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Distance and caution are vehemently advised by the Joint Information Commission in Snohomish County, as COVID-19 cases rise past levels seen in the spring when the entire state was required to shelter in place.

"It's much like we're driving on ice that when we hit the brakes we're still going to keep moving," said health officer at the Snohomish Health District, Dr. Chris Spitters.

The rolling two-week count for the county was 188 per 100,000, a record-breaking spike higher than any time since case-counting began. Snohomish County recorded 10,455 cases Nov. 10, with 217 in Mill Creek and 136 of those recovered.

More than 1,200 probable cases are awaiting test results. The change from Nov. 9 to the following day was an additional 132 cases, up from a recent count of 74 per 100,000. Updated information is here: https://bit.ly/2Uk1mZa.

With winter months arriving, people are more often indoors, adding to the risk of spread, officials warned.

"We're breaking COVID case records, and really headed into uncharted territory," Snohomish County Executive Dave Somers said in the weekly press briefing by the JIC, part of the emergency coordination center for the county.

Indoor time is higher risk for COVID-19 transmission, and officials say cases are from at-home interactions with family and friends, according to contact tracing data. Harvard Health says aerosolized coronavirus can remain in the air for up to three hours. Those germs are released when a person talks or breathes, even if asymptomatic. Holidays tend to come with gatherings. Officials are advising against that.

"Make a bubble of the five or fewer social contacts outside your household, and stick to that," Spitters said. “And I recommend that you keep it to the same five across time till we get a little further down the road with this."

Ideally, he said it is never a good idea at this stage of the pandemic for more than five people to gather. Officials are even advising that people mask up inside their own homes, to avoid spreading germs within their own bubble.

"Frankly, for the best public health outcome I recommend, you know if we could tolerate it – zero people outside our households at this point. But I think we have to be realistic – people need some level of social support and interaction. But let's do this," Spitters said.

Researchers are hopeful about a vaccine, with multiple options being tested. If that materializes, it is still at least a year before everyone could receive it, Spitters said. So the fix remains unchanged and focused around prevention.

COVID-19 does not appear to be dangerous to the majority of those infected, but the death rate is much higher than the flu, and no cure is yet found for those who become severely ill, doctors say.

The impetus behind prevention is keeping hospital capacity manageable and safe. Resources spread to thin will limit care for both COVID-19 patients and other hospitalized patients.

"That's one of our key priorities from the beginning and keeping our hospitals from being overwhelmed is top priority," Somers said. "These are some grim numbers we're looking at. They harken back to a time that was very difficult on everyone last winter. So this is information for you to help yourself and help the community."

The overfilling of hospitals is a twin concern to the protection of high risk people. The spike in cases is statewide, with updated numbers here: https://bit.ly/3lmOhKr. Cumulatively, the Department of Health reports 120,011 and 2,482 COVID-19 deaths in Washington state as of Nov. 9.

"We have nowhere else to send our patients if we run out of space here because everyone else is in the same boat in our region. So this is definitely a warning signal."

Beyond what Spitters describes as "just the general suffering that the infection causes," is medical resources and how far they can go. Other patients are sidelined when COVID patients must be prioritized, to restore breathing.

"Hopefully, we can bend this curve and get things back down before it does exceed capacity," Spitters said. He said it's not just beds, not just personal protective equipment, which currently are relatively OK compared to history, but staffing is a major problem. “There's a nursing shortage nationwide and in the region. So sometimes even though hospitals have beds, they don't have the people to put next to the bed to take care of the patient. So this is, I think, an impending crisis, if we don't bend this curve."

As the colder weather brings people indoors, and potentially together with people outside the “bubble” for holiday gatherings, officials are concerned.

"The third wave virus appears to be the largest wave yet (and the) fact that we're entering winter months with the highest case counts yet should really send shivers down to everybody's spine," Somers said.

See more local news in the print edition of the Mill Creek Beacon, on Nov. 13.