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HomeMy WebLinkAboutDuchinvbtrt-(--ffrtVOfficeoftheDirectorPublicHealth17401FifthAvenue,Suite1300Seattle,WA98104-1818Seattle&KingCounty206-296-4600Fax206-296-0166flYRelay:711www.kingcounty.gov/healthNovember23,2020MayorArmondoPavoneRentonCityHalt1055SouthGradyWayRenton,WA98057RentonCityCouncilRentonCityHall1055SouthGradyWayRenton,WA98057CityClerk’sOffice:citycIerk(rentonwa.govRe:ProposedEmergencyOrdinanceonUseoftheRentonRedLionforCOVID-19ShelterDc-IntensificationDearMayorPavone,andCouncilmembers,IamwritingtostronglyurgeyounottopassRenton’sproposedemergencyordinanceregardinguseoftheRedLionHotelforCOVID-19shelterde-intensification.Ifpassed,theordinancewillinterferewithoureffortstocontrolthespreadofCOVID-19.Iammedicaldoctortrainedinbothinternalmedicineandinfectiousdiseases.IreceivedmymedicalepidemiologytrainingattheUSCenteisforDiseaseControlandPrevention.IsitontheCDC’sBoardofScientificCounselors,OfficeofInfectiousDiseases,andontheBoardofDirectorsfortheInfectiousDiseaseSocietyofAmerica.Forthepastfiveyears,IhaveservedastheLocalHealthOfficerforKingCountyandourcounty-widehealthdepartment,PublicHealth—Seattle&KingCounty.AstheLocalHealthOfficer,itismyjobtotakesuchactionasnecessarytomaintainpublichealthwithinKingCounty,tocontrolandpreventthespreadofanydangerous,contagiousorinfectiousdisease.IhavebeenleadingPublicHealth’seffortstocontrolthespreadCOVID-l9sinceFebruary.Thisisthemostserious,complex,andchallenginghealthproblemthatIhaveeverworkedon.FromthebeginningoftheCOVID-19epidemic,publichealthdepartmentsacrossthecountryandtheCDChavebeenveryconcernedaboutpreventingoutbreaksamongpeopleexperiencinghomelessness.Personsexperiencinghomelessnessareaparticularlyhigh-riskpopulationfordevelopingsevereCOVID-19,andtorequirehospitalization,becausetheytendtobelesshealthythanthegeneralpublic,withunderlyingmedicalconditionsandco-morbidities.LargenumbersofpeoplewithsevereCOVID-l9canoverwhelmhospitals.asoccurredpreviouslyinNewYork,Florida,TexasandArizona,andisnowoccurringinmultiplestates. Whenoverwhelmed,hospitalsareunabletocareoptimallyfortheirpatients;thestandardofcarecandropsignificantly.Whenhospitalsareoverwhelmed,patientsneedingcarealsostayawayanddefertreatmenttheymayneed.PreventingoutbreaksofCOVID-19amongthehomelessisacrucialcomponentofourcountywidestrategy.OthercommonmethodstocontrolCOVID-19spread(e.g.,testing,contacttracing,physicaldistancing,andrestrictingmovement)aredifficulttoimplementamongpersonswhoareexperiencinghomelessness,andstay-at-homeordersareimpractical.ThoseresidingincongregatehomelesssheltersalsofaceadditionalseriousrisksforcontractingCOVID-19.CongregatesheltersareoftenverydenselypopulatedenvironmentsinwhichCOVID-19,oranyinfectiousdisease,canquicklyspread.Congregatesheltersaregenerallypoorenvironmentsforcontrollingthespreadofanoutbreakonceitbegins,becausetheylackindividualrooms,adequatespaceforphysicaldistancing,andenoughbathroomstomaintainpersonalhygiene.Onceaninfectiousdiseasebeginstospreadwithinacongregateshelter,itthreatensallresidents,plusthedoctors,nurses,foodproviders,andotherstaffwhoservethem.EvenasmallnumberofhomelessindividualscontractingCOVID-19indenselyoccupiedsheltersettingscouldcauseamajoroutbreak.Statesandlocalhealthdepartmentsthroughoutthenationhavemovedcongregateshelterresidentsintosaferspaces,includinghotelsandmotels,topreventthespreadofCOVID-19.TheCentersforDiseaseControl&Preventionrecommendsthatlocalcommunitiesdecompresssheltersviaadditional,temporaryhousingtoreducecrowding,particularlyforthehighestriskpopulations.Hotelsandmotelsareparticularlywell-stiltedfordiseasecontrolbecausetheyprovideindividualroomsandsufficientbathroomfacilities.Useofhotelsandmotelsforquarantineandisolationisanestablished,traditionalresourcepublichealthdepartmentsusetopreventthespreadofinfectiousdiseases.WeatPublicHealthhavepreviouslyhousedpatientsinhotelsandmotelstopreventthespreadofhepatitisA,measles,andtuberculosis.Forallthesereasons,“shelterde-intensification”isacrucialcomponentofourlocalCOVID-19strategy.AsLocalHealthOfficer,onMarch31st,orderedandauthorizedKingCounty,andlocalcitiesandtowns,toimplementthisshelterde-intensificationstrategyforreducingthespreadofCOVID-19.Iorderedshelterde-intensificationtoencourageandenablelocalcities,townsandKingCountygovernmenttorent,lease,orpurchaseavailablehotelandmotelroomstotemporarilyhousepersonsexperiencinghomelessness,onlyuntiltheepidemicissufficientlyundercontrolsothattheycanreturntotheircongregateorotherlivingsituation.Followingmyorder,KingCountyleasedandpaidfortheRedLiontohouseresidentsoftheverycrowdedDESCmainshelter.Withthisstrategy,KingCocintyisprovidingsomeofthemostvulnerableshelterresidentswithasafeplacetostayuntiltheepidemicissufficientlyundercontrolsothattheycanreturntothemainshelter.ICpassed.theproposedemergencyordinancenowbeforeyouwillhinderourde-intensificationstrategybyarbitrarilyrequiringformerDESCmainshelterresidentstoleavetheRedLionby June1,2021.Althoughwecannotpredictthetimelineoftheepidemicwithcertainty,thebestscientificevidenceindicatesthattheepidemicwillnotendbyJune1.Inaddition,itishighlyunlikelythatenoughofthepopulationwillhavebeeninoculatedwithavaccinetoendtheepidemicbythiscomingsummer.TheviruswilllikelystillbewithusandtheriskofcontractingsevereCOVIDwillremainhigh,particularlyforpersonslivingincongregateshelters.TheproposedordinancewillriskthehealthofthehomelesspersonsnowsafelystayingattheRedLion,andthecommunity.IaskthatyounotpasstheproposedemergencyordinanceandhelpuscontrolthespreadofCOVIDbysupportingourtemporaryuseoftheRedLion.WhenIwrotemyorderinMarch,1wasconcernedthatalocalgovernmentcoLildseeitasauthorizingconfiscationofprivateproperty.Toavoidsuchamisinterpretation,Iauthorizedtheuseof“legallyavailableresourcesto:de-intensifyorreducethedensityofexistinghomelessnesssheltersandencampments....“Withthosewords,Iwasnotreferringtozoningorlandusecodes,andonlymeanttoensurethatnobodywouldreadmyorderasallowingtheseizureofprivateproperty.Sincerely,JeffreyS.Duchin,MDHealthOfficerandChief,CommunicableDiseaseEpidemiology&ImmunizationSectionPublicHealth-SeattleandKingCountyProfessorinMedicine.DivisionofInfectiousDiseases,UniversityofWashingtonAdjunctProfessor,SchoolofPublic1-Iealth4015thAye,Suite1250,Seattle,WA98104Tel:(206)296-4774;Direct:(206)263-8171;fax:(206)296-4803E-mail:jet’Educhin(kincounty.gov