Seattle was the country's first coronavirus hot spot, and soon it could be one of the first big cities to reopen its economy. When and how that happens will depend largely on the region's ability to get adequate testing and protect its front-line health care workers, Mayor Jenny Durkan said.
"It's a marathon, not a sprint," she said. "We're not even really halfway through, even though we've hit the peak."
Just five weeks ago, COVID-19, the disease associated with the coronavirus, devastated a nursing home in an idyllic suburb east of Seattle. At least 37 people connected to Life Care Center of Kirkland died from coronavirus-related illness, according to King County public health officials.
It signaled the beginning of a national crisis that has infected more than 600,000 people and claimed over 32,000 lives, according to NBC News counts.
Washington has recorded just a small fraction of those numbers — 11,129 confirmed cases and 570 deaths statewide as of Thursday, according to NBC News counts. Officials credit some of that success to early interventions, such as social distancing measures and a statewide stay-at-home order.
"We asked the people to do some really hard things — we closed businesses, we asked people to stay home — and they did it," Durkan said. "As a result, we've been able to bend that curve, and the modelers believe we're on the downward trend."
The good news comes with hard decisions, however. Wednesday marked what would have been Tax Day, which was postponed until July to give the country more time to cope with the coronavirus. Now, cities and states must weigh reopening their economies while adhering to health and safety guidelines set by the Centers for Disease Control and Prevention and the World Health Organization.
On Thursday, President Donald Trump unveiled a three-phase plan for states to open businesses as coronavirus outbreaks subside. The guidelines don't mention specific dates, and Trump acknowledged that it would be "a gradual process" left to the discretion of governors.
Washington is still hammering out details on what that could look like, said Mike Faulk, a spokesman for Gov. Jay Inslee. He said overriding factors continue to be the rate of spread and hospitalizations and the ability to test on a mass scale, as well as trace and isolate cases and exposures.
"Staff are working very hard on it," he said, adding that more details would be released in coming days.
Seattle and neighboring communities will weigh various factors, including closely monitoring the rate of new cases, expanding testing and reporting capabilities and ensuring that the health care system is prepared to handle additional infections, Durkan said.
"That is probably the weakest link nationwide," she said. "There is not adequate testing anywhere in the country, and there is not the ability to do broad-based contact tracing."
Private labs say they now have capacity to test more people who aren't sick or showing symptoms of infections. Clinical labs, however, continue to experience delays and backlogs. In Washington, labs have capacity to conduct more tests but not the necessary materials, including swabs and vials, Faulk said.
At Harborview Medical Center in Seattle, all patients admitted for any reason began being screened for COVID-19 this week. The tests are administered by the virology lab at UW Medicine, the health care system affiliated with the University of Washington, which has the capacity to turn around thousands of same-day tests. Previously, only patients with symptoms or those whose medical histories were unknown were tested.
That's welcome news for lawmakers eager to reopen the economy but cautious about seeing a new spike in coronavirus cases.
The outbreak has already crippled Seattle's once-booming economy. In the second week of March, King County recorded 5,834 first-time unemployment claims, according to the state Employment Security Department. The number jumped to 44,613 the fourth week of March — almost 665 percent in just two weeks.
Across the country, 5 million people filed first-time claims for unemployment insurance last week, bringing the national total to almost 22 million in just one month.
"It's been devastating," Seattle contractor Todd Sekai said.
Sekai said that in the weeks since Inslee issued a statewide stay-at-home order, he has been forced to pause 16 projects and lay off 12 employees because private construction wasn't deemed an essential business.
Yet construction could be one of the first industries to resume, because workers can more easily practice social distancing on the job, Durkan said. Other businesses in which maintaining physical distancing is more difficult, such as bars, restaurants and event venues, could be the last to open.
Other West Coast cities, like Los Angeles, have already warned residents not to expect large-scale events until 2021. Durkan said that the same could be true for Seattle but that she will make that determination with other regional leaders.
Still, Durkan and other local lawmakers are testing the waters to gradually reopen economies.
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Earlier this month, Durkan ordered all public projects, including bridge repair and affordable housing construction, to close for two days to allow contractors and staff to implement additional social distancing and health and safety measures.
Those included making personal protective equipment available, improving worker hygiene and work site sanitation, and instituting decontamination measures that could be used if necessary.
"The minute we come together again, the virus can start spreading," Durkan warned. "We've got to be super careful and thoughtful about how we can start to let go of some of these restrictions."
Research suggests that early social distancing measures in Washington played a key role in keeping the region's infection rates down compared to those in places like New York City, which has the nation's highest rate of infection.
According to a report by the Institute for Disease Modeling in the Seattle suburb of Bellevue, infection rates in King County slowed in March. The effective reproductive number was nearly 3 at the beginning of March, meaning that each infected person was passing the virus to about three people. By March 25, the number was down to around 1, according to models revised through last week.
"We are cautiously optimistic that we are seeing that flattening of the curve," said Lisa Brandenburg, president of UW Medicine hospitals and clinics.
Keeping the number down will be key to reopening businesses, Durkan said. She will be working with other mayors in Washington and along the West Coast to ensure that communities are planning ahead for potential spikes as people resume old habits.
Durkan said she spoke with Los Angeles Mayor Eric Garcetti this week about working in tandem throughout the coming months. The relationship mirrors a larger effort by West Coast governors who announced a "Western states pact" this week.
"It's clear we've got to do it as a region," Durkan said. "The virus does not respect boundaries."