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Home My WebLink About20-04 - Res. Approving COVID-19 County Safe Start Application from Phase 2 to Phase 3 - 2020/06/16 L � Resolution No.ao—O 1'I A Resolution Approving a COVID-19 County Safe Start Application from Phase 2 to Phase 3 WHEREAS, Mason County Community Services, Public Health opened Incident Command for support of COVID-19 response on February 24,2020; and, WHEREAS, Mason County initiated Area Command on March 4, 2020 to address COVID-19 response; and, WHEREAS, Governor Inslee adopted Proclamation 20-25 STAY HOME — STAY HEALTHY on March 23, 2020 proclaiming a State of Emergency for all counties throughout the state of Washington as a result of COVID-19; and WHEREAS, Governor Inslee adopted Proclamation 20-25.4 Transition from STAY HOME—STAY HEALTHY to SAFE START—STAY HEALTHY COUNTY-BY-COUNTY PHASED REOPENING on May 31, 2020 and Mason County is eligible to apply to move into Phase 3 effective June 13, 2020. County applications will be approved or denied by the Secretary of Health; and WHEREAS,the Mason County Board of Health met in a special meeting, in compliance with the Open Public Meetings Act, on June 16, 2020 and approved the Application for COVID-19 County Safe Start Phase 2 to Phase 3; and NOW,THEREFORE BE IT RESOLVED by the Mason County Board of Health to approve the Mason County Application for County Safe Start Application COVID-19 Phase 2 to Phase 3 (Attachment A) and direct staff to send to the Secretary of Health. Adopted this 10' day of June 2020 MASON COUNTY, WASHINGTON BOARD OF HEALTH Scott Hil n, Hospital istrict #1 Ka by owell, Ci Commissioner Kevin Shutty, Co missioner Rand�Neatherlin, Commissioner . ATTEST /v4 Sharon Trask Com ' sioner Megssa ry, Cler f the Board Peggy n' u'skirk, Ho pital District#2 APPROVED AS TO FORM: ( Gary Plews, Fire Commissioner Tim Whitehead, Chief Civil Deputy Prosecutor Ked bc on, SheltorfSchool Board e e t MASON COUNTY COMMUNITY SERVICES Building,Planning,Environmental Health,Community Health 16 June 2020 John Wiesman Washington Secretary of Health RE: Mason County Application Dear Dr. Wiesman, I am pleased to write to you with our application to move from Phase 2 into Phase 3 of the Governor's plan for COVID19 recovery: Our interaction with DOH staff, Kathy Lofy,.and you have been essential into getting a measurable set of criteria that scales across counties. Your efforts are appreciated. Our continued primary focus is keeping people safe.while re-opening the economy that is vital to improving the social determinant factors of public health. Mason County will officially move into Phase 3 not earlier than 22 June 2020 or 48 hours after official approval notification from DOH. The Mason County Joint Information Center will post the start date and time through standard notification channels. Mason County understands that the state is not producing industry specific guidance for Phase 3 with the exception of pools/spas and sporting events. Guidance from Phase 2 is extended into Phase 3. Mason County seeks a full opening to Phase 3 with.the exceptions of pools/spas and county owned sporting facilities/ball fields. These areas will be approved upon commission and health officer review and'approval. Mason County offices will utilize the Phase 3 Safe Start Plan Template (https://www.goverrionwa.gov/sites/default/files/BusinessTem plate Phase- l.pdf?utm medium=em ail&utrn source=govdelivery )Appendix B for opening the county to the public at large with a tentative start date of 22 June, 2020 Please contact me if you have any questions.We welcome the opportunity to continue working with you. Sincerely, David Windom, MSHS Community Services Director Public Health Community Development, (Community Health/Environmental Health) (Permit Assistance Center/Building/Planning) 415 N.61h Street—Shelton,WA 98584 615 W.Alder Street—Shelton,WA 98584 Shelton:360-427-9670,Ext.400 Shelton:360-427-9670,Ext.352 Belfair:360-275-4467,Ext.400 Benin 360-27574467;Ext.352 Elma:360-482-5269,Ext.400 Elma:360-482-5269,Ext.352 } Public Health Community Development (Community Health/Environmental Health) (Permit Assistance Center/Building/Planning) 415 N.6`h Street—Shelton,WA98584 615 W.AlderStreet—Shelton,WA98584 Shelton:360-427-9670,Ext.400 Shelton:360-427-9670,Ext.352 Belfair:360-275-4467,Ext.400 Belfair:360-275-4467,Ext.352 Elma:360-482-5269,Ext.400 Elma:360-482-5269,Ext.352 MASON COU-NTY REQUEST FOR VARIANCE Phase 2 to Phase 3 Abstract Mason County Application for Variance to move from Phase 2 to Phase 3 David Windom dwindom@co.mason.wa.us Mason County Application for Variance Metrix Covid-19 Activity Target<25 cases/100,000/14 days 4.6 Trends in Hospitalizations Down (from 1 to 0) Reproductive rate for the Western Region 0.9 Healthcare System Readiness % Licensed beds Occupied by patients 68%GREEN (target<80%) % licensed beds occupied by Suspected/confirmed COVID-19 cases 0 occupied for 0%GREEN (Target<10%) Testing Average number of tests performed per day during the past week(or average% tests positive for COVID-19 during the 223 tests-31.9 tests per day-.1 cases per day past week) (target 50 times the number of cases or 2%) Median time from symptom onset to specimen collection (target<2 median Null days) Case and Contact Investigations J Percent of cases reached by phone within 24 hours of receipt of positive case report 100% (target 90%) Percent of contacts reached by phone or in person within 48 hours of receipt of 100% confirmed positive lab report Percent of cases being contacted daily(by phone or electronically) during their 100% isolation period (target 80%) Percent of contacts being contacted daily (by phone or electronically) during their 100% quarantine period (target 80%) Protecting high-risk populations Number of outbreaks reported by week (defined as 2 or more non-household cases epidemiologically linked within 14 none days in a workplace, congregate living, or institutional setting) (target 0 for small counties) Statement of Purpose Mason County seeks a collaborative and responsible approach to moving our community from Phase 2 Recovery into.Phase 3. Mason County, operating with a comprehensive partnership including the community, tribes, health care, first responders, city, and county leadership, continues to meet or exceed the criteria needed to reopen our local economy and support medical systems. Mason County's population estimate is 66,768 (census.gov, 5/5/2020). As a responsible governing body, Mason County is seeking this variance to prevent collapse or further unnecessary and preventable second and third order of effects to the population and economy. It should be noted that our primary focus is always keeping the community safe while moving into Phase 3 Washington's Phased Approach. Governor Inslee, in collaboration with local elected officials, the Department of Health, and local health jurisdictions, has established a data-driven approach to reopening businesses and modifying physical distancing measures while minimizing the health impacts of COVID-19. This approach reduces the risk of COVID-19 to Washington's most vulnerable populations and preserves capacity in our healthcare system, while opening businesses safely. The plan involves assessing COVID-19 activity in the state along with healthcare system readiness and our state's ability to perform extensive testing, isolate and manage cases, quarantine their contacts, and protect high risk populations. The state will implement a phased approach to reopening businesses and modifying physical distancing measures when disease activity is adequately y suppressed, and readiness is achieved in five key areas: healthcare system readiness, testing, l case and contact investigations, and protecting high-risk populations. Metrics ,JVPhasesand Ruk Assessment - - { . PHASESANDRISKASSESSMENT WuasatlkmtCW115gPMot Co"ty hai Waal PJtk state County Phases and Wsk Aisessmeift slime t lnasmaP aha to akremphaias a ad the key metrics Used to del"Iw county roadineis lo inoibetwien phases Sam a county to ovoo stet sof key metrics lorlhai 030a uceunty,or select a key melri tar addtional detail. yr 4 select a 1bun:, Mason County Rey metrlc--ceerenlly in Phase 2 Ptwses by County ` sea o n Y]L•0, Wal 'MeetLlq . -, l= Krop s t0�. trnmaz Rate per 100K of newly diagnosed 6:6 t25 Yes .rases dunnpA.Odor triosmks I. KFlckitat - l- e,mbeiefaseauagtestedfor 210.0 a50 Yes ' l I �, terns earn aeiv tax durLsg the pndr week P"Ma of k4,fd<,fozfecg 0.5%. t2% Yes (j ',;O:anoSan pesi:elar CO'ytQ•If durmgthe _ i past week - ItssM Ws;We - Porcem of tkenseaeeasoswp7ee 68.0% <80% Yes aywuems 'Parcmlol GCM:ed. - .l beds.eriapied VyCQM!Ocensedaedson;upfed 0.0% c1056 Yes — by COyID�l9 oses Pfwel PhazeY Pha o] Ptazea t Pocent of Lcenaed �� 1 ds ebsy'": l:rntrt dCrf=za CT '.-,,. ;.sowces:Ypsnmom state Department a Realfh MivosoftNdisei8l lof6 j) d-= jt= J \ T)•_yam_�rv+ry _ - I uvn u+vawuu COVID-19 Data Dashboard Fpidcmio!ogic tunes t EPIDEMIOLOGIC CURVES Date is of June 14,20201159PM PT i :Sa!ect an Optnn COVID•19III vII&d ington State team S Confirmefl Caics and Deaths by Ilnas Onset Date,and NoSpitaUzaUons by Admissfon'Date j76fc { Tho(hurt slmvrs theprogiesuon of file COWD-l9 owlileak in s%dttrif¢7tw Wi6set,haflfifdfr2ofiora and deotln wi time undo • ,FtospitaTwl Arw.vn Met;eptdemtutogic curve.Hw epdeo,101 ic(uiWiS the CM referred to to the phrose,'(lol7en the ,(ofts Deana Confirmed Can Counts *Confirmed Cases n Data are nxompl to for the mpst rrcent daft-,. Select County 3 t I KKiJ>afcounty s ; ' '.lt4kanoganCo- j .'rPatSfrc Coury'y '' j ter ' i retr 2020 Ma:2070 ppf 2.02n May 2a28 lun 202t1 Date of Ulnas Onset 91 of 26,158 confirmed cases do not ham an assigned county.I:Inesses from ure-last 4 to days may for yet be reported o i COVID-19 Data Dashboard 7.7 � o TESTING Data asoSlufie1a,2020t1:59PMPr . 5e!"t a Cuunt DprR-19 in Washington State J y tom" Number of lddil"aals Ml Tested,by.Spmim CoUtileon Date Tesfit lot put Inwashin on m Mot .. g7 fy' n+ring. gt Eeg•nir;q ar late Mdrth.dive through leafing Gecdme avoitdWe in sonx rorfunumliq which lfm(rr ad fesfM orodo&hty. ry E ' - I Number of fndlviduals tested S.69a of indVdualz tested posithv �tUsiEivc•Pdsvre;pates Incomplete)aNcgatire Negative(Diu lnmmp!eie) t lom f Bow z000 i pp 1 @p t �� , � r � ,• I ��. i�j a. !@pzzqq r r Si ! 9 � , Mar 2071) Apt 20z0 0 tun 29" Specimen Collection Date 7 S i 91,429 out of 471,265 ttst results do trot have an assigned county. Data current as of June 14, 2020 Application Narrative 1. Provide a brief epidemiologic summary of new COVID-19 cases since moving to Phase 2 a. The proportion of cases.without a known epidemiologic link to other cases. 1 of 3 or 33%. For the entire period from 24 February to June 13, 2 cases are unlinked.All other cases have known familial links. b. The age and race/ethnicity distribution of cases, hospitalizations, and deaths. i. No deaths since Phase 2 ii. 1 hospitalization, female, 50's iii. 2 cases within 1 family, 1 other iv. 2 Hispanic, 1 Caucasian v. 1 <19 y/o, 1-40's, 1-50's c. A list of the number of new or ongoing outbreaks (defined as 2 or more non- household cases epidemiologically linked with 14 days in a workplace, congregate living, or institutional setting in the county),the facility name and type, and for each facility, the number of cases associated with that outbreak. None d. A description of populations disproportionally affected byCOVID49. Numbers are too low to provide statistical relevance e. If COVID-19 is disproportionately affecting low income communities or communities of color in your county, what are your plans to protect these populations. We are reaching out to non-English speaking populations with culturally appropriate videos and information distributed through trusted organizations such as churches. 2. Testing Capabilities Mason County continues to maintain adequate capacity for testing. Mason General Hospital conducts daily drive-through testing averaging 25-35 tests per day. Other testing capacity exists with Harrison Hospital, Port Orchard, as well as Peninsula Health Care Systems in Belfair and Kitsap County. Laboratory resources are adequate through the public health lab and private labs. Total tests average 25-35 per day. Tests are geographically and economically available to all populations. Mason County has a Drive-Thru testing site available at Mason General Hospital as well as testing through clinical outlets. We have supported Mason General Hospital in promoting these testing sites in multiple ways. The test site triage line is on multiple websites throughout the county to include Mason general Hospital and Mason County Public Health. The Joint Information Center(JIC) has promoted the site in various ways to include public outreach in the English and Spanish language. The JIC partnered with Mason General Hospital creating a video of the step by step process that occurs at the testing site. It continues to be shared and promoted on multiple social media pages throughout Mason County. Kitsap County has 2 locations for testing available to our North Mason residents for convenience and working with our Hospital District 2 partners. All the above locations for testing are available to low-income, no insurance, or underserved populations. Testing sites have a triage phone line available to call and set up testing times and dates. 3. Median number of days from onset of symptoms to specimen collection. a. Since moving to Phase 2 we have had 3 cases, one asymptomatic close contact family case b. Median numbers not calculated for low response numbers 4. During the period of For each of the weeks you have been in Phase 2, report the total number of COVID-19 tests reported for the county, the number of negative and number of positive test results, percent positive, and what 50 times the number of positive tests would be. In addition, report the percent positive of all tests for the overall time period. The ideal target is to perform about50 tests per case and have a percent positivity no more than 2%. If the target is not being met, what seems to be the cause(s) and what are you doing to help address that? a. Week 1 (5/15-5/21):206 tests, 205 negative tests, 1 positive tests, .4% positive, r� Week 2 (5/21-2/27): 256 tests, 255 negative tests, 2 positive tests, .7% positive Week 3 (5/28-6/3): 218 tests, 217 negative tests, 1 positive test, .4% positive b. Sum total: 4positive tests/680#of tests = .5 percent positive. 5. Report or update the local health jurisdiction's resources to perform case investigations and contact tracing using statewide standardized COVID-19 case and contact investigation protocols. a. Mason County Department of Community Services, Public Health and Human Services Division maintains a highly trained communicable disease staff with experience in contacts investigations. i. With Mason County's population at 66,768 we have established 10 FTE's are required to conduct efficient contact tracing investigations. MCPH currently has 17 public health staff and 2 citizen volunteers, all trained in the Incident Command System, outbreak investigations and contact investigations. This is a total of 15.2 FTE's. This meets the guidelines of 15 investigators/100,000 population. No gaps identified for steady state operations. ii. Outbreak Considerations 1. A COVID-19 outbreak will be handled just as we would handle any infectious disease outbreak in these settings. Mason County Public Health (MCPH) staff will quickly and efficiently respond. Following all DOH and DSHS guidelines we will direct the outbreak response and investigation. 2. To date Mason County has experienced one (1) COVID-19 outbreak in a workplace setting of four (4) employee cases and one (1) contact case. Mason County Public health was able to contact all cases and conduct contact tracing investigation efficiently without diminishing or exceeding our capabilities. All within Phase 1. 3. With the help of our local Department of Emergency Management, we will ensure they have adequate PPE and testing supplies throughout the outbreak. Mason General Hospital has the testing capacity to serve our testing needs in the event of an outbreak in a local facility or workplace. MCPH currently has 17 public health staff and 2 citizen volunteers, all trained in the Incident Command System, outbreak investigations and contact investigations. This is a total of 15.2 FTE's. This meets the guidelines of 15 investigators/100,000 population. 4. At the peak in March, Mason County did not exceed the capacity of the first line series of investigators. 100 percent of positive cases are investigated within 24 hours. Most case investigations are completed within 12 hours. Pop 66,768= 10 FTE investigator(15/100,000 pop) 4- Public Health Nurses 9-trained community health and EH Specialists 4-trained administration staff 2-trained volunteers Tota 119= 15.2 FTE No further training scheduled at this time Mason County 1 workplace outbreak(4 employees and 1 contact case)case investigation complete <24 hours Reliance on DOH Resources • Per guidance from Secretary of Health John Wiesman, should any incident exceed the capacity of local resources, MCPH will contact DOH for an immediate strike team and request additional resources from DOL trained investigators. Ten additional investigators will be moved to Emergency Command where they have access to phones and computers. A MCPH nurse will supervise these additional resources. Mason County also has a partnership with the Squaxin Tribe to provide culturally appropriate case investigation. 4 • Relying on DOH to provide relief for local investigators avoids exhaustion and multiplies effectiveness. Mason County is currently in negotiation with DOH to supply case investigators and staffing for congregate quarantine/isolation through the use of a Memorandum of Understanding. b. The total number of cases identified over the past two weeks and the percentage of cases reached by phone or in person within 24 hours of receipt of positive lab test report (the ideal target is 90%). 2 patients/ 100% c. The total number of close contacts identified over the past two weeks and the percentage of contacts reached by phone or in person within 48 hours of receipt of positive lab test report on a case (the ideal target is 80%). 8/10 contacted/80% d. For cases, are you currently reaching out to them daily throughout their isolation period via a combination of phone calls and electronic means (e.g., text)to check on their overall status and ability to successfully isolate? Daily contact x8 days/100% e. For contacts, are you currently reaching out to them daily through a combination of phone calls and electronic means (e.g., text)to check on symptom development and their ability to successfully self-quarantine? Daily contact x 8 days/100% f. The department conducts case investigation seven days per week. 6. Facilities used for isolation and quarantine. Motel for<10 persons isolation/quarantine Time period indefinite Food, laundry, provided by Mason County (Jail kitchen and laundry) Paid w/Corona funds Food may also be.provided by families and public health for cultural appropriateness Building 10 County Owned Up to 75 beds for either isolation or quarantine County owned—indefinite time period Housing, laundry, food, recreation county provided Security services—private contract addition to county contract Showers + 2 interior bathrooms 2x Portable toilets and handwash facilities Mountain View Middle School (directly behind Mason General Hospital) 100 Bed Alternative Care Facility (portable) MOU with Shelton Schools—available until school starts Showers, bathrooms in school gym Food, laundry, recreation county provided Community Lifeline Homeless Shelter 30 beds added to capacity specifically for ill homeless (non- corona) On contract with county—will become permanent All services provided by Community Lifeline 7. In-home isolation a. The health department case investigator is asking each positive patient who is isolating at home if they have family or friends that can bring groceries or supplies. If the patient has no help, we access United Way, Meals on Wheels, Agency on.Aging, and the local Senior Center to provide emergency boxes of food and supplies. Money-is available to pay for rent in order to assist low income cases to stay at home. b. The health department case investigator/staff makes referrals to outside agencies. The agency will let us know when boxes of food/supplies is available and delivered. Money is available to purchase food or foods cards for low income/isolated patients c. Health department case investigator checks in with patient every day—so we know when supplies are low, more food is needed, or medications need delivery. 8. Outbreak investigation (see also section 5. a. ii.) a. Mason County maintains the ability to immediately respond to outbreaks in congregate settings such as long-term care facilities, homeless shelters,jails, and works with Department of Corrections for prison facilities. b. DOH is currently conducting screening within skilled nursing facilities for staff and residents. Mason County will assist DOH as needed to provide local contacts and context. c. Per guidance from Secretary of Health John Wiesman, should any incident exceed the capacity of local resources, MCPH will contact DOH for an immediate strike team and request additional resources from DOL trained investigators.Ten additional investigators will be moved to Emergency Command where they have access to phones and computers.A MCPH nurse will supervise these additional resources. Mason County also has a partnership with the Squaxin Tribe to provide culturally appropriate case investigation. An MOU is currently in the approval process that outlines the specific requests. d. Relying on DOH to provide relief for local investigators avoids exhaustion and multiplies effectiveness. 9. Lessons Learned from move to Phase 2 a. Roll out timeline needed better coordination. The notification came out on a Saturday with very short notice. b. DOH/state industry specific guidance lagged behind counties moving into Phase 2. Industries began re-opening without guidance. c. Counties should control specific industry specific openings. With the move to Phase 2, clarity was not achieved. Mason County Plan For the move to Phase 3, Mason County will officially move into Phase 3 not earlier than 22 June 2020 or 48 hours after approval from DOH official notification.The Joint Information Center will post the start date and time through standard notification channels. Mason County understands that the state is not producing industry specific guidance for Phase 3 with.the exception of pools/spas and sporting events. t' Guidance from Phase 2 is extended into Phase 3. Mason County seeks a full opening with the exceptions of pools/spas and sporting facilities/ball fields.These areas will be approved upon commission and health officer review and approval. Mason County offices will utilize the Phase 3 Safe Start Plan Template (https://www.governor.wa.gov/sites/default/files/BusinessTem plate Phase3 1.Pdf?utm medium=email&utm source=govdelivery)Appendix C for opening the county to the public at large with a tentative start date of 22 June, 2020 Hospital Data Input from Mason General Hospital daily ® R f HOW - -- a.� Akaba.mu} rl.awTr+fiKl i' I CC �o..t4`f c,r T ca..rvawl ® hray.o.mMsavWy hro�+a wq.nnfpa .� 5`avmatay�m cmnn-ro�ausaaensa s.en�,a�•eabaa varr,year>� rgwpmrnaaaWa s,astyeaa.,a+ ea�,2rsmuorc�e ra�yanm,aera C—.D a_-�-S.M. rw.'xmno— R �-ngme I OwahSama•:.Y ea.a4mn ' 3 days 4 wa.oa<.e 1 O i �� CAR�2a5va � � i .� .A::e,n,r,abxe ernaxaa cr�aeras, wlrrwrraea�a � surr�erau, [a�vxrfa,rn s�yxawY era e.,m>rur<.,m tasky¢awr can �cna a,.soa5 raaa-cnara , pill i .. - omlrni .mmwm. 3 6 3 42 I 0 SA 1:•v!Y 3l N42 fry Tlut i ' �.-.Nf/�Cf rsM1m. 1dLM hakPN� L+WI.�� 1 0.0% 1 143% i OA% 23,6% i OA36 ]1� saa�aatcorN4:.r' Care '. c)Fx.as 3.l Su'SNr 'Wy4irtw JA m.te i { . lBlSnk) - I xu•,am, tNi�r .O i (Blank) w...3mn (Blank) I c�.,r.u.o.•f.... i sr—Aatutu mvat9rY,k de•.dh' Ced aptindli'e j. sfs"dRl falb eld,DU s'+WVdeWb Patlfcl'ih ttmcrvd reeav BAf[ena Va C1 0m 9aAeal, ^rNlC ctta COVID-19 Disease Aativily f �s DISEASE ACTIVITY Data asot June td,2g2gtt59arnvr ff Soled a key metric CoVID-19 disease activity Le,ru i Rate of newly diagnosed COVID-19 cases during the prior hvdweeks _ This graphs shows the rate of newly diagnosed COVID-19 cases per 100.000 people during May 27 through Jun 09.The Department of I i { Health defines low dliease activity as having fewer than 25 cases per 100.000 people duringIhe prior iwoweeks. �", " Egeclira reprodimivp. Mason County Rare of newly diagnosed cases per 100K people �! --Case tale-Id-Latest use rate—Case rate(incompiete dta) - Goal 45 uses ' y,l 25 -------------------------------------------------------- Seim • a County Rate per 100K of newly 4,6 dlagnssod case•.auring lne piiortwowe'eks f, Masonv i Meeting goat of fewer than Yes 20 i 25 uses per 100,000 1 people t5 ' supporting detail to - - • Population 64.980 4b CoNirmedcase,In the 3 5 i 75 or mnra ! prior two week. 5a to i75 1010.25 Z tLtr 70M np,20" ,la y Nl6 lw 7270 •0 to.10 specimen CW1.1ion Date source.Washington State Oapaninent of Health and the Washington State Office 61 Financial 14anagemant i Microsoft Power BI .�-. 2 of f; Uov A R ¢ Home. IYd Aua]a4Yly O.IOmjalsyhmJs Masi�«+'a sh GM t—if b a. ...�qa TOM [ fetes4 2.:a Om[s'q CetN: i%ep'O'+A 4v,a etf+9 �i+L +9f LL a. 48 u i e , Sys.ma'aiapL4e co1:YU-t7'Wialtid= lh ¢M uaaM tletallt "¢ny.ae.a: Ca+�f„'2^eJm#e &vi+�Y deu3' .l)aii nenzhtccetsi0 Hd�YBi Y Di4. emus oxu. ..Wti Mu [s�M':±�i mu. J MASON COUNTY COMMUNITY SERVICES Building,Planning,Environmental Health,Community Health 1 � From the Office of The Mason County Health Officer Daniel Stein, M.D. 415 N.61h Street,Shelton,WA 98584* Phone:360-427-9670,Ext.582 ♦ Fax:360-427-7787*Email: DStein@co.mason.wa.us To whom it may concern: I would like to thank Governor Inslee, state officials and the public health community for support in responding to the COVID-19 pandemic.Since the initial outbreak,Washington State has led the country in creating policy that has helped flatten our curve. Mason County as well has created a strong, coordinated approach to combating the novel coronavirus.The initial "Stay Home, Stay Safe" proclamation along with the hard work of our area command, has helped us prepare our community for responding to the pandemic. Since Mason County was allowed to move forward to Phase 2 on May 23rd, we have been carefully monitoring for any additional spikes in cases. Mason had a single cluster of cases since that time, which was quickly evaluated, case and contacts were investigated, and the State's outbreak response team was notified.We are continuing to see low levels of,community transmission which has remained below the required rate of transmission recommended to move to Phase 3.As outlined in the variance request,we have been able to prepare our community and we feel that our healthcare system, case and contact investigations and isolation and quarantine availability are well prepared for additional cases that may arise. Based on this success, I am proud to support a proposed Phase 3 variance on June 22nd By setting a date for progression,we will be able to prepare our community through outreach and education. I recognize that relaxing social distancing rules and expanding businesses could pose a threat to increase the spread of this virus in our area, and that we may be potentially susceptible to additional spikes in cases. I believe that continuing to encourage social distancing, appropriate hygiene practices and broad use of masking is required to maintain our low incidence rate. We will be relying on the guidance for business openings as defined by the state.As we continue to cautiously restart our economy,we will evaluate and act quickly to contain additional outbreaks. If we can move forward with a Phase 3 variance,we will continue to monitor the situation. Mason County is prepared to reevaluate, potentially further restrict services and take a step back to Phase 2 if needed. I appreciate the excellent work of our Board of County Commissioners,the Mason County Board of Health,the Public Health Department,and our health system for allowing us to have this discussion. Sincerely, Daniel Stein, M.D., Mason County Health Officer Mason .wealth Mason General Hospital • Mason Clinic 20 May 2020 Mason Health certifies the following: 1. We maintain a minimum of 20 percent surge capacity which would allow us to accommodate a 20 percent increase in suspected or confirmed COVID-19 hospitalizations. 2. We report daily including on weekends all data required by DOH in WA HEALTH. 3. We maintain a minimum of a 14-day supply on-hand of PPE including N-95 masks, surgical masks,face shields, gloves and gowns. 4. We are not using PPE conservation strategies that involve the reuse of PPE supplies. Dean E. Gushee, MD, MS, FACEP - Chief Medical Officer Mason Health PO Box 1668 Shelton,WA 98584 360-432-7728 dgushee@masongeneral.com We are still able to affirm in item d, that we have sufficient of PPE to last at least 14 days including N95 respirators,surgical masks,face shields,gloves and gowns. We can reaffirm in item e,that we are not having to conserve PPE such that any staff have to wear an N95 or surgical mask for longer than one shift. Dean Gushee, MD I Chief Medical Officer Mason Genera I Rospital &Family Pf Clinics 901 Mt.View Drive Building One I Shelton,Washington 98584 Phone:(360)432-7728 1 Ext.286911 Fax:(360)427-1921 www.masongeneral.com United Community, Empowered People, Exceptional Health From: David Windom <DWindom@co.mason.wa.us> Sent:Tuesday,June 9, 2020 10:15 AM To: Dean Gushee, MD<dgushee@masongeneral.com> Subject: Phase 3 applicationv2.docx Good morning, I've included what I have so far on the plan. I'll need to have you do another letter based on the following guidance. I can pull some of this from Wa Health if that helps. III update metrics just prior to submission. Each local hospital must submit a dated letter explicitly certifying each of the following or alternatively, if a county's hospitals are all reporting into WA HEALTH, the local health department can use that information to report on the following elements, except for element"e"below which would require an email confirmation from the.hospital. If the county does not have a hospital, that local health jurisdiction must obtain the same documentation from the hospital(s)that serve the majority of the county's residents: a. The percent of licensed beds occupied by patients (i.e., hospital census relative to licensed beds). b. The percent of licensed beds occupied by suspected and confirmed covid-19 cases (ideal target is<10%). c. That the hospital is reporting, and will continue to report daily, including on weekends, all data requested by the Washington State Department of Health into WA HEALTH, and for how many days in the last 2 weeks they did report into WA HEALTH. d. The hospital has at least a 14-day supply on-hand for all of the following PPE, including N95 respirators, surgical masks, face shields, gloves, and gowns. e. Reaffirm that if or when the hospital is using PPE conservation strategies,that no staff person is wearing any one N95 respirator or surgical mask for longer than one a. shift, and that they are following PPE guidance on reuse or extended use in this guidance: https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/PPE- Reuse.pdf. CAUTION: This email came from outside Mason General Hospital. Do not click links, open attachments, or respond to the email unless you recognize the sender and know the content is safe!