As the novel coronarivus spreads in Western Washington, Spokane hospitals are adjusting policies and increasing virtual visits to prepare for the respiratory disease to make its way to the area.

So far there are no confirmed cases in Spokane County and only one confirmed case of COVID-19 east of the Cascades, in a Quincy resident in their 80s currently hospitalized in critical condition in Wenatchee.

But as providers in Spokane County await test results for dozens of locals, they are hoping to get ahead of what many expect will be confirmation of the virus’ inevitable arrival.

With guidelines for testing patients looser than they were, providers are working to identify whether patients who have the flu-like symptoms of the virus – cough, fever and difficulty breathing – really have it.

Because health care officials are asking people who are sick with these symptoms to stay home from work or school, and to call their health care provider before going to the clinic or emergency department, Providence and MultiCare Rockwood clinics are encouraging virtual visits for those experiencing such symptoms.

MultiCare is also waiving the cost of virtual visits for patients with COVID-19 symptoms, and Providence Express Care Virtual has ramped up its services and can see about 1,000 patients per day.

Some hospitals are already taking some precautions due to the novel coronavirus. Sacred Heart Medical Center, Holy Family Hospital, St. Joseph’s Hospital in Chewelah and Mount Carmel Hospital in Colville are all enforcing visitor restrictions, as would be used during peak flu season.

All patients at the hospital are limited to two visitors at a time, and those visitors must be immediate family members who are 18 years of age or older.

“We understand the importance of seeing loved ones while you are receiving care, and know the value visitors bring to our patients,” say guidelines Providence released. “At this time, we encourage patients and their families to communicate through phone and video chat.”

MultiCare Deaconess and Valley Hospitals do not have visitor restrictions in place.

The Spokane Regional Health District will lead emergency response planning should COVID-19 spread in the Spokane area, and hospitals are a big piece of the community response puzzle.

Tiffany Turner, who manages the preparedness response program at the health district, said she believes our region is prepared and has the plans, training and relationships to fall back on because they have been in the works for years.

The health district would be responsible for coordinating with local hospitals should they be needed to increase their capacity for patients needing treatment in the event of a pandemic situation.

An estimated 80% of patients who get COVID-19 do not need to be hospitalized and only experience mild symptoms. Hospital rooms are necessary to treat the estimated 20% of COVID-19 patients who experience more severe or critical illness due to the virus, requiring oxygen or a respirator.

After local officials emphasized the needs for more hospital rooms in Western Washington due to an outbreak at Life Care Center in Kirkland, where 44 cases have been identified and 10 people have died, the Washington State Hospital Association issued a statement Thursday about hospital capacity.

“Most hospitals in the state do not have extra capacity and are not holding beds open for possible COVID-19 patients. However, hospital space can and will be made quickly available in an emergency or with a surge of critically ill patients,” the WSHA statement said. “Many hospitals have activated their emergency response plans to prepare to respond to community need, though most hospital operations are continuing as normal (including planned procedures).”

Even local hospitals operate at fairly high capacities, regional emergency planning documents show. A Dec. 28, 2017, capacity report about Spokane hospitals found that the mean operating capacity was 90.5%, which was considered somewhat lower than usual due to the holiday week of the survey.

Reporters pressed King County officials on Friday about why they had not closed down Life Care Center and moved out the 63 remaining residents.

“There’s no capacity at hospitals or nursing homes to take them,” King County Executive Dow Constantine said at a news conference Friday.

Many of the residents are receiving care at EvergreenHealth Hospital in Kirkland, but King County Public Health Director Patty Hayes said that hospital was nearing capacity and county officials were looking to other hospitals for help.

“We’re assessing where they need to go,” Hayes said Friday.

To prevent the spread of the virus, patients with COVID-19 need to be treated in airborne infection isolation rooms, according to Centers for Disease Control and Prevention guidelines. These rooms allow for negative air pressure and airflow to keep the patients isolated from others. Some hospitals have the ability to convert entire units and additional rooms to treat patients in a similar environment.

Together, Spokane-area hospitals have about 85 rooms to treat patients in a negative airflow environment. Sacred Heart also has a special pathogens unit with 10 beds. Two COVID-19 patients from the Diamond Princess cruise ship in Japan are currently in that special unit in satisfactory condition. They have yet to meet the requirements to be discharged.