Month: December 2020

I intend to take the next two weeks off. Expect my next scheduled MWF post to appear at 5AM Monday, January 4, 2021. Please put that date on your calendar and look for the email so it isn’t shunted off into a Junk, Spam, or Promotions folder.

I have been writing these posts for four years. I am not done. I thank you, my readers, for the encouragement you provide. The task of learning a topic well enough to organize it and then write about it clearly enough that I can understand it myself (and, hopefully, others can, too) is satisfying, exhilarating–and consuming. 

As this tumultuous year staggers toward a close I wish you and all of us the happiest, safest, and healthiest holiday season we can possibly manage. 

Keep to the high ground,
Jerry

P.S. For a clear explanation of how the new mRNA vaccines work and how they are different from previous vaccine technology I recommend this youtube video: https://www.youtube.com/watch?v=oMXGGmBfkf8&feature=youtu.be  It is probably not perfect in every detail and nuance, but the video is a great animated explanation of how the Pfizer and Moderna vaccines work. [One fine point: the video mentioned something called “self-amplifying mRNA vaccines.” Neither the Pfizer or the Moderna vaccine is “self-amplifying” in the way illustrated as far as I can determine.]

As we stagger toward the end of 2020 there is hope, a hope tempered, for many, by skepticism and uncertainty. Vaccines against the scourge of Covid-19 are becoming available at a record pace, even as multiple worries and wonderings percolate among us. The concerns run the gamut from “I’m just not sure it’s safe” to “the vaccine is a plot by Bill Gates to track us by implanting nano chips in our bodies so the masterminds of the New World Order can control us.” Much concern stems fundamentally from doubts about the motivations of the vaccine innovators–folks we don’t know–toiling away somewhere meddling with biology we struggle to understand. We wonder how much money and politics pollutes the whole endeavor. All that concern is heightened by four years of a president consistently unmoored from reality and from science. [Watch “Totally Under Control” on Hulu or Amazon Prime for a comprehensive review of pandemic mismanagement, the last year of that unmoored reign.] Our suspicions have been stoked by at least a half century of Republican declarations on the evils of “big government,” by countless dystopian movies and novels (e.g. The Matrix), by religious leaders prognosticating the End Times evils that supposedly lurk among us, and by the fantastical conspiracies that crazy folk like Alex Jones spend their lives spinning. Small wonder that we harbor lingering doubts about everything.  I take great comfort in reading the transparently presented vaccine trials themselves, like the Pfizer vaccine Phase III trial I reviewed here. I firmly believe that the, literally, thousands of people involved in this vaccine effort and trials and others like it, are primarily motivated by a desire to help their fellow humans threw off the oppression of this virus by developing a safe and effective vaccine. Keep in mind there will never be a vaccine that has zero risk. There is absolute certainty. There will always be the chance of an idiosyncratic deadly or debilitating reaction. That said, a detailed report of nearly 20,000 people vaccinated with an excellent interim result is good enough for me–especially when I compare it to the isolation we have kept for nearly a year and the misery and death associated with Covid-19 that creeps closer each day among our friends and acquaintances.  I have copied and pasted below Betsy Brown, M.D.’s December 16 post in Update from an Epidemic. I encourage you to sign up for her daily email at that link. I look forward to it each evening. She is a physician in Seattle whom I know as an acquaintance through several friends. Her emails offer me some surprising insights. I reproduce this one as an expansion on the issue of trust and as an example of her excellent work as an commenter on the pandemic.(In this one Dr. Brown expanded my mind on a topic about which I’ve written, Smallpox variolation and vaccination.) Keep to the high ground,  Jerry I have known about the Tuskegee Study for years. The Tuskegee Study is a major factor in why so many African Americans distrust the medical system, and especially, the research arm of it. The Tuskegee Syphilis Experiment ran from 1932 until 1972 (!). African American men who had latent syphilis were followed to see the natural history of the disease. The men thought they were getting free health care and were unaware they were infected. The syphilis was left untreated, despite penicillin being available to cure it. 600 poor sharecroppers were followed to see the course of the disease. 399 had latent syphilis, at least 128 died from syphilis or its complications. Obviously violating ethical standards, when discovered, outrage led to new regulations to protect people in studies. This is one reason why “informed consent” in research is so detailed. Consent is considered vital.The other effect of the study being found out was that it added more fuel to African American’s distrust of the medical system, especially involving clinical research. This is a major reason many clinical trials have low numbers of African Americans as subjects. It is also why they may be distrustful of a vaccine for COVID-19. You can’t really blame them.But maybe when they find out that Dr. Kizzmekia Corbett, who is African American, helped design the vaccine, they will be more accepting. She hopes so.And then I read another story about early inoculations for smallpox and learned things I didn’t know. I wish I had known this hidden history earlier. The concept of inoculation with a tiny amount of smallpox came from Africa and China. A slave in Boston shared the idea of using inoculation in the early 1700’s when there was a smallpox outbreak. The inoculation with a tiny amount matter from a small pox lesion, called variolation after the smallpox virus known as variola. This caused a milder case of smallpox which then gave that person immunity. Occasionally the person inoculated got much sicker and sometimes died, which made people leery of the practice. This is a fascinating read and involves Cotton Mather of the Salem Witch Trials fame. The story includes conspiracy theories and blame, with slave owners taking ownership for an idea that was not original, and with others dismissive and fearful of African culture. Our culture of disinformation is not so new, after all.Later this concept of inoculation was used in Great Britain to inoculate people with a less virulent (not as dangerous) but related virus (cowpox or vaccinia) to prevent smallpox or variola. It worked and vaccinations were born, named after that first vaccinia inoculation. Now we hope to convince people they are safe and effective and not some conspiracy. Our work is cut out for us.Wash your hands, cover your nose, keep safe six, check your sources.And finally, my caveat is that this is my experience and my opinions, which are subject to change as more information is available, and not related to the organization I work for. Thanks for reading.https://en.wikipedia.org/wiki/Tuskegee_Syphilis_Studyhttps://abcnews.go.com/Health/kizzmekia-corbett-african-american-woman-praised-key-scientist/story?id=74679965https://www.cnn.com/2020/12/16/health/kizzmekia-kizzy-corbett-interview-moderna-vaccine-gupta/index.htmlhttps://www.seattletimes.com/nation-world/the-african-roots-of-inoculation-in-america-saving-lives-for-three-centuries/https://www.seattletimes.com/nation-world/nation/from-voter-fraud-to-vaccine-lies-misinformation-peddlers-shift-gears/

Last week Congressional District 5 (Eastern WA) U.S. Representative Cathy McMorris Rodgers, along with 125 of the 195 other House Republicans collectively lost their minds. In an act of sedition, they signed an amicus brief in support of Texas Attorney General Ken Paxton’s delusional lawsuit to overturn the will of the majority of the American people. (Here’s the amicus brief. Search for your Republican Representative by using CMD-F and entering their name. In addition to McMorris Rodgers you will find Rep. Newhouse of south central Washington and Reps. Simpson and Fulcher of Idaho, all Republicans.) Paxton, Trump, and their supporters would like the rest of us to believe that Paxton’s lawsuit was meant to salvage the presidential election from rampant voting fraud–but that is not what Paxton’s suit addressed. Paxton’s legal claim turned on the idea that the State of Texas (represented by Paxton, its attorney general) had the proper standing with the U.S. Supreme Court to contest the legitimacy of the voting of four other states, specifically four states in which the popular vote was won by Joe Biden: Georgia, Michigan, Wisconsin, and Pennsylvania.

The technical point on which Paxton’s argument turns is extremely narrow. He contends that in each of these four states election rules were changed in the lead up to the November election by state entities that lacked the authority to make those changes. Paxton’s entire argument rests on one clause in the U.S. Constitution: Article II, Section 1, “Each State shall appoint, in such Manner as the Legislature thereof may direct, a Number of Electors…” Paxton wants the U.S. Supreme Court to step in and invalidate the certified result of the elections conducted in these four states on the grounds that details of the voting rules in those four states were adjusted without specific action by the respective state legislatures. 

Paxton argues that these supposed constitutionally invalid voting rule changes in these four states resulted in such massive voting fraud that the U.S. Supreme Court needs to step in and invalidate the election results, thus throwing the selection of Electors to the Electoral College to the choice of the Republican led legislatures of those states. Paxton makes this shameless argument in spite of the fact that these four state have already been the subject of numerous grandstanding lawsuits contesting the results, all of which have been ruled against for lack of evidence and credibility, in many cases by judges appointed by Trump himself. The results of the elections have already been certified, sometimes (Georgia) by long time Republican Secretaries of State, and the Electors appointed by the popular vote were due to cast their ballots last Monday. 

Last Friday the Court summarily dismissed Paxton’s suit. The Court said the state of Texas did not have the legal standing to ask the Court to meddle in the electoral affairs of other states. Mr. Trump, in his mob boss mentality, must have figured the conservative members of the Supreme Court “owed him one” after his three conservative appointments to the court. Fortunately, the Justices decided against Trump and in favor of the rule of law.

One might dismiss the 126 U.S. Representatives who signed on to Paxton’s suit as sycophants fawning over Trump and their mutual supporters who have bought into Trump’s more than four years of incessant and baseless rhetoric alleging rampant election fraud. Their whole movement has felt so absurdly faceless as to be humorous–but is no longer funny. Trump and these Republicans are tearing at the fabric of our democracy, fostering a narrative of minority grievance that broke out into Trump supporters roaming the streets of our cities last weekend with paintball guns, real guns, and knives. These actions (and Trump’s continued grandstanding and refusal to concede) threatens the stability of our government in a way this country hasn’t seen since the Civil War. (Read Prof. Heather Cox Richardson’s history lesson from December 10.) 

McMorris Rodgers and company will, no doubt, soft pedal the meaning of her signature on the amicus brief. At least she will soft pedal her signature when speaking to the general voters of eastern Washington. Indeed, you can read her statement here. She speaks of “razor-thin margins” and the need for the Supreme Court to answer Paxton’s constitutional questions “so the American people can move forward.” Apparently, a seven million popular vote margin and the need to overturn the popular vote in four major states to change the Electoral College is, in her fevered mind, “razor-thin.” What does she mean by “move forward”? Think, Cathy. Trump lost the election. Does having the Supreme Court deliberating for weeks or months over a hail Mary pass to overturn the electoral will of the people strike you as “moving forward”? You, Cathy, are a member of a Party with a problem, a problem of people led to believe in a fantasy–and you and yours are dependent on those people in order for you to stay in power. 

You and your fellow signatories in support of Paxton’s suit are leading your deluded followers toward unrest and rebellion. In a world with proper consequences the U.S. House of Representatives would refuse to seat all of you in January based on Section 3 of Constitutional Amendment 14. 

Keep to the high ground,
Jerry

In most of our country the way elections work frustrates and angers potential voters. The two major political parties go through their machinations. The parties each offer a few candidates in a primary election in which, in most states, the voters get to cast one vote for one candidate for each elected office of only one party. (Washington State is a little unusual with its “top two” primary system.) Many voters ignore the primary election, beginning to pay attention only before the November general election when we are asked to choose among the candidates offered by the two major parties and (sometimes) a few other candidates.  Vast amounts of money and energy are expended on advertising and voter outreach, which is mostly designed to make us more disgusted with one candidate than the others, and sometimes succeeds in making us disgusted with all of them. Finally, we either turn away–or we hold our noses and cast a vote for “the lesser of evils.” Mostly, we don’t vote for “third party” candidates, no matter how appealing, for fear of the spoiler effect, the chance that one’s vote cast for such a candidate will take away a vote from the less evil of the two more likely winners. Voting with the spoiler effect in mind incentivizes a two party system–a system the Founders did not foresee.

There is a better way. The time has come to consider “ranked choice voting” (RCV). The states of Maine and Alaska have widely adopted the method. There are active movements to consider such adoption in many other states, counties, and municipalities.

Ranked choice voting is harder to explain than it is to demonstrate. This evening, Monday, December 14, from 7-8PM PST the Spokane Chapter of FairVote Washington is holding a Zoom meeting explanation of Ranked Choice Voting. I recently attended a similar chapter meeting. I found it fun and informative. If you are not a resident of Spokane County or  Washington State, you are still welcome to attend. The majority of the presentation applies to any voting area. You will find it an hour well spent. Sign up here: https://www.mobilize.us/fairvotewa/event/364899/  and invite your friends. Vicki Dalton plans to attend the Zoom presentation and will take questions. Vicki is our highly respected, very practical, very non-political (although nominally a Democrat) Spokane County Auditor–the official who oversees the mechanics and details of all elections that occur in the county.

Once the mechanics of RCV are understood, the method appeals to voters of all political stripes (even though some incumbent politicians will certainly view RCV as a threat to their power). RCV as a method promises to diminish partisan rancor and division–by disincentivizing negative advertising. (FairVote Washington is a non-profit group, organized as a 501(c)(3).)

Please sign up. It’ll be an hour well spent.

Keep to the high ground,
Jerry

P.S. If you would like a preview of the RCV, click and watch an excellent series of very short, animated youtube videos on the concept. Produced by CGP Grey, they’re entitled “Politics in the Animal Kingdom.” They’re  fun, thoughtful, and explanatory. (Note: These videos are meant for an audience in the U.K. where “First Past the Post” is what our current voting method is called and Ranked Choice Voting is called “Single Transferable Vote”. Also, the videos expand the concept of Single Transferable Vote to a broader reorganization of voting than is currently contemplated in the U.S. Nonetheless, as a presentation of general concept the videos are terrific.)

P.P.S. In Washington State the first step toward trying out RCV in any election is a slight modification of state law that would allow the voters within the state to adopt RCV as their method of choosing their elected officials at some level of government. There is already bipartisan support for such enabling legislation–and, if the legislature can’t get it done, there are plans to put such enabling legislation to the people as an initiative in 2022. 

First, A Calendar Item: Next Monday, December 14, from 7-8PM PST  the Spokane Chapter of FairVote Washington is holding a Zoom meeting explanation of Ranked Choice Voting. I just attended (by Zoom) a similar chapter meeting. I found it very informative. You will find it an hour well spent, especially if, like me, you are really tired of negative campaigning. Ranked Choice Voting as an election method is spreading across the United States. This is your chance to learn about it. Sign up here: https://www.mobilize.us/fairvotewa/event/364899/   I understand Vicki Dalton, the highly respected Spokane County Auditor–who oversees elections–is planning to attend.

Also THIS EVENING, After we made national news again with a politically motivated terrorist issuing a bomb threat and setting fire in the Spokane Democratic Headquarters.

Support the Spokane County Democrats on Zoom!
TOMORROW, Friday, December 11th
5:15PM – 6:00PM 
By Zoom
Sponsor Levels: $1,000, $500, $250, $100 
Sign-up to sponsor the event today! Contact Katherine@electbobferguson.com to let us know of your sponsor level. 
You can sign up with a donation of ANY size online here: https://act.myngp.com/Forms/-770535090633570560 We will be joined by Spokane Democrats Party Chair Nicole Bishop and State Rep. Marcus Riccelli for an update. 

Today’s Post:
The big news yesterday was the hearing and vote of the FDA’s Vaccines and Related Biological Products Advisory Committee. They recommended approval of Emergency Use Authorization for the mRNA vaccine produced by Phizer and its German partner BioNTech for people 16 and over. The FDA is highly likely to take the advice of this committee and grant approval this weekend. That should set the ball rolling for the first immunizations in the U.S. to occur next week. 

I did not attend the meeting, but I did peruse some of the materials presented at the meeting, including the 53 page FDA Briefing Document. More comforting and much easier to read was the peer reviewed presentation of the Phase III trial of the vaccine published in the New England Journal of Medicine, entitled “Safety and Efficacy of the BNT162b2 mRNA Covid-19 Vaccine.” It is worth a click, just to get some idea of what is entailed in a study like this. 

A total of 43,548 volunteer participants in the U.S., Brazil, Argentina, and South Africa were randomized to receive two injected doses three weeks apart of either the vaccine or placebo. Since Covid-19 is widespread in all these countries sending the participants out to live in the community in the way they had  done before their injections offered exposure to the virus (and avoided any need for intentional exposure). At the time of publication (the study is ongoing) the median followup after the second injection was two months. 

We hear “95% protection”? What did that actually mean in the real world of these volunteers? With a median follow up of 2 months and some followup out to around 3.5 months, counting those with symptomatic, test-proven Covid-19 that appeared at least 7 days following the 2nd injection, 162 people in the placebo group became ill and only 8 in the vaccine group. 95% = (162/170)*100. Starting a little earlier (7 days after the 1st injection), there were a total of 10 cases of severe Covid-19, 9 of them in the placebo group and one in the vaccine group. The graph of time vs. accumulating disease incidence is striking. The accumulating disease in the placebo group is a nearly straight line with a slope of about 45 degrees while the vaccine group’s line goes nearly flat (hardly any new cases) two weeks after the first injection. You can find this graph in the NEJM paper or, better, at the end of  Betsy Brown, M.D.’s  Update from an Epidemic December 9 post, along with some additional interesting commentary and links.

Reading the detail in the New England Journal article gives a clear idea what the odds of various reactions to the vaccine are with both the first and second dose. (Hint: plan on feeling crummy for a couple days after each dose.) In the “Discussion” section, the article also provides an update on a couple of lingering questions:

“These data do not address whether vaccination prevents asymptomatic infection; a serologic end point that can detect a history of infection regardless of whether symptoms were present (SARS-CoV-2 N-binding antibody) will be reported later.”

If the vaccine induces an immune response that keeps people from having an asymptomatic infection they could possibly pass along to the non-immune population, that would quell the spread in the population more quickly than if it does not. We do not have that information yet, but it’s coming!

“Although the study was designed to follow participants for safety and efficacy for 2 years after the second dose, given the high vaccine efficacy, ethical and practical barriers prevent following placebo recipients for 2 years without offering active immunization, once the vaccine is approved by regulators and recommended by public health authorities. Assessment of long-term safety and efficacy for this vaccine will occur, but it cannot be in the context of maintaining a placebo group for the planned follow-up period of 2 years after the second dose.”

In other words, it sounds like the folks in the study who received placebo will be offered the vaccine, instead of being left to face the ongoing threat of becoming infected. That seems only fair. One hopes that the 162 people in the placebo group who developed symptomatic Covid-19 so far (including 8 with severe disease) will be some of the last few of the volunteers who have to become ill. We are indebted to these volunteers and wish a speedy and complete recovery to all those who became ill in both groups. 

Obviously, we cannot yet know if some long term complication of the vaccine might show up, but I find these early results and all the detail that comes with them very encouraging. If I were offered the first dose of this vaccine tomorrow I believe I would step right up. I am so done with this…

Keep to the high ground,
Jerry

I keep thinking of a piece I encountered on the Public Broadcasting Service (PBS) website on November 24 entitled, “How the Cherokee Nation has curtailed the pandemic.” It is an intra-national example of what we might have achieved with better leadership. As of mid-November when the U.S. as a whole had tallied 250,000 deaths, the Cherokee Nation had just 33. In terms of the dead as a percentage of population that’s 0.078% dead in the overall U.S. and 0.024% among the Cherokee, a three fold reduction. (I’m using 320,000,000 as the U.S. population and 140,000 as the population of Cherokee Nation tribal citizens in their newly won reservation in northeastern Oklahoma, part of a July 2020 U.S. Supreme Court ruling designating nearly half of Oklahoma as Native American land.)

The Cherokee people have a long history of ill treatment by the United States government. A people whose land at the time of the colonists spanned a considerable inland territory in the southeastern United States, the Cherokee already had a well-developed matrilineal society, culture and system of governance of their own. In response to the encroaching culture of the colonists the Cherokee developed a writing system and adopted cotton agriculture, Christianity, and aspects of the colonial governance structure. Despite these adaptions to colonial ways the Cherokee were driven west to the Oklahoma territory in the Cherokee removal, essentially an act of ethnic cleansing, carried out under the direction of Andrew Jackson between 1836 and 1939, a part of the story of the Trail of Tears,. (It should surprise no one that Andrew Jackson is one of Mr. Trump’s idols.) The subsequent relations between the Cherokee people, the federal government, the Oklahoma Territory and later the state of Oklahoma is interesting reading, but it is beyond the scope of this post. 

“How the Cherokee Nation has curtailed the pandemic” offers an internal example of what we could have done as a country. Overall we now lead the world with 285,000 dead from Covid-19 occurring in our one country. Even on a per capita basis as a country we are still dismally outstanding, with 86 dead /100,000 we rank 14th among all nations. The Cherokee experience stands out both because of their history and because their numbers, gathered in the same way as the rest of the country, cannot be argued away. Focused as we are on the Covid that surrounds us, it is hard to pay attention to the success of many countries. For example, Mainland Chinese and Taiwanese Covid deaths of <1 per 100,000, South Korean deaths at 1 per 100,000, and Japanese deaths at 2 per 100,000 (compared with the U.S. rate of 86 per 100,000). Instead we tend to hear the word “spike” or “outbreak” and assume things are as bad or worse in other countries than they are here (or we simply dismiss the numbers as lies).

Tomorrow, December 10th, the “Vaccines and Related Biological Products Advisory Committee” meets to formally consider Pfizer’s application for Emergency Use Authorization for their mRNA vaccine for Covid-19 (click the link for meeting materials) . The meeting runs from 6AM-3PM PST and can be watched at https://www.youtube.com/watch?v=owveMJBTc2I&feature=youtu.be.  (This is the same vaccine that the United Kingdom approved and is already offering to its citizens–the same vaccine that the Trump administration declined to pre-orderbeyond 100 million doses.

There is a bit of light at the end of the tunnel of Covid sickness and death we face this winter. In the eventual aftermath this pandemic we need to remember, account for, and improve upon our dismal response to this one to better prepare ourselves for the next one.

Keep to the high ground,
Jerry

For those who took the time to watch last Thursday’s, December 3, meeting of the Spokane Regional Health District’s Board of Health one thing was clear. With the interim appointment of Dr. Francisco Velazquez as the interim District Health Officer local business interests got what they wanted, a doctor who is a creature of the corporate board room and will not make waves in the community.

The Board of Health meeting (watch here) unfolded as predicted (See P.S. in Cut Adrift in Covid).  The meeting lasted two hours and six minutes, thirty-five minutes of which was an “executive session” (which the public cannot hear or watch). The Board emerged from executive session (43:13) with a motion to appoint Dr. Francisco Velasquez as interim Health Director. The motion was made, seconded, and passed by unanimous voice vote within minutes of the Board’s return from executive session. There was no public deliberation. 

Dr. Velazquez appeared on screen during the entire meeting, appearing both before and after the executive session. He was silent, apart from a thirteen minute speech (1:34-1:47) in which he spoke in glowing terms of the staff of SRHD, nodded to other infectious disease issues in the community (Get your flu shot!), offered a brief update on Covid-19 tests. Surely, he met the expectations of those who has just hired him. The Board was relieved of the need to contemplate the grim local pandemic statistics nor did Dr. Velazquez challenge the Board toward any intervention. The message was, “Be calm, the good staff of SRHD has this all under control.”

The contrast between Dr. Velazquez and Dr. Lutz interaction with the Board was striking. Dr. Lutz served (without pay) as a member-at-large of the Board of Health for eight years prior to his appointment as Health Officer two years ago. Dr. Lutz clearly understood the mission of the Health Officer detailed in state law (RCW 70.05.070–copied in full below) to “Control and prevent the spread of any dangerous, contagious or infectious diseases that may occur within his or her jurisdiction.” Dr. Lutz was deeply engaged in those efforts. He appeared at the Board of Health meetings during the pandemic to offer a short fact-filled report of the details of his and SHRD’s efforts to serve that mission, not to offer platitudes and kind words to the Board. 

Commissioner Al French and his business allies got what they wanted from the engineered firing of Dr. Lutz. With Dr. Velazquez as Lutz’ replacement. Mr. French got a compliant Health Officer who attends entire Board meetings and offers flowery speech of little substance when asked to report. Dr. Velazquez face is directed at the Board. Dr. Lutz’ face was directed at the community he was tasked to serve. 

The remainder of the current meeting was all end-of-year congeniality. Commissioner Al French, the man behind the curtain, along with Andrea Frostad, were counted as present at the beginning of the meeting but were not seen in the video and gave no more indication of their presence. Ordinarily, Board of Health meetings are held just ten times a year and are little noticed by the public. The November 5 meeting, in contrast, the one at which the Board voted 8 to 4 to fire Dr. Lutz, was viewed 9,400 times. By the December 3rd meeting public interest waned–just 270 views on YouTube in the two days that followed it. 

How soon after a public outrage that our attention turns elsewhere. 

The pandemic thrust the SRHD Board of Health under the spotlight. We need to remember the eight of the twelve members of the Board who voted to fire Dr. Lutz. Municipal elections happen again in less than a year. In two years there will be five newly drawn county commissioner districts to fill. In the meantime we need to learn enough civics to understand and knowledgeably push for a revamping of the composition of the Board of Health. 

Public Health Action Coalition Team of Spokane (PHACTS) is gathering people interested in furthering these efforts. Check out their Facebook page, https://www.facebook.com/PHACTSpokane, or email an inquiry to publichealthspokane@gmail.com. KXLY profiled PHACTSand has covered input from City Council President Breean Beggs and State Legislative District 3 Representative Marcus Riccelli. 

Keep to the high ground,
Jerry

RCW 70.05.070

Local health officer—Powers and duties.

The local health officer, acting under the direction of the local board of health or under direction of the administrative officer appointed under RCW 70.05.040 or 70.05.035, if any, shall:
(1) Enforce the public health statutes of the state, rules of the state board of health and the secretary of health, and all local health rules, regulations and ordinances within his or her jurisdiction including imposition of penalties authorized under RCW 70A.125.030 and 70A.105.120, the confidentiality provisions in RCW 70.02.220 and rules adopted to implement those provisions, and filing of actions authorized by RCW 43.70.190;
(2) Take such action as is necessary to maintain health and sanitation supervision over the territory within his or her jurisdiction;
(3) Control and prevent the spread of any dangerous, contagious or infectious diseases that may occur within his or her jurisdiction;
(4) Inform the public as to the causes, nature, and prevention of disease and disability and the preservation, promotion and improvement of health within his or her jurisdiction;
(5) Prevent, control or abate nuisances which are detrimental to the public health;
(6) Attend all conferences called by the secretary of health or his or her authorized representative;
(7) Collect such fees as are established by the state board of health or the local board of health for the issuance or renewal of licenses or permits or such other fees as may be authorized by law or by the rules of the state board of health;
(8) Inspect, as necessary, expansion or modification of existing public water systems, and the construction of new public water systems, to assure that the expansion, modification, or construction conforms to system design and plans;
(9) Take such measures as he or she deems necessary in order to promote the public health, to participate in the establishment of health educational or training activities, and to authorize the attendance of employees of the local health department or individuals engaged in community health programs related to or part of the programs of the local health department.