COVID still ‘simmering’ in the county, while booster uptake remains low

EVERETT — COVID is still “simmering” in the community, Dr. James Lewis said Thursday at the Snohomish Health Department’s Public Health Advisory Council meeting.

COVID hospitalizations and case rates are relatively low. But Lewis, the county health officer, said: “If anything I’ve learned from COVID, is that you never know what it’s going to do.”

One recommendation remains constant: Stay current on COVID and flu vaccinations, Lewis said. Just 30% of eligible Snohomish County residents have received a bivalent booster shot.

The many headlines and emerging research about boosters raise questions about which types are most effective, and at what intervals. Despite the complexity of the research that Lewis reviews, he said even people not at risk for severe illness should get their boosts.

“The main reason is because it will reduce your risk of symptomatic infection still, even if you’re not high risk,” Lewis said. “But the other reason is, it likely will decrease the amount of time that you’re infectious to others, and so reduce the risk that you would transmit to someone else who would be high risk.”

Higher-risk groups — like seniors and people with weakened immune systems — still suffer from severe illness and even death. In Snohomish County, around 50 patients were hospitalized for COVID last week, and an additional 15 residents of long-term care facilities fell ill from a facility “outbreak.”

And anyone can suffer from long COVID, with a range of mild to severe symptoms that might drag on for months.

Lewis said it’s not clear that an annual plan for booster shots makes sense, but that could change.

“I appreciate (the FDA) trying to come up with a simplified approach,” he said. “That being said, there’s definitely areas that we need to research more to come up with optimal ways to do this, not just for the timing of how often people are getting vaccines or booster shots, but also, what the makeup of those shots is.”

The county health department links to the current booster guidelines from the Centers for Disease Control and Prevention. Those guidelines vary based on age, type of first vaccination series, length of time since the last dose of vaccine, length of time since previous COVID illness and other special situations.

The official COVID case counts seem quite low, but they have lost some usefulness as more people test at home.

As an alternative, wastewater treatment facilities can sample water as an indicator of virus activity. When people have COVID, they can shed the virus in their feces.

The Washington Department of Health processes and publishes wastewater sample data, including several locations covering parts of Snohomish County. Lewis said the county “has some of the best wastewater data in Western Washington” — data that has correlated with disease transmission in the community. It roughly aligns with hospitalizations from the summer and late fall.

Lewis is actively working to get the health department more timely access to that data.

“I think it could potentially give us an early warning, not months early, but maybe a couple of weeks early,” Lewis said.

The newer, more contagious, strain of Omicron, XBB.1.5, hasn’t dominated other strains of the virus on the West Coast, according to CDC data. It’s another unknown and unpredictable variable.

Yet at the end of January, the worst of the tripledemic could — emphasis on “could” — be behind us, for this season. The University of Washington’s Seattle area data shows a sharp drop in total cases of flu and RSV. Influenza A peaked at 929 cases at the end of November, and dropped to 28 cases last week. RSV peaked at 582 cases in mid-November, and dropped to 61 cases last week.

But like COVID, RSV has acted unpredictably, with an off-season surge last year, Lewis said. And the flu sometimes peaks twice in one season.

“There’s lots of things that are unusual about what’s been going on with respiratory viruses this year, so I wouldn’t count it out,” Lewis said.

Currently the county health department does not have any flu or COVID vaccine clinics scheduled. Check the department’s website for more information: snohd.org

Joy Borkholder: 425-339-3430; joy.borkholder@heraldnet.com; Twitter: @jlbinvestigates.