YAKIMA, Washington-June 19, 2020. Today, the hospitals are at capacity. Not enough staff to care for sick COVID-19 patients. In fact, no more capacity for any critically ill person-whether they have a heart attack or a stroke (Washington State Department of Health, 2020). For Yakima, Washington, the reality of the pandemic most of us are trying to avoid is here now. It is June 19th and much of the country is thinking about Black Lives Matter, extrajudicial murder, Tulsa, and an upcoming election. Yakima is now the hottest spot on the West Coast and will soon top New York City as the hottest spot in the country (Coronavirus in the US: Latest map and case count, 2020). How did they get here, and what can they do to keep the community safe?
Yakima is unique in Washington State-a heavily agricultural community, with 63% of the workforce being essential, 49% of the community being Hispanic (44% White), and a poverty rate that is twice that of the state.
When COVID-19 hit the state, many of the people and leaders in Yakima joined in the effort to decrease the epidemic. The health department quickly leveraged existing partnerships across the community to accomplish essential testing and outreach. For example, the Yakima Valley Farmworkers Clinic took on testing and outreach, with large agricultural employers using their community outreach staff. The Washington Tree Fruit Association and the Yakima County Development Association partnered with Health District staff to perform site visits with agricultural employers to provide COVID-19 safety education to employers and staff and to review safety measures already in place. The largest local hospital-Virginia Mason Memorial-teamed up with the health department, assisting with surveys and data modeling. While many groups and people were aligned to contain the epidemic, and the county should have been well set for containment based on the strength of these partnerships, containment did not happen.
While some local leaders support the efforts for public health containment-testing, identification of positives and their contacts and tracking their contacts, care, and recovery-many organizations and people have not. Some local political leaders considered the epidemic to be like the regular flu-a gross underestimate of its health impact-and a hoax perpetrated by democrats trying to unseat President Trump, or somewhere in between those extremes. Danny Westneat wrote in the Seattle Times on June 17th that Yakima is a debilitating case study of the struggle between returning to work and no income. And, wearing a mask has become a political statement for many across the county.
An initial survey done in communities throughout the county showed that 35% of the people in the County actually used masks when out in public. Some communities reported that 5% and fewer used masks. Whole families have been observed in stores without masks and not socially distancing. A graduation party in one community was estimated to include more than 1000 participants-very few with masks.
Most employers have taken the epidemic seriously and have encouraged their employees to distance, use masks, and stay home when ill. Some have worked closely with local public health to investigate possible clusters of cases, and others have not. Some of the most effective outreach has been through some of the business organizations mentioned earlier and through farmworker-oriented groups such as the United Farm Workers and the Yakima Valley Farmworkers Clinics. Local experts have also provided geomapping support that enabled the health department to focus on hot spots with educational outreach and masks.
The health department has partnered with the state department of health for contact tracing capacity and is working to train community health workers to reach directly into the effected communities. There is a need to expand communication strategies that position trusted leaders in the community to message resisters and those affected by the virus to clarify that the epidemic is real and that there are things all people in the community can do to minimize risk and help the county move forward.
For now, the epidemic is in full flight and many lives are being affected by the virus. Today, that means inadequate hospital capacity to care for even the normal emergencies that affect residents.
Yakima can be a community that pulls together, uses prevention effectively-such as masks, testing, tracking, isolation, and needed supports. Or, it can remain divided, and all people in the county will be at greater risk. The governor has just required masks be used in social situations for the entire county. Yakima is ramping up testing, tracing, and isolation. Success and the health of the community will depend on all-or almost all-people pitching in for the good of everyone.
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