King County health officer: An endemic state does not mean ‘the outbreak is over’

In King County — and across much of Western Washington — COVID case numbers are falling.

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Health Officer Dr. Jeff Duchin said Thursday he hopes this decline continues, and that the region “can move to a more sustainable and less disruptive long-term strategy to limit the harm from this virus.”

“But for right now, there’s still a whole lot of COVID-19 going on,” he said.

Watch Dr. Duchin’s update here.

While cases and hospitalizations have been falling since Jan. 10, Duchin says these numbers are still very high in King County. In January, people who are not fully vaccinated were twice as likely to have a COVID-19 infection, 13 times more likely to be hospitalized, and 16 times more likely to die from COVID.

“Our vaccines, especially with the booster dose, are continuing to provide most people with excellent protection from serious infections,” Duchin said.

In addition to vaccinations and boosters, Duchin spoke to the continued importance of COVID precautions — including wearing masks, avoiding crowded and poorly ventilated indoor spaces, isolating from others when you are sick, and getting tested if possible when you have symptoms or have been exposed to someone with COVID.

“Together, these strategies, these layers provide the additive level of protection that we need for this time while we have such high levels of COVID-19 continuing to circulate in the community,” he said.

Pandemic vs endemic

After recapping the numbers, Duchin switched gears to address the discussion surrounding a shift to an “endemic” stage, where COVID would become more like the seasonal flu.

“When people talk about the COVID pandemic ending and COVID becoming endemic, I think what they’re really saying is they believe the worst is behind us,” he said. “And there are good reasons why that may be true, and I hope more than anything that it is. It’s not a certainty.”

“We shouldn’t assume that a variant that’s worse than delta, or worse than omicron won’t emerge in the future,” he said. “The transition from pandemic to endemic will not happen suddenly or by decree, but gradually, as we move from a new, emerging, and unfamiliar, highly unpredictable pandemic, to an endemic state that is more predictable with respect to the virus’ virulence and its occurrence over time.”

Local health officer: Transition from pandemic to endemic won’t be like a ‘light switch’

The timeline for this transition and what the endemic state will look like, however, are unknown, and will be influenced by a number of factors, Duchin says, including how the virus evolves, new variants, and how well immunity from vaccination and infection holds up.

“But the term endemic doesn’t really help us know what we can expect with respect to severity of illness, frequency of surges, seasonal patterns, or overall impact on the population,” he said. “What it does do is imply a more predictable range of illness, occurrence, and impacts. We just don’t know with much certainty yet what that state will look like.”

“So from my perspective, the pandemic versus endemic terminology debate is of little practical value, and can even be counterproductive if it leads to complacency by implying the outbreak is over, or by equating endemic with relatively mild or not serious, or to the failure to plan and take the necessary steps that we need to take to help us live with COVID-19 with the least disruption and impact on our health, our economy, and our society over the long-term,” he added.

Duchin says we should instead be focusing our energy on protecting ourselves and our community given our current reality and the unpredictability regarding how COVID will evolve.

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