SEATTLE — When Mary Lankford checked into the Salish Lodge & Spa with her husband and 6-month-old baby on Sept. 30, the lodge had known for a week that multiple employees had tested positive for COVID-19. But Lankford did not find out about it until a news report announced the outbreak later that evening.
Lankford and other guests who stayed at Salish Lodge between Sept. 22 (when Public Health – Seattle & King County began its investigation) and Sept. 30 (when Public Health publicly announced the outbreak) were angry that they had not been informed as soon as the cases were discovered.
Salish Lodge says it followed the guidance of the county public health office, and Public Health – Seattle & King County says it generally focuses on zeroing in on who may have been exposed and informing that targeted group.
Hotel guests say they just want to know whenever there are COVID-19 cases where they’re staying.
The Salish Lodge outbreak of 25 cases, and a recently confirmed case of six guests who tested positive for COVID-19 at the Residence Inn by Marriott Seattle Downtown/Lake Union, have raised the question of who should be notified, when, and by whom when there is a COVID-19 outbreak at a hotel. (The Residence Inn’s general manager declined to comment Wednesday, citing guest privacy concerns, but said no staff members have tested positive.)
The answer, it turns out, isn’t one size fits all. When and who to inform about a COVID-19 outbreak is a delicate balancing act that must take into account the resources of county public health and the affected business, employee and customer privacy, the potential for spreading misinformation, community well-being, maintaining customer trust and numerous epidemiological concerns.
The Salish Lodge outbreak showed that hotels are in a unique position as businesses that provide many services to a large clientele over days rather than hours, and as places that guests see as a home away from home.
As Seattleites become quarantine-weary and many Washington hotels see an uptick in local staycationers, the situation that unfolded at Salish Lodge carries lessons about the evolving relationships and responsibilities between guests, hotels and public health in the COVID-19 era.
“Safety is the new luxury”
The pandemic has taken a significant toll on the hotel and travel industries. According to Visit Seattle, hotel occupancy rates in the Seattle metro market sat at 38.5 percent for the week of Sept. 20 — compared to 82.4 percent for the same period last year.
Anthony Anton, Washington Hospitality Association (WHA) president and CEO, says hotels must invest in COVID-19 safety for guests and staff if they want to survive the pandemic.
“So much of our reputation and public trust is connected to our profitability,” said Anton. “We’re having to learn and get better and we’re really diligent about it, because if people don’t trust us, they’re not going to come back.”
Washington’s Department of Health has some COVID-19 safety guidelines for hotels, but the industry has largely taken measures into its own hands to make customers feel safe, including guidelines developed by WHA.
Even local boutique hotels with fewer resources than big brands have stepped up their efforts. The 111-year-old Hotel Sorrento has survived many global crises, and armed with that historical precedent, Managing Director Shannon Sheron and Creative Director Tiffiny Costello visited several downtown hotels at the start of the pandemic to observe others’ COVID-19 safety protocols. Based on those visits, they formulated a solid safety plan that includes PPE for housekeeping staff, disinfecting high-touch areas every two hours, and daily temperature checks of guests and staff at dining facilities. The Sorrento hasn’t had any known cases of COVID-19.
“Safety is the new luxury,” said Sheron.
While COVID-19 prevention protocols vary by hotel, they all look to state and county health authorities for guidance on what to do after an outbreak, including who to notify.
County health guidelines only require businesses to contact those who had direct contact with infected staff or guests. When it’s not possible to directly contact all who may have been exposed, county health may issue a news release.
Alan Stephens, the general manager at Salish Lodge, said they’d like more guidance from the county public health department on when and how to notify guests and the public in the event of a COVID-19 outbreak.
“It wasn’t until the 30th of September that (Public Health — Seattle & King County) said, ‘You need to inform all guests that have been at the lodge since September 5th’ ... and that came as a surprise to us,” said Stephens. “Public Health has been amazing to work with. But I do think there needs to be, as an industry, whether in food and beverage or hotel operations, better clarification on reporting to public. When do you do that? When does that make sense? How do you do that? Who does that?”
The complicated calculus of who gets to know and when
Public Health — Seattle & King County first contacted Salish Lodge about possible workplace transmission and took steps to begin an investigation at the lodge on Sept. 22.
Salish Lodge says during the investigation it followed county health department guidelines for businesses to the letter — isolating affected staff members, sending them home, keeping employees’ identities private and contacting anyone who had direct contact with those staff members.
Under those guidelines, businesses are only required to inform customers who may have been exposed about an outbreak.
But for hotels, “customers who may have been exposed” doesn’t necessarily include everyone staying there — only those who had close contact with infected staff.
There are drawbacks to broader notification, such as panic and the spread of misinformation, something Dr. Vance Kawakami, an epidemiologist for community COVID-19 outbreak response at Public Health — Seattle & King County, said they’ve seen in the past.
Because there is widespread transmission of COVID-19 in the broader community, if a person who works at a business tests positive, that does not necessarily mean they contracted the virus at the workplace or infected others there.
So, if businesses notified customers or the public every time a staff member or customer tested positive, they might be notifying people very often, Kawakami said.
When a large worksite is potentially exposed, a business ideally works with Public Health to investigate and identify close contacts and “get the messaging to them in a targeted fashion,” Kawakami said.
After learning about the first positive cases among staff, Salish Lodge hired a health agency to administer on-site testing to staff. When several results came back positive, Public Health — Seattle & King County decided to issue a news release to reach people who may have visited the Lodge but could not be contacted directly.
This was done “out of an abundance of caution,” said Kawakami, and after considering the situation at Salish Lodge carefully.
In other cases where those who might have been exposed can be identified and contacted, it’s up to the business to decide when or if to inform other customers or the broader public of a positive COVID-19 case associated with their business.
“I can see how guests could be frustrated,” said Kawakami, noting that businesses are often balancing customer trust with experts’ recommendations, but he stressed that businesses and the health department both want the same thing: to keep the community healthy and see an end to the pandemic.
“It’s a loss of trust”
When news broke about COVID-19 cases at Salish Lodge, guests were outraged that they hadn’t been told. The Lodge weathered more calls and emails from disappointed guests in days that followed.
“As I said to the front of house manager, you didn’t give us the choice to make,” said Chris Bauer, who was celebrating his six-year anniversary with his husband at the lodge when the news broke. “You decided for us that we were going to be safe, when we should have the agency to choose whether we feel safe.”
Bauer, a Portland-based retail manager, understands the difficulties of being a business on the pandemic’s front lines, but, he said, hotels are held to a different standard because they provide homes for guests.
Days after her family’s stay at Salish Lodge, Mary Lankford’s infant developed a cough and had to be rushed to urgent care, where he eventually tested negative for COVID-19. But Lankford and her husband spent hours in fear.
“I could not relax until we knew for sure,” Lankford said. “What upset a lot of us is not knowing, being misled, being put in that situation unknowingly.”
If they had known about the COVID-19 cases at Salish Lodge, Lankford said they never would have checked in because she has several vulnerable family members. That’s what’s at stake for guests: “We were unknowingly put in harm’s way, when we went above and beyond to protect our little family and my parents,” Lankford said.
Marissa Baker, an assistant professor in the University of Washington’s Department of Environmental & Occupational Health Sciences, said although there is minimal risk to Salish Lodge guests who spent most of their time in their rooms, their fears are reasonable.
“By withholding info, people can feel outrage and can perceive risk as greater,” Baker said.
Over the last couple weeks, Salish Lodge has learned a hard lesson about what guests expect from hotels in the COVID-19 era and has made changes to their COVID-19 safety protocols, including increasing PPE for staff, limiting operating hours for some amenities, and screening guests whenever they arrive or return to the lodge. They’re also limiting new bookings throughout October and temporarily offering only in-room dining.
Stephens says going forward, the Salish Lodge will inform all guests within 24 hours if even a single case of COVID-19 is found there.
Regardless, guests like Lankford and Bauer said they’re unlikely to stay at Salish Lodge again during the pandemic.
“It’s a loss of trust,” said Bauer.
Salish Lodge’s biggest take-away? Swift communication with guests about COVID-19 cases is essential.
“If we’ve learned anything from this, it is communicate, communicate, communicate,” said Stephens. “Our guests are our family and they deserve to hear from us. ... Having gone through this, that is the right way and the expectation in the industry.”
Baker, who teaches a risk assessment course at UW, says that transparency is vital as businesses weigh customer concerns and public health guidelines.
She suggests businesses tell customers what has happened, outline who is most at risk and perhaps offer resources or testing.
“You need to be upfront, and you need to lead with acknowledging the concerns of the people that are affected” Baker said. “It makes it not quite so scary.”