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Notes: A Stepwise Guidebook on Filling in Snahomish County Health District Clearnance Form 2009 Online

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The Definite Guide to Snahomish County Health District Clearnance Form 2009

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Instruction of Snahomish County Health District Clearnance Form 2009

I'm Dave summers nobody's kind of.executive and I just thought I want to.thank everybody for being on this.morning you know it's obviously.difficult times here in Snohomish County.in the state and in our country and in.the world but we have just an amazing.team of folks that have been working.24/7 to mitigate and prepare for the.corona virus and I know a lot of people.a lot of our residents are anxious many.are staying at home but I want to tell.you you're doing a fantastic job the.residents of Snohomish County are really.stepping up to the task and at the end.of the day personal action by our.residents and individuals is what can.help us flatten the curve and really nip.this thing in the bud as best we can so.we are teaming up with our Snohomish.Health District they are with us.together with the city of Everett and.our Emergency Management System and I.think the coordination efforts have been.going extremely well here we are a.county that is used to collaboration and.I'm just really really very proud of.everybody I also wanted to thank our.cities or tribes our congressional.delegation the governor and our federal.partners for their assistance in this we.are all in this together and we need to.support each other and our businesses.also have been extremely supportive it's.very tough times for them as well we.know that and we're working to come up.with plans to help them through this as.well as all our residents I do have on a.good note positive note we did receive.our first shipment OPP PPE equipment.from the strategic national stockpile.last night.we have not gone through it sort through.that yet exactly but we'll be doing that.today and getting that distributed via.the state's guidelines for that one of.the thing I wanted to mention before I.turn it over to others is that our.residents do not need permission to go.the grocery store or take care of their.essential business there are no.checkpoints but we are asking people.just to stay at home as best you can of.limit your travel and your public.contact to absolutely essential items.but again this is really up to you to.carry out and you're doing a great job.that staying at home so thank you for.that just keep it up and also last thing.is if you need information you can go to.the Sonoma shelf districts website or.Snohomish County snow cone or for more.information you'll find links to key.pieces of information about just the.latest things that are going out here in.Snohomish County so I think with that.I'll turn it back I believe dr. spitters.is up next dr. Thank You executive.summers good morning everyone thank you.for being here I first want to echo.executive summers sentence and thank and.encourage everyone out there that.personal action social distancing to.flatten the curve is really such a.critical part of this and and so you're.you really are doing your part and we we.need that to continue and I just want to.encourage you that it it does and it.will make a difference in the long run.and I just want to verify can people.hear me okay thank you so I'd like to.share three brief updates with you this.morning before we move on those updates.our case counts first in the home.account information on the growing.number of cases and long-term care.facilities and highlights from the.drive-through testing site that there's.no Michelle District launched this week.so first let's cover the new case counts.as of last night we had a total of eight.hundred 16 cases cumulatively of Kovan.19 involving Snohomish County residents.since the local outbreak of the pandemic.began.among these cases 71 are currently.hospitalized 21 are in isolation at home.or in long-term care facilities 18.individuals have passed away 418 have.completed their isolation period and the.remainder we're still in the process of.catching up with them for interviews and.education as a reminder the Snohomish.Health District is continuing to update.its website frequently around this and I.would just add that over the last.several days we've we've seen you know.we were getting 30 to 50 cases a week.reported per day reported last week and.now we're up more in the 80 to a hundred.per day over the last few days on the.website you can find additional data.charts resources and blogs to inform you.and answer many questions you have I.encourage you to check often and share.this important information with your.audience's colleagues and friends as.I've stated before individuals with.underlying health conditions like.diabetes heart disease lung disease.kidney disease as well as individuals.over 60 years of age are at higher risk.of severe illness that is.hospitalization or death on a due to.Coba 19:00 this is one of the reasons.we've assembled an outreach team focused.on infection prevention and control in.assisted living skilled nursing and.similar long-term care facilities the.steps taken earlier this month to.restrict visitors and increase.infectious disease protocols are.critical to the work being done by these.facilities serving these very highest.risk individuals right now we have seven.long-term care facilities with in.Snohomish County that have at least one.resident with Cove at 19 Washington.state guidelines for data release which.are intended to protect patient privacy.discourage us from releasing the names.of settings with fewer than five cases.for that reason I can only tell you that.Josephine caring center there Josephine.caring community in Stanwood with 120.with 21 cases today and sunrise view.here in Everett with 25k.today are publicly listed we are.providing guidance on testing criteria.in long-term care facilities and in all.settings but we are also encouraging.providers to use their best clinical.judgement to determine when it is.appropriate to test this is true.throughout the healthcare system whether.or not a facility has had a case or not.the Health District has a team of.nursing and allied health care staff.that helps respond to long-term care.facilities seeking technical.consultation or reporting respiratory.illness and we are working with them to.help coordinate support testing efforts.for their staff and residents in those.settings and to procure personal.protective equipment for those.facilities so that they can properly.manage the infectious risk when there is.a case staff at these facilities can.also go through their medical provider.or through our drives through site in.Everett if they are symptomatic for.kovat fever cough difficulty breathing.being the key symptoms as we announced.Sunday night testing kits currently in.very short supply in the region have.been supplied by the Federal Emergency.Management administration and the US.Department of Health and Human Services.for a drive-through testing site that.has been operating this week in Everett.this testing does have specific criteria.for individuals to qualify for the.testing and they must be used for.targeted testing of symptomatic.individuals through jointly sponsored.local federal drive-through testing.sites such as the one in Everett with.the generous assistance of many.community partners particularly from the.health and law enforcement in human.services sectors we've had 736 people.tested through the drive through site in.its first four days so almost 200 people.per day test results are being provided.through a national call center.established by FEMA and HHS with an.estimated 3 to 5 day turnaround I do not.have any test result numbers from the.site to share at this time but we look.forward to analyzing that information.as it becomes available in the coming.days and with that it's my pleasure to.turn it over to dr. Kent Culkin with the.Snohomish School District well thank you.dr. spitters as we take a look and talk.about how the this is impacted education.across Norma's County it's really hit.hard as we've been asked to really turn.our model from an in-house you remote.learning as quickly as possible and.serve our kids today what I want to talk.about is the safety that we've been.offering Emile's child child care and.access to learning from the very.beginning of this we've been charged.with really the safety of our students.our know staff and our community and.it's something that we hold up very.dearly as everyone does across the.across the nation we've come into you.know if you think back in the beginning.just on washing their hands and don't.touch your face and and coughin to your.elbow and sneeze into your elbow and.probably the big word that will define.this generation is social distancing as.we as we teach our communities how to be.safer but when governor Ansley and in.close schools and superintendent.reichter all provided guidance they.really gave us three things that we had.to focus on right off the bat and that's.one is to provide meals.number two is to provide childcare and.the last one is for access to learning.for our students and I'd like to talk.about those three first of all with our.meals logistically it's very complex but.all the districts across the county.really took this on and really have it.up and going in its success today I'm.not saying that there isn't challenges.but students and kids are being fed.across the county even our first day of.closure we were able to get out and.ketover 500 kids right now there are two.delivery models for feeding kids there's.one that's pick up where we take the.meals to a certain location and most.times it's it's elementary schools and.parents come and pick up the meals from.that point the other delivery model is.delivering meals on school bus routes.where their bus routes run the regular.meals kids come out to their stops and.they're handed their meals for the day.that's no homeless School District we do.a hybrid of both of these where we.deliver our meals on the.routes and then at the end of the route.we go to an elementary and do pickup for.kids yesterday we delivered meals to.just a little over 1,500 kids to see.home how important this is on how it's.going the Sultan community one of the.smaller school districts in one day.delivered over 1900 meals child care.child care was big to be given to.schools and and a huge thing out to.thanks out to our community partners big.brothers and sisters and the YMCA they.stepped up and partnered with a lot of.the school districts and just expanded.opportunities they already had in place.which has been nice I will tell you and.talking to my colleagues child care.isn't it hasn't been impacted as big as.what we thought it was numbers are small.in the Sonoma School District we have.two sites we have eight kids on one site.and seven kids at the other as of.yesterday but were prepared for those.numbers if they should happen to.increase as this closure goes on but.right now a good partnership with those.two community partners access to.learning this is someone like to spend a.little bit more time on because it's.difficult to say the least.this access to learning has really taken.the model that we have and really tried.to turn it around and it's not it's very.difficult and it's not going to replace.the typical child in the classroom and I.don't think anybody intended it to but.it is it's it's going there we're trying.to get out we're trying to get.technology to all of our kids that's one.of the things we're doing is is seeing.that kids have their not only computer.but internet access and that brings.challenges of its own some districts.across the county we're ahead of the.curve as they already had every child.having their own computer and that helps.some for the rest of us including.Snohomish Schools we've been handing out.computers in the last three days we've.had about well over a thousand computers.and hotspots I will tell you that that.didn't solve those problems of.connectivity either as we have some.folks that live in areas that have tough.connectivity and even the hotspots don't.work we also have places where now that.mom and dad are at home trying to work.from home and.maybe two or three kids trying to also.get on the computer that that really.strains the internet connectivity well.really the true challenge of education.is what we're plagued with and that's.educating all kids access and tracking.is difficult as we do not know how many.kids check in how many kids are.connecting how long they connect for.when we talk about measuring progress.how a student is doing with their work.do we collect the work do we grade it.all these are questions that were.running into in the education and if we.do grade what are we assessing are we.assessing really what the child knows.are we assessing the bound of the.barriers that he said that he or she is.having with with connectivity or or the.time of the day or what it's like in.their home so it's really struggling as.we take a look at breeding as educators.we know we'll tackle all these problems.and under the circumstances that all.students will receive a great education.out of these circumstances the best.tools we have we've got some great.teachers and we've got families that are.eager to partner with us as we offer.this personally in a discussion with my.board just this week we understood the.challenges but decided to not let.perfect get in the way of good and we're.going to start really pushing out.education and rely on our professionals.and our families so we know that this is.going to cause some challenges and some.issues but together we're going to work.through these issues and we also know.that education next Friday may not look.like what it looks like today however we.have one constant that we're shooting.for and that's connection between our.teaching the individual student I think.also importantly I want to talk about.our seniors because we have to get our.seniors to over the point and get them.to their their diploma by the end of the.year this is the end of the thirteenth.year and so they're it's pretty exciting.times for them this is very complex and.I know that in order to do this we're.gonna have to work with seniors.individually to see where they are and.what it's gonna take to get them going.one of the big questions is is what.about credits and how do we hand out.credits for this last semester so they.can have their final credits to graduate.the state has been great in this in in.working with us on how to waive credits.how to work.with the high school and Beyond plan.graduation pathways and we also know.that the State Board of Education is.thinking right now on other ways that we.can wait certain requirements to.graduation going however no matter how.we get the kids to to graduation we must.also know that there's a essential.learning that has to happen for seniors.there's still standards that they need.to master in order to be successful at.the next level we have our teachers and.our staff that are working and good and.work hard to make sure that those.standards are get to our seniors we.can't overlook the mental and the.emotional toll that this disclosure was.having on our kids and first of all for.our seniors they may miss or drastically.or may miss or have drastically changed.once-in-a-lifetime events.what will graduation ceremony look like.or what we have graduation ceremony what.about awards banquet sports competitions.musicals and concerts all those things.are big things and I know in times like.this we say well we're just going to.have to move through them and we will.but we must realize the impact it has on.our kids and our families for the rest.of our others our students how is this.kind of close are going to manifest.itself in its future and the same thing.for our staff and families as.superintendents as superintendent in.Sonoma schools I am sure that I share.the same thoughts my colleagues our.colleagues across the county will get.through this we have some dedicated.passionate teachers and staff that want.to do the best for kids and along with.the families we know we're going to.implement evaluate and adjust constantly.and every day is a new challenge and a.change in education thank you very much.[Music].any idea how many people came in the.first shipment yeah there's a question.in the chat box about how much PPE came.in and the first ships in them and I.personally don't know and it sounds like.executive summers mentioned the same.thing we're waiting to see what's in the.trailer I imagine that will that.information would come out today.you.so the question is wouldn't I wait yeah.sorry we couldn't unmute ourselves we we.do no know we received nine pallets.worth.we'll have that sorted out and get big.into that today so by the end of the day.we'll have further information on them.Thanks a question for me I read dr..spitters what impact has the change in.contact investigations had on the.increasing number of infections in the.past week well again you know what's.largely driving the the incidents in the.communities is the just transmission.from individuals who either don't know.they have the infection aren't very.stick to their families and other other.close contacts you know we I can't tell.you what impact the change it hasn't.really been a change as much as you know.we're we're really focusing on on.getting the interviewing the case is.getting them to share the information.about contacts with us giving them.information this you to get back out to.those contacts particularly the you know.the fundamental message is for their.household members and other analogous.very close contacts in their personal.and work environment to stay home for a.couple of weeks and you know it's just.too early to tell the course of this.right now things are going up I don't.think that's either driven by you know.made worse or better by the current.approach we're just doing the best we.can to get people identified isolated.and then their close contacts.quarantined and you know we're in this.for a while again the the long-term goal.is to reach the point where sustained.transmission is no longer occurring in.the community but.because a sufficient proportion of the.community is immune that is previously.infected and to stretch that out in a.way where we don't drown the health care.system or other key infrastructure other.key elements of the infrastructure so.you know that's really our goal and then.so if you look at that metric which.might be the hospitalizations.hospitalizations have been increasing.but overall the hospitals are not not.you know at crisis yet they certainly.are feeling stretched but that's really.our primary metric is how they're doing.yeah I have a question that says now.that OSPI has set Monday for the day to.start putting out educational materials.what does the district prepared to do on.that Monday deadline.well I'll first say that Monday is just.a date out there that OSBI put on.districts across the county I've been.preparing for that and it's probably.just the next step in where they're.going rather than just a real start a.date for that.I know it's Snohomish school district.we've been working in this past week and.a half to number one get computers and.an internet connectivity to as many.students or to all students as possible.we've been opening up that communication.between the teachers and the child and.the students so they get more.comfortable on how to interact with one.another and we know starting yesterday.and today that we are starting to tell.teachers and staff to reach out and get.in direct contact and start moving so.that Monday.we're continuing rolling with that.education between the teacher and the.student this has been going on in a.limited prior to this but as our board.said we're not going to let perfect get.in the way of good and we got a lot of.professionals get out and start.interacting with our kids and that's.where we're at and Monday will just be.the next step in that I communicated.with my community that as days go by and.they turn into weeks education will get.will get more in tune more more.perfected as both sides really learn how.to interact through this new way of.learning also on Monday we hope to have.a document two hours to our parents to.really outline what's happening and how.we're moving forward so all the Monday.is a date set by OSPI it's just a.continuation of where districts are I.will really encourage folks to go to.their districts websites wherever their.child goes to school because a lot of.things are on those websites for.resources and also for guidance of where.the districts go up.you.sorry for that delay takes us a minute.to get unmuted here so this question.regarded regarding hospital beds from.the federal government we are working.with the FEMA Corps of Engineers and.others for standing up Hospital capacity.here in the county and we're doing.walkthroughs as we speak of potential.sites in Everett and East County and.other places around the county so yes.there are beds coming the exact number.and maybe the doctor wants to get in.this a little bit more but they number.the hundreds and just to note that the.hospital capacity excuse me in early.morning Hospital capacity is really.intended to get folks out of our.hospitals that don't really need to be.there that can be treated another way to.open up that capacity in the hospitals.for the those in critical need so yes we.are working with federal government on.that there will be that type of capacity.here in the county and more details to.come.okay and I think the executive summers.the the number of hospital beds is still.a a number that's being assessed and.developed between the federal and state.partners as as this evolves I don't have.a specific number that that's been given.to us there was a question also about.our more mobile testing sites headed to.Snohomish County right now we're at.capacity with the testing supplies that.the federal government gave us and those.who are who are have symptoms and who.are interested can go to snow HD Sno HD.org website and click on the kovat icon.to get to that page and then from there.you can click into the the triaging.algorithm for forgetting access to the.testing if you meet qualifications.expansion of that would require more.test kits that we currently don't have.access to and then to wrap around those.test kits we'd have to set up an.additional site so that's you know.thought and possibility for the future.right now we've just got the one.operating site in Inever.oh I should add many of our healthcare.systems in the in the private sector are.operating drive-through settings and so.I think the main thing is for patients.who are seeking individuals who are.seeking testing if you have an existing.healthcare provider contact them and.find out what their direction is to you.the pursue testing and if if you are ill.and there's no alternative then you know.do certainly go to the the Health.District website and try to register.through that.you.I just wanted to thank all the reporters.who jumped in oh there's another.question let me give that to dr. spinner.hearse.there we go.I had muted myself again but I can't.auto unmute myself so the governor.yesterday talked about a slight decline.in the rate of increase in the number of.cases statewide as a glimmer of hope.have we measured that rate of increase.in Snohomish County well just looking at.the data we've had over the last three.prior days yesterday 90 cases reported.the day before that eighty the day.before that eighty the three days before.that were 50 40 and 60 so for us at.least locally things are still up these.are you know day to day variations are.driven by just natural variations and in.who seeking care testing hues results.coming back so some of this is you know.multifactorial multiple factors feeding.into a daily total but it's certainly.not stable and and at the local level.I don't see any any mitigating or.relieving information I think we just.have to see how things pan out over a.little bit longer period of time.and I would encourage you to remember.that that what we see today in in cases.reported really reflects people that.were tested earlier maybe in the week or.late last week who became ill probably.several days before that and who were.infected several days before that so.today's snapshot tells you about what.was going on in terms of transmission.you know 10 to 14 days ago so for.instance to determine what the social.distancing efforts what kind of impact.they've had it's really going to take a.few more weeks to really see what we're.what we receiving in terms of flattening.the curve and so it is going to take.sustained effort and patience on.everyone's part and.respect and I just want to echo what I.was alluding to earlier that you know.patients who are people who are ill if.you're feeling mildly ill just please.stay home and your household contact.should be home anyway but if you're ill.doubly so and then if you're feeling you.know moderately the severely ill call.your healthcare provider and ask about.whether you should be tested or what.other evaluation is needed to determine.what it is that you have and what needs.to be done for that.

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How can I convince my mother to take me seriously when it comes to my mental health? When I went to the doctor, the form I filled out indicated that I have severe anxiety and depression. It's been 5 months, and she still hasn't made an appointment.

Honestly it took 2 years with one of my teenage clients and almost a year with another before the parents believed ME as the therapist that the depression was real. There are so many possible reasons but I’d stay on her. She’s forgotten by now. It could be she feels like it might be her fault and she can’t handle that. It could be she’s never been happy herself and she thinks that’s normal. Or even that she can’t handle you getting happy/happier because she will then be reminded how unhappy she is. None of these are okay, but perhaps may help you figure out how to get through to her. Good luck Continue Reading

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