State health officials are planning to ramp up a robust public health response in the coming weeks as Washington state residents get antsy to reopen parts of society.
The second phase of suppressing COVID-19 includes strong testing and contact tracing. State officials hope to test 30,000 people a day in the coming weeks.
Contact tracing presents a different challenge, however.
There are 700 people who are trained to do contact investigations, health officials said Wednesday, and by the second week of May, they will have 1,500. The state is enlisting members of the National Guard as well as volunteers to help.
"By May 11, we will more than double the current workforce to do this work," state Health Secretary Dr. John Wiesman said Wednesday.
Contact tracing starts when investigators call people who have tested positive for COVID-19 and conduct detailed interviews.
They find out when a person tested positive, when the person first started noticing symptoms and where the person went. This includes the three days before the individual developed symptoms, since the respiratory virus has been proven to spread even in asymptomatic people.
The interview also provides a road map for the rest of the investigation, asking who the subject was within 6 feet of during the time of illness.
People who come into contact with a person who has COVID-19 will be called and interviewed to see if they have any symptoms. They will be given access to a test and asked to isolate themselves until those results come back. Even if asymptomatic, a contact might be asked to quarantine for two weeks since it can take that long for symptoms to develop.
Wiesman estimates each case investigator can interview seven people with confirmed COVID-19 cases a day, and that a contact interviewer can conduct 21 interviews a day. Wiesman emphasized such contact-tracing efforts will be needed on a long-term basis.
"We are starting from a system that was not robust in the first place and trying to play catch-up, which is what we're doing," Wiesman said. "That being said, we would have had to scale up or surge beyond what any usual workforce would be."
Spokane County Health Officer Dr. Bob Lutz said the approach to contact tracing will be different going forward. The county receives some help on contact tracing from the Department of Health.
"It's a Herculean effort, but if we are going to box in, and to some level not contain but suppress this infection, that will be needed," Lutz said.
Spokane County added two new cases on Wednesday and has 317 confirmed cases, with 19 deaths. Fourteen people are in the hospital receiving treatment. Statewide, Washington added 212 cases on Wednesday and 10 new deaths.
The Spokane Veterans Home confirmed three new employee cases of COVID-19 for a total of 13 on Wednesday, while the number of infected residents remained at 25, according to the Washington Department of Veteran Affairs. Test results for at least 45 employees were pending.
The nursing home confirmed its second death among 80-some residents on Tuesday, when three other residents were hospitalized. The facility's first case at the end of March was an employee who was awaiting a COVID-19 test result and returned to work in the area of the home's initial 19 cases after three days without symptoms.
The Walla Walla Veterans Home also reported its first case related to the facility in an employee on Wednesday, according to the Department of Veterans Affairs. The employee is self-isolated at home, and no residents have tested positive.
The nursing home was already scheduled to begin testing all residents Wednesday with the help of the Walla Walla VA Medical Center, according to the Department of Veterans Affairs. All six residents tested have been negative, as well as seven employees.
As of Wednesday afternoon, no residents or staff at two other WDVA nursing homes had tested positive for COVID-19. The facilities are in Orting and Port Orchard, where all 224 residents have tested negative.
In Idaho, Kootenai County confirmed two new COVID-19 cases on Wednesday for a total of 56, according to the Panhandle Health District. Bonner County has reported four cases, while Benewah, Shoshone and Boundary counties have confirmed none.
Statewide, Idaho reported about 1,700 confirmed COVID-19 cases with 29 additional positives since Tuesday, according to the state health department. Fifty-four people have died in the state.