How did Vashon — a small, rural island community with limited resources and an aging demographic — achieve a COVID case rate 70 percent below large, urban mainland King County?

And what factors contributed to Vashon having 30 percent fewer COVID cases and 55 percent fewer hospitalizations than south Whidbey communities — a place both demographically and geographically similar to Vashon?

A newly published peer-reviewed study describes Vashon’s pandemic response and provides insights into these questions — showing how islanders came together to fight an unprecedented threat to public health, rallying around the banner of the nonprofit VashonBePrepared.

The study, published in the journal Public Library of Science (PLOS ONE), documents the grassroots work of highly organized teams of volunteers on Vashon, combining saturation public education and community outreach with home-grown volunteers who provided professional-level COVID testing, contact tracing, and vaccination.

“We decided to widely share the results of our research because what we all achieved on Vashon can be accomplished anywhere a community puts its mind to it and provides the needed organization and support,” said Dr. Jim Bristow, a leader of Vashon’s Medical Reserve Corps (MRC) and the corresponding author of the study.

The efforts of Vashon’s MRC — led by a group of local doctors with 100 combined years of expertise and experience in internal medicine, pediatrics, infectious disease, immunology, and molecular diagnostics — included establishing a testing site early in the crisis, rapid contact tracing, and planning and implementation of Vashon’s mass vaccination campaigns.

The mass vaccination campaigns were made possible through an innovative partnership with Vashon Pharmacy. In addition, the team also widely advised local businesses, agencies, and schools on COVID safety practices.

According to Bristow, the work of the nation’s 750 MRCs needs to be more widely appreciated and better funded.

“Our study of Vashon’s community effort suggests MRCs could be an enormously valuable resource when the nation is faced with the next public health crisis,” he said.

The study used standard statistical modeling techniques to compare publicly available statistics from three Puget Sound populations — Vashon, the similar communities of Whidbey Island, and the King County mainland.

“Whidbey is a similarly remote island setting that served as a control, allowing comparison of the two island community environments,” Bristow said. “Whidbey’s population is larger and more diverse than Vashon’s, but its southern communities are quite comparable to Vashon and had similar mobility during the pandemic.”

The analysis demonstrates that while age and other demographic factors were reliable predictors of COVID rates on the mainland, demographics could not explain the significantly lower rates on Whidbey and Vashon.

The authors speculated that islands tend to have a strong sense of community that other studies have shown can translate into lower COVID rates.

But a direct comparison of Vashon with the demographically and geographically similar communities of south Whidbey found that Vashon achieved significantly greater success in contact tracing and vaccination.

As a result, Vashon had 30% fewer cases and 55% fewer hospitalizations per capita than the other island community.

Why? Bristow contends that Vashon was organized and ready, from the start, to confront the public health crisis in a unified way, in contrast to many other communities.

“Our experience suggests that the elements of success must be in place before the emergency arrives to be most effective,” Bristow said. “In our community, we had the nonprofit VashonBePrepared and our well-practiced volunteer Emergency Operations Center (EOC), supported by Vashon Island Fire & Rescue. We also had our federally registered Medical Reserve Corps and a longstanding Community Emergency Response Team (CERT) in place. That made all the difference.”

Rick Wallace, the volunteer manager of Vashon’s EOC, described the wide-reaching public messaging campaign — begun at the dawn of the pandemic — as being crucial.

A pivotal moment, he said, occurred in the first week of emergency activation when Fire Chief Charles Krimmert, serving as the Incident Commander of the island’s emergency response, ordered the transparent release of all EOC situation reports — documents typically used for internal briefings, said Wallace.

“That decision, made within days of our pandemic activation, quickly went island-viral, and established a reliable and comprehensive source of information for our community,” Wallace said.

The reports — detailing current local cases and hospitalizations, mandates from county, state and federal governments, information and advice from the Medical Reserve Corps and more — were available to islanders through a number of channels.

These included Voice of Vashon’s Alert Service opt-in email list, and several community Facebook pages, Wallace said. He added that it was “incredibly valuable” that The Beachcomber began a weekly summary of the reports in the spring of 2020.

According to Bristow, the 11,000 residents of Vashon also deserve enormous credit for the success of Vashon’s unified pandemic response.

“We sometimes say the most important word in public health is public — and that’s what happened here,” he said. “The vital pandemic information was there for everyone through a saturation public health communications effort. And our neighbors pulled together as a community to take steps to protect themselves and each other.”

The study focused on the public health response of the Vashon community, which was one of four core objectives of the island’s emergency activation. But food security, housing security, and economic recovery were the other important objectives under VashonBePrepared’s pandemic response umbrella.

These efforts, said Wallace, recognized the economic and social impacts of the emergency and their potential for devastating Vashon’s community life — peaking when the island faced 22 percent unemployment and 40 percent of the island’s businesses were closed or making no money.

In response to this unprecedented hardship, he said, VashonBePrepared established a community relief fund with over $500,000 contributed by island residents. Another $250,000 was added to the fund by leveraging reimbursements through the King County Office of Emergency Management access to federal funds from the CARES Act.

The Relief Fund, Wallace said, went largely to support food, housing, and economic recovery efforts by an array of island nonprofits including Vashon Maury Community Food Bank, Vashon Island School District nutrition program, Vashon Maury Senior Center, Interfaith Council for Prevention of Homelessness, Vashon Youth and Family Services, and St. Vincent de Paul Vashon.

The Relief Fund covered the cost of more than 25,500 meals, many of them delivered to homes and neighborhoods. More than 4,300 bags of groceries were distributed. Funding to the Chamber of Commerce Ask an Expert program made it possible for 400 residents to get expert help in filing for unemployment benefits.

Bristow, looking back now at what was accomplished in terms of pubic health on Vashon, starting almost immediately at the dawn of COVID and continuing through the many permutations of the pandemic, described the community’s response as selfless.

“[It] required everyone to make personal sacrifices to keep each other safe, and our community was almost uniquely willing to do that,” he said. “Even three years later, it still amazes me.”

The full study can be read online.