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Update: Omicron cases confirmed in King County

Update as of 12/10/21: The Omicron variant has been identified in five additional residents in King County. Omicron is now circulating and we expect that infections from Omicron will continue to increase over the next several weeks.

Among three cases with information available, none were hospitalized.  The cases noted recent travel within the U.S.; none had traveled internationally. The three cases were vaccinated, one had received a booster. There is no evidence to show these cases are linked to one another nor connected to the first case identified in King County. Case investigation depends on an ability for Public Health to contact and reach individuals to learn about where infections may have occurred and provide prevention counseling. Because Public Health is not always able to gather this information from individuals, it’s possible that we may not have more specifics on the other two cases.

“Although the Delta variant remains widespread and responsible for the vast majority of cases, Omicron is now circulating and we expect that infections from Omicron will continue to increase over the next month,” said Dr. Jeff Duchin, Health Officer, Public Health – Seattle & King County.  

“COVID-19 poses the greatest threat for serious illness to unvaccinated people. The most important thing to know is that the same layered COVID-19 prevention measures that work for Delta also work for Omicron and other variants. Get vaccinated and boosted when eligible, wear a high-quality, well-fitting face mask, avoid poorly ventilated and crowded indoor spaces, and isolate and get tested if you have symptoms or are exposed to someone with COVID-19.”

12/8/21 — Based on our investigation, we’re able to share more information about the case of Omicron identified in King County, announced on 12/4/21. The patient has experienced mild illness and has not required hospitalization. There is no evidence of widespread exposure from this case. The patient has not reported any recent travel, suggesting the Omicron variant has been spreading locally.

12/4/2021 — The Omicron variant has been identified in a resident in King County. The Washington State Department of Health confirmed today, December 4, 2021 that three cases of the Omicron variant were found across the state in King, Thurston, and Pierce counties.

The King County case is a woman in her twenties who tested positive for COVID-19 on November 29, 2021. Genetic sequencing results confirmed the Omicron variant. Based on vaccination records, the individual was vaccinated, and received a booster shot recently, likely after exposure.  

While this is the first reported case in King County, it is likely not the only case. With the variant now identified in multiple states and other countries, Public Health expects to see more cases confirmed in our region in the coming days and weeks. As we have since the early days of the pandemic, Public Health will continue to provide updated information about this variant and the trends we are seeing in King County as soon as we have that information.

Additional information from Dr. Jeff Duchin on the Omicron variant

We recently sat down with Dr. Jeff Duchin to discuss the Omicron variant. Below is the conversation with some additional perspectives now that a case has been found in Washington state.

Q: Now that the variant has been identified in King County, what advice do you have for our community?

As I mentioned this week, based on how rapidly the virus is being identified elsewhere, we expected to identify the variant locally.

It can be unsettling to take in news about a new variant, particularly when there are still unknowns. My advice is to recognize that while there is reason for concern, we are not going back to square one of the pandemic. Omicron may pose new challenges that we will need to respond to, but compared to the early days of the pandemic, we know much more about COVID-19, and we’re better prepared for it. We know layered protections work together to maximally reduce risk, and that will continue to be the case for Delta and for Omicron if that becomes a dominant strain circulating in our community.

Q: What are you thinking about as you are reading the news of the Omicron variant?

Several things. First, this is not the news that I or any of us wanted to hear this holiday season. I know the constant media coverage and contemplating grappling with this virus longer than anticipated is stressful for many. I hope the following information helps put the current situation and the reasons for concern, with all its uncertainty, in perspective.

Second, the identification of this variant in so many countries and states shortly after it was first reported by scientists in South Africa, is another example of how rapidly this airborne virus (SARS-CoV-2) that causes COVID-19 can spread around the globe, and that we live in a highly interconnected world. We need a global solution to this pandemic.

Third, even with a highly mutated virus like Omicron, we are not going back to square one of the pandemic. We know what works to prevent the spread of viruses that cause COVID-19, including: wearing high-quality and well-fitted face masks or respirators; improving indoor air quality through ventilation, filtration of air and UV technology; avoiding crowded indoor spaces; physical distancing; getting tested and staying home and away from others when you have symptoms; and, if you are infected, letting contacts know that they need to be tested. We also have vaccines and treatments available.

I’m also reminded that we are still early in the emergence of this virus that causes COVID-19 and the resulting pandemic, and we have a lot yet to learn. COVID-19 is not done with us, as much as I, and I know you, want it to be.

The virus will continue to evolve, and the scientific and public health communities will continue to pay close attention to understand if new variants pose a threat to human health. 

Q: What do we know about how Omicron might impact us?

We really don’t yet have a reliable understanding of the most important questions we need to answer: how easily the virus spreads, whether it causes more or less severe illness, and how effective our existing COVID-19 vaccines and treatments are against Omicron. But we do know enough to be concerned, and we can think about and plan for different possible scenarios.

For example, early observations suggest the Omicron variant may spread even more readily than Delta and may be good at re-infecting people who had some protection from previously being infected with the Delta variant. Because of its large number of mutations, there is concern about whether our vaccines and antibody treatments will work as well against Omicron (more on this, below).

It’s important to understand that nothing is known with certainty at this time, and although it will likely take weeks or longer to have more reliable information, I expect us to learn new things about Omicron frequently given how closely it is being studied worldwide.

At this time, it is the Delta variant that is the cause of our ongoing local and national outbreak. And the combination of strategies we’ve used against Delta will likely serve us well against Omicron and other variants.

Q: Should we be re-thinking travel, gatherings with friends and family, or scale-back on events where multiple people gather?

Travel poses special risks for COVID-19. The U.S. Centers for Disease Control and Prevention (CDC) has updated guidance for international travel. For travel within the US, vaccination is recommended, as well as taking precautions before, during and after travel.

At this time, I don’t think people need to cancel domestic travel plans, but some people may want to reconsider their plans based on their personal risk tolerance.

Everyone should take steps to reduce their risk for COVID-19, as described above. COVID-19 risk is additive – when making decisions about travel or gatherings, think about the level of COVID-19 at your destination and the risk to you and others based on the size and number of gatherings, type of activities, and the vaccination status of others you will be with. Unvaccinated people, older adults and people with weakened immune systems are at higher risk and should consider taking extra precautions.

Vaccinated domestic travelers should monitor their health and get tested if they develop symptoms. It’s also a good idea to get tested 3-5 days after travel even if you’re fully vaccinated. Unvaccinated domestic travelers should get tested 3-5 days after travel even if no symptoms, quarantine for 7 days even if the test is negative, and quarantine for 10 days if they are not tested.

Q: Do you anticipate the new Omicron variant to lead to new public health measures?

COVID-19 is throwing another curveball at us with the Omicron variant, but at the moment we don’t know if it’s throwing mostly balls or strikes.

Although at this early time we can’t predict with certainty, I’m optimistic we can continue to use our current strategies and tools to manage the Omicron variant. But if we see a rising threat to our healthcare system — for example, increases of severe illnesses — we will need to consider whether additional actions are needed.

Currently, the take-home message is to keep doing what’s working for us in King County to continue our recent downward trend in cases and hospitalizations. That means vaccination, booster doses when eligible, good-quality masks or respirators indoors, avoiding crowded indoor spaces, improving indoor air quality, and other COVID-19 prevention measures. Vaccine verification for indoor activities and large outdoor events provides additional protection.

Layered protections work together to maximally reduce risk. If there is room for improvement in how we are using our current tools and strategies, this is a good time to make those improvements.

Q: How important is vaccination?

Vaccination and getting a booster dose when eligible are currently the most important things we can do to protect against COVID-19 caused by the Delta variant and a potential Omicron threat. Although we don’t yet know for sure how well our current vaccines will work against Omicron, there is a good chance they will offer meaningful protection.

The more people who are vaccinated, the more protected we will all be. King County residents should be proud of our relatively high vaccination rates: 85% of people 12 and older are fully vaccinated, and almost half a million residents have received their booster. But we still need improvement, especially in young adults, children, and certain racial and ethnic groups and neighborhoods. Booster doses are very important for those who are eligible because they increase the level of protection against Delta and other variants.

Vaccination greatly reduces your risk of getting and being hospitalized for COVID-19 now. Over the past 7 days, a King County resident was hospitalized for COVID-19 every 3 ½ hours, and most of these are unvaccinated people. Our latest data show that in King County, people are 36 times more likely to be hospitalized for COVID-19 if they are unvaccinated.

Unvaccinated people remain at highest risk from both the Delta variant and a possible future Omicron outbreak. We will continue to work with community partners and healthcare providers to increase access and remove barriers to vaccination and close the remaining gaps in coverage.

Q: Finally, since there is a lot to wade through with all this news, what should we be paying attention to?

It may be helpful to take a step back, take a breath, and remember that it will take a few weeks before we have more reliable information about how Omicron will affect us.

Compared to the early days of the pandemic, we know much more about COVID-19, and we’re better prepared for it. We now know this virus spreads through the air and therefore high-quality, well-fitting masks are very important. We know that the virus builds up in closed spaces, so we can make sure there’s good ventilation indoors to reduce the risk of spread. We know that the vaccines have been extraordinarily effective at reducing risk of severe illness, and everyone 18 and up can get important additional protection with boosters.

Paying attention to what we know works and using the tools we already have available is the right approach for now.

Originally published 12/4/21; updated 12/8/21.