“Those who cannot remember the past are condemned to repeat it.”

It was only a little more than a month ago when the first known cases of COVID-19 were reported in our Spokane community. This pandemic, which began in a city few had heard of in late 2019, immortalized by the World Health Organization’s labeling of the “novel coronavirus,” has spread to more than 180 countries and has been documented in almost 3 million people globally (and unconfirmed in untold many more). In the United States, we have seen almost 900,000 confirmed cases, more than 12,000 cases in Washington state, and more than 300 cases here in Spokane County.

We have heard and read about the nightmarish experiences of front-line health care workers, first responders and citizens across the United States, finding it amazing these stories could be happening in a country that prides itself on the best and most advanced health care system in the world, albeit unprepared for such an onslaught.

We’ve been shocked by how the struggle for something as simple as a paper mask and a “test kit” has brought this country to its knees. This life-altering event has impacted everyone, some more so than others, at many levels: physically, psychologically and socioeconomically.

We find ourselves a month into this challenging time, frustrated by being asked to “stay home,” and asking ourselves how much more can we take? Before answering that question, let’s compare ourselves to past generations who suffered through experiences measured in terms of years and decades – we’ve endured much more with much less.

The governor’s “Stay Home, Stay Healthy” proclamation issued March 23 was needed, because short of an order, recommendations for social distancing were not being followed. This was done based upon an understanding of the science behind mitigating epidemics that could no longer be contained. It was a necessary and strong step to bring COVID-19 under control, knowing well its impacts.

While much has been spoken to the differences between Eastern and Western Washington, COVID-19 doesn’t recognize geographic differences, to include state borders. Knowing this, we were able to locally prepare for the arrival of the pandemic as the Puget Sound region was being affected. I vividly remember reaching out to a West Side colleague whose advice was to be as aggressive as possible in Spokane to prevent a repeat of his experience.

We have been fortunate, so far. Mostly thanks to your willingness to abide by the “Stay Home, Stay Healthy” order, more people are staying healthy and lives are being saved. Our recent data have been encouraging, as we have seen a “flattening of the curve” with fewer confirmed cases and hospitalizations.

But admittedly, we’re only an outbreak away from changing this positive trajectory. Eastern Washington has seen significant outbreaks in long-term care facilities in Yakima and Tri-Cities, as well as a meat plant in Walla Walla County that has impacted adjacent counties. Clarkston’s neighbor city, Lewiston, is experiencing an outbreak in a long-term care facility that has contributed to many cases in Asotin County.

Is Spokane ready to loosen the requirements of “Stay Home, Stay Healthy?” There are many conditions that would need to be met before we could do so.

Public health efforts include more broad-based testing, isolating those who are infected (maybe even those without symptoms), and quarantining those who’ve been in contact. Hospitals and clinics need to have sufficient PPE and be able to quickly respond to outbreaks. Businesses would need to ensure safe environments supporting physical distancing requirements.

And everyone would need to maintain their physical distance, wear masks when out, stay home when sick, and continue to wash their hands after touching frequently touched surfaces.

Can this be done? Yes, if we’re willing to be cautious and willing to retreat if necessary.

What keeps me awake at night is thinking about the decisions made and those to be made. Nothing has been or will be easy, and I realize what is being asked of everyone affects both lives and livelihoods. I worry about those who already live at the margins of our society and how the effects of COVID-19 on them could be devastating.

Yet, I’m also aware this has greatly impacted every member of our community – just some more so than others. I believe we can do this, but it’s not going to be easy and will require sacrifices, some greater than others, but necessary.

Public health is what we as a society do collectively to assure the conditions in which people can be healthy (IOM, 1988).