Coronavirus Skagit

A Skagit County health advisory group is preparing for life after COVID-19, and how systems can be rebuilt so they are focused on recovery and equity.

In its COVID-19 recovery plan, the Population Health Trust will aim to identify the harm the pandemic has caused, and look at how to address gaps in services caused or exacerbated by it.

“We need to take a strongly future-oriented stance and predict what might be needed as all these rapid changes are taking place,” said Kristen Ekstran, community health analyst with the county and facilitator for the trust.

While in its early days of planning, the trust has found immense concern about mental health and substance abuse issues — referred to by the umbrella term behavioral health.

Ekstran said COVID-19 is producing additional anxiety and stress in everyone, but for people who have behavioral health issues “the isolation of the pandemic has made the recovery process difficult.”

She said the trust is pursuing interviews with those in four sectors that are suffering unequally due to the pandemic: veterans, Latinos, those with disabilities and members of the LGBTQ community.

These sectors suffer disproportionately under crises such as COVID because of persistent, systemic societal inequalities, she said. The inequalities include employment, education and transportation.

For instance, someone who works in a low-wage “essential” job and can’t work remotely — such as a grocery store employee — is forced to choose between staying safe or feeding their family, Ekstran said.

Someone who can’t afford a car and relies on public transit is forced to risk additional exposure to the virus, she said.

Loss of employment, fear of losing housing and concern for the health and well-being of loved ones all contribute to these feelings of anxiety, Ekstran said.

From her perspective in emergency medicine, Skagit Regional Health Chief Medical Director Connie Davis said the mental health impacts of the pandemic are apparent.

Davis, a member of the trust and of the county Board of Health, said the number of alcohol-related visits to the emergency department has roughly doubled during the pandemic.

Anecdotally, she said she’s seeing heightened depression and suicidal tendencies in those who have never before had behavioral health issues.

Margaret Rojas, a trust member who works for the North Sound Behavioral Health Administrative Services Organization, said calls to the agency’s crisis line have increased in number and in complexity.

Rather than people suffering with some kind of behavioral health condition, she said calls are increasingly coming from those “dealing with insecurities in employment, insecurities with housing and insecurities with food.”

“These aren’t the typical crisis callers we would normally get,” Rojas said.

After conducting interviews with those in each of the four sectors, Ekstran said the trust will release a countywide survey to collect information on how the general public has been impacted by COVID.

That information will be used as the trust move forward with its recovery plan.

— Reporter Brandon Stone:, 360-416-2112, Twitter: @Brandon_SVH

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