Western Washington State COVID-19 Experience: Keys to Flattening the Curve and Effective Health System Response

J Am Coll Surg. 2020 Sep;231(3):316-324.e1. doi: 10.1016/j.jamcollsurg.2020.06.006. Epub 2020 Jun 16.


Background: Washington State experienced the first major outbreak of COVID-19 in the US and despite a significant number of cases, has seen a relatively low death rate per million population compared with other states with major outbreaks, and has seen a substantial decrease in the projections for healthcare use, that is, "flattening the curve." This consensus report seeks to identify the key factors contributing to the effective health system disaster response in western WA.

Methods: A multidisciplinary, expert panel including individuals and organizations who were integral to managing the public health and emergency healthcare system response were engaged in a consensus process to identify the key themes and lessons learned and develop recommendations for ongoing management of the COVID-19 pandemic.

Results: Six key themes were identified, including early communication and coordination among stakeholders; regional coordination of the healthcare system response; rapid development and access to viral testing; proactive management of long-term care and skilled nursing facilities; proactive management of vulnerable populations; and effective physical distancing in the community.

Conclusions: Based on the lessons learned in each of the areas identified by the panel, 11 recommendations are provided to support the healthcare system disaster response in managing future outbreaks.

MeSH terms

  • Betacoronavirus*
  • COVID-19
  • Communicable Disease Control / organization & administration*
  • Communication
  • Coronavirus Infections / diagnosis
  • Coronavirus Infections / epidemiology*
  • Coronavirus Infections / prevention & control*
  • Delivery of Health Care / organization & administration*
  • Emergency Medical Services / organization & administration
  • Humans
  • Long-Term Care / organization & administration
  • Pandemics / prevention & control*
  • Pneumonia, Viral / diagnosis
  • Pneumonia, Viral / epidemiology*
  • Pneumonia, Viral / prevention & control*
  • SARS-CoV-2
  • Stakeholder Participation
  • Washington / epidemiology