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COVID Variant BA.5 is Becoming the New Dominate Strain in Washington

[KIRKLAND, Wash.] – (MTN) Health officials and epidemiologists are sounding the alarm about the latest COVID variants, BA.4 and BA.5, spreading across the United States and quietly driving up hospitalizations at an alarming rate.

COVID BA.5, and its close cousin BA.4, not only share mutations with the highly infectious original Omicron strain but has some of the mutations that caused the Delta variant to attack the deep lung tissues and additional adaptations that escape an immune response, including memory T cells. Data out of South Africa for BA.4 showed the R0, a measure of how easily a contagious disease can spread, was 18.6, with a real-world R0 of 10.0 to 12.0.

Previous variants including the original Omicron strains required 15 to 60 minutes of close contact to build up a viral load to cause an infection. The new strains, which represent 40% of new cases in Washington state according to the University of Washington Virology Lab, can be passed along through casual contact. Although masks are not required by regulations anywhere in the United States, healthcare professionals are urging people to mask up again. Including those who had previous infections and the vaccinated.

The current vaccinations are based on the original strain of COVID, which has since mutated tens of thousands of times, producing five major waves that swept the planet. Alpha, Delta, Omicron, Omicron BA 2.12.1, which caused a spike of new cases in Washington in late May and June, and now Omicron BA.5. Each mutation has adapted to bypass our immune systems and therapeutics. COVID variant-specific boosters are expected to be available in the fall.

It is a common belief that viruses always get weaker when they evolve, but that isn’t true. COVID, SARS, and MERS are all part of the coronavirus family which includes the common cold. SARS has a mortality rate of 1% to 2% while MERS, which evolved from SARS, has a mortality rate as high as 40%. While a common cold could be equated to a lazy housecat, COVID is closer to a male lion and MERS would be akin to a pack of starving lions. Cats and lions are felines – a scratch from a cat hurts while a scratch from a lion can kill. COVID lies between SARS and MERS.

The ability to spread easily isn’t the only evolution in BA.5 that has the medical community so worried, pre-print studies show it can evade all forms of previous immunity. Many people who had never caught COVID fell ill in May and early June, with a spike in BA.2.12.1 cases. Before BA.5 became the new dominant strain, a recent infection offered on average five months of enhanced immunity, but BA.5 is infecting people who had COVID just weeks earlier. Although other strains could evade front-line defenses, memory T cells weren’t fooled. Many who had previous infections or are vaccinated had mild symptoms that didn’t require seeing a doctor or hospitalizations. Data indicates that isn’t the case for BA.5, which can slip past the secondary immune response.

In Washington, new case rates are similar to the end of December, when the Omicron surge brought regional hospitals to their knees a few weeks later. Experts believe the case rate is much higher due to widely available home tests which go unreported, the end of COVID testing for international travel, and most employers dropping frequent COVID testing requirements. Fewer mild and asymptomatic cases are being captured. In San Francisco, wastewater data shows that COVID-19 has quietly spread at a faster rate than earlier spikes.

According to the Washington State Department of Health, area hospitals are already strained, in a situation eerily similar to December 2021. Statewide only 8% of acute care beds and 10% of ICU beds are available. Twelve percent of acute care patients have COVID, while ICU occupancy remains at a manageable 7%. A common question is if someone is hospitalized “with” COVID or “due” to COVID, but the point doesn’t matter. A patient that has COVID has to be treated differently and requires more attention, which saps already thin medical resources.

So far, the number of patients on ventilators remains far lower than in previous waves. While immunity to prevent symptomatic infection has declined significantly, protection from severe COVID symptoms appears to be holding.

As with previous waves, people 18 to 34 have the highest case rate while those 65 and older have the highest hospitalization rate. Officially, only three counties in Washington don’t have a “high transmission rate” for COVID.

Health and Lifestyle, Local

Yellow Alert! COVID makes a comeback in Washington state

[SEATTLE, Wash.] – (MTN) COVID cases have steadily increased in King County, moving the region to the CDC’s medium threat level as test positivity, new cases, and hospitalizations rising again.

COVID variant Omicron has split off into a number of variants, with the current surge being driven by BA.2. According to the University of Washington Virology Lab, 85% of new cases are BA.2, so-called “stealth Omicron” and the statewide case positivity rate is 12.4%. In King County, test positivity has grown from 3.2% on March 16 to 11.6% on April 17. Hospitalizations have increased over 100% in the last week, growing from an average of 32 people countywide a week ago to 70. Area hospitals are not strained by the current round of infections, and regional numbers aren’t near the levels seen from the Delta surge in the fall of 2021, and the Omicron surge in January 2022.

The increase started four days after the Washington State Department of Health lifted the mask mandate on March 12 and companies such as Microsoft announced a return to the office.

A combination of relaxed public safety measures and waning vaccine and disease acquired immunity are contributing to the new increase. The Omicron BA.2 variant has a much higher reinfection rate than other variants, estimated at 10% to 15%, and is more contagious than the original Omicron strain.

CDC guidelines recommend that a region at COVID-19 Community Level Medium (yellow) recommends that those at high risk for severe COVID to discuss with their primary healthcare provider whether they should wear a mask. Additionally, anyone who is exhibiting COVID systems should get a PCR test.

Common symptoms of Omicron BA.2 are somewhat different from the original, Alpha and Delta variants. Additional symptoms to look for include:

  • Runny nose
  • Sore throat – moderate to severe
  • Diarrhea, gastric upset, particularly in children
  • Fatigue that is profound and severe, particularly in children

This is in addition to more typical COVID symptoms that include fever and chills, muscle and body aches, dry cough, shortness of breath/difficulty breathing, headache, and a sudden loss of taste and/or smell.

Health and Lifestyle, Local

Washington ending the statewide outdoor mask mandate as COVID cases and hospitalizations decline

[OLYMPIA, Wash.] – (MTN) Governor Jay Inslee announced that the outdoor mask mandate would end on Feb. 18 and that it is, “no longer a matter of if, but when,” for the end of the indoor mandate.

The outdoor mask mandate was implemented on Sept. 13, as hospitalizations for the delta variant peaked in Washington. The requirement applied to large outdoor events with 500 or more people. Enforcement of the outdoor mask requirement was close to non-existent, with Lumen Field full of maskless fans through the fall and early winter, cheering for the Seattle Seahawks.

Data has shown that COVID transmission rates are significantly lower in outdoor settings and areas with excellent air circulation.

The statewide indoor mask mandate, that was brought back on Aug. 19 still stands. Gov. Inslee said that he was taking a wait-and-see approach, and would revisit ending the indoor mask mandate as early as next week. California, Illinois, New York, and Oregon have ended or announced they are ending indoor mask mandates this week.

Washington repealed almost all COVID restrictions on Jun. 30 as hospitals emptied of COVID patients and the statewide vaccination rate for residents 16 and over approached 70%. Less than two months later the state was facing record hospitalizations due to the more transmissible and virulent Delta variant, just as school was restarting.

Washington never fully exited the delta wave when the first omicron case was detected on Nov. 29. More than a half-dozen high school wrestling matches on Dec. 4 in Pierce and Thurston Counties became super spreader events. New cases of omicron exploded from the Canada border to the Columbia River flooding Western Washington hospitals during the last week of December. The combination of holiday travelers and lower vaccination rates in Eastern Washington created a secondary wave in January.

New COVID cases are declining across the state and hospitalizations have peaked on both sides of the Cascades. Despite the improvement, there are still over 1,700 COVID patients in Washington hospitals according to the Washington State Hospital Association.

With the hospital situation improving, the statewide pause of “non-urgent” surgical procedures announced last month, will come to an end on Feb. 17. When Gov. Inslee announced the 28-day pause on Jan. 20, many hospitals had already taken the extraordinary measure independently.

At the peak of the omicron wave, Washington medical facilities were brought to the brink of collapse. The darkest days were during the week of Jan. 16. In an unprecedented move during the COVID pandemic, a handful of patients were transferred by aircraft out of Western Washington to Eastern Washington and Montana hospitals. On Jan. 19, the demand for hospital beds was outstripping all available resources.

To avoid moving the state to crisis standards of care, the Washington Medical Coordination Center (WMCC) implemented a protocol called guaranteed-acceptance hospital rotation. During guaranteed-acceptance hospital rotation, larger regional hospitals took turns taking accepting transfer patients and finding some way to care for them. By Jan. 23, the peak of the crisis had passed, and the protocol was ended.

The WMCC, which operates out of Harborview Medical Center, provides assistance to hospitals that need to move patients when the institution has exhausted all other options.

In Idaho, new COVID cases peaked earlier this week with test positivity reaching 34%. Southern Idaho has been operating under crisis standards of care for almost a month, and some patients from the Boise area have been arriving in Eastern Washington hospitals. Historically Alaska, Idaho, Eastern Oregon, and Western Montana have relied on Washington hospitals to take in critically ill patients and specialized cases.

The positivity rate for COVID tests in Washington has dropped to 18%, according to the University of Washington Virology Lab. So-called stealth omicron has been detected in Washington, but there has not been an increase in cases.

Virologists believe that between the statewide vaccination rate and how transmissible the Omicron variant is, many residents have some degree of immunity. The United States Centers for Disease Control is not supportive of repealing mask mandates because nationally new case rates remain extremely high, with over 110,000 hospitalized COVID patients.

Breaking News, Health and Lifestyle, Local

As COVID rages, what’s next for Washington state

[KIRKLAND, Wash.] – (MTN) Washington state has set new records for COVID cases and hospitalizations, straining every aspect of life and leaving many to wonder, what is next?

Malcontent News has been tracking the Omicron wave in South Africa and the United Kingdom and using the data from these nations to build models for Washington. The path the current surge is taking aligns closely with the progression in South Africa.

New Cases

It took 28 days for the first SGTFs to show up in PCR tests in South Africa at a significant number, to the peak in cases. If Washington follows the same path, new cases in the state should peak on Jan. 17. The last update from the Washington State Department of Health (WSDOH) was supportive of an approaching statewide peak. An analysis of new case data indicated that the Olympic Peninsula, Central Puget Sound, the South Sound counties out to the Pacific Coast have already peaked. In Eastern Washington, many areas are still seven to ten days away.

In South Africa and Europe, cases declined rapidly. If Washington follows the same pattern, new daily cases will be 50 percent of peak by Feb. 2, and then drift to a plateau of 30 to 35 percent of the peak. The plateau will hold until Feb. 14, before starting to decline again.

Washington moved to test only symptomatic and close contacts on Jan. 4. Over the weekend Seattle Children’s Hospital reported they were incapable of testing most pediatric cases for COVID at urgent care clinics, reserving the dwindling supply to only the sickest of patients. The University Washington Medicine is struggling to test staff and immediate family, in compliance with the United States Centers for Disease Control CDC) guidelines.

Clark County residents have appealed to the state for additional testing resources and more access to booster shots. Among the eight locations receiving National Guard support by Jan. 24 for additional testing resources, Vancouver, Washington was not among the locations.

The University of Washington Virology lab is struggling to provide test results to Washington, and some Oregon healthcare providers, processing 12,000 to 14,000 a test a day. On Sunday, 31.9 percent were positive, creating some doubt that a peak in cases has arrived.

Hospitalizations

Hospitalizations are a trailing indicator. We predicted on Dec. 26. that Washington hospitals would run out of available resources by Jan 15. Governor Jay Inslee deployed the national guard and suspended all non-emergency surgeries on Jan. 13, to support overwhelmed hospitals.

In South Africa, seven percent of new Omicron cases resulted in hospitalizations. The unvaccinated made up 82 percent of all COVID hospitalizations. That rate was between 22 and 31 percent of the earlier Delta wave. The exact difference is hard to track after South Africa changed its testing criteria on Dec. 24, testing only people who were symptomatic or had close contacts. Adjusting for South Africa’s higher hospitalization rate versus the United States, and accounting for the lower hospitalization rate among Omicron patients, we initially estimated Washington would experience a 1.14 to 1.34 percent hospitalization rate. Currently, it is between 1.8 and 2.4 percent depending on the hospital region.

The single biggest factor that impacts the outcome of a COVID infection is age. In South Africa, only 5.7 percent of the population is over 60, while 34.1% is under 19. Although it is true that only 26% of the population is fully vaccinated, in Gauteng Province, which bore the brunt of the Omicron wave, 44 percent of the population is fully vaccinated.

In Washington, Stevens, Pend Oreille, Skamania, Asotin, Ferry, Whitman, Klickitat, and Columbia Counties have lower vaccination rates. According to the WSDOH on Thursday, 80 percent of all COVID hospitalizations statewide were unvaccinated – which mirrors the data released from South Africa on Sunday.

In South Africa, the surge of new hospitalizations peaked 10 to 14 days after the new cases reached a peak. If Washington follows that path, new hospitalizations will peak at the end of January.

Despite reports that many cases resulted in short hospitalizations, this was among vaccinated individuals. South Africa found that among unvaccinated individuals, the progress of illness was no different than prior strains of COVID.

The number of hospitalized COVID patients peaked in South Africa on Dec. 31 and remained almost unchanged through Jan. 6. Currently hospitalized coronavirus patients in the African nation are still at 83 percent of peak. The decline has been slow.

For Washington hospitals, this will be an insurmountable challenge. Although the governor announced a pause in elective surgeries statewide on Thursday, many hospitals had already voluntarily taken that step to expand resources. MultiCare reported ten days ago they were forced to implement CDC crisis staffing standards, having COVID positive workers who are experiencing mild to moderate symptoms continue to work.

An analysis of available hospital resources indicated that additional emergency staffing and converting PACUs to COVID wards added 60 to 75 acute care and 10 to 15 ICU beds statewide. With over 250 new COVID patient admissions a day, that added capacity was likely wiped out over the weekend.

If Washington follows the same hospitalization trend, by Jan. 26 the worst of the surge will be hitting our facilities. The number of COVID patients will peak on Feb. 4, and hold until Feb. 10. Although a decline will be accelerating by Feb. 20, a load of 83% of the peak would be unsustainable.

On Friday the WSDOH reported there were 2,135 COVID patients in Washington hospitals, an all-time record. Hospitalizations are increasing 50 percent every week. The IHME model projects almost 4,000 hospitalized coronavirus patients on Feb. 4, either in acute care or the ICU. If Washington follows South Africa, the number would reach 5,038 and then sustain at that level for two weeks before dropping to 4,000.

Last Monday patients were being transferred out of King County to Moses Lake, Richland, and Missoula, Montana. King County hospitals, University of Washington Medicine, and Harborview Medical Center are caring for a record number of COVID patients. In Spokane, Providence and MultiCare hospitals can’t take transfers. Doctors reported angry and desperate phone calls from rural hospitals trying to move patients to larger facilities.

MultiCare and Providence hospitals on both sides of the mountains have deployed tents again. In Everett, Providence Hospital was treating patients in the emergency department waiting room and the halls are lined with patients waiting for beds.

Deaths

Looking to South Africa, the number of deaths from Omicron was significantly lower compared to Delta. The age of the population, a 66% vaccination rate for those over 50, a historically lower COVID death rate compared to Europe and North America, and more available resources contributed to the better outcomes. Additionally, it is summer in South Africa.

COVID-related deaths started to increase on Dec. 11. It is unknown if deaths have reached a peak yet, but on Jan. 16, the 7-day moving average was 105 deaths a day. All signs in South Africa indicate the Omicron surge is reaching its finality.

In Washington, the population is older and in poorer health. Vaccination rates are higher, but almost one-third of the entire population is not only unvaccinated but politically indoctrinated into the status being part of their identity. They not only dismiss vaccination but all proven public health measures such as indoor mask wear.

Unlike prior waves in Washington, Omicron overwhelmed the larger and better equipped Puget Sound region facilities first. Idaho is starting to surge with new cases and Oregon is straining under its own tidal wave of cases. COVID patients in Eastern Washington will have fewer options than ever before.

If Washington follows the same as South Africa, COVID-related deaths will start to peak in mid-February.

Services and Infrastructure

It is estimated eight to ten percent of all American workers are sick, caring for a sick family member, or quarantining. The United States was already dealing with a worker shortage in 2021, which has been made worse by Omicron. By early February, up to 25 percent of all Washington workers could be sidelined with COVID.

Some of the impacts have already rippled through the region. Empty store shelves, recently restocked after the mountain passes reopened, will struggle to stay full. Pharmacists are warning people to refill their medications now, unsure of their ability to serve the community and have an adequate supply of pills.

Postal workers are driving routes for 12 to 16 hours to fulfill deliveries, and school districts are looking for parent volunteers or moving to virtual learning. In some cities such as Seattle, students have staged walkouts due to high infection rates. In Lakewood, the Walmart Super Center was forced to close for three days for a deep cleaning after 63 workers became sick with COVID.

The day-to-day impact for everyone will include school and daycare closures, spotty store shelves, delayed deliveries, and businesses forced into short-term closures due to a lack of staff. The economic fallout could last for much longer.

Without a dramatic increase in support, state healthcare workers and Washington residents will face a brutal five to six weeks where only the absolute sickest individuals will be able to get medical services, and basic goods and services will require patience to find.

Health and Lifestyle, Local, National

Record number of new COVID cases in Washington as hospitalizations climb

[OLYMPIA, Wash.] – (MTN) The Washington State Department of Health reported that the rate of new COVID cases exploded to 541.9 per 100,000 residents on Monday. The same report showed that coronavirus-related hospitalizations increased 49 percent in a week, from 736 on Dec. 26 to 1,099 on Jan. 2.

Several factors impacted today’s report, which may not show the true impact of COVID in Washington. Most tests sites were closed on New Year’s Day across the state, and numerous Western Washington test locations were closed on Dec. 30, 31, and Jan. 2 due to weather, power issues at one location, and insufficient staff. The hospitalization data appeared incomplete to the Malcontent News research team and will likely be updated tomorrow with more data.

A staggering 26 counties have extreme transmission, with another eight experiencing high transmission. Pierce County has the highest case rate in Washington, 771.0 per 100,000 people.

In King County, 25 people on average are hospitalized a day with COVID, breaking the previous record set during the Delta wave in September. Through Dec. 30, hospitalizations are up 81 percent, and the new case rate of 685.1 has never been higher.

The IHME forecasts hospitalizations will peak in early February, and COVID-related deaths will peak in March.

It wasn’t all bad news in the report. The number of Washingtonians who have received booster shots increased significantly from last week. There is strong evidence from multiple studies and hospitalization data from Israel, Europe, and the United Kingdom, that a third booster dose provides robust protection from severe COVID.

In welcome news to many parents, the United States Food and Drug Administration (FDA) authorized booster shots for 12 to 15-year-olds today and shortened the waiting period for the age group from six months after the second dose to five.

On Sunday, Dr. Anthony Fauci indicated that the United States Centers for Disease Control (CDC) was reconsidering new isolation and quarantine guidelines based on feedback. The CDC has faced withering criticism from healthcare providers and frontline workers for cutting quarantine time in half and relying on the honor system for those who are infected by asymptomatic.

Although Omicron has become the dominant strain in the United States, data out of Connecticut and Washington indicates it won’t squeeze Delta out. Complicating treatment and mitigation, ten percent of COVID cases continue to be Delta or so-called Delta Plus.

According to the New York Times, the United States recorded 1,003,043 new COVID cases on Monday, shattering all previous records. The 7 day moving average is approaching 500,000 new cases a day, which Malcontent News believes is a red line for United States hospitals.

There are now 102,479 people hospitalized with COVID, an increase of 41% from a week ago. Daily new hospital admissions now exceed all previous waves, except the first one, which peaked on Jan. 9, 2021. The United States will set a new all-time hospitalization record if the rate of increase remains unchanged during the coming week.

Testing resources in the United States are stretched to the breaking point, with laboratories processing a near-record number of tests daily. Monday night, the Georgia Department of Health tweeted they could not provide an updated COVID report because there is so much data.

University of Washington Medicine (UWM) officially takes over testing sites from King County on Tuesday. UWM announced that they would no longer provide prophylaxis COVID testing for work and travel, reserving resources only for people who are symptomatic or had close contact with someone infected with the coronavirus.

Speculation on how severe the Omicron variant is compared to Delta continues to run rampant. Disease acquired immunity, vaccinations, boosters, and demographic differences between nations have made reaching a concrete conclusion difficult. There is growing evidence that for the vaccinated, especially with boosters, the Omicron variant is mild to moderate for most.

For the unvaccinated, the data is less conclusive. In South Africa, hundreds have died in the last two weeks. While hospitalizations appear to have peaked, the number has remained almost unchanged for a week while the number of ICU patients and those requiring ventilators has grown. A study published by the United Kingdom Health Security Agency tracked 815 hospitalized Omicron patients with a median age of 45.5. The report found that 57 people had died in the group – seven percent. The ages of those who died ranged from 41 to 99.

Health and Lifestyle, Local, National

The arrival of 2022 brings an Omicron tidal wave and the wrong message about the severity

1 Comment
◼ Covid hospitalizations have surged 32% in Washington since December 20
◼ University of Washington Medicine suspends elective surgeries through January 14
◼ 25% to 30% of statewide COVID tests are positive
◼ Washington reported a record number of new COVID cases yesterday
◼ A UK report tracking the progress of hospitalized Omicron patients found 7 percent died within 28 days of admission, similar to hospitalized patients in South Africa
◼ Seattle Public Schools delays class restart on Monday to mass test students and teachers

[KIRKLAND, Wash.] – (MTN) Confusion is growing among Washingtonians who will return to work and school on Monday as pundits, health experts, and government leaders send mixed messages about the COVID variant Omicron.

The Washington State Department of Health (WSDoH) reported a new record for confirmed COVID cases on Christmas Even – 6,140. A literal and metaphorical perfect storm of the Christmas holiday, severe weather closing many Western Washington test locations for days, and laboratories becoming overwhelmed, have created an incomplete picture of new case growth.

The University of Washington announced beginning on Jan. 4, they will only test people who are symptomatic or have had close contact with a previously confirmed COVID case. Testing for work or travel requirements will no longer be supported.

The challenge facing testing labs is how samples are processed. During previous COVID waves, samples were tested as a pool, which increases efficiency. Technicians take four or five partial samples from individual test swabs and combine them together. The combined samples are PCR tested and if the result was negative, the individual samples tested together are marked negative. If the pool came back positive, each sample within the pool would be tested to identify the positive results. According to the UW Virology Lab, test samples this past week have been 25% to 30% positive, making pool testing ineffective.

Every Region in Washington State Has High or Extreme New Case Transmission

RegionCountiesPopulation12+ Fully Vaccinated16+ with BoostersCOVID Cases 7 Day MA
EastAdams, Asotin, Ferry, Garfield, Lincoln, Pend Oreille, Spokane, Stevens, Wahkiakum, Whitman705,47549.9%34.5%130.4
NorthIsland, San Juan, Skagit, Whatcom474,35062.5%40.8%201.1
North CentralChelan, Douglas, Grant, Okanogan272,12556.3%38.0%140.9
NorthwestClallam, Jefferson, Kitsap, Mason451,80059.8%43.2%214.7
Puget SoundKing, Pierce, Snohomish4,054,80067.2%39.9%403.7
South CentralColumbia, Franklin, Kittitas, Walla Walla, Yakima694,05051.9%33.9%153.6
SouthwestClark, Cowlitz, Klickitat, Skamania660,20056.6%36.5%214.8
WestGrays Harbor, Lewis, Pacific, Thurston474,07557.1%38.9%296.3
Data provided by the Washington State Department of Health on December 30, 2021 – vaccination rate data is through December 28, 2021, and booster data is through December 29, 2021

In South King County one test site in Auburn reported 49% of tests were positive for COVID. The total number of tests being run decreased significantly this past week due to weather and staff-related closures of test sites in Western Washington.

While headlines and soundbites describe Omicron as mild, an important detail is being left out – only if you’re vaccinated, boosted, and otherwise healthy. As the United States entered the last day of 2021, more than 90,000 Americans were hospitalized for COVID and more than 10,000 are being hospitalized each day.

Headlines around the world this afternoon announced, Omicron hospitalization risk lower than delta, vaccines provide good protection, U.K. study says. The U.K. Health Agency SARS-CoV-2 variants of concern and variants under investigation in England Technical briefing: Update on hospitalisation and vaccine effectiveness for Omicron VOC-21NOV-01 (B.1.1.529) was published in full on Dec. 31.

“The previous finding of reduced overall risk of hospitalisation for Omicron compared to Delta is confirmed by the updated Study 1. In addition, both studies find a substantial reduction in risk of hospitalisation for Omicron cases after 3 doses of vaccine compared to those who are unvaccinated, with overlapping estimate ranges. Both studies have been run on relatively small numbers of hospitalised cases and will require iteration. Despite the estimated reduction in hospitalisation risk and preserved vaccine effectiveness against hospitalisation, the very high number of Omicron cases means that there may still be large numbers of admissions to hospital.”

In August 2021, King County Health Officer Dr. Jeff Duchin mentioned the N95 Project as a trusted source for N95 masks. A check on the website showed that a 50 count box of N95 masks are available for $40.00, and a package of 10 count children sized KN95 masks are available for $10.50. We recommend wearing N95 or KN95 masks indoors as they provide the best protection against COVID when properly fitted.

NO PROMOTIONAL CONSIDERATION HAS BEEN GIVEN OR REQUESTED FROM PROJECT N95 OR ANY MANUFACTURER OF MASKS

CNBC reported this morning, “The latest data from the U.K. Health Security Agency found the risk of hospitalization for people infected with omicron is about a third of that posed by the delta variant.”

This appears to be good news but ignores multiple factors. First and foremost, this is more than double the relative risk that South Africa has reported. This is likely due to South Africa having a much younger and relatively more healthy population than Europe and North America.

Considering the potential impact on the United States, the United Kingdom has a much higher vaccination and booster shot rate. According to the U.K. Department of Health, 82% of all residents 12 and older were fully vaccinated through Dec. 22. Additionally, more than two-thirds of UK residents 12 and older who are eligible for a booster shot, have received one. Booster doses were recently introduced in the United States for adolescents 16 to 17 years old and are expected to expand to children 12 to 15 years old as early as next week.

Further analysis of United States Centers for Disease Control (CDC) data indicated only the New England states have a similar percentage of vaccinated residents. Among all US states, only Vermont and Maine had similar vaccination and booster rates to the UK. Hospitalization data in the first four hot spots of Hawaii, New York, Florida, and Washington do indicate that vaccines are helping to keep more people out of the hospital, but are not encouraging.

Vaccination Rates of United Kingdom Countries vs Most Vaccinated US States

UK Country12+ Fully Vaccinated12+ with BoosterMost Vaccinated US States12+ Fully Vaccinated18+ with Booster
Scotland84%58%Rhode Island85%46%
Wales83%55%Vermont84%54%
England82%55%Connecticut84%41%
Northern Ireland81%48%Maine84%48%
Washington78%41%
Texas67%31%
California77%36%
Florida74%31%
United Kingdom vaccination rate data from the BBC, December 23, 2021, using National Health Service data from December 19 to December 22, compared to the United States from the CDC, December 31, 2021 – Texas and California added to provide a benchmark among the states with the largest populations

In Washington, the most vaccinated counties are six to ten percent below the United Kingdom. San Juan County is the closest, with 77% full vaccinated and 58% boosted. The least vaccinated counties are 50 to 55 percent below the UK.

Vaccination Rates in Five Largest Washington Counties

CountyPopulationPopulation VaccinatedVaccinated with Boosters
King2,293,30074%43%
Pierce917,10055%34%
Snohomish844,40064%36%
Spokane527,60053%34%
Clark512,80057%36%
Data from the Washington State Department of Health, December 30, 2021

New York City is about a week ahead of Seattle in the progression of Omicron, and from Dec. 22 to Dec. 30, hospitalizations for COVID more than doubled, while the number of COVID patients in the ICU almost doubled. With hospitals in Washington state already full and reports of Idaho Panhandle hospitals once again being overwhelmed with coronavirus cases, hospitalists are growing concerned that medical facilities will be overrun.

Miami-Dade County in Florida is seven to ten days behind Seattle. According to the New York Times, Florida has the fourth fastest-growing hospitalization rate in the country outpacing New York and Washington. Officials in Hawaii have requested 700 medical personnel from FEMA as hospitalizations surge. So many people are sickened from Omicron that inter-island air travel and ambulance services on O’hau are starting to be impacted. Officials in Maui announced that a booster shot is now required to be considered fully vaccinated.

The Dec. 31 report from the UK Health Agency also showed alarming data for clinical outcomes for people once they are hospitalized. The study reviewed 815 individuals with laboratory-confirmed Omicron cases where were admitted to the hospital within the last 28 days. The median age was 45.5 years old and 57 died from COVID-related illness – a seven-percent mortality rate among hospitalized patients. The age of those who died was between 41 and 99, and the median time was just five days after collecting their test sample for genomic sequencing.

South Africa has observed similar outcomes among the hospitalized. The NICD has reported 848 COVID-related deaths in the last 14 days, including 81 Friday. In Gauteng Province, The number of hospitalized COVID patients is up almost 300% from a month ago – 85 percent are unvaccinated. As Omicron is progressing among the hospitalized the ratio of patients on oxygen, in the ICU, and on ventilators is higher or equal to November, when the wards were full of Delta patients.

On Dec. 20, the WSDoH reported there were 610 hospitalized COVID patients in Washington – the lowest number since August. On Dec. 28, the number had leaped to 897. Harborview Medical Center in Seatle went from three COVID patients to 27 in the same time period.

The U.S. Centers for Disease Control has contributed to the confusion while outraging the medical community. Leaders announced on Dec. 27 new guidelines which shorten quarantine and isolation time in half for asymptomatic and mild cases of COVID. As part of the announcement, the CDC said they were following available data. When pressed to present studies or supporting evidence during a Dec. 29 media briefing, a CDC spokesperson indicated data was not available. The foundation of the new recommendations is dependent on the honor system, and that people will follow the guidelines, including wearing a properly fitted N95, KN95, KN94 mask for an additional five days.

If You Test Positive for COVID – Isolate

Everyone, regardless of vaccination statusStay home for 5 days.
If you have no symptoms or your symptoms are resolving after 5 days, you can leave your house.

Continue to wear a mask around others for 5 additional days.

If you have a fever, continue to stay home until your fever resolves.

If You Were Exposed to Someone with COVID – Quarantine

If you:
Have been boosted

OR
Completed the primary series of the Pfizer or Moderna vaccine within the last 6 months

OR
Completed the primary series of the Jassen/Johnson & Johnson vaccine within the last 2 months		Wear a mask around others for 10 days.

Test on day 5, if possible.

If you develop symptoms get a test and stay home.

But, If You Were Exposed to Someone with COVID – Quarantine

If you:
Completed the primary series of Pfizer or Moderna vaccine over 6 months ago and are not boosted

OR
Completed the primary series of Jassen/Johnson & Johnson over 2 months ago and are not boosted

OR
Are unvaccinated		Stay home for 5 days. After that continue to wear a mask around others for 5 additional days.

If you can’t quarantine you must wear a mask for 10 days.

Test on day 5 if possible.

If you develop symptoms get a test and stay home

Among nations dealing with surges of Omicron cases, only South Africa has adopted similar isolation and quarantine requirements. In politically charged low vaccination rate counties across the United States, it is highly unlikely these guidelines will be followed.

Seattle Public Schools announced they were suspending all classes on Monday so that staff, faculty, and students can get COVID testing. The district was able to secure 60,000 tests and designated several schools at mass testing sites. Social media was full of questions from parents in other large school districts such as Lake Washington and Bellevue, wondering why a similar pause wasn’t being initiated. The Northshore School District has been pool testing the student body for months. A program that has been very effective at keeping the number of cases within the district down.

The continued messaging of Omicron being mild is frustrating hospital leaders. “There are very, very few people who get the common cold who end up in the hospital,” explained Hilton Raethel, Healthcare Association of Hawaii’s President and CEO in an interview with KHON. “And our hospital counts are going up every single day and, again, the common cold generally does not land you in the hospital — COVID can and COVID will.”

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In 48 hours, COVID hospitalizations increased 13% in Washington

[OLYMPIA, Wash.] – (MTN) Washington hospitals added 92 more COVID patients between Monday and Wednesday, eliminating two weeks of improvement in 48 hours as new COVID cases rose to early November levels.

According to the Washington State Department of Health (WSDoH), there were 610 hospitalized COVID patients on Dec 20. That number rose to 702 on Wednesday. The number of patients on ventilators had dropped as low as 79 on Dec, 16, and had increased to 95 on Wednesday. Statewide 91% of staffed acute care, and 88% of staffed ICU beds were filled.

The Washington State Department of Health (WSDoH) also reported a sharp increase in new COVID cases. In a week the 7 day moving average increased 86% from 84.1 to 156.3 per 100K residents. Nine of the ten counties with the highest case rates are west of the Cascades, fueled in part by multiple super spreader events at schools in Pierce and Thurston Counties in early December.

Percent of Total Population Fully VaccinatedPercentage of Vaccinated People with Booster DoseTotal Population in GroupAverage 7-Day New Case Rate
70.00% or above39.15%2,343,250210.7
60.00% to 69.99%35.36%1,669,300162.6
50.00% to 59.99%32.23%3,339,300124.5
40.00% to 49.99%29.41%268,97577.9
32.70% to 39.99%35.38%151,85080.6
7 Day New Covid-19 Cases per 100K average by Vaccination Rate for Total Population, Adjusted for Population by County, Booster percentage is based on totally fully vaccinated, not eligible, Average 7-day New Case Rate <25 normal, =>25 to 99.9 moderate to significant, => 100, high transmission

The Puget Sound region had some of the highest new case rates in the state. Pierce County was in second place with 225.6 per 100K, King County was in fourth place with 213.6 per 100K, and Snohomish County was in eighth place reporting 144.6 cases per 100K residents. Twenty-four Washington counties have substantial or high transmission.

The University of Washington Virology Lab and Trevor Bedford, Ph.D. of Fred Hutch, estimate the Rt in King County is 4.4. Rt, or “r naught,” is a measurement for how quickly a disease is spreading within a population. The figure is an estimation of how many people an infected person will pass a disease to. In King County, a person infected with the Omicron variant is passing it to 4.4 people. In comparison, the highest rate experienced after March 2020 was 2.1 during the Delta wave.

In a series of tweets today, Bedford estimated that the time it takes to become symptomatic is shorter than the original strain and Delta, about three days, which may be contributing to the meteoric rise in cases and what may be a near equally fast decline.

Understanding how much Omicron can spread and how sick it is making people remains somewhat of a mystery. When COVID first struck in December 2019, it was moving through a population with no prior exposure, without vaccines, and no understanding of what an effective treatment plan looks like. Two years later hundreds of millions globally who have had prior infections, 25 different vaccinations, different boosters shot protocols, and varying treatments have clouded the impact of the new variant.

Several studies out of South Africa and the UK indicated people have a 30% to 90% lower chance of being hospitalized due to Omicron versus Delta. However, data out of both nations have shown once a patient is hospitalized, the progression of an Omicron infection is the same as the Delta variant. Researchers aren’t sure if the lower rate is caused by Omicron being milder or if prior infections and vaccinations are blunting the severity among those who get sick.

Researchers in the UK are watching the United States closely to better understand the severity of Omicron. Due to the strength of the antivaccination movement fueled by COVID disinformation, the United States has a statistically significant population that is not only unvaccinated but who will not seek out hospital treatment until they are critically ill.

In Gauteng Province in South Africa, Omicron has peaked in alignment with a forecast prepared by the South Africa Department of Health at the start of the month. South African officials have reported almost 400 deaths in the last week, and Gauteng is still caring for over 3,500 COVID patients.

Another factor that will make tracking the progress harder is the holiday break between Dec 24. and Jan 3. There are fewer tests that happen over weekends and many testing centers will be closed on Christmas and New Year’s Day. The WSDoH won’t report data from Dec. 24 through Dec. 26, and it will take a couple of days for test results to catch up. The same phenomenon will occur from Dec. 31 through Jan. 2. Some may misinterpret the lower number of tests as proof that Omicron won’t have a major impact.

Doctors lost a critical tool in reducing hospitalizations during the Delta wave today, as the FDA paused the distribution of monoclonal antibodies from Regeneron and Lilly. The cocktail that was administered intravenously, was up to 70% effective in preventing hospitalizations but has been rendered useless by the Omicron variant. Sotromivab is the remaining effective monoclonal antibody but is not manufactured in the United States so supplies are tight. The U.S. Department of Health and Human Services distributed 55,000 doses this week nationally, with Washington getting 552. Another 300,000 doses will be ready in January.

On Wednesday the U.S. Food and Drug Administration (FDA) granted Emergency Use Authorization (EUA) to the antiviral drug Paxlovid, made by Pfizer. Paxlovid was shown to reduce hospitalizations and death by as much as 89% in phase three testing. The medical is a pill that can be taken at home, eliminating the need for injection clinics and putting high-risk COVID patients together for treatment. The first 265,000 doses will be distributed nationally in January. HHS has not released information on state allocations. With national COVID cases forecasted to be as high as 2.8 million per day by the end of next month, it will be a drop in a bucket filled with COVID.

The FDA also granted EUA for the Merck antiviral, molnupiravir. Developed to treat diseases a range of viruses such as influenza and Ebola, Merck reported phase three testing found the oral medical was 50% effective at preventing COVID hospitalizations. Millions of doses of the drug have already been staged across the United States in anticipation of its approval.

In November the FDA reluctantly voted to approve the drug in a 13-10 vote. After reviewing the data provided by Merck, effectiveness was projected to be 30%. Ultimately, despite the lower success rate, the advisory committee decided that the benefits outweighed the risks.

All three medications are meant to be administered to people who are at high risk for severe disease due to comorbidities such as having a compromised immune system. Some states such as Florida have stated they will ignore FDA guidelines despite the short supplies and will distribute the medications on a first-come, first-served basis.

The UK and France reported a record number of new cases today while in the United States, new COVID case counts exceed the peak set during the Delta wave. The IHME in Seattle predicts that between Jan. 1 and Mar. 1 there will be 140 million COVID cases in the United States. The same forecast estimates that Washington could experience 28,000 to 40,000 new cases a day toward the end of January.

On Dec. 22, Dr. Anthony Fauci said that large gatherings over the holiday would not be safe, even with booster shots and masks.

“There are many of these parties that have 30, 40, 50 people in which you do not know the vaccination status of individuals. Those are the kind of functions in the context of Omicron that you do not want to go to,” Fauci said during a White House briefing.

On the same day Fauci recommended skipping large gatherings, the TSA screened 2.1 million airline passengers. That was almost double the number of people from 2020 and 150,000 more people than 2019 B.C. – Before COVID.

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COVID cases fueled by Omicron skyrocket globally, nationally, and in Washington

Texas officials report the first Omicron related fatality in the United States

Editor’s Note: As a policy, Malcontent News does not quote or publish data from pre-print studies. The transmission rate of the Omicron SARS-CoV2 variant is so high it is spreading at a rate faster than the scientific review process. For this reason, we are using pre-print studies in our reporting and analysis for the Omicron variant. We will continue to backlink to all quoted sources to support transparency in reporting.

Updated: Story edited to report first Omicron death in the United States

[KIRKLAND, Wash.] – (MTN) Washington state moved back to high transmission risk for COVID as new cases fueled by the Omicron variant grew 32 percent over the weekend. The highly contagious variant was discovered in South Africa, spreading to over 90 countries in six weeks.

The United States was reminded how serious Covid-19 is this evening, with Texas reporting the first Omicron-related death in the nation. Judge Lina Hidalgo of Harris County, Texas, tweeted that a man in his 50s had died of Omicron. He was unvaccinated and had health issues. It is reported he was treated with monoclonal antibodies, which have been rendered ineffective against the Omicron variant.

The U.S. Centers for Disease Control (CDC) reported 73% of new COVID cases across the United States are the Omicron variant, swamping Delta cases. The World Health Organization estimated cases are doubling every 1.5 to three days.

The CDC estimates that Omicron is 90% of new COVID cases in the New York City area, the Southeast, the Ohio River Valley and Great Lakes states, and the Pacific Northwest. Omicron cases have been detected in 48 of 50 states, with Montana, Indiana, and Vermont confirming cases this afternoon.

On December 20, North Dakota, Montana, Indiana, and Vermont reported their first confirmed Omicron cases and Texas reported an Omicron-related death – Oklahoma and South Dakota lag the rest of the country in genomic sequencing of test samples

In Miami, lines of cars waited for hours to get COVID tests. Governor Ron DeSantis had boasted Florida had conquered coronavirus on Oct. 27, using data from the New York Times. On Monday evening, Florida reported more than 7,000 new cases a day, an increase of almost 300% in two weeks – second only to Hawaii.

The Washington State Department of Health (WSDoH) reported a sharp increase in COVID cases. The counties with the highest rates were distributed across Washington from the Olympic Pennisula to the Palouse. Only Wahikakum County reported low community spread on Monday.

Percent of Total Population Fully VaccinatedPercentage of Vaccinated People with Booster DoseTotal Population in GroupAverage 7-Day New Case Rate
70.00% or above39.15%2,343,250170.1
60.00% to 69.99%35.36%1,669,300136.0
50.00% to 59.99%32.23%3,339,300111.6
40.00% to 49.99%29.41%268,97577.6
32.70% to 39.99%35.38%151,85085.5
7 Day New Covid-19 Cases per 100K average by Vaccination Rate for Total Population, Adjusted for Population by County, Booster percentage is based on totally fully vaccinated, not eligible, Average 7-day New Case Rate <25 normal, =>25 to 99.9 moderate, => 100, high transmission

Federal officials believe the actual case count is much higher due to asymptomatic carriers and home testing, which isn’t reported to county and state health departments.

According to the University of Washington Virology Lab, the genomic sequencing of SGTF COVID test samples was 70% positive for Omicron on Dec. 16. Data provided by Pavitra Roychoudhury, MSc, Ph.D., of the University of Washington Virology Division, showed Omicron cases had been lab-confirmed in Benton, Franklin, King, Pierce, Snohomish, Thurston, Walla Walla, Whatcom, and Yakima Counties.

Researchers had looked at test samples as far back as Nov. 7 from Idaho, Oregon, and Washington.

Frustration was building on social media as Western Washington residents tried to find rapid COVID antigen tests, booster shots, and appointments for children 5 to 11 to get vaccinated. People waited for hours in long lines to get lab tested for Covid-19 and worried about travel plans as the time to get test results back grew past 72 hours.

Seattle Mayor Jenny Durkan announced that the Rainier Beach and West Seattle vaccination clinics will remain open for boosters and vaccinations into January 2022. Tests sites across the city run in cooperation with the University of Washington are expanding hours to try and meet growing demand. There are fixed test sites at Aurora, SODO, Rainier Beach, and West Seattle, as well as seven Curative kiosks placed throughout the City. In partnership with the City of Seattle, UW Medicine has also opened a site at City Hall, which is available to the public. Appointments are encouraged at all locations, and sites will be closed on Christmas Day.   

Area hospitals are at capacity even though COVID hospitalizations are low

The number of hospitalized COVID patients in Washington has slowly dropped through December. The WSDoH reported there were 640 hospitalized Covid-19 patients on Sunday, and 81 were on ventilators. The numbers are significantly higher than the end of the Fifth Wave in late May, and area hospitals are already filled with non-COVID patients.

Data from the U.S. Health and Human Services (HHS) found regional hospitals have scant resources to manage another surge. Almost half of the regional hospital beds available are at Swedish on Broadway in Seattle and St. Joseph’s Medical Center in Tacoma. The report indicated there were 730 beds available, but that includes resources for pediatric patients and neonatal incubators. Available ICU beds include NICU incubators, PICU beds, and critical care resources for post-surgical, transplant, trauma, and burn patients.

HospitalCityAcute Care TotalAcute Care AvailableICU TotalICU Available
OverlakeBellevue26417344
Swedish – Cherry HillSeattle17024216
Seattle Children’sSeattle308299612
U.W. Medical CenterSeattle6415813998
Swedish – BroadwaySeattle568907955
HarborviewSeattle40099710
Virginia MasonSeattle238203313
EvergreenHealthKirkland2518372
Swedish – IssaquahIssaquah10083026
Valley MedicalRenton292365027
St. Anne’sBurien161443123
Swedish – EdmondsEdmonds1731495
Harrison MemorialBremerton28136496
MultiCareAuburn13831161
St. FrancisFederal Way15545151
St. Anthony’sGig Harbor1080163
ProvidenceEverett61147778
Tacoma GeneralTacoma310-9462
Mary Bridge Children’sTacoma8334114
St. Joseph’sTacoma5732347614
Data is through December 9, 2021, as reported to the U.S. Health and Human Services for all hospitals with more than 50 beds and ICU resources within 30 miles of downtown Bellevue – acute care beds include adult, pediatric, and neonatal, ICU beds include NICU, PICU, and specialized critical care units for post-surgical, trauma, and burns

In a worrying sign from New York, officials reported on Monday night that while many people are experiencing breakthrough cases and having mild symptoms, unvaccinated individuals were 11 times more likely to be hospitalized.

More data released on vaccine and monoclonal antibody effectiveness against Omicron

In an announcement early Monday, Moderna said preliminary data from lab testing found that a booster of the currently available vaccine increased antibody levels to an effective level. The drugmaker said its currently FDA-approved 50 microgram booster increased neutralizing antibody levels 37-fold against Omicron and 83-fold with a 100 microgram “full dose” booster.

An independent study released last week that evaluated the effectiveness of the Pfizer, Moderna, and Johnson & Johnson vaccines had similar results. Vaccine effectiveness appears to be significantly impacted by how long ago someone received their final dose or booster. Multiple studies have found the Johnson & Johnson vaccine is significantly less effective.

Results from a study that reviewed the effectiveness of the Moderna, Pfizer, and Johnson & Johnson vaccines after three months, more than six months, with the previous infection, and with a booster. The Johnson & Johnson vaccine was evaluated using a Modern 50 microgram dose as a booster

A study from the U.K. found that relying on immunity from a previous COVID infection was only 19 percent effective against preventing symptomatic reinfection and 20 percent when relying on vaccination without a booster. The same study found that a booster dose increased protection by 50 to 85 percent. Overall the risk for reinfection was 5.4 times greater than Delta. The study done by the Imperial College of London used PCR test data from Nov. 29 to Dec. 11.

In New York, hospitalists at Mount Sinai Hospital were advised to stop administering monoclonal antibodies because they were ineffective against Omicron. The memo reported that most people seeking treatment had breakthrough infections with mild symptoms that didn’t warrant hospitalization.

Washington state is waiting for the first 552 doses of the monoclonal antibody sotrovimab. Granted Emergency Use Authorization (EUA) by the U.S. Food and Drug Administration (FDA) in May, it is the only remaining effective early treatment for Omicron in the United States.

Concern grows as the hopes of Omicron being “only a cold” fade away

South Africa officials reported 105 COVID-related deaths across the nation on Monday. The number of ICU patients has increased 144 percent since Nov. 25. Omicron appears to have peaked in Gauteng Province but continues to spread rapidly across the nation of almost 60 million.

United Kingdom officials reported another five Omicron COVID-related deaths, bringing the total to 12. Hospitalizations of children under 5 increased 39% week over week, and thousands of healthcare workers have been stricken with Covid-19 infections, causing staffing issues.

A study by the University of Texas Austin for the CDC was made public on Dec. 16. It looked at 18 different scenarios for the spread of Omicron. In ten of those scenarios, the healthcare system in the United States is overrun by patients.

President Joe Biden will address the nation on Tuesday to outline the administration’s new steps to aid states and communities while trying to curb the spread of COVID.

Yesterday, former President Donald Trump addressing a crowd of admirers in Dallas told the audience he had received his booster. A smattering of jeers and boos rippled across American Airlines Center.

“Don’t, don’t, don’t, don’t …” he said.

“There’s a very tiny group over there,” the former President added.

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Where London goes with Omicron Seattle will follow, with the rest of the US close behind

[KIRKLAND, Wash.] – (MTN) A record 93,000 new COVID cases were reported in the United Kingdom by the National Health Service just hours after Trevor Bedford, Ph.D., an Associate Professor, Biostatistics, Bioinformatics and Epidemiology Program Vaccine and Infectious Disease Division, at Fred Hutchinson Cancer Research indicated that where London goes, Seattle will follow five days later.

France closed its borders to the UK on Friday evening and on Saturday, London Mayor Sadiq Khan declared a “major incident” as Covid-19 hospital admissions rose 30% in a week. The National Health Service reported seven people have died from the Omicron variant and believe that “hundreds of thousands” of cases are going unreported. Cases are expected to grow at a dizzying rate well into January.

On Friday, Bedford told reporters that 50 percent of new Covid-19 cases in King County, were likely Omicron and doubling every 2.4 days. The next day, Pavitra Roychoudhury, MSc, Ph.D., of the University of Washington Virology Division tweeted that Omicron was 50 percent of all cases in Washington.

In an interview published on Saturday in the New York Intelligencer, Bedford shared his prediction on what is to come. “I can expect caseloads that are huge. I can easily expect a 50 percent attack rate from Omicron. I can easily expect that.”

“Attack rate,” is how much of the population will be infected – and Bedford predicts that half of the United States population will catch the Omicron variant. Because the United States does not take a national approach to genomic sequencing, and not all hospitals test patients for COVID at admission, the number of people already hospitalized is murky. From the earliest reports, the hospitalization rate was between 2% to 5%.

There was little good news to be found over the weekend on the impact the new wave is going to have on the United States. In the Northeast, Mid-Atlantic, and Great Lakes Region hospitals are already at or over capacity and receiving additional aid from FEMA. Many states are struggling with dwindling testing funds and a lack of data because tracking systems were dismantled over the summer.

A cascade of drug makers indicated late in the week that the current version of monoclonal antibodies in distribution aren’t effective against the Omicron variant. Unlike vaccines, which target all antibodies, monoclonal antibodies only target one. The antibody that was “cloned” in the process was effective against previous variants but doesn’t produce a significant immune response with Omicron.

In a series of studies, only Sotrovimab, produced by GlaxoSmithKline, showed promise against the fast-spreading variant. The monoclonal antibody received Emergency Use Authorization ( EUA) from the U.S. Food and Drug Administration (FDA) on May 26. Health and Human Services (HHS) reported they would be distributing 55,000 doses across the United States this week, with Washington receiving 552.

Back in the UK, the National Health Service reported that on any given day, about one percent of the national health force would be absent from work due to illness. In London, the number of workers calling out sick surged 40 percent. In the United States, healthcare workers have been fleeing the profession for years, while nurses have complained about short staffing for over a decade. Area hospitals will be impacted dramatically if Omicron starts to infect their workforces.

HHS reported over 68,000 people were hospitalized with COVID across the United States. Statewide on Friday, only eight percent of acute care and 12 percent of ICU beds were available. In King County many hospitals are already at or above capacity, but not due to COVID patients. A shortage of staffed skilled nursing and rehabilitation beds has left patients ready for discharge nowhere to go.

Over the summer when patient loads were lower, the Delta wave brought Oregon and Washington hospitals to the brink of crisis standards of care while collapsing the healthcare systems in Idaho and Alaska. Hospitalization rates for COVID and non-COVID patients are already much higher as the region prepares to face the biggest challenge yet.

According to HHS, EvergreenHealth Kirkland had 19 acute care beds available while Overlake had 17. Both hospitals were reporting ICUs near capacity with 3 beds at Evergreen and 4 at Overlake.

During the Delta surge, states learned that activating the National Guard for nurses and doctors was a poor option. Trained hospital staff who are “weekend warriors” were frequently already supporting surging hospital admissions. The activation in some cases made staffing situations worse.

King County residents vented their frustration on social media about the inability to get a booster shot, find home COVID antigen tests, and PCR test results being delayed. In other circles, Seahawks fans raged against the scheduling change against the Rams due to coronavirus.

Officials in the UK pleaded with government officials to implement further public health restrictions to stem the tide of new cases, as models indicate that by January, the island nation could see 3,000 to 4,000 new hospitalizations a day. Londoners were already starting to deal with closed shops and restaurants, and delays in services because so many people have been sickened.

It is unlikely any additional restrictions will be implemented across the United States, where COVID has been turned into a political weapon. The U.S. Department of Homeland Security (DHS) indicated in a Nov. 10 memo, “If a new COVID-19 variant emerges and new public health restrictions are imposed as a result, anti-government violent extremists could potentially use the new restrictions as a rationale to target government or public health officials or facilities.“

Numerous studies and growing real-world data from Africa and Europe indicate that immunity from prior COVID infections or vaccination without a booster provides enough protection to prevent severe COVID symptoms that result in hospitalization and death. Booster shots ideally received within the previous 12 weeks, boost immunity for more.

For people relying on viral vector vaccines such as Johnson & Johnson, AstraZeneca, or Russia’s GNCEM, there appears to be even less protection without a booster. On Thursday, The Centers for Disease Control (CDC) endorsed the recommendation from the Advisory Committee on Immunization Practices (ACIP) to recommend the mRNA Pfizer and Moderna vaccines over Johnson and Johnson. The decision was made due to the waning effectiveness of the J&J vax and nine confirmed fatalities, seven women including one from Seattle, and two men, from vaccine-induced immune thrombotic thrombocytopenia (VITT).

A study published on Dec. 14 found that Moderna with a booster provided the best protection from Omicron, followed by Pfizer with a booster, and then Johnson & Johnson with a Moderna booster. The study also evaluated individuals who had a previous COVID infection and then got vaccinated. They found that immunity was better than vaccination without a booster, but not as robust.

Real-world data from Europe and Africa indicate that relying on immunity from a previous COVID infection is offering little protection from becoming symptomatic. Epidemiologists have stated it is possible to be infected with the Delta and Omicron variants at the same time. It also appears that natural immunity from Omicron won’t protect a person from a later Delta infection.

There is mounting evidence that Omicron is no more severe than Delta, but little evidence it is less so. On Friday the Imperial College of London released a report that found no evidence that Omicron is “mild.”

“The study finds no evidence of Omicron having lower severity than Delta, judged by either the proportion of people testing positive who report symptoms or by the proportion of cases seeking hospital care after infection. However, hospitalisation data remains very limited at this time.”

The challenge for the public and health experts is comparing the current global wave to previous spikes in COVID cases. During the original wave in the spring of 2020, no one had any type of immunity. When the Alpha and Beta waves came in the winter of 2020, vaccines were just rolling out. When Delta arrived the variant was more transmissible and more severe than prior strains. It also was capable of nibbling around the edges of vaccine protection due to its mutations.

Omicron has arrived in a population that has received a variety of mRNA and viral-vector vaccines with different doses as well as disease acquired immunity from different strains. The timing of receiving a vaccine, prior infection, or a combination also impacts how much immunity a person has.

Many people are more mobile and have returned to work and school while simultaneously taking fewer precautions. An additional challenge is the rate of vaccination is not homogenous, with highly vaccinated communities adjacent to vaccine-resistant populations.

All of these factors are obscuring the true nature of Omicron and because the United States does a poor job of genomic sequencing in some states, little is known about the current hospitalized population and which variant patients have.

Although data out of South Africa has been more encouraging, experts had warned that the recent end of the Delta wave, a higher than understood vaccination rate, and the youthful nature of the South Africa population would favor better outcomes. Although only 26% of South Africa’s total population is vaccinated, over 34% of the county was ineligible due to age. On Oct. 20, the nation expanded vaccination to 12 to 17-year-olds and introduced booster shots to adults on Dec. 9. In reality, 44% of South African adults are fully vaccinated, including 61 percent of people over 50. Additionally, only 5.7% of South African residents are 60 or older.

Researchers are watching King County closely for several reasons. The region is a leader in genomic sequencing and research. As Omicron moves through the region it will provide critical data to build a better understanding of transmissibility, the impact on public health measures, prevention and treatment, and how severe Omicron is. King County is highly vaccinated, but has pockets of low vaccine acceptance, providing a more realistic cross-section. Finally, New York City is almost unique compared to other US cities due to its size, reliance on public transit, and the number of people who live in buildings with communal areas.

Dr. Cameron Webb, the senior policy advisor for equity for the White House COVID Response Team shared early symptoms to look for if you start feeling ill.

  • Sore throat, espeically if it is more than mild
  • Headache
  • Fatigue – severe fatigue appears more common in children
  • Runny nose
  • Sneezing
  • Dry cough

County health officials continue to appeal for people to get vaccinated and get a booster shot if they are eligible. They recommend frequent hand washing and wearing an N-95, KN-94, or KN95 mask whenever you’re out of your home, and to stop using cloth masks. When it comes to Christmas and New Year’s celebrations and travel plans, it is recommended to test the day off and celebrate outside or in well-ventilated indoor areas.

Because of the systems put in place by King County Public Health and supported by County Executive Dow Constantine, the region is better prepared to provide vital data to the rest of the nation. It is very likely that by Christmas, Seattle will feel a lot more like March 2020 than December 2021.

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BREAKING: King County residents are urged to prepare for the largest COVID wave to date

[SEATTLE, Wash.] – (MTN) A forecast created by Trevor Bedford, Ph.D., an Associate Professor, Biostatistics, Bioinformatics and Epidemiology Program Vaccine and Infectious Disease Division, at Fred Hutchinson Cancer Research Center, projects that King County will reach record levels by Dec. 22.

In a press conference on Friday, Dr. Jeffrey Duchin, Health Officer, Public Health Seattle & King County said, “The Omicron outbreak we’ve been talking about is no longer theoretical. It is real and it’s here.”

Dr. Duchin shared the current situation in King County, adding that UW Medicine is finding 40% of tests are positive for Omicron and new COVID cases are up 50% since Thanksgiving.

Dr. Santiago Neme, MD, MPH of UW Medicine expressed concern over the number of patients already in Washington hospitals. “Our numbers for COVID infected patients have decreased,” Dr. Neme, said, “but we have been operating at a full or over full capacity for several months in many areas of the state.”

“Any increase in hospital rates or utilization will be pretty challenging for us and very concerning.”

Dr. Duchin added that In King County, hospitals are already caring for twice as many patients as before the start of the Delta wave in August.

Bedford told reporters that the Seattle-Bellevue area would be one of the first cities in the United States to experience widespread Omicron infections and the area was only “a few days” behind London. “New York City is ahead of Seattle and Rhode Island is as well,” he said. But he added this may be due to Seattle having “great S gene drop out data.” S Gene Target Failure (SGTF) is a faster way to identify a likely Omicron variant infection from a positive COVID test. Genomic sequencing is required to make an absolute determination.

Dr. Alexander L. Greninger M.D., Ph.D., M.S., M.Phil., assistant director of the UW Medicine Clinical Virology Laboratory told reporters that sequencing has a 5 to 7 day lag time.

“The number of samples coming into the labs are as high as we’ve seen during the pandemic, yesterday and the day before,” Dr. Greninger added. The UW Medicine Virology Lab has sequenced about 100 samples, and “98 or 99” were positive for Omicron.

The model was created using genomic sequencing data of positive COVID tests, and information on transmission rates from other countries such as the United Kingdom and South Africa. Bedford estimated Omicron cases were doubling in King County every 2.2 days, which is supported by reports from the University of Washington Department of Virology. If the forecast is accurate there could be 2,100 Omicron cases on top of 500 Delta cases in King County by Wednesday. That would far exceed the record number of daily new cases during the fifth wave, and the doubling would continue every one to three days into January.

“Omicron is an airborne disease like Delta and spreads easier indoors, and is a lot more contagious,” Dr. Duchin said, adding, “We do not yet have a clear picture on severity.”

To prepare for the coming wave the message was clear, “The single most important thing you can do is to get vaccinated and boosted even if you’ve had a prior infection,” said Dr. Duchin, “but vaccination alone won’t stop the spread of Omicron.”

King County Health said we need to take advantage of as many layers of protection as we can. That includes wearing tight-fitting N-95, KN-95, or KN-94 masks indoors. The public should avoid crowded indoor spaces, especially if people are unmasked and there is poor air circulation. If anyone feels sick, they should get tested for COVID and stay home to help blunt the spread.

“If you do gather please do safely as possible,” Dr. Duchin appealed. “Limit the number and size of gatherings. Avoid crowded indoor spaces. Do a rapid test on the day of the gathering. Gatherings will be better in large outdoor places or indoor with open windows and doors.”

Dr. Duchin also recommends avoiding travel, especially to areas with high COVID transmission rates. He added that King County has not closed the door on further public health safety measures, but does not plan to add additional measures beyond the guidelines already in place.

The panel stressed that the severity of illness caused by Omicron is still not known. “My read on severity is still difficult – a large portion of infections are both breakthrough and reinfections,” Bedford told reporters. “It may well be the case that Omicron is intrinsically less severe than Delta, but we don’t know. What matters is how many cases do we get and what fraction of those cases require hospitalizations. That is going to be a very large number of cases, severity is not clear enough to know if it will be very bad, bad, or not so bad.”

When asked about breakthrough cases among the vaccinated, Dr. Greninger said, “Moderna and Pfizer are significantly better than Johnson & Johnson.”

“Serious infection is the most important,” added Dr. Duchin. “Meaningful protection against serious infection, hospitalization, and death will protect many of us in vaccinated communities.”

In King County, 160,000 people 12 and older remain unvaccinated and 250,000 have only had a single dose. According to the Washington State Department of Health, about one-third of fully vaccinated King County residents have received a booster dose.

Public and private employers were urged to start contingency planning now to prepare for staffing shortages. “We need to prepare for a large wave of people becoming ill quickly together,” added Dr. Duchin. “We will try to get guidance so we can get people back to work as soon as possible but plan for ‘large scale’ absenteeism.

Public testing sites for COVID will remain open through the holiday season except on Christmas and New Year’s Day. When asked what to do if you need a test on Christmas or New Year’s, Dr. Duchin recommended using a home test versus going to a hospital emergency department.

When asked about the rest of the United States, Bedford didn’t provide an optimistic picture. “Expect things to light up across the United States shortly – first in the cities and then rural areas.”

Looking ahead to the future, Bedford shared that the models he created in the fall have changed significantly due to the Omicron variant.

“Omicron makes things ‘significantly worse.’ I’m quite worried in nine months we will have both Omicron and Delta circulating,” adding, “Omicron will not get us out of this.”