As Cases of Delta Variant Rise in King County and State, Mask Guidelines Revised

by Andrew Engelson

With the highly contagious Delta variant of COVID-19 causing a rise in case counts and hospitalizations in both King County and Washington State among those who have not been vaccinated, local health authorities have revised masking guidelines.

On Monday, July 26, health officials from eight Puget Sound counties issued a joint statement recommending that all residents in those counties (including King, Pierce, and Snohomish) should wear masks in indoor public spaces.

"We recommend all residents wear facial coverings when in indoor public settings where the vaccination status of those around you is unknown," the statement reads. "This step will help reduce the risk of COVID-19 to the public, including customers and workers, help stem the increase in COVID-19 cases and hospitalizations in many parts of the state, and decrease the spread of the highly contagious Delta variant."

Public Health — Seattle & King County (PHSKC) health officer Jeffrey Duchin noted in an online press conference on Friday, July 23, that though vaccination rates in King County are relatively high compared to the rest of the nation, more than 700,000 King County residents, including 308,000 children under 12, remain unvaccinated or at a higher risk from infection. "I'm recommending at this time that all people, regardless of vaccination status, once again voluntarily wear masks in indoor public settings as an extra layer of protection to help us all stay safer," Duchin said.

The new local masking guidelines came a day before the Centers For Disease Control (CDC) offered similar recommendations on Tuesday, July 27, urging that all people, vaccinated or not, should wear masks in crowded indoor public settings in regions of the country where incidence of COVID-19 is high.

In the online press conference, Duchin pointed to a recent report from the University of Washington's Institute for Health Metrics and Evaluation (IHME) that predicted if universal masking was implemented in Washington it would "prevent between 540 and 880 deaths in Washington State by Nov. 1," he said.

In the Friday press briefing, Duchin noted that after two months of declining case rates, in the past seven days the trajectory of COVID-19 infections has significantly changed. Cases and hospitalization rates in King County are now rising, with the average number of new cases daily at 141 — twice the daily number over the past three weeks. According to the County's COVID-19 dashboard, case rates are higher in South King County, mirroring past pandemic trends. Among ethnic groups in King County, case rates were highest among Native Hawaiian-Pacific Islanders (148 per 100,000), Black residents (69 per 100,000) and Hispanics (50 per 100,000). Duchin also noted that in the past two weeks, PHSKC has seen a particularly sharp increase in cases among white residents.

According to a press release from the Washington State Department of Health (DOH), since July 8, hospital admission rates have increased for people in the 40 to 49 age range and the 70 to 79 age range and may also be rising in the 20 to 39 and 60 to 69 age range. Though hospitalization and death rates remain relatively low in King County, Duchin noted they are increasing and are highest in the 40 to 69 year age range. Deaths per day in King County average a rate of 1, down from 10 prior to the start of vaccinations in the County.

According to sequencing data from positive samples in the county, PHSKC estimates that 56% of cases in the county are now the highly contagious Delta variant, which causes those infected to produce about 1,000 times more virus than the original COVID-19 strain. Vaccines offer protection from this new strain.

"It's important to be clear that our vaccines provide excellent protection against the Delta virus," Duchin said in the press conference, and he was optimistic about rates of vaccination in King County.

Duchin reported that at least 80% of King County residents 12 years and older have now received at least one dose of COVID-19 vaccine and nearly 75% of those 12 and older have completed their vaccination series — making it one of the most highly vaccinated counties in the U.S.

"Vaccination is the single most important thing you can do to protect yourself and those around you," Duchin emphasized. Even with reports of breakthrough cases among those who are vaccinated, the Pfizer, Moderna, and Johnson & Johnson vaccines all provide a highly effective way to prevent hospitalization and death from COVID-19. Duchin noted that mRNA vaccines are some of the most effective ever made, according to a study by PHSKC epidemiologists of King County cases between June 9 and July 6.

Duchin said about 14% of people who tested positive for COVID-19 in that period were fully vaccinated versus 86% unvaccinated. Most of the "breakthrough" cases among vaccinated individuals were mild. The vast majority of hospitalizations and deaths were among those not vaccinated. In King County over the past 30 days, 94% of hospitalizations and 94% of deaths were among unvaccinated people. The King County analysis found that the rate of infection for unvaccinated people was 15 times higher than those vaccinated; the rate of hospitalization was 34 times higher, and the death rate was 43 times higher for unvaccinated individuals. These figures mirror national statistics showing that between 97% and 99% of deaths from COVID-19 in the U.S. are among unvaccinated people.

"The idea that we should use masks again … shouldn't deter anyone from getting vaccinated," Duchin said. "Vaccination, by far and away … is the most important thing you can do to keep yourself out of the hospital and lower your risk for dying."

There is overwhelming evidence that COVID-19 vaccines are safe and effective. They're available free of charge to everyone 12 years old and up, and you can find more information about where to get a vaccine at King County's COVID-19 vaccination information page or by calling 206-477-3977, 8 a.m.-7 p.m., to receive information in several languages.

Andrew Engelson is a Seattle-based writer and editor who lives in the South End.

📸 Featured Image: Individual wearing a face mask. (Photo: Susan Fried)