Katie Lindstrom, Pacific County health director

SOUTH BEND — It’s been a long year with even longer hours for the staff at the Pacific County Health and Human Services Department, with April 18 marking the one-year anniversary since the first local covid-19 case was reported in Pacific County.

County health director Katie Lindstrom recently chatted with the Observer about a wide range of coronavirus-related issues, including the recent spike in cases in the county, how local vaccination efforts have gone thus far, and the fallout after Johnson & Johnson’s vaccine was put on pause last week.

The following conversation took place on April 15 — the first day all Washingtonians age 16 and older were eligible to receive a covid-19 vaccine — and has been edited for length and clarity.

Chinook Observer: Can many of the newly reported cases be attributed to that karaoke night event at the bar in Raymond a couple of weekends ago?

Katie Lindstrom: “We’re seeing cases all throughout [the county]. We’ve definitely had some cases in the south county area … but around half of the new cases [from April 7 to 14] are tied to the Pitchwood Alehouse. And we’re continuing to get more, we just had another one that came in about an hour ago [on April 15].”

CO: Are there any other details you can provide about the event that led to this outbreak and whether they were following existing guidelines?

KL: “It was an indoor and outdoor event, is our understanding. They had outdoor seating and indoor seating. Obviously we weren’t there, so we can’t verify [exactly what happened], but from all accounts it was a crowded event and I would believe that would mean they weren’t following the 50% occupancy rule.

Karaoke is allowed under the state guidelines but there’s some pretty specific guidelines around it, like having space around the singing, having breaks between [singers], and making sure to wipe off equipment. I’m not sure if and how those rules were followed, but we do have pretty good reason to believe at least the occupancy limits weren’t being adhered to.”

CO: With April 15 being the first day of widespread vaccine eligibility in Washington, what are you seeing within the county so far in terms of the level of interest?

KL: “As of April 14, we still had a lot of appointments available [at the various upcoming vaccine clinics]. With Ocean Beach Hospital’s Pfizer clinic on April 15, I’m going to say about half of the appointments still aren’t filled. Granted, today’s the first day.

I will say that we have seen a decrease in demand. The demand was crazy early on, and people were banging at our doors to get vaccinated. After the over-65 group, I’d say the demand remained pretty steady — at least enough for us to consistently fill up all of our clinics. Up until about a week ago, when they opened it up to people like grocery workers and some of those other essential workers, we still had some demand but it’s definitely gone down.

Pull Quote

‘We might be getting fairly close to vaccinating most of the people who want it, at this point. My guess, when it’s all said and done, is maybe we get to 50% [of the county’s adult population vaccinated].’

Katie Lindstrom

County health director

“I do think we’re going to see a bump with some of our clinics next week, would be my guess, but I don’t expect it’ll last more than a week or two. We might be getting fairly close to vaccinating most of the people who want it, at this point. My guess, when it’s all said and done, is maybe we get to 50% [of the county’s adult population vaccinated].”

CO: Going forward, what can be done to increase the percentage of people who are vaccinated?

KL: “I think there’s a segment [of the population] who aren’t necessarily against the vaccine. I think this segment is just against it right now, like they’re sort of waiting and seeing. So I do think there’s a chunk that wants to wait and see more people get vaccinated and see how everybody does, and they might jump in. And then of course there’s a segment of the population I think that will never get vaccinated. It’s just very much against their beliefs and they’re not going to do it.

I think there might be another chunk of people that we need to make it really easy for. One of the strategies we’ve been talking about is reaching folks who might not seek out an appointment, but if they’re walking by and there happens to be a walk-in clinic and they can just walk in and get it — or maybe there’s a clinic happening at their employer — they might be inclined to do that.

So those are some of the strategies we’re looking at. We’re thinking about where some of those pop-up clinics can be held, like at a grocery store or a large employer — or even a small employer. We’ll also continue to really work and make sure we’re going back out to the people working at the canneries — sometimes those people come in seasonally — on a regular basis.”

CO: Pfizer’s CEO said recently that a third covid-19 booster shot will likely be needed within a year of getting fully vaccinated, and it may be needed annually akin to getting the flu shot. What do you think the future of coronavirus vaccines will look like after this mass immunization effort slows down and things hopefully get back to some level of normal?

KL: “A big game-changer I think, that is hopefully on the horizon soon, is the vaccine manufacturers are going to start making the vaccine in a way so that it’s easier for primary care doctors to provide it. If you think about your flu shot, most people get it from their primary care provider when they’re getting their annual check-up.

The reason they’re able to do that is because the flu shot has been manufactured in a way where it’s a single dose, or it’s in a multi-dose vial and you can puncture the vial and give two doses today and two doses tomorrow, so it works in that setting. The current covid-19 vaccines are all multi-dose vials, which is typically OK, but because they don’t use the preservatives and for other storage reasons, once you puncture the vial you need to use it within a few hours. So if you don’t have 10 people ready and wanting the Moderna shot, [you’ll end up wasting doses]. What are the odds a doctor will have 10 people coming in that day all wanting the Moderna shot within a four-hour window?

It’s just not set up right now for private providers to really be part of the game at all, and that’s why we’re really focusing on mass clinics. Because if we can get 300 people to come, we can open up 30 vials, we’re not going to waste anything and we can follow the safety guidelines. So my hope is that the manufacturers are really focusing on getting us the product in a way that can be more user-friendly for private providers and get them in the game. And then moving forward, if we need a booster shot each year, maybe the county’s involvement is standing up a couple of big snap clinics for booster shots and for anyone who doesn’t have a primary doctor.”

CO: With the county wanting to use the one-and-done Johnson & Johnson vaccine on the groups like the homebound and homeless population, has its recent pause had much of an effect on vaccination efforts in the county?

KL: “It has, actually … We had a schedule put together to vaccinate homebound people in south county with J&J, but with the pause we canceled those appointments. We were able to get some of those folks rescheduled to our Moderna clinic, and the rest are sort of on pause until we get a resolution. But we aren’t going to go out and use that vaccine until it’s reapproved and recommended by state and federal health officials … We haven’t heard of any adverse reactions or anything in the county for the J&J vaccine — actually, with any of the vaccines — so we’re glad about that.

Just to put it in perspective, this is six cases [of people reporting having possibly a severe adverse reaction] out of several million J&J doses administered nationwide. That’s an extremely low complication rate, and I think sometimes that perspective does get lost. The other thing I’ll note is that it does show the system is working … I mean, we don’t ever want complications, but we do want a system that is capable of checking it when there are trends and certain reactions, and then a system that pauses it and is able to study it. And that is playing out how it’s supposed to play out.”