The lack of medical care in Kitsap County continues to be a problem and will only get worse.
That’s what county health officer Dr. Gib Morrow shared at the Kitsap Public Health District board meeting Sept. 6, which was the first in-person meeting in 2 1/2 years due to COVID-19. About half the board still participated by Zoom.
Statistics support his comment. There is one doctor for every 1,500 people in this county. Statewide it’s one for every 1,200. Nationwide it’s somewhere in the middle.
While 70% of adults have a primary care doctor, and only 5% don’t have insurance, the county ranks very low when it comes to the number of OB/GYN docs and the number of hospital beds.
“I don’t know how to get more (hospital) beds in the community,” said Bremerton Mayor Greg Wheeler, who is also chair of the health board. He added that the state legislature needs to get involved in this major health issue.
Wheeler added that even if the county had more than one hospital who would staff it? “We need to attract people who want to be nurses,” he said.
Morrow said not having enough nurses has been a “huge issue throughout the pandemic.” He said lack of doctors, especially in primary care, also is a problem. People don’t want to do that work because it’s a tough field and doesn’t pay as well as being a specialist, he said. “We’re not training enough docs. A lot have left the workforce,” and there will be a real shortage over the next 10 years.
Hospitals are packed. “Our health care has been running at capacity. It’s busting at the seams. You do not want to work in the emergency department on a full moon,” Morrow said.
He added that too many people are using emergency rooms for issues that are not urgent. Ambulances often have to wait at the hospital for an opening.
Morrow said Omicron, the “targeted strain” now, bivalent COVID booster shots would be available. The Food and Drug Administration has approved it for people ages 12 and older. “I don’t think there will be a stampede” for the vaccine, he said. “Be patient. It should be pretty widely available” from local providers.
It is available as a booster for those who received Pfizer and Moderna shots, along with Johnson and Johnson.
Also, Morrow urged everyone to make sure their school vaccines are up to date for things like chicken pox and measles. “It took a hit in the pandemic. We’re still trying to catch up a little bit.”
Morrow said KPHD staff has been doing a tremendous amount of work on TB. Because it’s really not on many doctors’ radar, there have been some delayed diagnoses. That has led to a lot of contact tracing and testing.
He said one family with about two dozen relatives had two cases, 21 close contacts and seven treated.
Morrow said if someone inhales TB into the immune system it can stay inactive in the body for a long time. “Latent cases are a concern as well,” he said, adding TB can show up later, especially if a person ends up with a disease such as diabetes or arthritis.
He said that happens only about 5% of the time, but “it’s an incredible battle to get rid of.” It’s expensive to treat, and it can take a long time, up to 18 months. It’s about nine times less costly to treat during the latent stage. He said statistics show Kitsap County likely has 3,000 residents with latent TB.
Because treatment takes so long, some people “don’t take all the medications the way they should,” which can lead to problems, Morrow said.
Other issues include global travel and refugees. While only about 2.7% of people in the U.S. have latent TB, it jumps to about 20% worldwide. So refugees from Ukraine, Afghanistan and elsewhere need to watch for it. It’s also more prevalent in Native American and Hispanic populations, he said.
Morrow said about 95% of the cases in the U.S. are with gay or bisexual men. He said about 75% are white men, with 42% having HIV. It is transmitted by skin-to-skin contact.
He said this is not a dangerous strain, but there have been 15 deaths with 50,000 cases in 100 countries. One death was in the U.S., and Kitsap County has had three cases.
Morrow said it could be “stamped out completely” the way smallpox was by getting the vaccine not only to those who get it but to their close contacts, too. He added it’s an investigational drug that requires a lot of paperwork, but has proved to be effective. “It’s a big lift to get that prescribed to folks.”