YAKIMA, Wash. — In what seems like almost a lifetime ago, America’s coronavirus story started in January in Washington State, with the nation’s first confirmed case followed by an early outbreak that spread with alarming ferocity.
But swift lockdown measures were credited with holding down illnesses and deaths. By June, nail salons and bars had begun to reopen, even as the virus began to rage in Texas, Arizona and Florida. Washington still had relatively low case numbers, and some counties were even contemplating a return to movie theaters and museums.
Now, those plans are on hold.
The coronavirus is once again ravaging Washington, and the number of cases has hit grim new milestones. Since the middle of June, the state has reported an average of 700 new cases per day — the highest levels since the start of the pandemic. More than 42,000 people have been infected, and over 1,400 have died.
“If these trends were to continue, we would have to prepare to go back to where we were in March,” Gov. Jay Inslee said recently.
Six months after the coronavirus first reached the United States, the state that was on the initial front line — a state that locked down early and hard — is only now beginning to see how complicated and lengthy the fight may be.
A lot of things are going wrong at once. Young people, less likely to die of the virus and undoubtedly weary of social distancing measures, have been driving a spike in new infections in the Seattle area. And an outbreak here in Yakima County that began powering its way through agriculture workers in the spring has now spread widely through a community that has not embraced self-isolation and masking to the degree that many Seattleites have.
Yakima, the eighth-most populous county, now has the second-highest number of cases. While the county cannot be blamed for hot spots elsewhere, Yakima does show how the virus can simmer along at a seeming lull — until a fresh outbreak suddenly surges through an entire region, challenging officials to stitch together cohesive policies for a patchwork of different problems.
“It’s really important for people to understand that their individual behaviors, everyone’s individual behaviors, collectively have a big impact on transmission,” said Dr. Kathy Lofy, Washington’s health officer. “We can increase testing, we can do case and contact investigations, we can do outbreak response, but those activities only get us so far.”
When the virus first came to Washington, the eastern part of the state was not hit as badly as Seattle, a liberal city with legions of tech workers who dutifully stayed home. But lockdown measures were not as effective in Yakima, a much less affluent county where more than 60 percent of people work in meat- or fruit-packing plants or other essential jobs.
The county is home to a large Hispanic population, which officials have said is more at risk for the coronavirus because of crowded living conditions where the virus can easily spread or limited access to health care. Many people live paycheck to paycheck, and if they were able to get up and go to work, they did.
By mid-May, people who worked in Yakima’s fruit-packing facilities had started to get sick. Terrified of working on crowded assembly lines or in warehouses that weren’t regularly cleaned, many went on strike, even as the virus spread outside the buildings’ walls.
Cases hit a peak in early June, according to Dr. Teresa Everson, the health officer for the Yakima Health District, just as more workers were cramming into processing facilities for the beginning of Washington’s busy cherry-picking season.
Still, only a third of those in the county wore masks, according to one survey from health officials. In the last few weeks, infectious people have gone to at least 20 family gatherings, 15 birthday parties, two baby showers and two weddings, Dr. Everson said. Some businesses were even reluctant to work with her office, which was trying to track cases and do contact tracing.
“There are a few large employers that persistently do not return our phone calls and do not want to work with us,” Dr. Everson said.
Angelina Lara, who packs fruit for Allan Brothers, was among the workers who got sick, and she still has not recovered her sense of taste and smell. She cannot enjoy cooking the recipes her children find for her on TikTok, but she is grateful that no one else in her home got as sick as she did. She knows at least one person who has died. He worked in a warehouse, too.
Ms. Lara was among the workers who went on strike, demanding more protections, including free masks, which Allan Brothers initially wanted to charge for, Ms. Lara said. (The company did not respond to a request for comment).
Sitting at a picnic table in Sarg Hubbard Park, Ms. Lara and three other workers described being hassled by the police during the protests. Once, a man who was watching the demonstrations — a private citizen, they believed, who had come around before — drew a gun on them, one said.
Ms. Lara said she was dismayed that she had to fight for basic protections that some of her neighbors appeared to see as an infringement on their liberty.
“What liberty?” Ms. Lara said, shaking her head.
Local law enforcement authorities have been reluctant to aggressively enforce virus-control measures ordered by the state. When the governor issued a statewide mask mandate, Yakima County’s sheriff, Robert Udell, issued a statement saying that he would not arrest or detain anyone who violated the “controversial” rule.
As in many conservative towns, masks are a political issue here, and rumors have swirled: The masks are bad for your health. Officials are inflating the numbers.
The Coronavirus Outbreak ›
Frequently Asked Questions
Updated July 15, 2020
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Is the coronavirus airborne?
- The coronavirus can stay aloft for hours in tiny droplets in stagnant air, infecting people as they inhale, mounting scientific evidence suggests. This risk is highest in crowded indoor spaces with poor ventilation, and may help explain super-spreading events reported in meatpacking plants, churches and restaurants. It’s unclear how often the virus is spread via these tiny droplets, or aerosols, compared with larger droplets that are expelled when a sick person coughs or sneezes, or transmitted through contact with contaminated surfaces, said Linsey Marr, an aerosol expert at Virginia Tech. Aerosols are released even when a person without symptoms exhales, talks or sings, according to Dr. Marr and more than 200 other experts, who have outlined the evidence in an open letter to the World Health Organization.
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What are the symptoms of coronavirus?
- Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
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What’s the best material for a mask?
- Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles.
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Is it harder to exercise while wearing a mask?
- A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico.
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I’ve heard about a treatment called dexamethasone. Does it work?
- The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth.
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What is pandemic paid leave?
- The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave.
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Does asymptomatic transmission of Covid-19 happen?
- So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
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What’s the risk of catching coronavirus from a surface?
- Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
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How does blood type influence coronavirus?
- A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
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How can I protect myself while flying?
- If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
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What should I do if I feel sick?
- If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
“Our county health department’s cooking the books,” a Yakima County sheriff’s detective, Judd Towell, said one recent afternoon at a dusty gun range in Yakima. He went on to argue, without evidence, that the severity of the outbreak was not what county health officials were making it out to be.
Dr. Everson said she has heard plenty of such suspicions.
”We are accused daily of blatantly lying about our numbers to either scare the public or make money,” she said. “I don’t know what to make of that.”
Mr. Udell, who was stepping up to the range not far behind Mr. Towell, said that his wife had recovered from the virus and he did not share Mr. Towell’s theory. Still, when the outbreak moved to eastern Washington and the morgues in Yakima did not overflow, and the hospital did not run out of beds, Mr. Udell did not necessarily see a public health victory — he saw that people had been scared unnecessarily.
“At the beginning when the Covid started, there were these huge estimates of burning piles of bodies and all that kind of stuff, and it’s obvious the estimates have been way high,” he said.
With only 60 deputies and one of the highest murder rates in the state, Mr. Udell argues that he has bigger problems to deal with than enforcing the mask mandate. And ultimately, Mr. Udell, an elected official, has no interest in wading into a debate over masks that could alienate voters.
“I get emails, dozens of emails a day, saying ‘I’m never going to do it, you can’t make me,’” he said. “On the other side, we get emails saying, ‘Put those people in jail.’”
For health officials, there is no debate. The government can increase testing only so much, they say. But to reopen businesses, to re-establish a normal way of life, Washington will have to rely on a weary public that may have thought they had the virus beat.
Just a few weeks ago, the state was confident that it could reopen schools in the fall, allowing many parents to go back to work and fuel the state’s economic recovery. But amid mounting opposition from educators and health experts, those plans look increasingly unlikely. And on Tuesday, Mr. Inslee said that no counties would be allowed to loosen lockdown restrictions for at least two weeks.
In Seattle, still the heart of the state’s outbreak, many people are resigned to the precautions they envision for the foreseeable future. On July 4, families wearing masks grilled tortillas, played on swings and enjoyed the parks — many feet away from anyone else. Salons took customers’ temperatures before letting them in. At Target, people lined up six feet apart at the cashier.
Mr. Inslee, in a recent interview, sounded hopeful.
“Mask usage is changing very rapidly in my state,” he said. “What we’re asking people to do, they are doing.”
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