“Who won the pandemic? In our state (WA) it’s not even close”

By Danny Westneat, Seattle Times columnist

“Now that the coronavirus pandemic has wound down, morphing into a regular feature of our lives, it’s possible to look back and see which parts of our state and nation handled it well. And which did not.

“San Juan County, a group of islands in the northwest part of the state, not only survived COVID-19 better than anywhere else. It evaded the disease eight times better than the next best place, Jefferson County, which is out on the Olympic Peninsula.

When the coronavirus started to hit back in 2020, I thought ‘Oh, let’s see if we can borrow from history,’” he says. Long story shortened: The San Juans imposed the first mask mandate in the state, and possibly the first one in the nation. When the sheriff told James he couldn’t enforce it due to lack of manpower, James turned to the businesses to impose it instead.

“Measured by the ultimate marker of pandemic success — the death rate — San Juan County, population 17,850, ranks as the second-best county on the West Coast, and among the top dozen in the nation.

“The San Juans also had the lowest hospitalization rate in the state, by far, even though it’s one of the older counties demographically (35% of its people are 65 or older).

“For the first two years, we had the lowest case rate in the United States,” says San Juan’s health director, Dr. Frank James. “You’re the first person in the media who has called to ask us how we did it.” 

“I’ll get back to that last part in a minute. It speaks to whether society intends to gain any wisdom from the pandemic years. Or just try to forget what a debacle it was.

“So how’d the San Juans do it? For starters, they are islands, which James says gave them a built-in virus management advantage. It’s also a relatively homogenous population.

“But the story of what happened there isn’t just geographic luck. The county with the highest death rate in Washington state, Ferry County, has less than half the people of the San Juans, and is more remote. The reality is the novel virus eventually infiltrated every corner of every state. (Example: the North Slope Borough, up on the Arctic Ocean in Alaska, reports a COVID death rate more than 10 times higher than the San Juans).

“It turns out James, the health director, also teaches public health at the University of Washington. One of his courses there happens to cover past pandemics.

“When the coronavirus started to hit back in 2020, I thought ‘Oh, let’s see if we can borrow from history,’” he says.

“Long story shortened: The San Juans imposed the first mask mandate in the state, and possibly the first one in the nation. When the sheriff told James he couldn’t enforce it due to lack of manpower, James turned to the businesses to impose it instead.

“It was a huge ask of the businesses, and very contentious at first,” he says. “But they are pillars in this community. When they came around to it, it was like we had deputized all these respected people to help us. So wearing masks really caught on here, right in March 2020, earlier than anywhere else.”

“They also recruited volunteers and started an aggressive contact tracing system to isolate any outbreaks. Because cases were relatively low (due to the masks, James believes), this system didn’t get overwhelmed until well after vaccines became available in 2021.

“At the same time, James suggests they were careful not to push too far. Some residents wanted a quarantine — to close the ferries, shutting the islands off from society. The county decided that would be crippling for the fragile island economy, so they kept the ferries running.

“Ironically the San Juans are one of the least vaccinated places for childhood diseases. Against COVID it became the most vaccinated county in Washington , at 83%, and more than 95% for its seniors.

“Bottom line: By the time of the San Juans’ first death , in January 2022, the state had already suffered 11,000 deaths, the nation more than 875,000.

“The virus crashed through eventually. Suddenly this spring towns that had mostly evaded it were reporting the highest case rates in the state . By then most everyone had been vaccinated and boosted, “so it didn’t end up causing the severe disease that was experienced by almost every other community in the U.S.,” James says.

“The islands’ grand total of two deaths, one in January and one in March of this year, were among unvaccinated residents, the health department says.

“Businesses in the islands suffered mightily at times, as did schools and other institutions. It wasn’t a cost-free strategy, James said. Health workers there did get some death threats and protests, too, though it was more muted.

“I think for all the hardship, people came to feel they were living in a refuge, both from COVID and from the ideological insanity of what was going on around the country,” James said. “The community wasn’t as fractured as it was in many other places.” 

“The counties with the highest death rates bring up the rear in getting vaccinated. Ferry County is still only 43% vaccinated. Its neighbor Stevens County remains the least vaxxed place in the state, at 36%, despite 158 deaths and a rate nearly 30 times that of the San Juans.

“The tragedy is that most of the deaths in these counties happened after vaccination became widely available.

“The whole story of the pandemic in the United States is how terribly we did with it,” James said. “Was the suffering and death preventable? Not all of it, no. But most of it was. Look at San Juan County.” 

“Will people look? Most of what’s cited above is anecdotal — the cause-and-effect hasn’t been formally studied. But I haven’t seen much interest in after-action reports. America, satisfied with itself against all odds, is moving on.

“Congrats are due to the San Juans, though. It was a hollow cliché to say that we were all in it together. They really kind of were.

“There are no winners of a pandemic, of course. Only losers, and survivors. But the San Juans showed others a little how to come through one for next time, if they wish to see.

Danny Westneat: dwestneat@seattletimes.com. Danny Westneat takes an opinionated look at the Puget Sound region’s news, people and politics.