Editor’s Note:An early version of this story reported that the first Omicron case detected in the United States has been changed from Dec. 15 to Nov. 15.
[OLYMPIA, Wash.] – (MTN) The Washington State Department of Health (WSDOH) reported the 7 day moving average for new COVID cases had jumped to 1,047.9 over the weekend, obliterating previous records. There were 1,773 people hospitalized with COVID across Washington on Sunday, just shy of the previous record set on Sep. 6, 2021.
With an estimated 242 new COVID-related hospitalizations a day, hospitals in the Evergreen State are on the brink of running out of beds and staff. The I-5 corridor from the Canada border to the Columbia River has the highest case rates in Washington, sparked by several super spreader events in Thurston and Pierce Counties on Dec. 4.
COVID cases have exploded in Eastern Washington, including Spokane, Yakima, and Moses Lake. New cases are forecasted to peak in King County by the end of this week but are expected to continue to surge in Eastern Washington.
The updated IHME forecast model is catastrophic for Washington, projecting 3,189 acute care and 804 ICU patients hospitalized with COVID by Feb. 4. Malcontent News estimates there are 375 staffed acute care and 95 ICU beds available in Washington state, with a coming surge of 2,000 more patients in less than a month.
The Washington State Hospital Association made dire predictions last week. Dr. Francis Riedo, medical director for infection control and prevention at EvergreenHealth in Kirkland, told reporters that the state has “never been closer” to moving to crisis standards of care.
In the same briefing, Dr. John Lynch, medical director of Harborview Medical Center’s infection control program, said that UW Medicine and Harborview Medical Center had more COVID patients under care than at any previous point in the epidemic.
The situation is already dire for Puget Sound hospitals, will more than 97 percent of acute care beds occupied. King County Public Health reported 255 new COVID hospitalizations from Friday to Sunday – a rate of a new hospitalization once every 28 minutes. Hospitalizations in King County have surged 110 percent in a week as new cases skyrocket.
Earlier projections based on case data from South Africa and the United Kingdom estimated that King County hospitalization rates would be by 20% to 30% from the previous Delta wave. Projections reduced the percentage of COVID cases that resulted in hospitalization from 4.7% to 1.14%. Based on data from the first week of January, the rate is almost double – 2.13% – driving hospitalizations to a higher level than previously forecasted.
EvergreenHealth in Kirkland reported 44 hospitalized COVID patients, including one pediatric patient and another four in Monroe. A majority, 70 percent, were hospitalized due to COVID. The remainder is hospitalized for other reasons and co-infected with coronavirus. Five patients are fully vaccinated with boosters, including one in intensive care.
On Monday night, Seattle Children’s Hospital advised parents that its four walk-in urgent care clinics would not accept patients without an appointment due to the unprecedented patient load.
The Washington State Medical Association appealed to Gov. Jay Inslee to declare a crisis and deploy the national guard to support area hospitals. Previous options, including stopping elective surgeries, limiting day procedures, and “boarding” patients in emergency departments, are already being done.
“The time has come to admit that stopping electives and non-urgent care is not enough. We must declare the crisis that our health system is in,” the Jan. 6 letter stated. Cassie Sauer, the Washington State Hospital Association CEO, also signed the letter.
Unlike Idaho, Montana, and Alaska, which had to use crisis standards of care last fall, Washington state will not allow a single facility to move to the emergency protocols. The declaration would come from the state and only occur after all possible options to extend services were exhausted. Under crisis standards of care, patients could be denied care based on need, survival chances, and available resources. Washington developed computer software with Massachusetts and Wisconsin to determine who would receive care. Last week, Oregon announced it was adopting the same computer program.
The physical, mental, and emotional toll of two years of a COVID crisis has decimated the ranks of hospital workers across the country. Omicron is highly contagious and has significant vaccine escape, resulting in hospital workers being sickened. As hospitalizations have surged in the first ten days of January, the number of staffed beds available has slowly declined.
On Thursday, leadership at MultiCare, which runs 11 hospitals across Washington state, reported they had moved to crisis staffing standards in Western Washington. The standard, announced by the United States Centers for Disease Control (CDC) on Dec. 23, can require workers who are sick with COVID to continue to work if necessary to continue to provide patient care.
The Omicron variant arrived in the United States on Nov. 15 and has shattered all previous records for new cases, daily new hospital admissions, and total hospitalizations. One model projects that nation will face another 300,000 hospitalized with COVID by the middle of February, an impossible task for all existing hospital resources.
Knowledge is the best tool to fight against fear. A wise person chooses to be informed so they can make sound decisions. To join the fight against COVID misinformation, you can share this update through your social media platform of choice.
[KIRKLAND, Wash.] – (MTN) Health officials and researchers are in a race against time to unlock the secrets of the Omicron COVID variant and its potential impact on public health as more nations report discovered cases.
Washington state is one of the leaders in genomic sequencing of COVID tests samples in the United States, led by the University of Washington Medicine. Standard PCR tests can detect a marker for a potential Omicron variant. Omicron shares a mutation with the Alpha variant that the current PCR tests look for, enabling researchers to see if a specific spike protein has a deletion. That would become a probable case that would be tagged for confirmational sequencing.
President Joe Biden addressed the nation on Monday saying, “there are three messages about the new variant that I want the American people to hear. First, this variant is a cause for concern, not a cause for panic.”
The President went on to praise South African officials and their scientific community for, “the kind of transparency that should be encouraged and applauded.”
Currently, in Washington, 99.6% of new COVID cases are the Delta variant, and 0.4% are Mu. The last cases of the Beta, Epsilon, Eta, and Kappa variants were detected in June and the last cases of Gamma and Iota were in August.
“Omicron has an unprecedented number of spike mutations, some of which are concerning for their potential impact on the trajectory of the pandemic,” the WHO said in a statement today.
“The overall global risk related to the new variant …is assessed as very high.”
On Sunday, Dr. Angelique Coetzee told South Africa Today, “Most of these cases are mild whether they are vaccinated or not. There is no increase in our hospital admissions currently.”
Hospital admission for COVID-19 by week, South Africa Gauteng Province, Public and Private Hopsital, through November 28, 2021
Less than 12 hours later, the hospital admission data from the South Africa Department of Health painted a very different picture. In the previous week, COVID hospitalizations had increased 66% nationwide and 210% in Gauteng Province, the epicenter for Omicron cases. Two weeks ago 135 Covid-19 patients were hospitalized in and around Johannesburg jumping to 580 on Monday morning. Hospitalizations at public and private hospitals increased almost equally and officials at Baragwanath Hospital reported moderate to severe symptoms with almost all patients unvaccinated or partially vaccinated with the Pfizer vaccine.
Dr. Coetzee in her interview on Sunday went on to take a more cautionary position, “Two weeks from now we might say something different, but we urge…people out there please get vaccinated, listen, do the right thing, and stop going to big gatherings.”
She also added the unvaccinated should be worried, saying, “especially if you are above the age of 50, we have seen this many times.”
“There is a saying. You’re not safe until everyone is vaccinated.”
The 7 day rolling average for new COVID cases in South Africa grew to 2,275 on Monday, 90% of new cases are Omicron, and 10.8% of tests are coming back positive
The WHO appeared to address the reports from Dr. Coutzee and her reports on the severity of the new variant in a statement last night. “There is currently no information to suggest that symptoms associated with Omicron are different from those from other variants.”
The statement added, “Initial reported infections were among university students—younger individuals who tend to have more mild disease—but understanding the level of severity of the Omicron variant will take days to several weeks.”
Dr. Coetzee saw her first suspected Omicron variant patient on November 18 and has based her statement of symptoms being mild on two-dozen patients who are mostly university students and younger, and about 50% vaccinated. In an interview with the BBC on Thursday, she stated all were in good health with no comorbidities.
Although she is credited and has self-proclaimed to have “discovered” Omicron, the first detection of the B.1.1.529 variant was collected on November 9 in Botswana and confirmed by South African scientists on November 11. South African officials notified WHO on November 24, a day before Dr. Coutzee stated she contacted South African authorities on her observations.
Despite a lot of unanswered questions, a clearer picture is slowly starting to emerge. The three riddles scientists need to solve are how contagious Omicron is compared to the Delta variant, can it escape public health measures, preventions, and treatments, and if the symptoms are the same, worse, or milder than previous variants.
Here is what is currently known about the Omicron COVID variant.
Symptoms
For children, adolescents, and young adults there is conflicting information. One doctor is reporting mostly mild symptoms that can be treated at home while hospital officials are reporting cases are similar to Delta.
The WHO stated on Sunday, “There is currently no information to suggest that symptoms associated with Omicron are different from those from other variants.”
Transmissiblity
Concern is growing among the CDC, WHO, and a constellation of health officials that Omicron is highly transmissible. At least equal to Delta and possibly higher.
In less than two weeks, Omicron went from almost non-existent to 90% of new cases in South Africa. It appears it can effectively outcompete the Delta variant. However, this introduces bias in the data because the Delta wave had just ended in South Africa. Did Omicron become the dominant strain by outcompeting Delta or due to the absence of Delta? More research needs to be done to answer that question.
There are other variables that could explain the sharp increase in cases that go beyond the simple reproductive number, known as R0. Omicron has so many more mutations than previous strains, it could be benefiting from immune escape. Although the R0 is lower than Delta, its uniqueness compared to previous mutations enables it to reinfect people relying on natural immunity. So overall transmissibility may be lower than Delta, but its ability to escape immunity results in more infections.
Is it in the United States
Cassie Sauer, CEO of the Washington State Hospital Association said on Monday, “I think that there is almost no chance that it’s not [here.]”
The United States does not have a national standard or requirement to genetically sequence some or all COVID tests that come back positive. Those decisions are left up to individual states. It is likely that states with aggressive public health programs such as California, Washington, Colorado, New York, or Massachusetts will identify the first cases.
How long do researchers think Omicron has been circulating
Dr. Trevor Bedford from Fred Hutchinson in Houston, Texas successfully estimated the arrival of the original COVID strain in 2020, using data from the Washington State Department of Health. Using the same methodology, Dr. Bedford’s model indicates that Omicron likely started circulating between September 19 and October 21. There is no evidence to support that the variant originated in South Africa.
Credit – Dr. Trevor Bedford, Fred Hutchinson, Houston, Texas – probability of origin date for Omicron variant
Why are so many travelers testing positive
In total numbers, there aren’t many travelers testing positive. When you consider that in all but two cases the testing of 200 to 250 people on an aircraft has yielded one or two positives, the percentage of breakthrough cases is small. Headlines are blaring two positive cases detected, which is critical to know – they aren’t blaring 248 negative tests on 777 that landed tonight.
Because the people tested are 95% to 100% vaccinated, this creates a false data fallacy. You have an almost exclusive sample of vaccinated people.
In South Africa, the Department of Health has reported almost everyone hospitalized in the last two weeks is unvaccinated or only partially vaccinated. Dr. Coetzee reported 12 of 24 patients she cared for were unvaccinated.
Based on this early data, it appears the current vaccines remain at least moderately effective at preventing infection and remain very effective at stopping moderate to severe COVID.
Are the current vaccines ineffective
There isn’t enough data, and almost every public company making a vaccine announced over the weekend they were testing their current versions against Omicron. Pfizer, Moderna, and Johnson & Johnson announced over the holiday weekend they were testing to see if the current vaccines remained effective.
There is some data out of South Africa that is indicating that vaccines are helping prevent moderate to severe illness and the cases being detected among vaccinated travelers appear to be asymptomatic to mild. However, many of those cases were detected in the last 72 hours and more time is needed to see how these new cases will progress.
In Israel, the first three travel-related cases were fully vaccinated with boosters. One was Pfizer, one was J&J, and one was AstraZeneca. We know that the viral-vector vaccines haven’t performed as well against the Delta variant as the mRNA vaccines.
The evidence suggests that there is more vaccine escape with Omicron, but not outright vaccine ineffectiveness. It still appears to be preventing hospitalizations, which would indicate it would prevent deaths.
Pfizer said they could make a new version if required in 100 days and Moderna said it would take 60 to 90 days. Johnson & Johnson did not provide a timeline but made a statement today they could create an updated version if it was required.
There are some new COVID vaccines in development called subunit vaccinations. There has been no information about the impact Omicron will have on the research.
Is disease acquired immunity still effective
There is growing evidence that immunity gained from a previous COVID infection that isn’t supported by vaccination, is experiencing significant breakthrough numbers.
Researchers are working to determine if the sharp increase in the number of cases and the high positivity rate of tests is due to Omicron being equally or more transmissible than Delta, or if part of the increase is being driven by other factors.
The pattern of mutations found in Omicron is very distant from all previous strains.
Are monoclonal antibodies still effective
There is evidence that Omicron has a significant ability to resist monoclonal antibodies. Specific mutations may have the capability to not only bypass B cells but resist T cells (which isn’t the same as HIV which destroys your T cells).
UW Medicine is evaluating the performance of currently available antiviral treatments and we will know more information in the coming weeks.
Will the new antivirals that are pending approval still be effective
There was a report from Pfizer on Monday morning that Paxlovid is effective against the Omicron variant, which is very good news. This is easy to administer than monoclonal antibodies, easier to distribute, and cheaper.
Nothing has been stated about Monulpiravir from Merck. The FDA will be considering the EUA request this week but there are hints they will label Monulpiravir a Class C drug if the EUA is granted. A Class C drug can’t be used by pregnant women, women actively trying to get pregnant, and nursing mothers because the drug has not been tested to determine if it causes birth defects or pregnancy complications. The FDA has already requested data for Merck to understand the impact better.
What should I do
Health officials recommend you continue to do the same things you are doing now. Get vaccinated if you’re not already. Get a booster shot if you’re eligible, and over 2.4 million Washingtonians are currently eligible. Wear a mask, wash your hands, avoid crowded indoor spaces, and reconsider your short term travel plans if you were planning to fly.
Knowledge is the best tool to fight against fear. A wise person chooses to be informed so they can make sound decisions. To join the fight against COVID misinformation, you can share this update through your social media platform of choice.
[KING COUNTY, Wash.] – (MTN) Washington won’t know how many state employees, firefighters, law enforcement officers, health care providers, and teachers got vaccinated until November, but the predictions of a vaccine mandate caused employment apocalypse appears to be untrue.
Multiple local, county, and state agencies, police and fire, and universities reported 91% to 99% vaccination rates across the state. Approved exemption rates ranged from 1% to 7%, although an approved exemption may not ultimately lead to approved accommodations.
The last available data from the City of Kirkland indicated 70% of firefighters were vaccinated on October 5, a similar vaccination number statewide for all employees and closely mirrored the public vaccination rate at that time.
Thurston County Superior Court rejected a last-ditch attempt by dozens of state workers to block the state vaccine mandate. At the same time, Spokane firefighters filed a fresh lawsuit against the City, Mayor Nadine Woodward, and Fire Chief Brian Schaeffer for wrongful termination.
Seattle Mayor Jenny Durkan reported between providing proof of vaccination and approved exemption requests, more than 99% of city employees, including the fire and police departments, met today’s deadline. Only 16 firefighters and 24 police officers provided no documentation. Another 99 police officers have approved exemptions but have been denied accommodations. Those officers will not be automatically terminated. Up to 123 officers could face a “Loudermill Hearing” in the coming weeks, where their ultimate employment status will be decided.
Over the weekend, it was announced SPD would operate on a modified phase 4 emergency schedule of six 12 hour shifts for all officers. That was walked back today, with city officials indicating the department might operate on a modified phase 3 emergency schedule if it is required.
Multiple hospital systems reported vaccination rates from 95% to 99% across the state. One rural hospital in Moses Lake reported being walloped by an “exodus” of non-clinical facing employees today.
About 100 anti-vaccination mandate protesters with Waking Up Washington gathered outside Seattle City Hall for two hours of speeches and then marching through downtown. Some held Nazi-themed signs, and at least one speaker called for civil war.
The Seattle Police Department tweeted that the Seattle Office of Police Accountability had been notified about on-duty SPD officers waving a Gadsden flag from a cruiser and others honking and giving thumbs up in a show of support to anti-vaccination mandate protesters.
Washington State University football coach Nick Rolovich had his last-minute religious exemption rejected by a WSU review board and was fired with cause, along with four assistant coaches.
Seattle Public Schools expects 25% of student bus routes to remain cut for the foreseeable future due to existing staffing shortages made worse by vaccination mandate. The Washington State Department of Transportation also expects ferry service to operate on revised schedules but doesn’t foresee additional cuts to service.
We maintain our recreational travel advisories for Eastern Washington and our nonessential travel advisories for Alaska, Idaho, Montana, and Wyoming.
Washington State Update for October 18, 2021
Washington state Covid-19 update
As of 5:30 p.m. today, the state of Washington has not updated the COVID-19 dashboard. To support an 8 p.m. press time, we will publish today without updating cases and hospital status.
Thurston County judge denies last ditch attempt to block statewide vaccine mandate
In Thurston County Superior Court, a prosecutor argued that the vaccine mandate implemented by Washington overstepped the bounds of law and should be blocked. Superior Court Judge Carol Murphy disagreed with that point of view. However, she did not rule on the merits of the mandate.
“Even if the individual plaintiffs show that individual instances in which the proclamation and the resulting actions may be unjust, the plaintiffs have not met their burden to show that is unjust in all applications,” Judge Murphy said.
25 Spokane firefighters file wrongful termination lawsuit over vaccine mandate
Court documents show 25 firefighters filed a lawsuit against the city of Spokane, Mayor Nadine Woodward, and city Fire Chief Brian Schaeffer, according to a report by KREM.
According to documents, the firefighters sued for wrongful termination for failing to get vaccinated before the October 18 mandate. This is the second lawsuit filed by Spokane firefighters related to the mandate.
The COVID-19 vaccine mandate proclamation was issued by Washington Governor Jay Inslee on September 27, 2021. The declaration stated that all healthcare, education, and state employees must be fully vaccinated by Oct. 18, or they could be terminated.
Less that 200 City of Seattle employees ignore deadline to comply with vaccination mandate
For the City of Seattle, 94% of all employees provided proof of vaccination, 5% formally requested an exemption, and approximately 150 had not responded. For exemption seekers, if the city denies a request, many unions negotiated to provide the option to get vaccinated after October 18. Final numbers won’t be available until early November.
Among the fire department, 93% are fully vaccinated, 6% have requested exemptions, and 16 employees have not submitted any information. The Seattle Fire Department union also negotiated for employees to get vaccinated after October 18 if an exemption request is rejected.
The Seattle Police Department reported 91% of all employees were vaccinated, with 7% requesting exemptions and 24 refusing to submit any data. The Seattle Police Officer Guild and union president Mike Solan declined to negotiate with six other unions, potentially leaving officers with little recourse if their exemption requests are rejected.
An “unofficial” website claiming not to be associated with the Seattle Police Officer Guild, while using common language from union president Mike Solan, advised officers not to provide their vaccination status information before October 18. On Sunday, 130 officers had not provided any information. Jason Rantz and Mike Solan were accusing the Mayor’s office of “spin” this afternoon.
According to Rantz, 99 officers have approved exemption, but the city is unwilling to make accommodations. However, the talk radio entertainer indicated that the Seattle Police Officer Guild could continue negotiating with the city in good faith.
If you will forgive us for our spin, Rantz’s attempt to portray 24 officers being terminated as making “this city even more unsafe…with escalating violent crime and sky-high 911 response times“ reads like spin to us.
The City of Seattle has indicated that SPD could be on a modified Phase 3 plan tomorrow if required.
University of Washington Medicine Reports 99.2% vaccinated as deadline arrives
“This last week, we lost almost our entire materials management department … specifically to the mandate,” said Dr. Andrea Carter, chief medical officer for 50-bed Samaritan Healthcare in Moses Lake.
Materials management handles ordering supply, such as personal protective equipment, for staff. Before that, Carter added, the hospital lost seven workers to the mandate. “We rely fairly heavily on staffing agencies where we’re at. We don’t have a huge pool of staff, otherwise. And with the cost of those staffing agency contracts, that is hurting us a little bit,” Carter said.
Washington State Hospital Association anticipates 95% to 98% of all medical workers to provide proof of vaccination by today
Ms. Sauer also indicated she expects 95% to 98% of all impacted hospital workers to be vaccinated by today’s deadline and thinks the number could be even higher. Management at the various facilities across Washington doesn’t expect the numbers to be even, with rural hospitals in Eastern Washington expected to see more impact from today’s mandate.
Final numbers aren’t expected until early November. If results from other hospital systems are an indication, likely, at least some people refusing to get vaccinated will ultimately decide to take action that preserves their job.
About 100 protesters gather at Seattle City Hall and march against the vaccine mandate
Approximately 100 protesters gathered outside of Seattle City Hall at noon today to protest against the state vaccine mandate. About a dozen children were among the adults taking part in a “stay out of school” initiative.
The protest was peaceful, while speakers shared disinformation and conspiracy theories. At least one speaker who claimed to be a US Army veteran called for civil war. Several protesters held signs comparing the vaccine mandate to Nazi atrocities.
An anti-vaccine mandate protester with Waking Up Washington speaking at Seattle City Hall holding a sign making Nazi comparisons – photo credit Christina Val
Around 2:30 p.m., the group took the streets of Seattle, while Turning Point USA firebrand Katie Daviscourt attempted to lead the group to march in the street against traffic, telling people, “we have the numbers.”
Most in the group were disinterested in blocking traffic, although marchers briefly blocked an ambulance downtown.
There was not an active counterprotester presence, but the marchers were jeered for their Nazi-themed signs, including several people who claimed to be Jewish and expressing outrage at the comparison.
Seattle Police Department refers reports of officers supporting anti-vaccine mandate protest and waving Gadsden flags to OPA
During today’s anti-vaccine mandate protest, at least two marked and one unmarked City of Seattle Police vehicles with uniformed officers circled City Hall, honking and giving thumbs up. Another vehicle with uniformed officers was witnessed waving a “don’t tread on me” Gadsden flag associated with anti-government movements.
Multiple citizens complained to the Seattle Police Department and on social media, resulting in a surprisingly swift response from the department over Twitter.
“The official position of SPD is vaccines save lives. If you believe you’ve witnessed inappropriate behavior by officers and have add’l info, please contact @SeattleOPA. We’ve forwarded this, and another incident involving the use of the Gadsden flag on police vehicles, to OPA.”
Seattle Police tweet about multiple incidents involving uniformed SPD officers engaging in anti-vaccine mandate protest on duty
Nick Rolovich and four assistant coaches fired by Washington State University
Washington State football coach Nick Rolovich has been fired for cause after refusing to take the COVID-19 vaccine and being noncompliant with both state and university policies, the university announced Monday evening, according to CBS Sports. Rolovich sought, and appears to have been denied, a religious exemption from those mandates, which required employees be vaccinated against COVID-19 by Oct. 18 if they wished to continue working.
Additionally, four Washington State assistant coaches were terminated: Ricky Logo (defensive tackles), John Richardson (assistant head coach, cornerbacks), Craig Stutzmann (co-offensive coordinator, quarterbacks), and Mark Weber (offensive line).
Defensive coordinator Jake Dickert will serve as the team’s interim coach.
“This is a disheartening day for our football program. Our priority has been and will continue to be the health and well-being of the young men on our team,” said athletic director Pat Chun in a statement. “The leadership on our football team is filled with young men of character, selflessness, and resiliency, and we are confident these same attributes will help guide this program as we move forward.”
Rolovich was the highest-paid public employee in Washington state, making approximately $3.3 million a year as the head coach of the Washington State University Cougars. Rolovich was the coach for barely a season, despite serving for two years, including the Covid-19 shortened 2020 season, and for seven games in 2021.
It has not been reported if Rolovich will continue to draw part or all of his 2021 salary despite the termination with cause.
142 City of Seattle school bus routes cut – 25% of all transportation
With a combination of existing recruiting issues before the start of the 2021 school season, pay well below the low-income level in Seattle, and loss of drivers due to the vaccine mandate, parents, were left scrambling to fund school transportation for 6,700 students.
KING 5 reported students who will continue to receive uninterrupted bus service include those receiving special education services including transportation, students experiencing homelessness and foster students, students with a 504 plan that includes transportation services, schools that serve historically underserved students, and schools at interim sites.
KIRO 97.3 FM Geen and Ursula reported the starting salary with the company that the city contracts with to transport pupils, First Student, offers starting pay of $24 an hour – about $31,000 a year. A family of four living in Seattle that earns less than $72,000 a year was considered low income in 2017. That number has only gotten worse in the last four years.
Seattle Public Schools and First Student indicated the route cuts would be indefinite until more drivers could be hired. According to Gee and Ursula this morning, the city is considering options with King County Metro.
Travel Advisories
Due to increased acute care hospitalizations, we’re maintaining our recreational travel advisory to the East Hospital Region, including Adams, Asotin, Ferry, Garfield, Lincoln, Pend Oreille, Spokane, Stevens, Wahkiakum, and Whitman counties. Acute care and ICU capacity remain limited, and the ratio of Covid-19 patients to other hospital patients is exceptionally high. Please reconsider nonessential travel plans to these counties.
With the announcement that Spokane officials have requested additional federal resources to support local hospitals, the travel advisory will likely continue through the 2021 holiday season.
We strongly advise against all nonessential travel to Alaska, Idaho, Montana, and Wyoming. Hospital resources in these regions are constrained, and you may receive inadequate care in Alaska, Idaho, and Montana if you experience a serious medical emergency.
We are not adding a travel advisory for the Northwest Hospital Region, which includes Clallam, Jefferson, Kitsap, and Mason counties but don’t recommend engaging in risky recreational behavior on the Olympic Peninsula. Although hospitals are very constrained, the region is adjacent to the Puget Sound and West Hospital Regions, with adequate resources.
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Vaccination
No update
King County, Washington is reporting over 87.3% of age eligible residents are vaccinated with at least one dose. The highest rates of positivity are in areas with low vaccination rates statewide. The FDA has provided full approval of the Pfizer vaccine for anyone 16 and over and EUA approval for the Moderna and Johnson & Johnson vaccines.
COVID vaccines are free for anyone over 12 years old, and no appointment is necessary at most locations. Lyft and Hopelink provide free transportation, and KinderCare, the Learning Care Group, and the YMCA offer free childcare during vaccination appointments or recuperation.
Knowledge is the best tool to fight against fear. A wise person chooses to be informed so they can make sound decisions. To join the fight against COVID misinformation, you can share this update through your social media platform of choice.
[KIRKLAND, Wash.] – (MTN) Washington state set a new hospitalization record as COVID cases continue to grow. The Delta variant represents 98% of all cases in Washington state. The CDC released a study that examines breakthrough cases and hospitalizations from May to July, that provides a better understanding of vaccine effectiveness.
Washington state continues to set new records as cases and hospitalizations continue to rise. Through August 11, the 14 day rolling average Washington is recording 437.9 COVID cases per 100K. This breaks the record high that was set yesterday. New cases continue to grow exponentially, doubling every 7 to 10 days. The number of people seeking COVID tests has increased 20% to 50% in the last month throughout King County.
Washington State Newly Diagnosed COVID Cases per 100K During the Prior Two Weeks Through August 11, 2021
The Washington State Department of Health reports a data backlog for test positivity, with the published number 14 days old. According to Johns Hopkins University Medicine, the positivity rate for the last 30 days is 11.71%, and over the previous 7 days, 12.92%. We continue to see widespread transmission in the state, with a slight decrease in the 7-day average.
The 7-day moving average for COVID-related deaths has increased to 7 per day. It is important to note that fatalities are a trailing indicator that usually increases two to four weeks after hospitalizations begin growing.
Washington State University football coach Nick Rolovich, the highest-paid public employee in the state of Washington, says he will follow the state’s COVID vaccine requirement. He had previously said he would not get a vaccine due to personal reasons, even after WSU announced they would require vaccines. When asked about having to get vaccinated his only statement was, “It is what it is.”
On Pac-12 media day. Rolovich said, “I’m not against vaccinations, and I wholeheartedly support those who choose to be vaccinated, including our players, staff, and coaches… I think we all know this virus is deadly, and these vaccines are free. I urge everyone to consider being vaccinated. I do.”
From May 3 to July 25, Delta went from 2% of COVID cases to 80%, and New York City dropped mask mandates and occupancy restrictions.
CDC MMWR for August 18, 2021, Vaccine Effectiveness in New York City from May 3 to July 25, 2021
The small dashed line on the top of both charts represents overall vaccine effectiveness in preventing new COVID cases and preventing hospitalizations. The dash-dot line represents how many people have been vaccinated. The dashed line represents the total number of infections and hospitalizations among the unvaccinated. The solid line represents the total number of cases of infections and hospitalizations among the vaccinated, and the dotted line between them is the average between the two lines.
The study indicated that overall age-adjusted vaccine effectiveness dropped from 91.7% to 79.8% as the Delta variant became the dominant strain. In contrast, hospitalizations moved in a narrow range of 91.9% to 95.3%. The report states, “Currently authorized vaccines have high effectiveness against COVID-19 hospitalization, but effectiveness against new cases appears to have declined in recent months, coinciding with the Delta variant’s increase.”
It is important to remember that no vaccine is 100% effective and there is strong evidence that COVID vaccinations lessen the severity among those who get an infection, and vaccinated individuals have dramatically lower mortality rates compared to the unvaccinated.
Appreciation goes to Dr. Katrine Wallace, P.hD of the University of Illinois, Chicago, for bringing this study to our attention.
Almost two million Washingtonians who are vaccine eligible remain unvaccinated. The group Find a COVID Shot WA can assist anyone who needs help making an appointment. The group of 75 volunteers has been operating since the beginning of 2021 and offers support in 20 languages.
King County, Washington is over 80% vaccinated, and Washington state is over 70%. The highest rates of positivity are in areas with low vaccination rates statewide. The FDA is expected to provide full approval to the Pfizer vaccine next month.
COVID vaccines are free for anyone over 12 years old, and no appointment is necessary at most locations. Lyft and Hopelink provide free transportation, and KinderCare, the Learning Care Group, and the YMCA offer free childcare during vaccination appointments or recuperation.
Washington state reached an all-time high for COVID hospitalizations, surpassing the December 2020 peak, with the Delta variant representing 98% of cases. The Washington Hospital Association CEO Cassie Sauer reported there were 1,240 hospitalized patients with COVID-19. This number does not align with the Washington State Department of Health data, and we have reached out to understand the difference in numbers.
On August 18, 85.7% of available acute care beds in Washington state have patients. The data indicated there were 1,285 acute care beds available statewide and 314 in King County. The West, Central, South Central, and East Regions were over 80% utilization. According to the Washington State Department of Health, there are 1,205 COVID patients in acute care, an increase of 31 since yesterday. 13.4% of all hospitalized acute care hospital patients are being treated for COVID. More than 20% of acute care patients in The West Region, which includes Pierce County, are hospitalized with COVID. This indicates that the hospitals in that region are under stress.
Washington State Hospital Acute Care Beds Occupied by Patients – August 18, 2021
Statewide ICUs were 85.5% occupied with 176 staffed beds available. King County has 56 ICU beds available. The number of COVID patients in the ICU dropped to 342 patients.
Washington State ICU Patients with COVID – August 18, 2021
Washington state continues to have a critical shortage of blood, with a less than 24 hour supply for five out of eight blood types. The situation has deteriorated since August 3. There will be a blood drive in Kirkland on August 30 and 31. We will publish additional details when they become available.
The West Region, which includes Tacoma, is down to 11 available ICU beds and almost 2 out 5 ICU patients are fighting COVID. in the more rural North Central District, 45% all ICU patients are hospitalized with COVID.
With the epidemiological curve doubling every 7 to 10 days, our hospital system is in danger of being overrun.
Yesterday we reported on Governor Inslee’s directive requiring all employees and contractors working for private K–12 schools and public K–12 school districts, charter schools, and educational service districts to be fully vaccinated by October 18, 2021. Due to the overwhelming amount of news yesterday, we cut the story short. The vaccine directive includes most of Washington state’s childcare workers.
The mandate includes employees, contractors, and volunteers working in licensed and licensed-exempt childcare centers and in early learning and youth development programs. Individuals that provide babysitting services to friends, neighbors, or direct family members from the same household are exempt.
Employees must provide proof of vaccination by showing their vaccine card, certificate of COVID-19 vaccination, or Washington State Immunization Information System printout. Individuals cannot use attestation as proof of immunization, and daycare providers cannot opt-out.
Individuals who have a medical condition, have been recently infected with COVID, and are under recommendation not to get a vaccination for 90 days, or who have a genuine and deeply held religious exemption can apply with the state. State officials said anyone applying for an exemption will be rigorously vetted and personal and philosophical reasons are not allowed.
FACT CHECK: In 1905, the United States Supreme Court decided that the states have the power to mandate vaccinations (Jacobson v. Massachusetts, 197 U.S. 11 (1905)). Last week, Trump appointed Supreme Court Justice Amy Comey Barrett, denied an appeal from students at Indiana University to block the school’s vaccine mandate. Because the Supreme Court was not in session, enabling Justice Comey Barrett to render a decision independently. A three-judge federal appeals court panel, including two judges appointed by former President Donald Trump, previously sided with Indiana University to require vaccinations.
To comply, employees need to have their second mRNA vaccination dose or the single-dose Johnson & Johnson vaccine by October 4, 2021.
Kirkland-Bellevue-Woodinville
We will be featuring area businesses that require vaccinations for their customers and require their staff to be vaccinated. The Lounge at DeLille Cellars is a place where you can enjoy wine by the glass and bottle with hand-crafted fare from Executive Chef Michael C. Toni. Located in Woodinville, they offer light bites for sharing to salads, sandwiches, entrees, such as steak frites and fresh pasta made daily.
No promotional consideration is given. If you have a business that requires proof of vaccination and you’re located on the eastside, send an email to tips@malcontentment.com. We’ll feature a new business here every day.
Burnout among nurses is reaching a crisis in the United States. Now dealing with the fourth wave (or fifth wave in Washington state) in the last 18 months, the trauma, stress, long hours, and under-appreciation is shrinking the nursing corps, and that is even before vaccination mandates started in hospital systems across the United States. In an interview with ICU nurse Cassandra Alexander, she quipped, “Why stay in a hard, dangerous, seemingly thankless job?”
Toyota, the largest car company in the world, is having to cut 40 percent of its global production, shutting down plants in its home nation of Japan. The production reduction is happening due to the global semiconductor shortage and parts suppliers closing in Malaysia due to a severe COVID outbreak in the archipelago. For US customers who want a Heche en Nippon product, the slowdown impacts the RAV4, Corolla, Camry, and Lexus ES.
As a disclaimer, we try to pick from more neutral sources so we’re not exactly fans of Vanity Fair. However, the differences from the on-the-air message versus what goes on behind the cameras at Fox News are worth highlighting. While hosts like Laura Ingraham and Tucker Carlson rail against vaccination and masks, mandates, vaccine cards, and mask wear, their employer has a different take.
In a Tuesday memo updating staff on COVID-19 procedures, Fox News Media chief executive Suzanne Scott said that the company has “asked all employees—whether on-site as part of our essential workforce or working remotely—to upload their vaccination status” into an internal database. “All employees must enter their status no later than today, August 17th, by close of business,” Scott wrote.
Scott added that while masks remain optional for vaccinated employees, the company is “requiring employees to wear a mask in small, confined spaces with limited opportunities for social distancing and where there are multiple employees, including control rooms.”
Arkansas
Hope that Arkansas had hit its peak fourth wave peak is fading as cases and hospitalizations started to climb again. Of Arkansas’ 262 school districts, 118 have issued mask mandates and another 87 have banned them. The state did cross a critical milestone, with 51% of the eligible population vaccinated against COVID.
Hawaii
On Oahu, where Honolulu is located, Straub Hospital is overcapacity in its ICU as the state deals with its worst surge of COVID cases ever. Dr. Johnathan Paladino reported the ICU was at 125% capacity and is currently at stage five of its seven-stage disaster plan. Patient triage is now being performed in a tent. Earlier in the week, the Queens Health System had also run out of ICU capacity. The disaster plan, based on military battlefield triage will hopefully not get to stage six or seven. At stage six care would be rationed, with the most critically sick could find care delayed. Stage seven is so-called “black tag triage,” where the sickest patients, regardless of having COVID or not, would be moved to comfort care.
Missouri
Missouri state representative Sara Walsh, another outspoken critic of vaccination and masks, reported that her husband has died of COVID. Steve Walsh died early this morning after the couple becomes infected in July. Neither were vaccinated, and the state representative said she didn’t get vaccinated because of concerns about friends’ negative reactions to the vaccine and said she didn’t feel she needed it as she’d been healthy since the pandemic began. Walsh is running for U.S. Representative Vicky Hartzler’s 4th District congressional seat in the 2022 election.
Governor Kate Brown announced that educators in the Pacific Northwest state who teach K-12, have until October 18 to receive a vaccination or face termination. “We will need confirmation from a qualified medical care provider on any medical exemption. And, we will be reviewing that each religious exemption that is requested is based on bonified beliefs,” said PPS Chief Human Resources Officer Sharon Reese. The mandate comes one day after Washington state issued a similar directive. Oregon has one of the fastest-growing rates of COVID in the United States, with many rural hospitals overwhelmed.
Texas
While Texas Governor Greg Abbott battles COVID in isolation at the governor’s mansion, he continues to battle mask mandates in Texas school districts. The town of Paris, Texas found a loophole in the Governor’s executive order, and modified the school dress code, making masks required.
“The Texas Governor does not have the authority to usurp the Board of Trustees’ exclusive power and duty to govern and oversee the management of the public schools of the district,” Paris ISD said in a release posted on its website. “Nothing in the Governor’s Executive Order 38 states he has suspended Chapter 11 of the Texas Education Code, and therefore the Board has elected to amend its dress code consistent with its statutory authority.”
Texas Attorney General Ken Paxton is taking the San Antonio Independent School District to court after the district mandated all staff be vaccinated for COVID-19. The School District is claiming they have the right to mandate vaccinations under the Equal Employment Opportunity Commission rules, while AG Paxton says it violates state law. We wrote yesterday how the Supreme Court has addressed challenges on vaccination mandates at a state level since 1905, and it is likely Texas will not prevail in its challenge.
Georgia
Parents in Cobb County, Georgia are pulling their children out of school, just three weeks after the 2021-2022 school year started. Last week the entire fifth-grade class at East Side Elementary was sent home because of a spike of COVID cases in the school. Parents had to select either remote or in-person learning during the spring, while masks and social distancing requirements were in place. The district voted not to require masks, going against federal guidelines. The situation has gotten tense with parents on both sides of the argument squaring off. Georgia’s PICUs are 75% to 90% full, with a growing number of pediatric COVID patients.
Wisconsin
Republican State Senator Andre Jacques, one of Wisconsin’s most conservative lawmakers and an outspoken critic of mask and vaccine mandates, is in the hospital with COVID. Jacques, who is married and has six children, reported on Monday night that several of his family members are also sick. On Wednesday no one would comment on his condition beyond he has pneumonia, is very tired, but in good spirits. Since his positive test, his legislative office said it “has been following all protocols.”
Minnesota
The number of children in childcare becoming infected with COVID is growing, with 120 new cases among the unvaccinated a week. The increase started at the height of summer camp season in the last week of July, said Dr. Beth Thielen, a pediatric infectious disease specialist at M Health Fairview. “That was really before things even started to spiral in Minnesota.”
You may have seen a claim that 45,000 people have died within 3 days of receiving the COVID vaccine based on information in the VAERS database. This misinformation is often touted with, “look it up for yourselves,” and has been shared widely on social media.
The VAERS database is a self-reporting tool, that anyone can complete online. It is true you can download the data and do analysis. The data is raw, has not been reviewed or verified, and relies upon the honesty of the people reporting. That would require in part, 45,000 reporting in three days that a relative had died from the vaccine. It is a significant leap to then assume that you had 100% reporting and it was 100% accurate.
But wait, there’s more. The VAERS database only has 6,000 self-reported fatality reports from December 2020 to July 2021. In early May there were 4,700. So where did the 45,000 number come from?
The organization America’s Front Line Doctors is behind the numbers and the lawsuit. But there is a huge problem with the claim, even if you want to cling to it as fact. The lawsuit states that an unnamed person (Jane Doe) who is a computer program calculated her estimate of deaths happening within 3 days of vaccination by examining the VAERS data and comparing it against medical claims. The lawsuit goes on to say, “The number of deaths occurring with (sic) 3 days of injection with the Vaccines exceeds those reported by VAERS by a factor of at least 5.”
There in the lies the problem. We don’t know when the data was pulled, but we do know the number of reports had to be under 6000. No explanation was given on the factor of five. Even if there was any veracity to the claim, the number in the lawsuit should be between 25,000 to 30,000. The other critical point is the data in VAERS is unverified data.
Americas Frontline Doctors were behind a July 27, 2020, viral video touting a cocktail of hydroxychloroquine, zinc, and Zithromax as a treatment for COVID. The claims were untrue, created a shortage of hydroxychloroquine, and left states like Oaklahoma looking to sell back the drug they bought last year under the advice of then-President Trump when he retweeted their video.
The three leaders of Americas Frontline Doctors are Dr. Stella Immanuel of Houston, Dr. Dan Erickson, and Dr. Simone Gold.
[KIRKLAND] – (MTN) The Washington Department of Health will announce on Tuesday which counties will fall back to Phase 2 with 13 counties at risk of reinstated restrictions. Three counties moved backward to Phase 2 on April 16 – Cowlitz, Pierce, and Whitman. None of those counties are at risk of going to Phase 1, but none meet the requirements to move back to Phase 3.
For counties to remain in Phase 3, each must have less than 200 new COVID cases per 100,000 residents and less than 5.0 hospitalizations due to COVID per 100,000 residents. Currently, 13 counties exceed these requirements.
Douglas
Franklin
Grant
King
Kitsap
Lewis
Lincoln
Pacific
Pend-Oreille
Skagit
Snohomish
Spokane
Stevens
Yakima
New infection numbers are a leading indicator for hospitalizations, which increase 2 to 3 weeks after a surge in cases. Fatalities start to increase 4 to 6 weeks after.
Falling back to Phase 2 will reduce indoor occupancy in public spaces such as restaurants, gyms, and stores from 50% to 25%. Professional sporting events such as the Seattle Mariners games at T-Mobile Park will not move to lower occupancy. In Pierce County, where Phase 2 restrictions went into place on April 16, restaurants reported a 25% drop in business.
Nationally there are 37,000 COVID patients in the hospital, a sharp drop from the third wave, which saw numbers exceeding 110,000. According to the CDC, patients between 18 and 64 now represent the largest group hospitalized with the virus.
Washington state has seen declining infections and hospitalizations for people over 75 while rates are rapidly climbing for those under 50. “There is a very sharp increase, it appears, in younger adults…these are largely people who think that their age is protecting them from getting very sick from COVID-19,” Cassie Sauer, CEO and president of the Washington State Hospital Association, said during a press conference on Monday.
During the same press conference, Dr. Chris Baliga of Virginia Mason Franciscan Health stated, “40% of our cases were under the age of 40, which is mind-boggling to me. We never saw that earlier in the pandemic.”
The rise in infections is coming at the same time vaccine hesitancy is taking hold in certain Washington counties. Currently, some areas have thousands of excess doses available while other regions can’t meet demand. Governor Jay Inslee announced today that vaccine distribution would move to a needs-based model. Areas with higher demand will get more doses in an attempt to get ahead of the surge. Anyone 16 and older can get a COVID vaccination in Washington state, and vaccination is free.
Additionally, the CDC and FDA paused using the Johnson & Johnson vaccine after reports of a rare clotting disorder sickening 15 women and caused 3 deaths. The pause slowed down the vaccination rate and added to hesitancy. Both organizations concluded that the risk was extremely rare, with over 8 million doses previously administered. Use of the J&J vaccine restarted last week with an added warning about the potential of clots and additional treatment guidelines sent to physicians.
The increase in COVID cases striking Washington, Oregon, and the Idaho panhandle is coming during a transitional time. The CDC changed guidelines on wearing masks, stating that individuals no longer need to wear masks outdoors and in small group settings, but recommends continuing to wear masks at large outdoor events such as concerts. Gov. Inslee announced earlier this week that Washington state had adopted those guidelines.
There is additional confusion on mask guidance, with some people believing that wearing a mask is no longer required after getting vaccinated. No vaccine is 100% effective, and herd immunity has not been achieved in the Americas. Vaccination significantly prevents infection and dramatically lessens the impact of becoming sickened by a break-through case. Because a vaccinated person could become infected in rare cases with a new variant and is more likely to be an asymptomatic carrier, masks are still advised when in an indoor public setting per CDC guidelines.
In many locations in the United States, the B.1.1.7 variant from the United Kingdom is becoming the dominant strain. The U.K. variant is up to 2 times more contagious than the earlier strains and targets younger patients with worse symptoms.
Another trend concerning the medical community is that younger patients are coming into the hospital in a sicker state. This delay narrows treatment options, including the use of therapies used on patients such as former President Donald Trump, that can lessen the impact of infection if delivered before symptoms become severe.
Only 9 Washington counties meet both requirements for new cases and hospitalizations to stay in Phase 3 – Asotin, Clallam, Columbia, Garfield, Grays Harbor, Klickitat, Mason, Walla Walla, and Whatcom.
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