SPOKANE COUNTY, Wash. — Spokane County Regional Health Officer Dr. Frank Velazquez sat down with KREM's Mark Hanrahan to speak about the start of his time as the county's interim health officer, as well as what he foresees happening in the county's coronavirus response.
Velazquez took over after the Spokane Regional Health District Board voted to fire Dr. Bob Lutz. Velazquez is serving in an interim role.
The following is a transcript of the interview. It has been lightly edited for clarity.
KREM's Mark Hanrahan: Have you guys been in talks with any Eastern Washington providers for a plan to distribute vaccines when they arrive here?
Dr. Frank Velazquez: So that's a really good question. So we do have two groups, including a task force, that have been working not only with local providers, but department of health and all the other agencies to make sure that we have a plan for access and distribution in Eastern Washington, specifically in the Spokane area. So that has been ongoing for quite some time, and we're awaiting the potential receipt of those in the near future. So we can then activate all of the pieces of that process, but we're ready pretty much anytime.
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Hanrahan: Are able to say what providers are going to be able to distribute those when they arrive?
Velazquez: So that was a very good question. We don't have the definitive providers that have been approved. We do know that there are about 20 entities that have applied. We do anticipate that perhaps Providence and MultiCare, having the largest number of high-risk providers, will be two of organizations, but we don't know that for a fact as of yet.
Hanrahan: Are you guys still kind of along the thinking along the same lines at that mid-December timeframe for the first dose, or first batch of vaccines to arrive here?
Velzaquez: That's what we've heard. And I think that will be ideal. But we are ready for that date, whenever it may be, in keeping our fingers crossed, that it it is mid-December.
Hanrahan: I have a second grader, and as you know, second graders in Spokane Public Schools went back to in-person learning today. Has the guidance and thought on sending them back kind of remained the same as it has in the past with the incidences of transmission within schools among these young learners being relatively rare?
Velazquez: That is correct. I've been participating in that fairly actively, since my first day here. We, and what I mean by we, I mean the district, we have been working very closely with the school superintendent in all the districts, including the Spokane district, and we actually talk about three times a week. Because we're keeping track of a number of variables that impact the model that we use for bringing kids back to school, particularly young learners. We're very excited that we have been able to move forward with young learners, because we do believe it is very important. But we're in active communication with our school districts pretty much every other day. And our goal has always been let's try to bring the young learners back to school. And we did work very closely with the Spokane school district to do that. We are tracking a number of variables. And not only the number of cases, but also the capacity of the school's COVID-response teams, etc. So there are a number of variables that are looked at to make determinations. And I think the way we're doing it, which is, we are as a team, and when I say as a team, is not only us in the district, but our school superintendents. We're all working together with a commonality of purpose and trying to make sure that we can bring the students back in the safest way possible, and keep them in school, if at all possible, going forward. So long answer, but as one of the areas that we do spend a fair amount of time, it is one of the key areas that we've spent time on.
Hanrahan: Is there any type of timeline or any thought on when we might be able to bring back third, fourth, fifth and sixth graders?
Velazquez: So we're only looking ahead in the future in very small increments, because the future is very difficult to predict. But I can tell you that we continue to work with the school districts to determine future plans. And the future plans include other grades, but we will move with those one step at a time, and leave a little bit of time so we can see what the outcome is, and then reevaluate and realign. What we're encouraging is our school districts to continue thinking into the future. Although I don't know what the future looks like, I think it is important that we continue planning for the future. And we will continue doing that with them.
Hanrahan: As you mentioned, we can't predict the future. But do you foresee more grades than just kindergarten, first and second grade, returning to in-person learning this school year?
Velazquez: I think that's a difficult call. And the reason for that is because one of the single largest variables we have right now is the Thanksgiving holiday, and then the upcoming holidays. And if we follow the trajectory of previous holidays, we tend to see a significant increase in cases after those. And in our conversations with the school districts, we've been very careful to monitor that, not because of in school transmission per se, because as you mentioned, is it remains relatively low. But, because the higher the number of cases in the community, the more likely that a teacher, a parent, a staff may come in contact with someone that is carrying the virus. And that increases the potential for that virus making it into the school, or making it to the rest of the staff or teachers in the school. So we're a little bit cautious between now in the next few weeks just because of those variables.
Hanrahan: Obviously, we've seen kind of the surge in cases in recent weeks here in Spokane County. It appears that continues with the numbers released today. Are your contact tracers with the SRHD able to keep up with all the contact tracing now?
Velazquez: So we have we call them disease investigators, because they do look at all the diseases in addition to COVID. But we have 15 of those that are in the district. And they typically look at the higher risk cases, we do have by contract access to another 33 from the Public Health Institute, which is a nonprofit that provides that service and most of the contact tracing can be done remote over the phone, for example. And we do have access to another about 120 from the state that can help balance the workload. And what I mean by that is, if the volume is too high, we can rely on some of these other resources to help us with a contact tracing. But depending on what the risk is, we typically focus on the higher risk and then may refer some of the other low risk cases. And one of the things we're encouraging the public in general, is we weren't notifying all contacts. But we're asking people, if you're positive, can you please also notify your contacts, because it does increase the efficiency of the process of moving forward. So our disease investigators, I can tell you are working seven days a week, 20 hours a day. They're doing their best to keep up, the resource from PHA in the state are very helpful. But I do, I am a little bit concerned about the the pace that these folks in this team have kept for so many, many, many months. So ideally, if the number of cases starts to go down, the workload will be facilitated somewhat and we're keeping our fingers crossed with the rollbacks and people being very mindful on Thanksgiving, and I appreciate everybody that was very careful around Thanksgiving. Hopefully, we will be able to keep up a little bit better.
Hanrahan: But you feel like you are able to keep up with the current demand?
Velazquez: We are doing our best to keep up, and I can tell you there are some days that are more difficult than others. Now, we are looking at perhaps adding to some of the teams here I know that there are some efforts to do that.
Hanrahan: Since we just came out of Thanksgiving, obviously the next holiday that people are looking forward to is Christmas. Is there any guidance to the community on on holiday travel for Christmas yet?
Velazquez: No. Remember, we are on rollbacks until December the 14th, and that will hopefully give us some guidance going forward into December. And I think a little bit of common sense will be helpful from all of us. An example, my family, we're rethinking travel for the time being, not because there's guidance to do so, but because it makes sense to us to really limit any travel in there very near in the near future. So I think we need to wait until December 14th. And look at the outcomes or the rollbacks, look at where we are as a community, and then guidance will come accordingly. But I know a lot of people that are rethinking travel just because it makes sense for them and their family not to pursue it in the very near future.
Hanrahan: Later on this week, the SRHD has a board meeting. Is there any thought on a timeline to name a permanent health officer? And are you interested in that position?
Velazquez: So I do know there's a board meeting and do not know the timeline. Though I don't know if that's one of the topics, it is not something that I was aspiring to or pursuing. But I'll tell you after working with people here, whomever comes here, this is an incredible job with incredible people that has incredible impact. So whoever that person is, they they should consider themselves very fortunate to be part of that team, whenever that happens and whoever that person is.
Hanrahan: Are you interested in being that person?
Velazquez: I haven't thought that far actually. I'm still a little bit on the learning phase. And one of the most exciting things about this particular position is being able to interact with people that know so much about so many things. And you learn something new every day, you have a new experience every day, and you can help people in a different way, pretty much every day. There's not very many jobs, that you can say that actually. Yes, it's quite rewarding.
Hanrahan: If you were just to take a step back and look at the current state of affairs in terms of COVID, the number of new cases, the positivity rate in Spokane County, hospital capacity in our region. Are you concerned with where we're at? Are you growing more concerned? Are you optimistic? Where do you stand with all this?
Velazquez: So one of the areas that I'm spending and the team here are spending a lot of time on, is working with our healthcare partners. Because again, as a team, we're tracking. And when I say as a team, I don't mean just as our HD I mean, our health care providers and us, we're looking at capacity, we're looking at staffing, and we're looking at better utilization, and planning for the future. In the event that we do see numbers increase, that we can be ready for for that. I can tell you, I always worry a little bit. As a physician, I have to, I guess it's second nature. I worry about people getting sick, I worry about the staff. I worry about the families. So I do worry about that. And I think the best way to address that concern is what we're doing, which is proactively planning. So we know what what the challenges are or could look like and what we can do about it. So I think planning is is always a good solution. And we're doing that. I'm very grateful to our healthcare partners.
Hanrahan: Are we in a better or worse position than we were a month ago?
Velazquez: I think we have a little more cases. And that's always worrisome. And I think we've said that, that our number of cases has continued to increase. Like, if you look at the numbers from last week, it went down a little bit on Thursday, then went right back on Sunday. So we're hoping that the impact or rollbacks can be seen two or three weeks from when we started to implement those, which was about two and a half weeks ago. And see if those numbers start to plateau a little bit, because I think it will be helpful, because we have to think about when during the winter months, we're in flu season. So as I just covered, I think we have a lot of other things to worry about when we get come into winter. If you have chronic pulmonary disease, winter months are not your friend. And because we see a lot of more morbidity of people with lung infections, and so on and so forth. So were trying to anticipate a little bit, but we're getting to the month in which is probably the most difficult to manage.