Seattle CNN  — 

“Chaos” was how Dr. Kevin Hanson described his emergency department at EvergreenHealth hospital in suburban Seattle.

Nearly 20 coronavirus patients were coming in every day. Staff members were running out of personal protective equipment. Even one of the doctors became severely ill with the virus.

“It’s very sobering,” Hanson said. “It gave us all a lot of pause, saying ‘are we doing the right thing?’” 

But that was a month ago. Now, Hanson strolls past room after room with empty beds. The lights are off. The waiting room is nearly empty.

Dr. Kevin Hanson/EvergreenHealth ER director

Chaos has turned into quiet.

“We’re probably 10% to 15% of what we were seeing with Covid at sort of the peak,” Hanson said.

His Kirkland hospital is a testament to what has changed in Washington. Once leading the nation in deaths and considered a hot zone to avoid, Washington state now ranks number 17, with 870 deaths from the novel coronavirus as of May 7.

How did it happen? With a unified approach, say local officials and scientists who spoke to CNN. Even before stay-at-home orders became part of the American vocabulary, Amazon and Microsoft, both headquartered in Washington, encouraged their tens of thousands of Seattle-area employees to work from home.

It was not by chance.

“We included (the tech giants) in our plans and conversations from the beginning,” Seattle Mayor Jenny Durkan said. “The first phase of having people telecommute and not come downtown really started breaking the back of the virus.”

That took thousands of people off Seattle’s streets just three days after Washington recorded the nation’s first known death at a time from Covid-19 on February 29. That same day, Washington Gov. Jay Inslee declared a state of emergency.

“This was an all-points bulletin,” Inslee told CNN. “And I think it was successful because it set the public up to be willing to do things very, very rapidly.” 

Eleven days later, Inslee banned gatherings of 250 or more in the most populous counties, and by March 13, he ordered community centers and schools to close. Restaurants followed.

Seattle Mayor Jenny Durkan with mask on overlooking city

“We had a unified message from the governor to the county executive to the mayor,” Durkan said. “So that we spoke with one voice.”

‘I wanted to jump up and down’

Across the country, in New York, Dr. Isaac Weisfuse feared New York would overtake Washington as the epicenter of the coronavirus outbreak.

“Any virus can be to New York City in 24 to 48 hours,” the epidemiologist said, noting New York’s global connection to world commerce. New York City is also one of the most densely populated cities in the country with a reliance on mass transit, making it a perfect place for a highly contagious virus to spread.

Weisfuse, a former deputy commissioner with New York City’s department of Health and Mental Hygiene, said he was concerned that warnings from the scientific community weren’t getting through to the public clearly enough– long before it became the world’s epicenter with more than 25,000 deaths.

“I wanted to jump up and down cause I didn’t really understand why it wasn’t more of a crisis kind of feel” with local politicians, Weisfuse, who is also a professor at Cornell University, said.

Unlike Inslee, New York Gov. Andrew Cuomo took an optimistic approach at first, as he sat alongside New York City Mayor Bill de Blasio at a press conference after the first New York coronavirus case was announced on March 1.

“Excuse our arrogance as New Yorkers… we think we have the best healthcare system on the planet right here in New York,” Cuomo said. “When you’re saying what happened in other countries versus what happened here. We don’t even think it’s going to be as bad as it was in other countries.”

Cuomo and de Blasio decisively reversed course, but the mayor was blasted for getting in a final workout before the shutdown of theaters and gyms took effect.

“The politics of New York City are complicated,” Weisfuse said. “There’s this sense that these emergencies are almost like opportunities for politicians to show how decisive and how in control they are.”

On April 30, at the governor’s daily press conference – now embraced by national audiences for his steady approach – Cuomo told CNN “no state moved faster at the time from the first case to total shutdown.”

New York’s full stay-at-home order became effective on March 22, a day before Washington State and three days after California.

Inslee said the timing of his shutdown order was by design, and happened after most public places were already closed down.

“If you’re going to lead a parade… you got to make sure someone is behind you,” Inslee said. “And if you go too fast and the public is unwilling to accept, then you’ve lost your connection to the community.”

A game-changing discovery

A few floors above Hanson’s emergency room at EvergreenHealth hospital in Kirkland, Dr. Francis Riedo made the discovery that sent many of Washington’s public officials and the Centers for Disease Control into overdrive.

In late February, before the US learned Covid-19 had escaped in its communities, Riedo randomly selected two patients for a coronavirus test. Neither had been out of the country or had any connection to infected countries –  both tested positive. 

Dr Francis Riedo/Medical Director of infectious disease

It proved community spread was already happening. 

“It was a moment of recognition that everything had changed,” said Riedo, director of infectious disease control at EvergreenHealth. “Over the next five days we tested 42 more and found 32 more patients who were positive.”

Many of those came from the Life Care Center down the street in Kirkland.

More than 100 cases and at least 35 deaths were eventually linked to the nursing home, and the nation watched in horror as a macabre parade of ambulances took one patient after another to local hospitals.

Weisfuse, the Cornell professor, said he believes that played a role in how Washingtonians responded.

“(Washington) went through the crucible of having a really difficult initial outbreak that in other places wasn’t quite that bad or as evident at that moment,” he said.

The Life Care case was an early stumble in the Washington response. Not only were patients dying, a third of the staff fell ill and was unable to return to work. It took more than a week for a federal government medical team to arrive and offer hands-on help.

The governor said  the operators of the nursing home share some of the blame for that.

“This corporation had a responsibility for the medical care of their patients,” Inslee said. “And to some degree we couldn’t just walk in on day one without some coordination with them to really understand the circumstance.”

A Life Care spokesman said nursing homes have been held to a different, unfair standard compared to hospitals.

“No hospitals were blamed for deaths that occurred there after being hit with the virus,” said Tim Killian, a Life Care spokesman. “The virus happened to us when there was still confusion over how contagious it was and how it spread.”

The nursing home was struggling to get enough testing and PPE for its staff, Killian said.

EvergrenHealth nurse writes on window what patient needs including chapstick

That was, and continues to be, an issue statewide, Inslee said.

“We did not have enough PPE for nurses and many facilities, and to some degree still don’t,” he said.

He blames President Donald Trump because “there’s only one person” who has the power to force mass production of PPE.

“I wasn’t disappointed, I was infuriated for weeks.” Inslee said. “Because we desperately needed this material.”

But he says the federal government has ramped up production and some supplies are coming in. Washington has even been able to return some government-provided ventilators since flattening its curve.

Inslee has started opening things up in his state, but at a cautious pace.

State Parks are open, some construction is allowed again, as are limited in-person car sales. Boeing, the state’s largest employer, has workers back on the lines.

By May 31, the state may let people return to dining in restaurants with restrictions, and curbside retail may begin.

Science and data will dictate the pace, Inslee said.

“This is very important because as we move away from the blunt instrument of social distancing towards the smart weapon of testing, contact tracing and isolation, we have to have that capability up and running.”