County tables COVID mandates resolution

Medical community seeks changes to clear up misconceptions about masks, treatments and when private rights should yield to protect public health

Faced with opposition from the medical community and an adverse legal opinion, the Cowlitz Board of Health on Tuesday tabled a controversial resolution opposing future COVID 19 mandates.

It was not immediately clear whether the board will bring the document or a revised version up again at its next meeting, now scheduled for Oct. 31.

The resolution asserts constitutional rights that it says prohibit any orders for mask wearing, vaccinations and lockdowns.  It also asserts that mandates violate principles of medical ethics to do no harm, protect informed consent and require respect for bodily autonomy., noting that some of the measures caused social and speech delays in children.

It also states that no county assets  (staff time, money or facilities) will be used to enforce “future unconstitutional mandates.” 

It is largely a symbolic statement, because counties cannot countermand state laws and regulations.

However, it makes a number of false and misleading assertions that could misinform the public and undercut efforts to fight the spread of the respiratory virus. Among them: masks don’t work, that the pandemic did not cause excess deaths,  and that the government “unconstitutionally” suppressed information about Ivermectin, hydroxychloroquine and other medications that have proven to be ineffective and potentially harmful.

“It is critical (that) the resolution include evidence-based statements to clarify  potential misperceptions in the community and remain in alignment with Washington state law,” according to a letter to the board from Corey Balkan,  chair of the St. John Community Health Board, and Sean Gregory, chief executive of the PeaceHealth Columbia Network.

The politely worded letter asks the board to delay action on the resolution so it can be revised.

Retired Longview physician Tom Hickey also submitted a point-by-point rebuttal to the resolution that appears in full at the end of this column along with the entire county resolution. Hickey serves on the PeaceHealth/St. John Community Health Advisory Board and  the Community Health Partners  Advisory Board.

Some excerpts from Hickey’s response:

“An overwhelming body of evidence shows that Ivermectin and hydroxychloroquine had no beneficence and showed significant maleficence. Therefore, such use would violate the ethical principles you outline above.”

“We have found … a preponderance of evidence indicating that masks do provide some protection from respiratory viruses.”

The resolution “implies that the Covid 19 illness did not have a significant impact on Cowlitz County. While we appreciate debate about the value of various lock-downs, school closures, shelter in place orders and mandates, there is no question that COVID-19 had devastating affects (sic) on Cowlitz County.”

“Patient autonomy is a foundational principle but is not absolute when such autonomy endangers others.”  For example, Hickey cites Washington law mandates that tuberculosis patients must be quarantined.

The proposed resolution appeared on the board’s agenda out of the blue, catching some members by surprise because it has not been discussed previously. It was put forward by the health board chairman, Kelly Lane.

It seems doubtful that Lane, who is not an attorney or health care provider, wrote the resolution himself. Did he collaborate with Cowlitz County commissioner Arnie Mortensen, a vocal opponent of COVID mandates?  

Lane had not yet responded to my emailed questions. If and when he does, I will add them to this story.

The three county commissioners are the only elected members of the seven-member board (It added a seventh member Tuesday: Alice Fine, a representative of the Cowlitz Indian Tribe). None of the board members is an epidemiologist, although member Linda Campbell is a retired school nurse.

Lane is one of four non-elected members of the health board and represents so-called “consumers of health.” In his 2022 application for appointment, he said he had cared for a disabled veteran and elderly mother and mother-in-law and has experience with the frustrations of navigating health care systems including Medicaid, the U.S. Department of Veterans Affairs and private health insurance companies.  

COVID cases are rising statewide and nationally,  but at this point state authorities are not proposing a resumption of mask , vaccine or lockdown mandates. Nevertheless, increasing cases are giving rise to county resolutions in other rural Washington counties opposing attempts to do so.

One statement approved earlier this month in Lewis County cited constitutional objections to the mask-wearing mandate that Gov. Jay Inslee ordered in early 2020 after declaring a public health emergency. It asserts — without citing evidence — that “there is no conclusive medical evidence that such mandate produced a demonstrable decrease in diseases.”

Lewis County’s statement is limited only to mask mandates and does not address vaccines, medications or lockdowns or make some of the more outlandish claims contained in the Cowlitz resolution. Nor does it try to draw a line in the sand, as the Cowlitz proposal does by saying no county resources can be used to enforce and state or federal mandates.

As I reported previously, the county has no authority to defy state laws or edicts, and it can’t adopt standards that are less stringent than the state’s. The Cowlitz County Prosecuting Attorney’s Office, which is the county’s lawyer, has advised the health board members that parts of their resolution are illegal and could result in criminal charges against them.

Here is the full text of a the county’s proposed resolution, with comments and rebuttal by Dr. Tom Hickey. Hickey’s comments are in italics.

To: The Cowlitz County Board of Health

Regarding: Proposed Resolution as noted below

Dear Cowlitz County Board of Health members:

We the undersigned respectively request that a decision to adopt this resolution 

be postponed until a more comprehensive discussion happens with health care 

providers in Cowlitz County and other stakeholders and until some statements in 

the resolution and its preamble are clarified. 

We have questions and comments with respect to several statements noted 

below.

BEFORE THE BOARD OF HEALTH OF

COWLITZ COUNTY, WASHINGTON

MEDICAL FREEDOM RESOLUTION

REJECTION OF UNSCIENTIFIC MASK MANDATES, CLOSURES, OR RESTRICTIONS RELATED TO RESPIRATORY OR OTHER DISEASES, AND RECONFIRMING PERSONAL FREEDOMS  AND THAT NO GOVERNMENT SHALL FORCE ANY INDIVIDUAL TO USE A MEDICAL INTERVENTION OR FORCE SOMETHING ‘ONTO’ OR ‘INTO’ ANY INDIVIDUAL’S  BODY WITHOUT THEIR INFORMED CONSENT

WHEREAS, WA State Law RCW 70.05.060 establishes the responsibility to supervise  the preservation of the lives and health of people in COWLITZ county through the Cowlitz County Board of Health (B.O.H.); and

Respectfully, we request that the Board of Health insert the full text of RCW  70.05.060 at the beginning of this resolution and again before listing the resolution components 1-11.  

It is necessary for the Cowlitz County Board of Health to unequivocally declare  their commitment to and conformity to the  powers and duties of Cowlitz County board of health as articulated by Washington State Law as per RCW 70.05.060. The Cowlitz County   Board of Health does not have the right to act independently of the Washington State Board of Health.

WHEREAS, the Cowlitz County Board of Commissioners has previously passed Resolution #21-005 of January 12th, 2021 which was both uncontested and unanimousrecognizing that citizens can make responsible decisions that don’t need mandates; and

WHEREAS the four principles of medical ethics, being 1) respect for bodily autonomy, 2) beneficence, 3) nonmaleficence (do no harm), and 4) justice, and the tenets of informed consent are imperative in the practice of medicine and health care, and

​What is the reference for this articulation of principles of medical ethics? We have no dispute with the principles but a reference is warranted. Also it would be prudent to note that none of the principles are absolute. For example patient autonomy is a  foundational principle but is not absolute when such autonomy endangers others. For example failure to be treated for active TB and refusal to quarantine would require that public health officials including this Board of Health take action to protect other citizens. That is codified in Washington State Law. Similarly a patient’s autonomy to drive a car is  not absolute. If a person has had a seizure, that person cannot drive for six months. This is not just good public health but is also Washington State law. 

WHEREAS, lock-downs, quarantines and mandates have proven harmful to children’s  mental health and education, while at the same time the morbidity rate for COVID-19 was and is less than 1% in adults, and a fraction of that in children, and total death counts in the U.S.  remained steady before, during, and after all phases of the ‘pandemic’, with ‘COVID deaths’ skyrocketing even while influenza deaths completely disappeared from statistical data; and 

Respectfully, the statement above implies that Covid 19 illness did not have a  significant impact on Cowlitz County. While we appreciate debate about the value of  various lock-downs, school closures, shelter in place orders, and mandates, there is no  question that Covid-19 had devastating affects on Cowlitz County and on our health care provider system here. We had to redeploy clinicians from clinic work to hospital work to  deal with Covid 19 illnesses. Clinicians from Portland metro had to come up here to augment clinician resources to deal with Covid 19 illnesses. Surgeries at St John were  postponed to free up beds.  We often transferred patients to other facilities whenever beds became available due to our severe shortage resulting from Covid 19 admissions. There should be no doubt that Covid 19 was a major disruptor of health care services in the county. 

 Respectfully, please enclose references to the assertion that “total deaths in the US remained steady”. We have reviewed public records with respect to Death Rates in  the US from 2019-2022. There were no deaths from Covid 19 reported in 2019. In 2020, 2021 and 2022 Covid 19 was the third leading cause of death in the country.The CDC data also shows an overall increase in death rates in 2020-2022 for most age ranges compared to 2019. It is estimated that over 1 million excess deaths occurred in  the US due to Covid 19.

The data for Cowlitz County also documents a significant uptick in total deaths ,  particularly in 2021 during the Delta Covid surge. The Cowlitz County Health and Human Services department reported an 18% increase in deaths in 2021, with most excess  deaths due to Covid 19. During most of 2021 Cowlitz County deaths from Covid 19 exceeded state averages significantly.

In further demonstration of the impact of Covid 19 on this county, the Cowlitz  \County Commissioners who sit on the BOH should recall the unprecedented action they took in September 2021 when they approved a request from the County Coroner for the  lease of a refrigerator truck needed to house the dead bodies attributed by health officials to an excess of Covid 19 deaths. We request the statement above be significantly reworded to accurately reflect the  impact of Covid 19 on this county. ​

WHEREAS, there is NO Constitutional authority to restrict individual unalienable rights ever RCW 43.06.200 -.270 and any prohibition on assembling peacefully is in direct violation of RCW 43.06.220 Section 2(g), which specifically does not permit the suspension of first  amendment rights even under a declaration of emergency; and

WHEREAS, Scientific evidence and peer-reviewed studies show that masks are not effective against respiratory viruses, that they impede social and speech development critical to  the life success of children, and that they increase CO2 intake, (a “greenhouse gas”) to dangerous levels; and

Respectfully, please enclose references for these statements regarding masks. We  have found a preponderance of evidence indicating that masks do provide some protection from respiratory viruses and that any increase in CO2 intake is not dangerous.  Please also note that virtually every significant surgery performed in the US and  worldwide for decades has been done with the surgeons wearing masks. Does the  Cowlitz County Board of Health really think surgeons would operate wearing masks if the masks impaired their judgement and performance? 

WHEREAS, State and Federal agencies destroyed their own credibility by using unconstitutional means to suppress accurate information about COVID treatments such as  Ivermectin, Hydroxychloroquine, Vitamin D3, and Quercetin, calling their promotion  “disinformation,” while simultaneously promoting and marketing directly to children ineffective  and dangerous or even deadly treatment regimens such as Remdesivir and mechanical ventilators which caused the deaths of many thousands of people; and

Respectfully, please enclose references for these statements regarding treatments. We find multiple evidence that Ivermectin and Hydroxychloroquine were used  often to treat Covid 19 after initial studies suggested benefit. Any suppression was not very successful. 

Subsequently an overwhelming body of evidence showed they had no beneficence and showed significant maleficence. Therefore, such use would violate the  ethical principles you outline above.  We also want to make it clear that mechanical ventilators are only used when a patient’s respiratory system is unable to sustain life and  any maleficence from ventilators is outweighed by potential beneficence in this situation in which death is imminent without such support. 

WHEREAS, Cowlitz County and the state of Washington suffered immeasurable economic and societal harms as a result of Governor’s proclamations that have been pursued in a non-uniform, unequal and arbitrary manner along with unconstitutional mandates, restrictions and forced business closures have led to the destruction of commerce, jobs and livelihoods; and

WHEREAS, citizens have personal and practical recourse to choose their own  guidelines to mitigate their personal risk of contagion with viruses, diseases or illnesses; and 

WHEREAS, the children of state residents were denied access to appropriate education,  for which taxes continue to be paid; and

WHEREAS, State and Federal mandates irreparably harmed millions of our precious Senior Citizens by the unnecessary use of lockdowns, restrictions and mask rules that isolated them from normal social interactions, basic caregiver access, and from their family and loved  ones, causing a dramatic worsening of loneliness, stress, anxiety, and depression, increasing the risk for dementia and of death from all causes;

THEREFORE, BE IT RESOLVED by the Cowlitz County Board of Health that subject to the  Constitution and laws of the United States of America and the Constitution and laws of the State  of Washington:

Respectfully, given the potential misinterpretation of these resolutions as being in contradiction to RCW 70.05.060 we recommend that a statement be added: None of these resolutions will be enacted if they violate Washington state law or are inconsistent with RCW 70.05.060

1. Coercion  and  undue  influence  shall  not  be  used  to  compel  any  individual  to  use  a  medical intervention.

Please note this is a redundant statement. Use of undue influence and coercion   are already considered unacceptable legally and under tenets of medical ethics. However there  are  situations  where  an  individual’s  failure  to  accept  treatment  for  a  condition  which  may   endanger others, can result in the patient being quarantined to protect other citizens (as per the  Active TB example). 

2.  That  no  Government  entity,  agency  or  subdivision,  shall  force  any  individual  person  to put  something  ‘onto’  or  ‘into’  an  individual’s  body  without  informed  consent  of  said  individual.

This is also a redundant and unnecessary statement  

3. That  the  inalienable  right  to  medical,  religious,  and  conscientious  exemption  from  any medical intervention requirement shall be honored. 

This  requires  an  addendum  that  there  are  circumstances  in  which  the  County  Board of Health may quarantine or otherwise intervene with an individual to protect life.

That reasonable accommodation to the use of an exemption to a required medical intervention shall respect the full body of science regarding the intervention declined, the medical condition  the intervention is meant to prevent, and naturally acquired protection.

4.  No Cowlitz County assets will be used to enforce future unconstitutional mandates from   State  or  Federal  governments  that  are  related  to  lockdowns,  closures,  or  vaccinations having to do with any COVID or other disease.

This  should  be  redacted. The  Board  of  Health’s  duties  and  roles  are  defined  by  RCW 70.05.060 and state public health mandates cannot be ignored by any County. 

5.  During  Emergency  Declarations  by  the  State  or  County,  the  acting  Health  Officer  shall have  powers  limited  to  24  hours  unless  a  vote  of  the  B.O.H.  approves  an  extension,   limited to 21 days maximum.

Respectfully,  please  consider  extending  the  Emergency  Declaration  window  to   72 hours given the practical challenges of convening the BOH. Also it does not seem prudent for the Board of Health to handcuff themselves to the “21 day maximum” and we respectfully request that be deleted.

6.  During  such  Emergency  Declarations  declared  by  State  or  County,  all  public  health decisions  regarding  restrictions,  quarantines  and/or  mandates  must  be  approved  by  a  vote of the BOH, gathered or to be convened for emergency events.

Respectfully, this  should  be  redacted.  The  County  is  required  as  per  RCW   70.05.060  to  follow  the  State  Board  of  Health  directives.  Specifically  :(1)  Enforce  through  the local  health  officer  or  the  administrative  officer  appointed  under  RCW 70.05.040  if  any,  the  public  health  statutes  of  the  state  and  rules  promulgated  by  the  state  board  of  health  and  the  secretary of health.

7.  That  any  Public  Health  Emergency  of  International  Concern  (P.H.E.I.C)  is  not  unilateral and requires a vote of the Board of Health to be accepted in our county. 

Again,  this  should  be  redacted  since  it  is  in  violation  of  Washington  Law.  The  County must follow RCW 70.05.060

8.  During  pandemics  and  national  public  health  emergencies,  the  County  Health  Officer  and/or  Dept.  of  Health  and  Human  Services  shall  present  all  proposed  policies,  guidelines and recommendations pertaining to response measures impacting citizens of   Cowlitz County to the B.O.H. for approval prior to implementation.

Respectfully,  please  add  to  this  statement  “or  as  soon  as  possible  when  the   Officer takes action in an emergency.”

9.  Cowlitz  County  will  not  require  anyone  to  provide  any  Vaccine  Passport  or  any   documentation  certifying  vaccination  or  post-infection  recovery  to  gain  access  to,  entry upon, or service from Cowlitz County operations. 

Respectfully,  this  should  be  redacted  or  addended  to  say  “except  as  per Washington State Law” 

10. Cowlitz   County   B.O.H.   will   not   impose,   require   or   prohibit   mandates   for   private companies. 

Respectfully,  this  should  be  redacted  or  addended  “except  as  per  Washington State Law.”

This resolution shall take effect immediately.