Jenny Durkan
Former Mayor, City of Seattle
Chair, Washington State Bar Association Task Force on Emerging Technologies and the Practice of Law
Former President, Association of State and Territorial Health Officials
Preparing for the Worst
Seattle: The American Epicenter
On January 20, 2020, Mayor Jenny Durkan learned the first confirmed Covid-19 case in the United States was in the Seattle region. In mid-February, local news profiled how the medical and public health community had diagnosed and contained spread from that patient through testing, contact tracing, and isolation. But just weeks later, Durkan received the jarring news that multiple deaths and infections had been traced to a local retirement community; clearly, the virus had been spreading undetected. Thirty-nine nursing home residents died from the virus over those first weeks, and medical providers and a significant number of first responders had to be removed from duty and quarantined.
Seattle became the first American city to experience COVID-19. In those first days, the most precious commodities were data, expert advice and, most importantly, Durkan’s ability to understand and prepare for a worst-case scenario despite rosy public health predictions. Drawing on national and global mayoral and expert connections, she stood up formal and informal advisory networks, convened her emergency cabinet to conduct a tabletop exercise on pandemic response, galvanized businesses, and consulted renowned disease modelers to get ahead of the virus. She also worked hard to learn from and share her experiences with other mayors in Washington, the United States, and globally.
Every January as Seattle mayor, you plan a special meeting of your cabinet to do a tabletop exercise to prepare for a possible, large-scale emergency. Because of what we were seeing in China and our area’s close ties to that region, I decided I wanted to focus on pandemic response. Shortly after that, the first case in the United States was diagnosed in a patient in our area. However, the public health and medical community felt they had contained the virus in that case and the successful response was documented by the media.
“We conducted our emergency planning meeting on February 12. The head of public health said it was good to do the exercise but felt we didn’t have to worry because the one case had been contained and there was no data that showed we would have a broader outbreak.”
“Unfortunately, just a few weeks later on February 28 we learned of the outbreak, deaths, and sickness at the nearby senior center. Public health officials again were hamstrung by the lack of testing and cautioned that there was no data to show broader community spread.”
Unconvinced, Durkan enlisted globally renowned disease modeling experts to help her better understand the potential scope of the outbreak, including Dr. Trevor Bedford of the Fred Hutchinson Cancer Institute. Bedford, Dr. Helen Chu of the University of Washington and their team were turning an existing door-to-door study to find flu cases in Seattle into an effective way to find locally spreading COVID-19. Their data provided models that gave Durkan a realistic picture of what lay ahead for Seattle.
Ongoing access to modeling is critical. We learned the hard way that what you have in front of you isn’t telling the truth, or the whole picture. The disease spread quickly and silently. Public health officials were constrained because their hard data was limited to the known few dozen cases; however, Dr. Bedford’s research and model indicated we likely could have at least 1,100 cases at that time, doubling every 6 days. We were sitting at the last day of February, so by mid-April we could have 70,000 cases and over 1,000 deaths. That changed everything about how I was going to approach it. We were facing a tsunami if we did not act, and the lack of testing had left us blind to it.
Ensuring Locally Accessible Testing Capability
Hampered by CDC’s delays in developing tests and the narrow initial focus on using tests to diagnose disease in patients who were already sick, Seattle’s charge quickly became using community testing and local modeling to discover where the disease was spreading and where it might go next. Having this information would allow hospitals, health care workers, nursing homes, schools, and businesses to prepare and protect the vulnerable. Again, state and local public health officials were themselves hobbled by the lack of resources, including the scarcity of testing. Seattle and other cities had to look outside the normal delivery channels.
The lack of access to testing in the beginning left us flying blind to the spread of the disease, and limited options for slowing that spread. It set us on a path that was unnecessarily difficult and required too many innovations and pivots. It also created a kind of a “Hunger Games” competition for resources among cities and states. For an effective response, you really need to know what’s going on in your city. But that just was not possible because testing was such a scarce resource, and was controlled very carefully by the national supply chain. It was distributed to the states, and to public health, but none directly to us in Seattle, even though we were the major population center in a multi-state area.
To address the issue, Durkan tapped into her own mayoral networks, including the C40 Mayors, a global climate conference that pivoted in 2020 to work on COVID. Through this group and ties to the local Consulate, Seattle gained access to test kits from South Korea. The city overcame concerns from local public health leaders about how the tests would be conducted or analyzed by setting up an agreement with the University of Washington to process the tests and utilizing trained fire medics to do the tests. Seattle set up geographically convenient, free drive through and local testing sites that were used by a majority of residents. Seattle later used this model and infrastructure to administer free vaccinations. It was the first city to reach a 70% vaccination rate and despite being the epicenter of the first outbreak, Seattle navigated the pandemic to be the US city with the lowest rate of disease, hospitalization and death from Covid-19.
Wide based, free testing is critical. Future response plans should include a way to accomplish that immediately and at scale. You simply cannot tailor the right response if you do not know the scale and demographics of the problem. This is best done by empowering the people who are going to have that ability. In our case that meant a close collaboration between state, county ,and city efforts, together with the strong work of hospitals, health care providers and community-based organizations.
Creating a Network of Cities
Seattle saw the benefit in connecting cities to share access to information and supplies. Following Seattle’s initial cases, Durkan networked with national mayors through her connections at the U.S. Conference of Mayors and through programs for U.S. and global mayors created and supported by former Mayor of New York Michael Bloomberg. Understanding the power of connected mayors, Mayor Bloomberg had worked with Harvard to create the City Leadership Initiative. The program provided ongoing research, support and other resources for city leaders and held a three-day leadership “boot camp” for small groups of new Mayors from across the globe.
I was in one of the early Harvard Bloomberg classes after I was elected and had developed a lot of close relationships through that program and through the U.S. Conference of Mayors. I relied on those people throughout the pandemic, including executives at the Bloomberg organization. In fact, as I was walking into a TV interview in the first day or so when we learned of the deadly outbreak, I called [former Mayor of South Carolina] Steve Benjamin, who was the immediate past President of the U.S. Conference of Mayors, close to Mayor Bloomberg and now at the White House. Mayor Bloomberg and his organizations were already monitoring and planning pandemic responses. They moved very rapidly to provide a range of resources and data to mayors throughout the country and globally. As the virus and the threat evolved, so did the response.
The call with Mayor Benjamin resulted in a conference call with dozens of mayors, during which Durkan was able to outline what was happening in Seattle, and led to a regular series of calls among mayors. By March 3, 2020, Mayor Bloomberg, through Bloomberg Philanthropies and other entities, helped fund and scale the Coronavirus Resource Center at John Hopkins University, which provided ongoing data, tracking and information about the spread of the virus. Seeing the need for journalists, public health officials, local governments and others to have access to their data, a dashboard of county-level data was added. These types of efforts and connections helped states, mayors and local government get access to modeling information, share experiences, and collaborate to find supplies.
A Pandemic Kitchen Cabinet
While struggling with daily decisions against a worsening epidemiological picture, Durkan realized Seattle needed its own team of experts – a “pandemic kitchen cabinet” – devoted to identifying problems before they could hamper the response. She built an ad hoc team of local and national experts that included disease modelers, epidemiologists, policymakers, and global disaster response leaders. The team met weekly throughout much of the pandemic’s height to help Seattle anticipate response needs.
I think putting in place the expertise to have a regional expert advisory group would be incredibly helpful. Ensuring those experts had connectivity and were in touch with what was happening nationally across regions, would help with some of the partisanship that we saw. One reason things fractured in some regions was that not everybody was hearing or experiencing the same thing.
Transparency = Trust
I think putting in place the expertise to have a regional expert advisory group would be incredibly helpful. Ensuring those experts had connectivity and were in touch with what was happening nationally across regions, would help with some of the partisanship that we saw. One reason things fractured in some regions was that not everybody was hearing or experiencing the same thing.
Collaborate Urgently, Disagree Privately, Unify Publicly
Building a cohesive plan for Washington state as a whole was equally vital. While disagreements existed from time to time around Seattle’s response and broader actions across the county and state, communities needed to see their leaders united and working for them – not fighting one another.
Durkan credits the strong leadership of Governor Jay Inslee, County Executive Dow Constantine, and other officials, as well as the relentless work of public health and healthcare leaders and workers. She recounts early pandemic calls to tie in with the Governor’s team, the county executive, and state and county public health officials, focused on learning the same information, hashing out disagreements, and, ultimately, getting onto one page for the good of all Washingtonians.
Everyone has to be committed to putting science and the safety of residents and businesses first. It cannot be about political power or turf. You’re going to have various tensions between governor and mayors – or there’s going to be political tension east and west or north and south. There is not going to be a one size fits all solution for every town, city, state or region. However, ensuring all leaders and residents have access to the same information, and reaching unified plans and messages is really important.
“For us, there was no playbook or manual for responding to the pandemic. I was fortunate to have state, regional and local leaders who came together quickly to respond to the immediate and ongoing crisis. At times we disagreed on some pretty fundamental things, but we were all committed to finding the best path forward. We would go in a room, review the data, hear from experts and hash it out. Then we would come out with a unified plan and message. Critical to that was letting the public know why we were making the decisions, and always emphasizing that it was a very dynamic and uncertain time. It was always important to convey that we were in it together, and that we were going to have to pivot and adapt as things changed.”
You have to remember: People were terrified. The most effective responses were ones that empowered people to know their choices could make things better and protect them, their families, and their neighbors. An important lesson is that any response and public messaging should be about individual and community empowerment, so that people believe and understand they’re not just in charge of their own destiny but can act to protect their neighbors and loved ones. In future crises, leaders need to ask how we can educate people, motivate people, and make their personal response part of their civic pride. People need to know how they can take destiny in their own hands. I think that’s a real human need.
“In Seattle, every time we were open with people about what we were doing and why, and how their actions could get us to a goal and make everyone safer, they rose to the challenge.”
Getting Down to Business
Among Durkan’s priorities was finding ways to deliver services that had come to a crashing halt. Challenge Seattle, a coalition of businesses run by former Washington Governor Christine Gregoire, provided game-changing ingenuity, resources, and people power. Coming off the heels of work they had done together around community safety in the wake of another disaster – the January 22nd mass shooting in downtown Seattle – Durkan called Gregoire to inform her of the first deadly outbreak and say it was time to mobilize the CEOs of Seattle’s largest companies around the COVID response.
My first call was to [former Washington Governor] Christine Gregoire and I said, “Okay, it’s here. You need to call your CEOs, let them know and get ready.”
“We were very fortunate to have this organization, Governor Gregoire’s leadership, and a group of CEOs fully committed to doing the right thing. This, coupled with the strong leadership and collaboration of Governor Jay Inslee and Executive Dow Constantine and the work of public health, hospital, and healthcare leaders were key to our successes. We were constantly talking to our businesses and business leaders and getting back information and watching the numbers. This led to significant innovations like work from home, which data showed significantly disrupted spread and “flattened the curve.”
The constant communication also led to regulatory changes for small businesses to try to keep them open and people employed, like loosening rules on liquor licenses, promoting take out and converting roads and sidewalks into outdoor seating patios where restaurants could serve.
Services when the World Stops
As the first U.S. city to be hit with COVID-19, Seattle became the first to contend with the impact of lockdowns, including their disproportionate impact on communities of color and essential workers.
As soon as Amazon started working from home, we immediately saw the economic impact the loss of workers had on surrounding businesses. I realized we were going to need some huge economic relief for small businesses and for employees who are suddenly out of work. We worked closely with our U.S. Senators Patty Murray and Maria Cantwell, but knew federal relief would take some time to reach us. We needed to find ways to provide some immediate help and resilience for the people who suddenly literally didn’t have a job or a paycheck, or the small business owner who has no income and still has to pay the rent and other costs.
Early on, Durkan realized that small businesses would be among the hardest hit and that basics, like food, would be harder to afford. That escalated to a lack of childcare when schools closed – and kids who wouldn’t have food without access to school lunches. Working with the county executive, the City of Seattle drew on a robust network of community organizations, including those that had helped conduct its census and ensure communities of color weren’t under-counted. Collaborating with these organizations and others was vital to identify crucial programs and create continuity of operations. Key programs included grocery vouchers facilitated through a city relationship with two large grocery chains, services aimed at ensuring socialization for those in long term isolation, and use of an existing program that trained homeless people in local restaurants to make meals for seniors delivered by rideshare drivers.
Every government and business have a Continuation of Operations Plan (COOP). But they tend to be focused on natural disasters and emergencies of a limited, known duration. The pandemic was at a dramatically different scale. It is imperative that government identify vital services provided to their businesses and residents, particularly to the most vulnerable. COOP plans need to include various ways those services can be continued when the world stops and the disruption is of significant and unpredictable duration.