When an unmasked Gov. Jay Inslee announced the end of the coronavirus state of emergency after more than two years, he did so with matter-of-fact language. Language for a boardroom.
“We are now in a position to be able to continue our efforts against COVID in multiple ways, without the necessity of an emergency order declaration by the state of Washington,” Inslee told the media on Sept. 8. “Accordingly, I’m announcing today that the emergency declaration will lapse on Oct. 31.”
The virus — while still claiming hundreds of lives every day, nationally — was relatively under control in Washington, Inslee said. That week, the state would report 84.3 cases for every 100,000 Washingtonians and 6,453 cases overall — a precipitous drop from the 1,804.7 rate and 138,172 cases in the January 2022 Omicron-driven spike.
Most of the 85 emergency orders that Inslee issued in the past two and a half years to arrest the virus had already expired or been retired. The most onerous of the restrictions — those requiring businesses to shut down or restrict occupancy and civilians to wear masks in most situations — had been lifted earlier in the year. An additional 12, mostly to do with health care facilities, were already set to expire on Oct. 27, days before the new deadline.
The end of the emergency wouldn’t be that big of a deal, was the message. Nothing much will change.
The fight against the virus — one that successfully mobilized a large portion of the population and unleashed a torrent of federal resources onto the local level, ripped away pretense and exposed fundamental cracks in our social fabric — is shifting into a new maintenance phase, and there will be no tickertape parade.
SHOOT, the messenger
“The pandemic is over,” President Joe Biden told CBS News anchor Scott Pelley as they walked through the Detroit Auto Show, trailed by cameras filming for the subsequent “60 Minutes” broadcast that aired on Sept. 18.
It was a comment that launched a thousand headlines and not a few late night jokes to the guffaws of fully masked audiences. For many, the pandemic doesn’t feel over.
According to the Centers for Disease Control and Prevention (CDC), the seven-day moving average of coronavirus deaths was 408 the day of the interview. Nearly 7.5 percent of American adults reported “long COVID” symptoms, or symptoms they experienced for months after otherwise recovering from a coronavirus infection.
But, to some degree, the president was speaking the truth, at least when it comes to the government’s role in the coronavirus pandemic response.
The federal government announced that the current bivalent booster, optimized for the Omicron variant of the virus, would be the last one assured to be freely available. The initial vaccine course and subsequent booster had been one of the few truly universal health interventions that many U.S. residents had ever experienced.
Various courts ended federal mask mandates in transportation spaces and struck down the CDC’s attempted eviction moratorium. The federal funding appropriated by the Trump administration’s CARES act and the Biden administration’s ARPA legislation has since been largely disbursed, although some from the Federal Emergency Management Agency will last at least through the end of 2022.
Locally, at least, declaring and maintaining the state of emergency was necessary to secure those funds, said Dr. Umair Shah, secretary of Washington state’s Department of Health. But that is mostly over. Now, with the availability of the coronavirus vaccine and the new therapeutics to treat severe cases of the illness, the state is in less of an acute state of emergency and more concerned with long-term management.
The danger posed by the virus isn’t over, particularly for vulnerable groups with underlying conditions, disabilities and comorbidities, who are still under threat as requirements for and enforcement of public health interventions, like masking, wane. Uptake rates for the new bivalent booster are low, even in Washington state, where more than 80 percent of the population has at least started the original vaccination regime.
That makes for a tricky line for public health messengers to walk: End the emergency, but maintain the vigilance. Shah likened it to a patient using medication to get high blood pressure under control. The immediate problem — a heart struggling to pump blood, inching toward arrest — stabilizes; that doesn’t mean that the patient can go to town on sodium.
“Just like there is a science to medicine, there’s an art to medicine. There’s also a science in public health. There’s also an art to public health,” Shah said. “I think the real challenge we’ve had throughout this pandemic is always having tradeoffs for every decision, every milestone.”
Early on, when the virus was “novel” and its mechanisms were unknown, health professionals and politicians were adapting to and disseminating new information in real time. In Washington, the refrain became “follow the science,” a phrase used to justify Inslee’s decisions under sweeping emergency powers.
Like the federal government, the state is also transitioning away from the front-and-center role that it played in coordination during the height of the pandemic. In a series of plans with hopeful names like “WA Forward” and “Transformational Plan: A Vision for Health in Washington State,” it has also backed away from warlike messaging around “beating” the virus and into the uneasy détente of “coexisting” with COVID-19.
“We get to this point where we’re able to not have as much of an emergency as we are working through what does it mean to coexist with COVID-19, the virus and the disease, and the pandemic itself over time,” Shah said.
The role of health care provision, which the state took on in a massive campaign to acquire and distribute the vaccine and other resources, will shift back to the private sector — a return to “normal,” such as that is. The state will remain vigilant, it says, maintaining capacity to deliver personal protective equipment, surge vaccinations and deploy testing, as needed. The message: We will not be caught unawares again.
That may not be as seamless as it sounds, however.
The pandemic stretched the private system thin. It’s been holding itself together using emergency orders and waivers, said Taya Briley, executive vice president of the Washington State Hospital Association (WSHA), a group that advocates for hospitals in the state.
“The aftermath of the COVID hurricane is just as bad — and in some ways even more challenging — than the COVID hurricane itself,” Briley said. “And of course, we’re not out of the pandemic yet.”
Hospital staff are exhausted. Resources are depleted. Some hospitals are concerned about closing or minimally cutting services right when accessing things like routine medical care becomes critical. Health care settings are begging people to get the necessary primary care and other steps needed to stay healthy and out of their facilities, which is challenging, as messaging around the state of emergency removes a sense of urgency.
“I think a lot of people are really eager to move on from the pandemic, and we do stop doing these healthy steps of immunization and masking when in crowded places, I think, at our peril,” Briley said.
Right now, Briley said, hospitals are inundated with patients who delayed care earlier in the pandemic. Some are staying in hospital beds rather than moving on to long-term care facilities, creating a holdup in the system. Waivers allowing hospitals to admit more patients than normally allowed are connected to the emergency order.
“We’ve got multiple hospitals currently operating at over 100 percent capacity, and that waiver will go away,” Briley said.
It doesn’t help that the expiration of the state of emergency lines up with an expected surge in COVID-19 and the traditional flu season, a time when hospitals seek additional flexibility from the government anyway. Those waivers are supposed to be a stopgap measure, but hospitals are already reaching for it. That’s a “big, red flag” that things are not back to normal, Briley said.
The WSHA will be coming to the state legislature, hat in hand, looking for additional resources to close the gaps that have opened up just in 2022.
The legislature, of course, has its own political and funding priorities to deal with.
THE POLITICS OF SCIENCE
The public health response to the onset of the coronavirus required rapid, sometimes painful measures to prevent the spread of the illness before it could cement its grip on a vulnerable state and nation. In 2020, the part-time legislature was just ending its session when Inslee declared the state of emergency and began handing down proclamations, shuttering schools, closing non-essential businesses and restricting gatherings.
State Sen. Rebecca Saldaña remembers those early days. “We pivoted as much as we could as a state legislature and allocated millions toward public health,” Saldaña said. “That was March 2020.”
“[Inslee] declaring the emergency saved lives,” she said. “For me, personally, it was critical he took the leadership he did during those times.”
Individual Republican legislators took to the courts to resist Inslee’s actions, filing a lawsuit in May 2020 to stop Inslee’s “Stay At Home” order, which aimed to restrict Washingtonians’ movements largely by closing places they could go to. State workers attempted to sue over the state’s vaccine mandate; that policy won’t end, although the state is moving toward an “incentive-based” system to encourage workers to get the new boosters, Inslee said when he announced the end of the emergency order.
The state of emergency announcement was welcome, but late, wrote Minority Leader Sen. John Braun in an emailed statement.
“For a time the state of emergency was justified, because of what we didn’t know about COVID,” Braun wrote. “Unfortunately, Governor Inslee began drifting away from the data and toward other metrics that seemed more political than scientific.”
State law also sets a bar for an emergency order, Braun argued, a standard that hasn’t been met for a long time. Inslee hasn’t issued a coronavirus-related order that impacted a large swath of state residents for a long time.
“The state of emergency easily could have ended back then,” he wrote.
When the legislature reconvened in 2021, the majority and minority parties took widely different stances on what lawmakers should do to react to the governor’s emergency orders and deal with the ongoing emergency. Democrats moved to codify some of Inslee’s executive orders, giving them life outside of the context of the emergency, and passed longstanding priorities, including tax increases and police reform. Republicans decried such actions as a power grab while the “ability of the people to meet with and oversee the actions of their elected representatives was limited,” Braun wrote.
For Saldaña, it was a matter of moving the ball forward. The legislature was just in the process of removing austerity measures imposed during the recession of the late aughts and early 2010s when the pandemic hit, she said. Things that became possible during the pandemic — increasing access to benefits, making child care more accessible, investments in public health, relief for undocumented immigrants — were things that many on the left had long felt were necessary.
“What we learned is that there’s nothing like a crisis to push you to do something you knew was the right thing to do anyway and make it happen,” she said.
That was certainly true for certain aspects of public life in Seattle and King County.
Coronavirus relief funds and new taxes were used to plug holes in systems like the regional response to homelessness. As Deputy Mayor Tiffany Washington told the City Council during budget discussions on Oct. 14, the city doesn’t provide basic, mat-on-the-floor shelter anymore — the whole system transitioned to “enhanced” shelter of a type that was considered revolutionary in 2017.
A larger version of a payroll tax that the City Council failed to push through in 2018 passed in 2020, bringing in hundreds of millions of dollars meant to address systemic inequities through added services and resources. Public meetings moved to purely online and then hybrid formats, increasing access for members of the public who couldn’t otherwise engage with the City Council at 2 p.m. on a week day.
Some of those changes will stay. Others — specifically the payroll tax and its uses — are already getting a second look, as Mayor Bruce Harrell seeks to close a significant budget gap opened, in part, by council actions to support Seattleites using one-time funds during the pandemic.
While the pandemic created an existential threat that impacted everyone — if not in the same way — the durability of systems remains profound. While changes took place, society is primed to snap back. There has been no seismic shift.
Maybe, after all this, Washington will just move into a somewhat new, still precarious “normal.”
Read more of the Oct. 26-Nov. 1, 2022 issue.