As Inslee Allows More Counties to Open, King County's Public Health Officer Warns of 'Serious Storm on the Horizon'

by Carolyn Bick

Cases of COVID-19 in King County and throughout the state of Washington may be going down, but Public Health — Seattle & King County's Health Officer Dr. Jeff Duchin says that this is just the calm before the "serious storm on the horizon."

"I think we may be watching the tide silently recede before a tsunami," Duchin said in a Feb. 12 press conference, referring to what he and many other health experts around the country believe has the potential to be "a very large and destructive fourth wave" of COVID-19 cases driven by the B.1.1.7 variant, an extremely contagious and probably deadlier variant of the original novel coronavirus. It is one of three variants that have been detected throughout the United States.

"[B.1.1.7] is silently doubling about every 10 days, and it is expected to become widespread in the next month or so, as exponential growth accelerates," Duchin said. "What [exponential growth] means is that the larger an outbreak gets, the quicker it accelerates. … We need to continue to do everything we can to prevent the spread of COVID-19 in all aspects of our lives and get our numbers and hospitalizations as low as possible, before the variant reaches this critical mass and erupts."

Duchin appears to be one of the only health experts in Washington State who are trying to warn the public that this wave is upon us. In contrast, health officials at the state's Department of Health and Governor Jay Inslee are painting rosy pictures of the state's situation, focusing most of their attention on the arrival of a vaccine. Inslee has even gone so far as to open up five more regions to Phase 2, which allows for indoor dining, indoor gym use, and indoor religious ceremonies, according to the State's Roadmap to Recovery plan.

Inslee had previously opened up both the West region and the Puget Sound Region to Phase 2. He did so by removing the requirement that regions must meet all four metrics laid out in the Roadmap to Recovery to move into this phase. Now, regions must only meet three metrics, which means that these regions aren't necessarily doing any better. Officials have simply moved the artificial goalposts of what they want to use to determine the health of a region.

Moreover, as Duchin noted in a Jan. 29 press conference, the Roadmap to Recovery and these metrics were created before the arrival of the much more contagious and probably deadlier coronavirus variant. The variant has been detected in King County, Snohomish County, and Pierce County, all of which are now open to Phase 2 activities. As of this writing, 15 cases of the variant have been detected in the state. Just a few days ago, only five cases had been detected in the state.

Duchin has not spoken directly about Inslee's decision, except to say in the Jan. 29 press conference that the "mixed messaging" the decision reflects is "very challenging." In the Feb. 12 press conference, he said that while he is "very glad to report that our new cases continue to fall," this doesn't mean that we are in the clear — not by a long shot.

"Because we started a fall from such a high altitude, even though we are still falling, at the moment, we remain at a high level of COVID-19 transmission," Duchin said.

At the time of this writing, King County has seen almost 80,000 cases of COVID-19 since the outset of the pandemic. Of those cases, more than 5,000 people have been hospitalized, and 1,300 people have died, Duchin said.

"We've had 39 more deaths since we spoke a week ago," Duchin said. "Our seven-day average of new cases is about 200 cases a day. Our 14-day incidence is about 156 [people] per 100,000 [people], which is still considered high-risk. We saw 15 hospitalizations per day in the past week, and about three people died of COVID-19 every day last week."

Additionally, Duchin said, health disparities persist amongst the state's most vulnerable populations, particularly in South King County. Areas such as Auburn, Renton, Kent, Federal Way, Tukwila, and SeaTac are seeing cases rates that are three times as high as in central Seattle. The hospitalization and death rates are also three-to-four times higher in these areas.

He also highlighted the fact that these disparities also persist in vaccination rates.

"Compared with people who identify as white, people who identify as Black are three times more likely to be hospitalized and over 50% more likely to die. And those who identify as Hispanic are six times more likely to be hospitalized and three times more likely to die," Duchin said. "Yet, these groups are underrepresented among those who have been vaccinated."

He said that these disparities also extend to healthcare workers, as public health experts are seeing more doctors and nurses than medical assistants and technicians — many of whom are People of Color — getting the vaccine.

"We want to encourage everyone who works in a healthcare setting to please come forward for a vaccination. It protects both you and those around you," Duchin said.

Duchin said that health officials have been working hard to address these disparities, such as opening vaccination sites in Kent and Auburn but that "we clearly need to do more to close those gaps." He said that PHSKC is doing "new outreach to high-risk, hard-hit communities." This outreach includes a partnership with Microsoft to launch a new vaccine site for older, high-risk adults and their caretakers in Redmond. This partnership involves several community organizations to reach out to older adults in Black, Indigenous, and People of Color communities, as well as in Russian and Ukranian communities.

Duchin also said PHSKC has created a set of vaccine equity principles to address inequities across the board and that PHSKC is supporting vaccination efforts at its Kent and Auburn vaccination sites by "engaging with 20 community partner organizations serving older adults and working with our community navigators to help … schedule appointments for elders." He said that these efforts have so far been successful and that PHSKC looks forward to expanding these efforts as more vaccine becomes available.

According to top national health expert Dr. Anthony Fauci, enough vaccines to get everyone vaccinated should be available starting in April, though it will likely take several more months to get enough people vaccinated. Fauci's statement came after the Biden administration's efforts to ramp up vaccine production and Johnson & Johnson's recent Emergency Use Authorization filing for a one-dose vaccine.

Duchin said that the best things people can do is to wear tight-fitting masks, as per the Centers for Disease Control's most recent guidelines, and to avoid gathering together. His reminders of best practices come just before Valentine's Day, when many usually go out to restaurants. Last week, Duchin tweeted out a ProPublica article entitled, "Why Opening Restaurants Is Exactly What the Coronavirus Wants Us to Do." The article warns that governors' decisions to allow indoor dining and other indoor activities before vaccinations become widely available "could create superspreading playgrounds for dangerous variants and squander our best shot at getting the pandemic under control," according to epidemiologists and public health experts.

"We cannot become complacent, because we are not close to a 'We got this' moment," Duchin said.

Carolyn Bick is a journalist and photographer based in South Seattle. You may reach them here, and can check out their work here and here.

Featured image: The CDC's variant tracker shows 15 cases of the B.1.1.7 variant detected in the state.

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