0:04

This is COVID 19 Seattle,

0:06

I'm Dave Ross

0:07

and I'm Aaron Granillo.

0:08

Story broke on this day. One year

0:10

ago, the country's first confirmed case

0:13

of COVID 19 landed in

0:15

Washington. Snohomish County health officer Dr

0:17

Chris Spitters delivered the news.

0:19

The gentleman is a Snohomish County

0:21

resident, and he is currently

0:23

in Providence

0:24

Medical Center. That 35 year old

0:26

man had touched down in Seattle just a few

0:28

days prior after flying in from Wuhan,

0:31

China. At that time, there were only

0:33

six known deaths from the novel

0:35

coronavirus. A year later, COVID

0:37

19 has killed more than 400,000

0:40

victims in the US. Dr. George

0:43

Diaz treated that first COVID patient.

0:45

He's an infectious disease specialist at

0:47

Providence Regional Medical Center in

0:49

Everett. And Dr Diaz, can you take

0:51

us back to that moment when you first

0:54

learned about our patient one?

0:56

Yes. We had been

0:58

expecting patients to come

1:00

to the US with COVID. So we had done

1:03

a lot of preparation within our hospital in our health

1:05

system to be ready for patients like this.

1:07

So we had already done large drills

1:10

at our hospital. When we got the call

1:12

to admit

1:14

this patient and that we had the first patient, the US

1:16

We were obviously surprised. You

1:19

know, you often do preparations, and then nothing

1:21

happens. But in this case, we

1:23

got the call that we would be admitting

1:25

this patient. So our

1:27

our thoughts turned to activating all of our protocols

1:30

and getting our checklist

1:32

done so we could make sure that we're ready

1:34

uh, when he came. What precautions

1:36

did you take? And were you aware of

1:38

the time just how infectious this

1:41

particular virus was? We weren't

1:43

exactly sure. Although

1:45

we had started really looking into this

1:47

in December when the first reports

1:50

were coming out of China and what we

1:52

what we had heard was that it appeared to

1:54

be quite contagious. And we had heard that there

1:56

were, uh, substantial lockdowns

1:59

going on in China because of the rapid spread.

2:01

So while we didn't know specifics,

2:04

we were very concerned this was gonna be

2:06

contagious and likely

2:08

deadly. We had heard about some deaths already.

2:10

We elected to use our Ebola precautions.

2:13

That's the highest level of isolation

2:15

that we have available on.

2:18

We had drilled on that, given the uncertainties

2:20

of the infectiosness and the mortality of the virus,

2:23

we felt that we should take the highest

2:25

level precautions. And so we trained on,

2:27

uh, the Ebola precautions

2:29

that that had been in place for several years,

2:32

and that's what we prepared for.

2:34

Can you elaborate on that, Dr Diaz? I mean,

2:36

I've heard stories about, you

2:38

know, robots going in there to to

2:40

treat this first patient.

2:42

Yeah. So the Ebola precautions

2:44

are quite intense. Uh,

2:47

it requires standing up a special

2:49

pathogens unit, which was

2:51

a two bed unit that we created in our hospital.

2:54

It required very specific

2:56

airflow, very specific

2:58

PPE use. We

3:01

did use our telehealth robot, which

3:03

was a state of health unit that

3:05

was inside the patient's room. The

3:07

idea for this was to try to reduce

3:09

exposures as much as possible. The

3:12

nursing staff that provided direct patient

3:14

care were in the room with him. But

3:17

any other, uh, caregivers

3:19

that needed to interact with the patient could use

3:21

a robot, including myself. And

3:23

so on the first day, when he arrived, we

3:26

turned on the robot. They wheeled the

3:28

robot to the patient's bedside

3:31

and I could do an exam with a stethoscope

3:33

that's built it on the robot. As

3:35

well, as take a history from him, uh,

3:39

you know, visually using the robot screen.

3:41

And did you did you sound the alarm? Did you

3:43

did you call the state government? Did you call the federal government

3:45

to say, "Hey, it's here. Let's do

3:47

something." Uh, they called us

3:50

so the patient had presented to one of our clinics

3:52

the day before. And, uh,

3:55

because of his history, he was very up front

3:57

about the fact that he had traveled to

3:59

Wuhan and he was there visiting family

4:02

on when he got sick. He,

4:04

um, immediately went and reported

4:06

to symptoms, so he was very compliant.

4:08

And with his history, the clinic appropriately

4:11

got him tested with the help of the county

4:13

health district and those samples

4:15

were then sent on to the CDC and

4:18

resulted overnight. So it

4:20

it was the next day that we were advised

4:22

by the CDC that they wanted us to admit the

4:24

patient for observation. Did everything

4:26

that happened stem from that one case,

4:29

or are we thinking now

4:31

that a lot of people entered the country

4:33

simultaneously with the virus? And

4:35

that's how the spread started? Yeah so the

4:37

county health department did an extensive

4:39

contact tracing, uh, basically,

4:42

you know, working backwards. The

4:45

patient himself was extremely compliance and

4:47

open about everything he had done

4:49

for the few days he was at home

4:51

before he came to the hospital.

4:53

And so they were able to trace

4:55

all the steps and, uh, did

4:58

contact tracing with I think, around 60 people

5:00

that might have been exposed on

5:02

and none of those persons turned positive.

5:05

You know what we know now is that

5:08

at the time that our patient was diagnosed,

5:11

there were likely probably thousands

5:13

of other patients in the U. S. That

5:15

were code positive that we didn't know about,

5:17

uh in part due to the difficulty

5:19

we had with testing initially.

5:20

Dr. Diaz, I wonder if you can reflect on this

5:22

week's milestone when the country

5:25

surpassed 400,000 deaths.

5:28

What does it mean to you from your perspective,

5:30

as the doctor who treated the country's

5:32

first confirmed case?

5:33

Yeah, you know, ah, year out

5:36

from our first patient, we have a pretty

5:38

grim outcome so

5:40

far, with 400,000 Americans

5:42

dead from the virus and countless others who

5:45

are debilitated from the effects

5:47

after the infection. Uh,

5:49

we've struggled as a country with

5:52

feeling the pandemic, maybe more so than any

5:55

other country on Earth and

5:57

it's a likely a result of the fact

5:59

that we aren't a unified country. And

6:01

the messaging that was coming from the federal government

6:03

with respect to masks and public health

6:05

measures were employed

6:07

in some places and not very well at others. And,

6:10

you know, thankfully, within the state of Washington

6:12

we have a governor's

6:14

office that has been working very closely

6:16

with public health, and the messaging

6:18

for Washingtonians has been aligned,

6:21

um, locally. And I think that's

6:23

helped us avoid some of the dramatic

6:26

problems that have occurred in other states. But

6:29

it's really, you know, mostly

6:31

sadness about the people that have died.

6:34

I think most of us know people that have

6:36

had the infection or even

6:38

died. So this is affecting

6:40

our entire community on Unfortunately,

6:42

it's not slowing down nationwide,

6:45

so this is something that will be with us until

6:48

we get our whole country vaccinated.

6:50

Did this have to happen,

6:52

or could it have been

6:54

prevented? Well,

6:57

I think there were likely going to be deaths

6:59

in the US regardless, but you know when

7:01

you compare the responses

7:03

to other advanced nations and we're

7:05

an Advanced Nation, we have, you

7:08

know, the highest health

7:10

care resource is in the world. Many patients

7:12

come from around the world to receive medical care

7:14

in the U. S. Uh, most of the

7:18

pharmaceutical companies that have invented therapeutics

7:20

that we're currently testing, um are

7:23

are made in the U. S. So

7:26

we have a really huge

7:28

advantage. Uh, starting out

7:30

with the resources we had and we

7:32

compared to other countries that have similar resources,

7:34

for example, South Korea or Taiwan or

7:37

Japan. Uh, their responses

7:39

have been one of national unity

7:41

where the entire population is

7:44

on the same page with respect to

7:46

how they're dealing with this virus. And

7:49

unfortunately, we haven't been, uh

7:51

and the results from that are evident.

7:53

Of course, we have a new administration now,

7:55

you know, speaking about unity.

7:58

But as you mentioned Dr. Diaz, we are

8:00

incredibly divided as a nation.

8:02

So are we are we in too deep

8:04

already to reverse the course of the pandemic?

8:07

Or can this new Biden administration

8:09

create positive change in containing

8:11

the spread?

8:12

Well, firstly, for us to get past

8:14

the pandemic. We have to have our population

8:16

vaccinated. And I think

8:19

that the new administration is appears

8:21

to be making the right moves with respect to

8:24

a national game plan for getting

8:26

our folks vaccinated. That

8:28

will be welcome news within our state,

8:30

for sure. But there are, unfortunately

8:33

many people in our country that

8:36

are exposed to disinformation

8:39

on believe false things about

8:41

this vaccine that's unsafe, when in fact,

8:43

we're quite certain that it's safe and effective,

8:46

and those beliefs

8:48

may be pretty well baked in. And

8:50

it may be difficult to convince people to get

8:52

their vaccines on in those

8:55

areas where these beliefs are

8:57

strongly held. Uh, those

8:59

areas will be a continued source of ongoing,

9:01

uh, infections and deaths.

9:03

How frustrating is that for you to

9:05

know that there is so much disinformation

9:08

and misinformation about the vaccine?

9:10

It's a huge problem, and it directly

9:12

makes my job worse because

9:15

for people that don't wear masks or

9:17

don't socially distance or don't follow the guidelines

9:19

from public health, those are the

9:21

people. They're coming to our hospital, uh,

9:24

you know, extremely ill. Our

9:27

staff our medical and nursing staff and respiratory

9:30

therapists have been dealing with us for

9:32

the past year and much of

9:34

this can be avoided by human behavior.

9:36

And so as

9:39

people don't do the things they should be doing, like

9:41

getting vaccinated is putting more

9:43

burden on people on the front lines.

9:45

There

9:45

is intense pressure to reopen schools and, of course,

9:47

to

9:47

reopen businesses. Would it be ethical

9:50

at some point, once the vaccines available

9:52

to anybody who wants it to say,

9:54

okay, those of you who didn't get it,

9:57

that was your choice. But we're going

9:59

to reopen and

10:01

we'll wear masks. But

10:03

we can't keep the society closed down because

10:06

of you. Well,

10:09

you know, I hope we get to that point,

10:11

you know, because I think that, for example,

10:14

restaurants, for example,

10:16

um, you know it's a privilege

10:18

to be able to go to restaurants, sit down and eat and

10:21

you know, if if there's ah,

10:23

a portion of the population is vaccinated

10:25

and we know that they're safe in,

10:27

you know, a crowd. Perhaps

10:29

it makes sense to say, for example,

10:32

you know well, if your vaccinated we can

10:34

prove it, you can go to

10:36

a restaurant or a gym, you

10:38

know, your kids could go to school. And

10:40

for those people that choose to

10:42

be vaccinated, perhaps,

10:45

you know, they're choosing to have their children be,

10:47

uh, at perpetual homeschool,

10:50

right? I mean, most places

10:52

require vaccinations for measles,

10:54

mumps and rubella. And

10:57

don't allow children to attend school

10:59

if they don't agree to be vaccinated because,

11:02

you know, they're not only risking themselves, but

11:04

they're risking the population. So

11:06

I have not heard much, uh,

11:09

in this direction yet, but I would imagine

11:12

that that would be something that would be considered

11:14

as we move forward because I think people

11:16

that they're doing the right things being

11:18

getting back, they wearing masks, social

11:20

distancing. Uh, they

11:22

should be able to get back to normal

11:25

life if they're no longer pose a risk to

11:27

the population.

11:27

Beyond the the

11:30

main question right now of

11:32

when am I eligible for a vaccine?

11:34

The other top question that I get the most from friends

11:36

and family is when do we get back

11:38

to normal? So what is your expectation

11:41

speaking as an infectious disease doctor?

11:43

And do we ever fully get

11:45

back to where we were pre COVID

11:48

days?

11:49

I think it's possible for us to get back

11:51

there. It really means that we have to have

11:53

90 or 95% of our population

11:56

vaccined. I think if that's

11:58

the case, then we could probably

12:00

safely reopen you know, our entire

12:02

economy. Um, you know, as

12:04

it was, pre COVID, but that

12:07

that really takes a national effort and

12:10

in Washington a full state effort to

12:12

get everyone vaccinated. Right now, we are still

12:14

waiting on vaccine shipments from

12:16

federal government. The governor has been

12:18

working on, you know, mass vaccination programs

12:20

around the state, Uh, to get up over

12:23

a million or two, you know, per day nationally

12:25

so , this is something that I

12:27

think it's certainly possible. It's gonna be a lot of

12:29

effort on. It really takes our

12:31

community be fully on the same page to

12:33

get there. Although I think we have trouble getting people

12:35

to accept the idea of carrying some sort

12:38

of ID card. That's the only drawback uh

12:40

drawback I see with that plan. Yeah,

12:42

it would have to be secure, you know, we

12:45

currently use the Washington state registry to

12:48

administer vaccines. So, for example, at

12:50

providence, if I if we vaccinate somebody at

12:52

Providence. Uh, that vaccination

12:55

record goes into a Washington state registry, which

12:57

is, you know, a

12:59

record for the entire state on.

13:01

So if someone gets vaccinated somewhere else, we could look on the registry

13:04

and see if they've been vaccinated elsewhere. I

13:06

would imagine that could be securely tied to something

13:08

like your driver's license so that people

13:11

would be, you know, securely able

13:13

to find out if one is vaccine

13:15

or not.

13:17

The thought right now is that this

13:19

new contagious variant

13:21

of COVID could be the dominant strain

13:23

in the United States in a month or two.

13:25

As far as I know, we don't

13:27

have any confirmed cases of this variant here

13:30

in our state. But how concerning

13:32

is that that there is this new not

13:34

not any more deadly, but certainly more

13:36

contagious strains circulating around

13:38

the country now?

13:39

Yeah, it's extremely concerning, you know,

13:41

in the UK, where they're variant

13:43

was discovered, uh, likely

13:45

contributed to a major surge in that country

13:47

with an increasing number of cases.

13:50

Not only that, but it shifted the

13:52

people that were getting infected. So because

13:54

it's so much more contagious. Uh,

13:57

previously, Children who were less

13:59

likely to be infected just by their nature of their

14:01

immune systems are now being

14:04

more likely infected in the U. K. And

14:06

so this this does affect the

14:09

population, you know, with a more

14:11

contagious strain. That being

14:13

said, the current vaccine that we have appears to be

14:16

likely safe and effective for that these

14:18

variants as well. And so

14:20

for those people that elect not to

14:22

get vaccinated when their time comes, uh,

14:25

their risk will likely be even higher

14:27

than currently it is. Dr George Diaz,

14:29

he treated the first COVID patient, infectious disease

14:31

specialist at Province Regional Medical Center in Everett.

14:33

Dr. Diaz, thank you very much. Thank you so

14:35

much for having me. We'll be back with you next Thursday

14:38

to discuss the latest coronavirus news. You

14:40

can subscribe to this podcast, and you can also

14:42

find our news coverage on my northwest.com

14:44

or listen live at 97 .3

14:47

FM.