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Puget Sound health experts share what they’ve learned since the COVID-19 pandemic hit

Some of western Washington's top doctors and scientists reveal what they've learned about the pandemic so far.

SEATTLE — More than six months into the coronavirus pandemic and everyone has had to adjust their daily lives in some way. It feels like we've all learned a lot.  

That's also the case for some of western Washington's top scientists and public health officials.

KING 5 asked several of those officials: "What are the top things you have you learned in the past six months?"

Here are their responses:

Dr. Jeffrey Duchin

Health Officer, Public Health Seattle - King County

An important early lesson is that alignment of elected leaders and public health and medical experts allowed a rapid and effective response to the initial COVID-19 outbreak through community mitigation measures including the stay-at-home order, limiting public gatherings and non-essential activities, and face mask requirements.

The COVID-19 outbreak highlighted and exacerbated existing structural and health inequities in our society. Communities experiencing longstanding poor health outcomes from lack of access to health care and from social, economic, and environmental disadvantages are being hit hardest by COVID-19, while also making up a large portion of the essential workers that keep our society functioning.

I did not expect the recommendation for wearing face masks in the community to prevent COVID-19 transmission. Before this outbreak we recognized the importance of medical-type (surgical) masks in preventing spread from ill people in health care settings, but not for people without symptoms in the community. Based on accumulating data, wearing face masks when in public has become a pillar of our fight against COVID-19.

Another surprise has been the finding that a large proportion of COVID-19 infections are spread from people without symptoms. Initially, outbreak control focused on spread from people after onset of symptoms only. With a new pathogen, there's a lot we don't know. We need to expect constantly evolving information and adjust our strategies accordingly.

We need to come together as a community and support one another in the fight against COVID-19 to a degree that I had not envisioned. The battle against COVID-19 will be long, tough and costly in many ways. The challenge of sustaining the behavior changes necessary to drive COVID-19 levels down enough so that will allow our kids to get back to school and all of us to get back to more economic and other activities is daunting. We need to support one another to the greatest extent possible as we fundamentally rethink the way we interact and the way we structure our environments at home, in workplaces, and anywhere people gather in order to decrease the risk to ourselves and our communities - especially the most vulnerable.

The speed with which promising COVID-19 vaccine candidates are being developed. The number of promising vaccines under development and entering clinical safety and effectiveness trials is unprecedented and a reason for optimism. Although we cannot predict if or when a safe and effective vaccine will be ready for use, the extent of research and development to make that happen is like nothing that's come before.

Dr. Ali Mokdad

Professor, Health Metrics Sciences - University of Washington

I have been surprised by the lack of a nationally coordinated response to the pandemic. A lack of strong coordination at the national level has led to patchwork responses across states and very different situations in different states.

I have also been surprised by the slow response to emerging information about the efficacy of masks, and other key data (for example, that bars are a high source of transmission). We know that masks are very effective, and yet we are still seeing that it takes a spike in cases for more people to decide to wear masks and for officials to put policies in place to increase mask wearing.

I’ve been surprised at the attacks on scientists and the scientific community. This is a very emotional time for many people but scientists who are trying to work in this field have received many hateful messages. Myself and others regularly receive threats for our work.

I’ve been deeply impressed by the community response to the pandemic. Many people have come together to work on providing resources, such as free masks for the community. The country as a whole lacked preparation but individuals have responded to support each other.

I’ve also been very impressed by the dedication of our medical staff at UW Medicine and around the country. Doctors and nurses are doing incredible work right now to protect people from infection and save lives.

Dr. Eric Shipley

M.D. Emergency Room Director, Overlake Medical Center

Kids are indeed at extremely low risk. The elderly are at greatest risk.

Treatments: "Yes" to Remdesivir. "No" to everything else except perhaps Decadron or Steroids.

Contact transmission: COVID is spread ostensibly by respiratory secretions. The incredible fear of touching some contaminated surface and then touching nose and transmitting illness is dramatically overstated. Transmission typically occurs when people are in close contact (5 feet) of someone with illness for 15 minutes.

COVID affects nearly every organ system. Hence the multitude of symptoms: Headache to Diarrhea.

Hospitals still have capacity and COVID admittance is still very low in King County.

Dr. Mike Barsotti

MD, FAAP. Vice President WCAAP. CEO Sacred Heart Children’s Hospital

Pediatric patients continue to be at low risk for severe disease, but that does not mean that they cannot become sick with COVID.

MIS-C can be a significant process for children and the long term consequences remain unknown.

Masking is the single most important deterrent to spread but cannot be effective if the vast majority of the population does not participate and masking alone cannot eliminate the disease.

Test capacity and testing turn around time (though improving) remain a barrier to how we deliver care.

Balancing the developmental need for school in the pediatric population with the potential for spread remains a delicate issue that requires “out of the box” solutions. 

Dr. Frank Bell 

MD, FAAP. Board Member WCAAP. Pediatric Infectious Disease Physician, Swedish:

Measures to prevent the transmission of COVID infection are challenging given that infection can be passed on by individuals who have only very minor symptoms, or no symptoms at all.

Although a challenge, we now know how to do this, the principles to help prevent the transmission of infection are clear, keeping physical distance between ourselves and others, wearing face-coverings in public and washing/sanitizing hands frequently.

In order to isolate individuals with potential COVID infection and to quarantine those who may have been exposed, we need to continue to work on providing child and family-friendly testing for those who have symptoms compatible with COVID.

School closures are hard on kids and their families; in focusing on the potential benefits of keeping schools closed, it’s easy to lose sight of the very real harms (to education, work prospects, physical and emotional health) of removing in-person education and adult-mentoring and oversight in schools.  

Given the structure of our communities including access to employment, education and health care, it should not be a surprise that the impacts of COVID have been so much more devastating for children and families from racial & ethnic minorities and for those facing economic hardship, but the differential impacts of COVID on these groups has been revealing, and worrying.

Dr. Kim Hauff

MD, FAAP. Secretary WCAAP. Pediatric Hospitalist, Swedish

Racism is embedded within all of this. We as pediatricians need to continue to advocate for kids; but particularly Black kids. We must do better and strive for anti-racist work.

I continue to be inspired by the entire medical profession -- from MAs to RTs to support staff to researchers and cafeteria workers. These essential workers and what they represent are one of the reasons I choose to be a doctor. 

Kids will always amaze and inspire me. They adapt to most anything; and will rise above this a stronger and more powerful generation. My three-year-old daughter who wears a mask with pride to the park can attest to this. 

With many unknowns still about COVID disease, transmission, and its effects on kids we must rely on science and the scientific process to help guide us. I would never have guessed in January that I would be discussing p-values, research, and public health with my 70-year-old mom during our weekly phone check-ins. 

Pediatric providers support one another. We want to make school, the pandemic, racism, and all the things affecting our children better. We are all on the same team, fighting the good fight.