With more than 100 new COVID-19 cases in Washington confirmed Tuesday, federal and state officials are tightening visitor restrictions at nursing homes statewide.

The novel coronavirus leads to mild symptoms in most people who have it, but for people older than 60 and those with underlying health conditions or compromised immune systems, the disease can be severe.

Washington officials reported 267 confirmed COVID-19 cases, including 21 deaths tied to three long-term care facilities in the Seattle area.

Gov. Jay Inslee announced strict visitation rules, following the Centers for Medicare and Medicaid Services’ guidance, for long-term care facilities as cases of COVID-19 were confirmed in nearly a dozen nursing homes in Washington.

“We need to look forward,” Inslee said. “If we’re going to stop this epidemic or seriously slow it down, we need to look at what’s coming in Washington state, not just what is here today.”

Meanwhile, Inslee is expected to announce Wednesday a ban on events and social gatherings attended by more than 250 people in Snohomish, King and Pierce counties, the Everett Herald reported. Chris Reykdal, Washington’s superintendent of public instruction, said Tuesday evening he doesn’t expect Inslee’s announcement to shut down public schools, according to the Seattle Times.

Under the rules announced by Inslee for all state-licensed long-term care facilities, residents will be limited to one visitor per day, a log will be kept of all visitors for 30 days and any resident with symptoms will be kept in isolation if they may be contagious.

New federal guidelines indicate facilities that have Medicaid and Medicare patients can restrict visitors who reside in communities where there is community spread of the disease as well as restricting visitors who have symptoms or recent travel history in countries with community spread of the disease.

The Centers for Disease Control and Prevention has heightened its recommendations for those at higher risk for severe illness due to the disease.

“This weekend the federal government made a very specific recommendation in this context that travelers, particularly those with underlying health issues, defer all cruise ship travel worldwide,” Nancy Messonnier, a director at the CDC, said during a news conference. “We also recommend that people at higher risk avoid nonessential travel such as long plane trips.”

In King County, which has 190 confirmed cases, health officials have urged residents to take recommendations seriously to limit social contact and social distance from others to prevent the spread of the virus.

Ten long-term care facilities in King County have residents or workers with confirmed cases of COVID-19. Additionally, in Snohomish County, several confirmed cases have been linked to Josephine Caring Community in Stanwood.

There are 24 deaths reported thus far in Washington, with 21 of those deaths connected to three long-term care facilities: Life Care Center in Kirkland, Issaquah Nursing and Rehabilitation Center, and Ida Culver House in Seattle.

So far, 2,175 of the 2,442 people tested for the respiratory disease in Washington have tested negative. In the majority of people who get COVID-19, the disease is mild, with moderate symptoms, including a cough, fever and difficulty breathing, that do not require hospitalization. The disease is more severe in people over the age of 60 and those with underlying health conditions.

Employees at nursing homes and assisted living facilities will be screened for COVID-19 symptoms at the start of each shift under new state regulations designed to contain the virus.

“We also know that there’s an increased risk of rapid spread of COVID-19 among persons who are living in congregate settings, such as long-term care facilities,” Gov. Jay Inslee said at a news conference today.

Weathering the economics

of the COVID-19 outbreak

As Congress ponders potential sick leave measures, state leaders in Washington are proactively working to ensure certain workers who need to quarantine can do so without losing pay.

The state will take additional measures to help workers who are affected by the outbreak. State workers will be able to work from home with normal pay, for as many as 14 days. Other workers will have increased access to unemployment insurance, paid family or medical leave to provide them with additional security while caring for themselves or their family, Inslee said.

“The most powerful force to restrain this epidemic are the individual decisions of 7 million Washingtonians,” Inslee said.

Employees will be eligible for expanded unemployment benefits if they’re under isolation or the business that employs them temporarily shuts down due to COVID-19 concerns, he said.

Starting next week, the state will be more lenient on businesses affected by COVID-19 that are late on payments to the government or in turning in required information, Inslee said.

“The sweep of these policies are really going to help people weather this economically,” he said.

The state is considering policies that would cancel or restrict large gatherings of people, but is first analyzing the consequences before final decisions are made, Inslee said. Local officials can make such a call but it would be more effective as a statewide policy, he added.

Only two cases confirmed

in Eastern Washington

There are still only two confirmed cases of COVID-19 east of the Cascades, one in Kittitas County and one in a Grant County resident who has since died. The 84-year-old Grant County man was hospitalized at Central Washington Hospital in Wenatchee, which is testing additional patients for the disease.

The Grant County resident had not traveled outside the county in recent weeks, meaning the virus likely was spread somehow in the community. Grant County health officials have asked individuals who were at events where the man was two weeks before his hospitalization to monitor symptoms.

In Spokane County, health officials say they are not recommending canceling events, such as basketball tournaments, yet.

“We are not at the point – yet – where we should be canceling things and that sort of (precaution), and I emphasize the word yet,” Spokane County Health Officer Bob Lutz said.

While he is not recommending events be canceled, Lutz recommended those who are sick should stay home, and that future actions from the health district will depend on the evolving situation. Spokane County still does not have a confirmed COVID-19 case, and health officials need to test people locally to determine if it is in the community.

Currently, Lutz said testing capabilities are still limited, which makes it difficult to determine how widespread the disease is and if it is in the community. In weighing decisions, Lutz said he looks to the capacity of the region’s health care system to treat individuals who may need higher levels of care.

“It’s this balance between the community that needs to be kept healthy and well and making sure you have enough resources to care for them,” Lutz said.

While the majority of people who get COVID-19 will not need to be hospitalized, those who get severely ill might need oxygen or respiratory support. Lutz said Spokane County is still in the containment phase of efforts, but moving toward mitigation eventually, and health officials expect to see the spread of the disease in Spokane eventually.

“The reality is that all you’re doing is delaying something,” Lutz said. “You can delay it, but you can’t prevent it.”