Health officials: sharp rise in cases makes Phase 2 return possible
1,700 new cases in two weeks puts county at risk
Last updated 5/5/2021 at 10:10am
A fourth wave and a return to an earlier phase for Snohomish County is possible with infection rates taking an upward turn in the data-review two weeks after Easter.
The alarming rate of COVID-19's new cases and hospitalizations is nearing a level unsafe to maintain acceptable resources for emergency care in hospitals, officials say.
Snohomish County case counts spiked with 1,700 new cases in the two-week rolling count, more than double the two-week increase one month ago, said Dr. Chris Spitters, health officer for the Snohomish Health District. He said the vaccination effort was helping, but not enough people are fully vaccinated to turn things around.
The county had fully vaccinated about 26% of eligible people, as of April 15. Spitters anticipates a possibility of lifing restrictions once 80% are fully vaccinated. Currently eligible are people older than 16. A pending FDA request by Pfizer would free up emergency-use of its mRNA vaccine for children between the ages of 12 to 15.
Until herd-immunity through vaccination ends the pandemic, the same advice continues: mask up, wash hands, and physical distance. Outdoor gatherings are safer than indoors, due to ventilation.
Spitters said the detailed advice of the CDC for fully vaccinated people stands (https://bit.ly/2QlT9VT). But his recommendation is more cautious. Spitters recommends fully vaccinated people mask when joining with unvaccinated people, even if they are presumed low-risk for serious illness. The reason is to prevent possible asymptomatic spread and slow the infection-rate spike.
In past Joint Information Commission meetings, he has also mentioned lingering illness that impacts people months after they are deemed "recovered," in case data. Other media reports say children are susceptible to that consequence of COVID-19, known as "Long COVID."
"We've made great progress with vaccination," he said, "But we're just not at a point where there's enough immunity in the county to prevent these, these kinds of problems," Spitters said.
Even with the safety pause of the J&J vaccine that shuttered Angel of the Winds Arena, one of seven mass vaccination sites for the county, the county has fully vaccinated 23% of its population, and 36% have started the vaccination-process. Full vaccination is when a person is two weeks past the two-shot protocol for Pfizer or Moderna, or two weeks past the J&J's single-dose vaccination.
J&J is still temporarily paused for a safety review, triggered by six cases of a rare stroke that occurred after the viral vector vaccine was given. It is not yet clear whether the strokes were caused by the vaccine, but the CDC review may shed light on that (https://bit.ly/3v7gARx).
The CDC says vaccines "should" work on variants and researchers are gathering data to determine whether boosters are needed, and if a new vaccine will be required to fight new mutations of the virus. In the meantime, more cases, from a spike protein's perspective, means more opportunity to change.
Spitters said the more people are ill, the more chances the virus has to morph. The increased number of hosts gives nature a chance to change, through natural selection, and develop into a new strain that is less controlled by the vaccine.
County's phase may change
With the stark jump in cases announced April 20, Spitters warns that the county is likely to return to Phase 2 or even Phase 1 if things do not turn around. He said it is not inevitable, but if things do not turn around "that's where we're headed."
The Healthy Washington criteria requires a set of milestones to move to more promising phases, or reverse to more restrictive ones. The next state-level evaluation of counties, determining what phase will impact public interaction and business-activity, is scheduled for May 3, but in past pandemic changes, announcements sometimes came earlier than anticipated.
"We can turn this around if people just take action, protect themselves, don't gather – particularly with groups of unvaccinated people indoors. We can ... absolutely turn this around before the next decision-point," Spitters said.
Prior to the Easter holiday and other gathering-heavy holidays, health officials warned that contact-tracing pointed to gatherings as a key driver for spreading the virus.
With the J&J pause slowing the pace of vaccination, Pfizer and Moderna are still being administered. Both are mRNA vaccines, which teach the body to make a protein that fights COVID-19. The CDC says 14 days after the second shot, and the expected immunity is around 90%.
As for who is getting sick, it is no longer predominantly people over the age of 65.
"The case rates are up in all age groups, but particularly the young – younger adult age groups, 20 to 29," Spitters said.
As of April 20, 36 people were hospitalized and one was on a ventilator. Once on a ventilator, the risk of death is higher.
"The majority of hospitalizations now are among individuals under 60 years of age," Spitters said on April 20. Slides from his April 20 presentation are here: https://bit.ly/3ve572v.
The rate for hospitalizations is close to the metric of five per 100,000, a level that could be a push to return the county to a previous phase, Spitters said.
Variants and other contributors to COVID-19 spread are also a concern. B.1.1.7 and B.1429 are now the predominant strains in the county, Spitters said, and they are 50% more transmissible than the original version of COVID-19.
"So we have even less of a margin of error," he said.