County Faces Steep Decline in Available Vaccines, Youth Sports Teams See Outbreaks

by Carolyn Bick

There appear to be a small, but growing number of COVID-19 outbreaks among youth sports teams in King County, most of which have occurred in the South End. As of this writing, there have been 10 outbreaks this year, sickening 34 youths and eight adults.

In a press conference on Friday, April 9, Public Health — Seattle & King County (PHSKC) Public Health Officer Jeff Duchin mentioned that in the past week two more outbreaks had been traced back to youth sports teams, bringing the total to 10. Duchin first mentioned outbreaks among youth sports teams in a press conference last week. He said these outbreaks were attributable to situations before and after sporting events, such as team meals and travel, rather than during the sporting events themselves. These youth sports team outbreaks have appeared alongside a rise in cases across the County and State in adults — particularly young adults — in part due to similar socialization activities. They also come as the County faces a severe vaccine shortfall.

In a follow-up email to the Emerald, PHSKC Public Information Officer Kate Cole said that there have so far been three outbreaks in Kent, two in Auburn, one in Covington, one in Seattle, one in Woodinville, and one in Snoqualmie. Cole said that half of the outbreaks occurred in teams associated with K-12 schools, and the other half occurred in community sports clubs.

When the Emerald asked about ages of the players sickened for last week's story, Cole explained in an April 7 email that she wasn't able to get ages, because "we don't currently have a classification for 'youth sports' in our database, so the team has to pull this data manually meaning it can be tricky to get stuff like this."

She later clarified in an April 10 email that this doesn't mean PHSKC doesn't have the data, and offered to get this information to the Emerald in the coming week. In an April 12 email, Cole said that the youth who became sick with COVID-19 were aged 12 and older.

When the Emerald followed up on April 9 to ask whether there is racial demographic data available for the 10 documented outbreaks, Cole replied that because there is such a small number of youth cases, sharing the racial demographics may unintentionally lead to identifiable information.

"For instance, if a school knows their cricket team was shut down for COVID, and there's only one kid on the team of a certain race (and one kid of that race in the outbreak data), it becomes obvious that child had COVID," Cole explained.

The Emerald also asked whether any of the youths sickened have had to be hospitalized. However, PHSKC does not track that information, as it relates to outbreaks, Cole said.

"We track hospitalizations for COVID (you can find it on our dashboard), but we don't systematically link that information to individual patients we're investigating as part of outbreaks," she said. "That said, it's worth noting that COVID hospitalizations for people 19 and younger in King County has been pretty rare — the King County hospitalization rate for the pandemic as a whole is 25 per 100,000 for ages 10-19, and 19 per 100,000 for ages 0-9."

These outbreaks represent just a fraction of COVID-19 cases in the County — which currently stand at an average of 255 new cases per day, Duchin said in the April 9 press conference — but they come just as some children in grades K-5 in Seattle Public Schools returned to partial in-class instruction, and students grade 6-12 who chose in-class hybrid instruction are preparing to return on April 19.

Duchin said in the press conference that cases continue to rise among all age groups, with the exception of those 75 and older, and that cases are rising most sharply in those aged 18-24. He also said that the County's overall rate of hospitalization is double what it was in early March, with "one person hospitalized every two hours every day, all day," and that hospitalizations are currently highest among 40-69-year-olds, followed by those 20-39 years old. However, over the past week "more 20-39-year-olds were hospitalized than people over 70 for COVID-19."

"The increasing number of hospitalizations among young adults reinforces that although the rate of hospitalization is low in this group, when COVID-19 is widespread, severe cases will occur, even in younger people," Duchin said. "COVID-19 can cause severe disease in people of all ages."

Duchin's warning comes two days after the Centers for Disease Control and Prevention's Director Dr. Rochelle Walensky said that more and more young adults are requiring hospitalization, due to severe cases of COVID-19.

Duchin said in response to a KUOW reporter's question that it will "take a bit more observation to know with any certainty whether the hospitalization rates in these populations are significantly changing," and likened the rise among young people to the rise the County saw in this past autumn's and winter's surge in cases. He also noted that young people "are starting out at a relatively low rate of hospitalization, compared to other groups."

With respect to whether any variants of concern are driving the rise in hospitalizations, Duchin said that "we are very early in the game" with respect to those variants, and that he likely won't have any information about that for another week or two.

Though he remarked on the "tremendous statistic that we have not had an outbreak in a long term care facility now for over one month," Duchin said that people continue to be exposed to the novel coronavirus or one of its variants in everyday situations, such as in the workplace, social events, and households.

"Nearly 40% of cases reported going to workplaces during their exposure period in the last month, and that's an increase from earlier this year," Duchin said. "Thirty percent have cited attending family visits or group meals, parties, weddings, or other social events, during their exposure period, which is also an increase from earlier this year."

The increase in social event exposures appears to line up with Washington State's March 22 move into Phase 3 of the State's reopening plan, which allows for significantly more gathering both indoors and outdoors. The State as a whole is seeing a rise in case counts, and Duchin said in the April 9 press conference that Washington appears to be heading towards a fourth wave of COVID-19. He has warned about this in recent past press conferences, too.

It should also be noted that last summer there were no variants of concern to contend with. Now, there are at least five.

But this does not mean that either the State or even individual counties will move back into a more stringent reopening phase.

Just before the press conference on April 9, Gov. Jay Inslee's office sent out a brief press release stating that, in order to move back into a more stringent reopening phase — in this case, back from Phase 3 into Phase 2 — a county will now need to fail both health measurement metrics of case counts and hospitalizations rather than just one, as had been the case before. The decision comes just a few days before all counties are assessed to determine whether they may stay in Phase 3.

"Given the incredible progress on vaccinations and our focus protecting people from severe illness, we believe analyzing and requiring both metrics together is the right approach to make sure we're considering the connection between COVID cases and our medical system and hospitalizations," Inslee said in the press release.

He did not note that the state will be receiving a significantly lower volume of vaccines than it had planned on, which means that though everyone 16 and older will be eligible for the vaccine on April 15, many will see their vaccinations delayed. This is due to a major manufacturing error at a Johnson & Johnson plant in Baltimore, Maryland, which ruined millions of the company's one-dose vaccines. The shortage will affect vaccine supplies for at least three weeks, and the federal government has cut Johnson & Johnson vaccine supplies from about 5 million to just about 700,000 doses nationwide for the week of April 12.

In response to the KUOW reporter's question about the effects of the cuts — specifically, which populations in King County will now no longer be getting a Johnson & Johnson vaccine as planned — and whether PHSKC is trying to ensure that those who will now no longer be getting the Johnson & Johnson vaccine will still get one of the other available vaccines, Duchin said that "whenever possible, we work with a provider and if the population is appropriate to use a different vaccine."

"However, as I mentioned, overall, our vaccine supply at this point is decreasing below what it has been for the past two weeks. So, in all areas, there will be fewer first doses available, which is creating the situation we had hoped would not exist, where supply is less than what is necessary to meet the current eligibility," Duchin said, noting also that the County next week will see a significant increase of eligible people, "without a proportional increase in vaccine supply. So, what that is going to mean is that across all sectors, there will not be as much vaccine available as we would like."

He went on to say that PHSKC will no longer be able to hold certain vaccination events, until that supply is back to appropriate levels, and that the County is " looking, at best, at a stable vaccination supply overall."

"That will mean, as I predicted, more people trying to access a stable or potentially lower number of vaccine doses. That is why we are really trying to emphasize the importance of this week everyone reaching out to those who are currently eligible by virtue of a high-risk condition, or being an essential worker, or equity considerations," Duchin said. "Going forward, to the extent possible … we want to continue to focus this vaccine in an equitable way on those populations at highest risk of developing severe COVID-19 infections, being hospitalized, and dying."

He did not answer the question regarding what populations will be most affected by this cut in vaccination availability.

📸 Featured Image: COVID-19 vaccination site. Photo by Macau Photo Agency under a Creative Commons license via Unsplash.