Delta Fuels Another 48% Increase In King County COVID Cases

SEATTLE — The latest surge in COVID-19 infections continued to gain momentum in King County over the last week, and hospitalization rates are beginning to rise after several weeks of stability. However, hospital admissions remain lower than previous peaks, which officials credit to relatively high immunization rates.

Dr. Jeff Duchin, health officer for King County, hosted his latest briefing on the evolving coronavirus situation Thursday, honing in on a few areas of concern locally while providing some context about how the trends compare to other parts of the United States.

"Like much of the country, we are experiencing a delta-driven surge in COVID-19, with cases continuing to rise steeply in King County," he said. "Over the last seven days, we've seen an average of 344 cases per day, which is a 48 percent increase over the last week."

Duchin said King County was officially within the Centers for Disease Control and Prevention's substantial category for transmission by late July, and his office projects the county has since moved into the high transmission bracket.

"This is approximately twice as many cases as we saw at our peak last summer," he said. "Most of these cases are among the unvaccinated."

The health officer said case rates continued to rise across age groups, with the greatest increase among residents ages 18 to 49.

Hospitalization rates are rising, but they remain well below previous peaks

For hospitalizations, the health officer said recent data highlight a clear upward trend, with rates tripling since early July and new admissions averaging 62 per day over the last week. Admissions are also trending younger.

"Over one-half of our hospitalizations are in 40 to 69-year-olds, but rates are rising in the 25 to 35-year-old and 35 to 49-year-old groups as well," Duchin said. "The average age of hospitalized patients has dropped by about 10 years since January 2021, as more older adults have been vaccinated, and with changing social behaviors among the younger population."

While the trends are cause for concern, especially as hospitals across the region report they are near capacity, the health officer said it was important to note hospitalizations remain much lower than previous peaks, due in large part to relatively high immunization rates.

"Our current hospitalization levels are still only one-quarter of the fall/winter peak, and one half of the spring peak, and we continue to report a low number of deaths: Less than one per day on average since mid-July, which is down from an average of 10 deaths per day just before we initiated our vaccination program in December," Duchin said.

More people are seeking their first dose

Though mild breakthrough cases do occur in fully vaccinated people, the health officer said King County's latest surge continues to have an outsized impact on people without their full series of immunizations.

"For the 30-day period from June the 22nd through the 21st of July, 88 percent of COVID-related hospitalizations have not been fully vaccinated," Duchin said. "87 percent of COVID-related deaths are not fully vaccinated, and 75 percent of all cases are not fully vaccinated."

One encouraging sign in recent days is an uptick in people seeking vaccinations for the first time. Duchin said King County recently hit the 81 percent mark for residents 12 and older with at least a dose, and 76 percent have completed their series.

"Over the last seven-day period, 10,400 King County residents received their first vaccination," he said. "This is a 14 percent increase from our low point on July 20...and this is great news because it represents a reversal in our recent trend of fewer people seeking vaccination, and I hope this reversal is sustained."

King County's vaccination rates are climbing:

• Total population (all ages)
  • 70.3% with at least one dose
  • 65.3% with full series
• Residents 16 and older
  • 82.3% with at least one dose
  • 76.6% with full series
• All eligible residents (12+)
  • 81.4% with at least one dose
  • 75.6% with full series

Duchin credits the comparatively high immunization rates with greatly aiding King County in avoiding more significant impacts from the latest surge, which many communities are seeing across the country.

"Relatively high-level vaccination coverage in King County — especially among our older adults, with 88 percent of our adults over 50 years of age fully vaccinated — is providing a strong defense against what too many people in states across the U.S., and especially in Southern states, are experiencing, with explosive rates, overloaded emergency rooms and intensive care units, and a stressed health care system," he said. "Some states in the Southern U.S. with lower vaccination coverage have hospitalization rates that are five to 10 times higher than what we are currently seeing, and death rates 10 to 30 times higher."

Even amid the fifth wave of infections, Duchin said King County has the fourth-lowest hospitalization rates in the country and the second-lowest death rates. Still, the delta variant continues to pose unique risks compared to earlier interactions of the virus.

"We do have enough unvaccinated people to sustain a delta surge that will cause serious preventable infections, hospitalizations and deaths," Duchin said. "It's important to know if you're exposed to COVID-19 in King County right now, you're likely exposed to the delta variant. This virus is significantly nastier than previous COVID-19 viruses, and it's challenging us in new ways that we were not wanting to deal with this summer."

The added risk factors associated with delta are one reason why King County continues to recommend indoor masking, even in communities with high levels of vaccination coverage.

"Given the increase in cases and hospitalizations we've seen this week, I want to remind everyone of our recent directive that recommends everyone, regardless of vaccine status, wear masks indoors in public spaces," Duchin said. "This is an easy step we can all take to add an important extra layer of protection that helps people who aren't vaccinated, like children under 12, as well as people who have compromised immune systems. Universal masking in indoor public spaces provides a more reliable way to ensure everyone is staying safer in settings where it's not possible to verify an individual's vaccination status."

Officials say recent outbreaks illustrate continued risks in certain indoor settings

Other "layers of protection" health officials underline include being mindful of crowded areas with poor ventilation and taking several factors into consideration when evaluating personal risk, especially since it is difficult to know someone's vaccination status, and the virus can spread among people who do not know they are infected or are asymptomatic.

"Risk is additive, so the risks you take add up," Duchin said. "The more often someone does things that increase their risk, the more likely they will be infected. To lower your risk of COVID-19, do fewer risky things."

According to Public Health - Seattle & King County, three recent outbreaks illustrate the risks present in riskier settings, including one at an indoor music venue, where 26 cases were identified among 374 attendees at a concert in mid-July. While proof of vaccination was required at the door, officials said status was not verified for staff, masks were optional, distancing was impossible and ventilation was poor.

"You need to sort of understand individually how much risk you are willing to assume," Duchin said. "How important is it for you to go into a crowded bar where you don't know everyone's vaccination status, where you'll be in close proximity, where there may be poor ventilation? People can choose where to go. They can choose what bars to visit, what restaurants to visit, what businesses to visit, and they can make those decisions based on how safe those places seem. I think people will go where they feel more safe, and that's why you're seeing many businesses now require vaccination for their patrons and their employees."

To help limit further impacts of the surge, updated public health guidance asks anyone experiencing potential signs or symptoms to seek testing for COVID-19 as soon as possible, even if they are fully vaccinated. Anyone who has contact with a suspected or confirmed case should also get tested, whether or not they show symptoms, officials said. Those who test positive should isolate themselves from others for at least 10 days.

While much uncertainty remains, and potentially a few more "bumps in the road," Duchin said he remained confident the pandemic threat will recede over time.

"For now, our outbreak continues to evolve and our understanding is evolving, and our actions need to evolve as well to reflect the reality of our pandemic," Duchin said. "Delta denial is dangerous. I know that no one wanted to be grappling with more contagious COVID-19 variants this summer — I certainly did not. We have multiple effective ways to reduce the risk for all. We continue to be able to do the things we want and need to do more safely, and that's largely because of the high vaccination coverage we have here, relatively speaking. But at this time, vaccination alone is not enough, because not everyone can be vaccinated. We need to continue to use all the tools available to us."