King County's Omicron Surge Improves, Amid An Uncertain Future

SEATTLE — King County has kept up a steep decline in COVID-19 cases since the omicron surge peaked in January, and the latest metrics show promising signals that the worst of the wave could be in the rearview mirror.

Dr. Jeff Duchin, King County's health officer, hosted his first briefing in nearly a month on Thursday, bringing some cautious optimism as trends head in the right direction, but transmission remains stubbornly high.

Duchin said case counts have sharply declined across all age groups since peaking on Jan. 10, when the county averaged 6,400 daily infections. Over the last week, he said that number had fallen to 2,200 cases. The health officer cautioned that figure is still eight times higher than the average number of cases reported right before the omicron surge began.

"I really hope this decline continues and that we can move toward a more sustainable and less disruptive long-term strategy to limit the harm from this virus," Duchin said. "But for right now, there's still a whole lot of COVID-19 going on. Our hospitals continue to struggle to provide care to everyone, and it's still not possible to predict the course of the pandemic with certainty."

The health officer said hospitals across King County continue to struggle with a "massive ongoing strain," due to a mixture of high patient loads, critical staffing shortages, and a significant backlog in surgeries and other delayed health care, exacerbated by a 700 percent surge in COVID-19 patients over the omicron surge.

So far, hospitalizations are down roughly 20 percent from their January peak, Duchin said, but remain about six times higher than pre-omicron times, still averaging about 50 new admissions every day. Approximately one in six acute care beds and one in five ICU beds are occupied with COVID-19 patients.

To alleviate some of the stress, and help preserve lifesaving care, Duchin recommended people avoid non-emergency visits to emergency rooms, including for illnesses with mild symptoms, and keeping up to date with routine checkups at primary health care providers to lessen the chance of needing more advanced care.

County health officials also encourage people to upgrade their face coverings, utilizing N95, KN95 or KF94 respirators if possible, as another layer of protection, along with seeking out booster shots.

To that end, Duchin said a considerable age gap remains for boosters and third doses, with the vast majority of seniors having received one, compared to a much smaller portion of younger age groups. The health officer said the availability of same-day appointments for vaccines and boosters has improved in recent weeks.

Boosters and third doses by age group:

• 65+: 85%
• 50-64: 60%
• 35-49: 50%
• 18-34: 34%

Boosters may prove vital in limiting the effects of future variants and mutations, including BA.2, a close relative of omicron. While there are plenty of unknowns to contend with, Duchin said early data is promising that existing vaccines and boosters will hold up against BA.2, even if it's more infectious.

"The preliminary data for other countries where BA.2 has become common suggest that it spreads even more effectively than BA.1, which is the cause of the current outbreak in the U.S. — these estimates are 20 to 30 percent more transmissible," Duchin said. "The good news though is that BA.2 does not appear to cause more severe illness, and that our current vaccines, especially with the booster dose, appear to protect well against both BA.1 and BA.2 omicron viruses."

The high level of infections in the recent surge may help guard against another large wave, Duchin said, but BA.2 could prolong the current situation and also pose an even higher risk to those who remain unvaccinated.

"It's not clear what the impact of BA.2 will be on the omicron surge, whether it will prolong its tail, or perhaps lead to a second peak, or have no detectable impact at all," Duchin said. "To some extent, this will depend on whether people who have been recently infected with BA.1 during our large omicron surge are well protected against BA.2. Even if so, infections would generally be expected to not be severe. On the other hand, people who are unvaccinated and not recently infected would be at a similar or even higher risk for infection with BA.2, and for that reason, for hospitalization and death as well."

In closing, Duchin said King County was in a much better place, with more people becoming vaccinated and boosted and with more effective treatments on the horizon. At the same time, the health officer said the usual precautions would remain necessary, especially as thousands of people continue to be infected and hundreds are hospitalized each week.

Those layered precautions are the same things that have been recommended for months, like improving indoor ventilation and air quality, wearing high-quality masks, limiting time spent in crowded indoor areas, and isolating and testing when exposed or experiencing symptoms.

While the exact route back to normalcy remains unclear, Duchin said he was confident better things are ahead.

"Looking ahead, it's reasonable to expect high levels of vaccination with boosters, plus recent post-infection immunity in the population, could protect against another major surge coming soon. We don't know how long immunity from omicron will last or how well it or current vaccines will protect from future variants. So that limits what we can say with certainty.

But over time, population immunity from vaccination plus natural infection should lessen the impact of COVID-19 significantly. Increasing access to improved treatments will also help a lot. If we're lucky, the virus won't deal us a new, highly-transmissible, severe, immunity-evading variant. But there's no guarantee that future variants will be mild.

For this reason, we need to build COVID resilience and better future preparedness for COVID-19. The long-term trajectory of the COVID-19 pandemic will bend toward something we can manage successfully as part of our routine lives. But exactly how long it takes to get there, and what unanticipated bumps in the road might lie ahead, remain uncertain."