Face coverings again recommended for indoor public settings

By Public Health – Seattle & King County staff

Public Health – Seattle & King County now recommends that all county residents 5 years of age and older, regardless of vaccination status, wear face coverings in indoor public settings.

This extra layer of protection will help us all stay safer, including those who are unvaccinated, such as the 300,000 children in King County who aren’t able to get vaccinated yet, and the many thousands of people who have immune systems that are weakened or suppressed.

“This virus will is getting better and better at finding people who are unvaccinated, and that is what we are seeing in the recent data from King County,” said Dr. Jeff Duchin, Health Officer, Public Health – Seattle & King County, on Friday, July 23. “While we would all like to have COVID-19 completely in the rearview mirror, and although our vaccines are greatly diminishing the threat, we remain vulnerable to continuing COVID-19 spread impacting our community, especially for those who remain unvaccinated and those who aren’t able to be protected, including children under 12 and people who are immunocompromised.”

After weeks at some of the lowest levels of COVID-19 since last year, the number of COVID-19 cases and the size of outbreaks in King County have begun to rise again. An uptick is not unexpected as restrictions on activities are relaxed, but the rising numbers should prompt all of us – vaccinated as well as unvaccinated – to take extra precautions.

Concerning trends in cases, hospitalizations, and outbreaks

COVID-19 has been on the rise in King County since June 29, when King County’s indoor mask directive ended. At that time, Public Health was reporting an average of 61 new cases daily. Since then, our average daily case counts have swelled to 141 – a 130% increase in just over three weeks.

Hospitalizations and deaths have remained relatively low compared to past peaks, which is what we would expect in a county with relatively high rates of vaccine coverage. But recently, hospitalizations are also on the rise. Over the last seven days, 45 people were admitted to hospitals in King County for COVID-19, a 32% increase over the previous week, and the hospitalization rate has doubled from 1 per 100,000 per week on July 7 to 2 per 100,000 per week on July 17.

A number of recent outbreaks have occurred in indoor settings where people have prolonged contact with one another, such as gyms and social gatherings. These outbreaks, like others reported nationally, include indoor public settings where unvaccinated and fully vaccinated people are in contact with each other and are not masking. There are some instances of infection even among vaccinated people engaging in indoor activity in a poorly ventilated space without masks.

Vaccines are as important as ever

The best way to stem this increase is for everyone who is eligible to get vaccinated. The large majority of recent cases, hospitalizations and deaths are among unvaccinated residents. Over the past 30 days in King County, 94% of hospitalizations and 94% of deaths due to COVID-19 occurred among people who aren’t fully vaccinated.

While the share of COVID-19 cases among fully vaccinated people has increased over the last month, illness rates among vaccinated people are low compared with unvaccinated people. About 14% of people who tested positive for COVID-19 between June 9 – July 6 were fully vaccinated, compared with 86% who were not. The hospitalization rate is 34 times higher among unvaccinated residents compared to vaccinated residents, and the death rate due to COVID-19 is 43 times higher among unvaccinated residents compared to vaccinated residents.

COVID-19 vaccines provide very high-level protection against what’s most important: serious infections with hospitalization and deaths. Since no vaccine is 100% effective, it’s not surprising that some vaccinated people may develop COVID-19 and be able to pass the infection to others, although that is much less likely than for unvaccinated people. When vaccinated people do become infected, their illness is typically mild and not serious. Unfortunately, the Delta variant may increase the risk of vaccinated people developing mild breakthrough infections compared to earlier strains, but our vaccines still offer excellent protection.

The role of variants in King County cases

When you’re exposed to COVID-19 today in King County, it’s most likely that you’re being exposed to a highly contagious variant of the virus. Of the recent COVID-19 test samples genetically sequenced in King County, about 90% represent a variant of concern and not the original strain of the virus, and about 60% of these are the Delta variant. This is concerning because the Delta variant is so contagious.

Why are cases rising?

Nailing down exactly where people are being exposed is complicated. Contact tracers ask people who test positive for COVID-19 about where they’ve spent time during their contagious period. Comparing the most recent 30 days with the month prior, an increasing share of people with COVID-19 report having attended a social event (36% vs 28%), visited a bar or restaurant (15% vs 10%), or and to have travelled out-of-state (17% vs 9%).

What should we do about it?

The most important way to protect yourself and your community is to get vaccinated. Vaccines provide strong protection against the original strain of COVID-19 and variants of concern.

Wear a mask in indoor public settings

The increasing numbers mean that all of us, even people who are fully vaccinated, should consider taking extra precautions, especially in indoor settings with other people. Unvaccinated people are currently required to continue wearing masks in public, indoor spaces and should continue to do so.

Washington state already requires unvaccinated people to wear masks in indoor public settings, although in stores and other public spaces, there is no practical way to know who is vaccinated and who isn’t. For this reason, universal masking in indoor public spaces provides a more reliable way to ensure everyone is safer as we monitor the current increasing disease trends.

Masking in public spaces is also beneficial for those who are in close contact with someone at increased risk, to model mask-wearing for children, and to protect from other respiratory illnesses or allergens.

In addition to masking, as a community, we need to add as many layers of protection as possible right now.

• Airflow and ventilation are crucial variables indoors. COVID-19 builds up in the air as infected people breathe, and the risk increases where people are exercising, singing, or shouting. Windows and doors should be opened when possible to maximize the movement of air. Building and business owners should consider upgrading HVAC systems and air filtration. When possible, gather outside, where the risk is much lower.

• If you have even mild symptoms, whether or not you’re vaccinated, get a COVID test and quarantine yourself away from others while you wait for your results.

• If you’re already vaccinated, now is a time to listen to friends, families and co-workers who may have concerns and help connect them with information to help answer their questions.