SEATTLE — As much of the United States prepares to see large clusters of Covid-19, the disease caused by the novel coronavirus that’s circling the globe, this city and the surrounding area are already in the thick of it.

As of Tuesday afternoon, 190 people had tested positive for the coronavirus in King County, which includes Seattle, and 22 had died, including the first fatal case in the country. State and local health officials here have already issued emergency declarations, set up quarantine sites, and asked the public to avoid large, nonessential gatherings. The county spent $4 million to buy a motel in the suburb of Kent and set up modular housing units as living spaces for infected people who can’t be quarantined at home or are homeless.

In short, what’s happening in this part of the country could be a preview of what’s to come in other corners of the United States.

“We need to have the priority be Washington state, because we are the tip of that effort and the rest of the country frankly is looking to us for leadership on how we handle this crisis,” Gov. Jay Inslee told reporters late last week.

The region’s biggest employers, including Amazon and Microsoft, have urged employees to work from home. The streets of Seattle — the heart of a metropolitan area of nearly 4 million — have become less crowded, and rush-hour traffic has subsided. At the same time, the city is by no means a ghost town.

On Friday, vendors in Pike Place Market, the downtown tourist destination known for fishmongers tossing whole salmon back and forth, estimated foot traffic was down about 50%. In the International District on Saturday, when patrons ordinarily wait outside in even the dreariest Pacific Northwest weather for their favorite dim sum, the most popular restaurants were busy but none had the usual line out the door.

Experts stress that it’s possible other parts of the country may have just as many cases as Washington state — but that the outbreak here seems outsized because there has been more aggressive testing. Almost all the deaths so far are tied to an outbreak in a nursing home in Kirkland, located to the east across Lake Washington, exacerbating case counts because it involved a vulnerable population.

It’s also possible that Seattle just got unlucky.

Brandyn Graves, 30, sells N95 masks outside CenturyLink Field before a Sounders FC match in Seattle. Health authorities have urged the public not to buy the masks to avoid shortages for health care workers. Jovelle Tamayo for STAT
Starbucks at Pike Place Market over the weekend. Jovelle Tamayo for STAT

“It may be that Seattle … had an early introduction that did take off into a chain of transmission,” Marc Lipsitch, an epidemiologist at Harvard’s T.H. Chan School of Public Health, said in a call with reporters last week. “It’s quite possible that we’ll see some places with lots of cases once we start testing, and other places that you would have expected to have similar risks maybe having fewer cases. But it’s really early, and the only way to move this from speculation to fact is to test.”

The local health agency here, known as Public Health – Seattle & King County, is well-regarded. But, like many public health organizations, it’s chronically underfunded, and it’s trying to contain the outbreak in Kirkland while dealing with the reality that many people, perhaps more than 1,000, in the region are infected and don’t know it.

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King County has “one of the best public health [departments], if not the best” in the country,” Centers for Disease Control and Prevention Director Robert Redfield told a House panel Tuesday. But, he added, “they’re struggling right now. That’s not what we need. We need to be prepared.”

Chrissie Juliano, executive director of the Big Cities Health Coalition, which represents health officials in the country’s 30 largest cities, praised state and local officials in Washington for their efforts, saying health officials’ “risk communication has been clear and transparent and shared on multiple media and in multiple languages.” But she said funding is undoubtedly an issue.

“They will need dollars, like those passed by the Congress … to backfill expenses that they’ve undertaken in the response to date,” Juliano said.

Sounders FC fans make their way to CenturyLink Field before a match over the weekend. Days after a worker at CenturyLink Field tested positive for novel coronavirus, the football club opted to keep the match as scheduled. Jovelle Tamayo for STAT

State officials have not called for the cancellation of sporting events and other mass gatherings. That decision has drawn some criticism, especially after 33,000 people attended a professional men’s soccer game Saturday. Inslee has authority under the state’s emergency declaration to cancel events, and has said he’s considering “mandatory measures” that would reduce “the number of social activities that are going on,” but hasn’t done so.

Philip Bagley, a Seattle Sounders season ticket holder — who described himself as “just a former history teacher who has spent way too much time on past epidemics and public health” — decided not to attend the match over the weekend. He said he disappointed his teenage son in doing so, but thought attending was too risky. He said he was “a little surprised King County hasn’t been more aggressive about social distancing.”

“It’s going to be a miserable few weeks here, maybe a couple of months, but the sooner we get ahead of it the better off we’re going to be,” Bagley said.

Nancy Messonnier, the director of CDC’s National Center for Immunization and Respiratory Diseases, told reporters this week it’s up to local officials to decide whether events should be canceled. Authorities need to consider the risk of exposure to the virus and whether people were traveling for the event, Messonnier said, as well as whether attendees would include people at higher risk for the more severe consequences of an infection, like older residents.

“The decisions in Seattle may look quite different than in a location where there’s not community spread,” she said. “We’re going to need to follow the local community’s lead.”

King County has not recommended blanket school closures, although some universities and high schools are implementing tele-teaching and some districts have shuttered schools where Covid-19 cases, or potential cases, have been reported.

Patty Hayes, the director of public health in King County, said during a Friday press conference that, when away from school, children tend to congregate anyway, or be handed over to caregivers who are often older — putting those vulnerable populations at risk.

“Sometimes keeping children in the classroom and under the supervision of the school is the best advice,” Hayes said.

Sakayi Perkins, a security worker and host at Operation Sack Lunch, which offers daily meals to Seattle’s homeless population, steams dining tables and chairs. Jovelle Tamayo for STAT
Seattle coronavirus
A temporary public hand-washing station at Pike Place Market. Jovelle Tamayo for STAT

There are also concerns about the vulnerability of Seattle’s homeless population, the third largest in the U.S. At a meal site run by the group Operation Sack Lunch on a recent day, people shuffled past a large hand sanitizer dispenser before getting their beef curry and sitting down to eat in its cavernous dining hall.

Beverly Graham, the organization’s executive director, said food servers are always under strict hygiene and health requirements, but last week staff put out new signs and flyers directing people to wash their hands. They’ve also begun steam cleaning surfaces in the dining hall several times a day, instead of once daily. Some organizations that rely on volunteers to serve food have had to curtail services as people stay home, Graham said.

“We’re being overly cautious because this is a community that already has compromised immune systems and we need to be very careful with them,” she said.

As case counts build, the state has also taken steps to make testing more available.The University of Washington’s health care system UW Medicine is screening employees at a drive-through clinic in an open-air garage.

With all the response measures being rolled out, some officials here are worried about what it will mean for other health resources. It’s impossible for the public health agency here to do everything at once, County Executive Dow Constantine told reporters.

“If there’s a hot spot here, and then one there and then one there,” he told reporters, “people’s attention is being appropriately drawn to those and away from the community-wide public health work we need to be doing to keep everyone safe across the population of 2 1/4 million people.”

Andrew Joseph contributed reporting.

  • They are worried about the homeless population. No way, since when? They live in sleeping bags on streets in near freezing temps. With feces, filth, needles and disease. Remind the homeless to wash their hands, is almost funny. I like what Patty Hayes, Dir. of Public Health had to say about the children should keep going to school.

  • If you’re a reporter why don’t you report about how people can adjust to this drastic change in their environments . No ones talking about how all these small businesses are going out of business in the city, or major hotel companies are letting off thousands of workers . This is a real problem with people being left off of work while this pandemic is in its early stages .. how will people pay their bills if jobs arnt hiring and they are firing because Businesses left and Right are being shut down and leaving family’s with nothing . If the gonvement could pause all activity and pause all payments like mortgages , rent , electric then the people wouldn’t be flipping out .

  • Am I the ONLY one missing THIS POINT…..I can see why people are wanting to get “tested” BUT what GOOD IS IT REALLY IF they ARE allowed to MINGLE afterwards, socialize, TRAVEL, etc., in other words, what is to stop anyone from contracting the virus AFTER they take these tests, making INITIAL tests UNLESS?????

  • Thank you Seattle, Governor Inslee, The U of W and the Dr who both defied the CDC in making the virus tests. Thank you for coming together in a crisis situation. Filling that leadership void that the Federal Government left for the States to fill. You are running point on this and the rest of the States are watching. As you go so shall we all go. Good luck, from your sister city to the South,

  • What a difference a day makes. I live in Seattle, and today Seattle pubic schools announced a two week closure starting tomorrow. And the Governor today mandated that events with crowds >250 people (e.g. sporting matches) can only go on without attendees. People are urged not to go to crowded venues like bars. Concerts are being cancelled and restaurants are shutting down due to a lack of customers. The good news is that people are largely staying calm and following the advice of health officials and political leaders. We know it will get worse before it gets better, but we will weather the storm in Seattle. At least we are not seeing the same type of leadership vacuum that is apparent in Washington, DC, where the chief concern appears to be protecting industries, not people. Our local health departments are making heroic efforts to do their jobs under very trying circumstances.

    • I would say the government was the first to step in with funding and assistance. I did not see any of Seattles politicians coming to the rescue when there was cases popping up in Kirkland and people were one by one dying. So please dont say at least your not taking the Washington DC approach, because that’s a lie. You had no approach but to whine and cry for the government to step in. I am a Seattle resident 6 mos out of the year. It’s my second home. I could never make it my first because your politics are so liberal you actually hurt and ruin the beautiful city I had to leave.

    • Tara, for someone who lives in Seattle half the year you have not been paying attention to what has been happening here. UW-Medicine took the lead and developed their own coronavirus test kit and is doing drive-up testing for healthcare workers. The Seattle Flu Survey pivoted and tested their flu samples and were the first ones to identify that coronavirus was active in our area. The Kirkland nursing home situation is a tragedy for sure, but that’s in Kirkland, so Seattle officials really could not do much there. Apparently the nursing home has had difficulties obtaining the testing kits promised by the Feds for weeks now. The liberal politics in Seattle mean that the primary concern here is not the stock market, but on taking care of the disadvantaged members of our community who will bear the brunt of this pandemic. This includes supporting hourly workers who will have their hours cut, resupplying food banks, making sure that the uninsured and underinsured get tested, as well as the elderly etc. If you think this problem can be solved at a local level than you don’t have an understanding of how easy it is for viruses to cross borders. This is an international disaster that will take a coordinated worldwide effort to contain it. Trumps wall, or the little of it that he has built, will do nothing to stop the virus. That effort falls to each of us.

  • 190 diagnosed and 22 dead means a greater than 11% death rate, and one is a teenager. That is major. WHAT IS SEATTLE WAITING FOR? The WHO has today March 11 declared the spread of this SARS-CoV-2 as pandemic. What on earth makes Seattle’s government so indicisive, not cancelling big gatherings, not curbing travel, not quarantining and not locking the city down?? Flagrantly the dire warnings by Italian Doctors are thrown into the wind. It started there with one concentrated area too – and then it spread like wildfire. Now that country is running out of medical supplies, beds, health workers, etc. It is so bad that triage now must select which patients to treat. Seriously – is this what Seattle wants??? Tell your leaders to WAKE UP. The measures to be taken are tough, but they appear to work !!

    • I hear you. So few have courage, your NY mayor had the courage and outlook for saving lives 🙂

      It’s like its falling on death ears though out the world and they’re stunned by the fact it’s going to hurt their economies so much to react as they should be.

      From WHO
      “We have called every day for countries to take urgent and aggressive action. We have rung the alarm bell loud and clear,” WHO chief Tedros Adhanom Ghebreyesus said in Geneva overnight.

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