COVID More Prevalent Than Ever, Death Rates Rising In WA: Report

WASHINGTON — COVID-19 transmission continued to gain ground this month, but at a slower pace than in August, according to the latest report from the Washington State Department of Health. At the same time, officials found the prevalence of infections reached a new all-time high, outdoing even last winter's surge, with 1 in every 106 Washingtonians estimated to have an active case by Sept. 8.

Another growing area of concern is a rapid increase in the number of new deaths. The report found daily averages soared from between five and 10 deaths per day in July to 27 per day by the end of August. Earlier this week, state hospital officials reported that admissions were on the decline for the first time in weeks but noted one of the reasons was that more patients were dying.

"[W]hen you've got fewer people in the hospital, it is because some have died," said Cassie Sauer, president of the Washington State Hospital Association. "There is a number of counties that are either ordering additional morgue capacity through refrigerated trucks or working with their morgues to figure out how to increase capacity."

On Monday, Sauer said at least 30 COVID-19 patients had died in Washington in just 24 hours.

County-level trends from Washington's latest situation report:

• Case counts in the five largest counties —Clark, King, Pierce, Snohomish and Spokane — remain at levels exceeding their winter 2020 peak but show recent flattening or declines.
• Among midsize counties, cases are also at or above prior peaks. Thurston is seeing increases in counts. Grant, Cowlitz, Skagit, Benton, Yakima and Kitsap show flattening in counts. Franklin and Whatcom show declining counts.
• Among small counties, counts are increasing in Stevens, Grays Harbor, Lincoln and Pacific. Counts are flattening in Douglas, Kittitas, Whitman, Walla Walla, Mason and Island. Counts are declining in Okanogan, Clallam, Lewis, Pend Oreille, Jefferson and Klickitat. All other small counties have fewer than 10 cases per day.
• Testing shortages have been reported from across the state, and it is unclear to what extent they may be playing a role in the flattening or declining case counts seen in some counties.

The report released Thursday found hospital admissions remain very high, despite the recent decline, with occupancy levels lingering well above earlier peaks. State health officials are preparing for the likelihood that hospital occupancy strains will continue through the fall. An analysis earlier this month found hospitalization rates were significantly higher among unvaccinated patients across all age groups.

"What this tells us is that our individual choices and behaviors today are going to determine whether or not our friends and families will have full access to health care in the near future, for any medical need, not just COVID," said Dr. Scott Lindquist, state epidemiologist for communicable diseases. "The current surge of patients is overwhelming our hospitals. With school in session and flu season almost here, our best option for getting through the surge is to wear our masks and get vaccinated."

According to the DOH, Washington's current level of immunity would only be sufficient to reduce hospital admissions if transmission rates were much lower.

"Under higher or 'moderate' transmission, however, the rate of immunity would not be enough, and hospital admission and occupancy would increase, especially among the estimated 39% of the population susceptible to infection," DOH wrote Thursday. "Vaccinations remain highly effective at protecting against hospitalization."

Here is the Washington State Department of Health's recap of the highlights from its report:

• COVID-19 prevalence is at a new high. The current best estimate of prevalence is 0.94%, or about 1 in every 106 Washingtonians. The previous reported high was 0.64% in August 2021, or about 1 in every 156 Washingtonians. About 39% of the population remains susceptible to COVID-19 infection.
• Transmission continues to increase, but at a slower rate. On Sept. 2, the best estimate of the effective reproductive number (Re, which tells us how many new people each COVID-19 case will infect) was 1.14. On Aug. 6, this estimate was 1.49. A reproductive number above 1.0 means that cases will continue to increase. To see cases decline, the reproductive number needs to stay well below 1.0 for a substantial amount of time.
• COVID-19 deaths are increasing. The seven-day rolling average of deaths has increased rapidly, from 5-10 deaths per day in July to 27 per day by the end of August.
• Hospital admissions and occupancy for COVID-19 are still very high. After a peak of 190 daily admissions (seven-day rolling average) at the end of August, the current average has declined only slightly to 186. Both admissions and occupancy remain at very high levels. Although some recent declines are apparent as of Sept. 18, current occupancy levels still far exceed those observed during the previous highs of winter 2020.
• Hospital projections indicate high levels of admissions and occupancy for COVID-19 are likely to persist through the fall. The projections pose two scenarios based on increasing rates of transmission, one with a lower or “modest” rate, and another with a higher or “moderate” rate. Under these scenarios, hospital admissions by the end of December could decrease, or they could increase to between 141 and 240 admissions daily. The number of beds occupied through December could decrease, or they could increase to between 1,100 and 2,000 beds per day.

The state's biweekly reports are assembled with data from the Washington Disease Reporting System and modeling from the Institute for Disease Modeling and other regional partners. Read the full report on the DOH website.