Washington State Gov. Jay inslee Extends Stay-Home Order

by Carolyn Bick

Washingtonians will remain under a stay-home order past the original stop date of May 4, Gov. Jay Inslee announced in a press conference on April 30.

Joined by Vice Admiral Dr. Raquel Bono, director of Washington state COVID-19 health care response, as well as state health officer Kathy Lofy, and the Washington State Emergency Operations Center deputy intelligence section chief Katherine Guest, Inslee said that the decision to keep Washingtonians under a stay-home order was not an easy one, but was necessary, based on current modeling data. The stay-home order is meant to combat the spread of the novel coronavirus.

Inslee explained that while the state's cases have dropped, the spread of the novel coronavirus is still too high, and the risk of a dramatic increase in spread is too great to reopen the state. He laid out the metrics on which the state is basing its current decisions. These metrics include infection and death rate, hospitalization rate, and spread rate, as well as projection models based on different data sets. Other metrics, such as testing and isolation capacity, the state's ability to conduct contact tracing, and risk to vulnerable populations are also included.

Inslee said that Washingtonians can't become "inured" to death, because "each of these numbers is a person." According to the data, he said, the state's Hispanic population is most affected by the novel coronavirus.

"If we stop our efforts today, we are going to see a lot more people die in the state of Washington in the not-so-distant future," he said.

Inslee said that testing capacity currently stands in the mid-4,000s range, but needs to rise to at least 20,000 tests per day. He said that he believes this is a "reasonable" number, but that these tests will be prioritized for those in hospitals. He also said that antibody serology testing is currently going on in Seattle vis a vis testing leftover blood from blood banks to check antibody levels.

Inslee said that he will hold another press conference on Friday, May 1, to address specific dates around the current stay-home order, as well as to describe the plan to reopen the state's economy in phases. This press conference will include guidance around reopening hospitals for non-urgent surgeries.

In a press release also sent out today, Inslee provided clarity and guidance on Proclamation 20-24, which was issued by his office on March 19 and prohibited "non-urgent" medical procedures by institutions from dental offices to hospitals.

The proclamation originally placed limitations on "healthcare services, procedures, and surgeries that, if delayed, are not anticipated to cause harm to the patient within the next three months" and though examples were provided for what types of procedures to delay, it did not provide a definition of "harm."

Today, Inslee clarified in a typed statement that the assessment should be made by individual providers, using "clinical judgement" for non-urgent or elective services but said that the risk of the patient receiving services during the novel coronavirus pandemic should be part of the overall assessment made by the provider. The statement also clarified that all procedures for which delay would result in "worsening a life-threatening or debilitating prognosis" are allowed under the proclamation.

"Washingtonians have taken the threat of COVID-19 seriously, and that includes our doctors and nurses," said Gov. Inslee. "But there are some much-needed procedures that aren't being performed that should be."

Inslee provided a list of considerations for providers to use to determine whether or not a service or procedure ought to be performed that included the "possibility that delay results in more complex future surgery or treatment," "increased loss of function," "continuing or worsening of significant or severe pain," and other criteria. He also outlined "prerequisites to performance of healthcare services, procedures and surgeries," which included the ability of the provider to meet infection and prevention control standards and maintain appropriate personal protective equipment — which Inslee says is still in high demand — and more.

Inslee also stated that for procedures that require an overnight stay, hospitals may not exceed 80 percent of available bed capacity, with "beds" being defined as "licensed and staffed," to ensure adequate capacity for hospitals to address emergencies, be they related to COVID-19 or not. Read the full statement here.

Carolyn Bick is a journalist and photographer based in South Seattle. You can reach them here.