centers for Disease Control and Prevention recently acknowledged growing evidence, Lofy explained, that droplets in airborne particles can remain suspended in the air and travel distance beyond six feet, especially during choir practices, in restaurants, and in fitness classes.

Unfortunately, while more is known about how the virus spreads, it’s still difficult to pinpoint exactly where COVID-19 is being transmitted, which Lofy says is a problem that’s not unique to Washington.

“When we interview cases, it’s often difficult to determine with certainty where the individual was infected because they often have more than one potential exposure, because many people may not remember all their activities in the 14 days before becoming ill, or may not want to share all their activities with us,” Lofy said.

Occasionally, health officials are able to identify where two or more infections have occurred, which is considered an outbreak.

“But these identified outbreaks likely only represent a portion of transmission that’s occurring in the community, and we likely are only detecting a fraction of these outbreaks,” Dr. Lofy said.

Because of the limits in data about where transmission is occurring, Lofy says they have to rely on the science around how the virus is spread, and reports of outbreak investigations in other areas.

“Our leading national infectious disease experts at the Infectious Disease Society of America have stated that eating indoors at restaurants, going to an indoor gym, attending a church service with singing, going to bars, and going to movie theaters are activities that put us at high-risk for spread of COVID-19,” Lofy said. “A recent CDC study also reported that dining in a restaurant, bar, or coffee shop was associated with an increased risk for COVID-19.”

The new restrictions, which ban indoor gatherings and indoor dining were made with the hope of limiting some of the highest risk activities for the spread of COVID-19, and should be able to help Washington state flatten the curve, again.

“Flattening this curve is essential to saving lives and ensuring that our hospitals don’t become overwhelmed with COVID cases, like we’re seeing in many hospitals in the Midwest and elsewhere in the country,” Lofy said. “If we act now, we can be successful.”

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