Washington, Oregon show promising coronavirus trends

Two states at the forefront of the coronavirus outbreak that has infected hundreds of thousands of people across the country are beginning to see infection rates slow as strict social distancing requirements show early results of paying off.

Officials in Washington, the first state to see a confirmed COVID-19 case in the U.S., and neighboring Oregon say they are cautiously optimistic that the case curves in their states are beginning to bend downward.

The number of new cases in both states has dropped for four consecutive days, and the most recent data shows new cases are just a fraction of what they had been at each state’s peak.

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“We are cautiously optimistic that what we’re doing is working,” said David Bangsberg, founding dean of the Oregon Health and Sciences University-Portland State University School of Public Health.

Washington reported 298 new coronavirus cases on Tuesday, a 3 percent increase, bringing the total number of cases to 8,682. As recently as last week, Washington reported almost 1,000 new cases on a single day. 

On Wednesday, Washington Gov. Jay InsleeJay Robert InsleeInslee says Trump coronavirus response akin to if FDR called Pearl Harbor 'a hoax' Green group proposes nearly T infrastructure and clean energy stimulus plan Washington state bishops respond to Trump's push to reopen churches: 'We will wait' MORE (D) said the number of cases had fallen enough that a Department of Defense field hospital set up in Seattle could be redeployed. It’s a sign that the state believes it has the hospital capacity to handle the number of cases it will eventually face.

In Oregon, the case count rose by 49 on Tuesday, a 4 percent increase that brought the total number of cases to 1,181. That figure was half of the number of new cases Oregon reported on Friday, its worst day so far.

“When we look at the various models and see what they're saying, probably the middle to end of April is where we'll see our peak,” Dean Sidelinger, Oregon’s health office and state epidemiologist, told The Hill. “We think that's a reflection of the early and decisive action that our governor and the state took to protect Oregonians.”

In both cases, officials and public health experts said early actions were crucial, even though neither state had much of a playbook to follow. 

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Inslee declared a state of emergency after the second and third confirmed cases showed the virus had been spreading undetected through the community. He issued a stay-at-home order on March 23, among the earliest such orders in the country.

“As the first state in the country with a COVID-19 case, Washington officials have had to make a lot of decisions with less information than we’d like to have, and develop guidance at the same time as we implemented it. Luckily, we have acted quickly at several key moments throughout the response, including implementing physical distancing strategies early on,” Kathy Lofy, Washington's state health officer, said in an email.

Oregon’s first case of the coronavirus was not confirmed until much later, but Gov. Kate Brown (D) issued a stay-at-home order the same day as Inslee — and just nine days after the first Oregonian died from COVID-19.

“We put [the stay-at-home] order in place around the same time as other states like Washington and California and New York, but we were earlier in our epidemic, and that's helped us keep cases low,” Sidelinger said.

Those watching from the outside said both Washington and Oregon have some built-in advantages that helped them get ahead of what might otherwise have been startlingly broad outbreaks. Laboratories attached to some of the most cutting-edge medical technology companies in the world are in Seattle, and their experts quickly started tracking the spread of the virus. 

At the same time, both cities have substantial percentages of workers who can work from home. Major institutions such as Microsoft and the University of Washington ordered those who could to work from home long before governors made orders more explicit. 

And while the federal government downplayed the threat of the virus’s eventual arrival in the United States, both Washington and Oregon officials began planning for someone with the virus to show up at an airport on one of the many flights between the Pacific Northwest and Asian hubs.

“They had begun planning for this before they saw their first case, because they knew they had extensive travel links to Asia,” said Jeremy Konyndyk, a senior fellow at the Center for Global Development who ran U.S. Agency for International Development’s Office of Foreign Disaster Assistance and helped organize the Obama administration's response to the Ebola outbreak. “They took those measures because their public health professionals who were advising their politicians were saying this is what you've got to do.”

Perhaps most importantly, officials said, the curve is bending downward in both states because residents took seriously the orders to stay at home.

“The longer people stay in, particularly as the weather gets nice, it gets harder and harder,” Sidelinger said. “The sacrifices they're making, we know they're huge. We're working hard to make sure that people know their sacrifices are working.”

The outbreak in Washington and Oregon — and to some extent in California, the first state in the nation to order people to stay at home except for essential reasons — has developed much differently than in states like New York and Florida, and even in states with a smaller number of cases like Indiana. In those states, governors waited longer to tell residents to stay at home. 

Several Southern governors refused to close their beaches to spring breakers and others who flouted the Centers for Disease Control and Prevention’s social distancing guidance. The case curves in those states are bending upward, as Washington's bends downward. 

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“I think the lesson is that implementing multiple interventions on the early side is a winning strategy,” said Janet Baseman, associate dean for public health practice and an epidemiologist at the University of Washington.

But officials said that both Washington and Oregon face challenges ahead, especially as they begin to ease restrictions in the coming months. The first phase of strict social distancing has given both states a window of opportunity, one they can use to begin robust testing and tracing the contacts of those who have contracted the virus. But the strength of a potential second wave of infections will depend on how well those testing and tracking programs work.

“As we establish control of this for the first wave and when we relax our social distancing interventions, testing and contact tracing will be a very important part to monitor for the second wave,” Bangsberg said. “We need to anticipate and look proactively for it. The earlier we detect the second wave, the easier it will be to contain it.”