Amid a COVID Surge, Washington Hospital Leaders Wonder Why Fewer People Seem to Care

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A wave of infections since mid-March has meant a steady increase in COVID-19 hospitalizations. But during this surge, fewer people seem to be talking about it.

And that has hospital officials showing some frustration as they fear Washingtonians might not fully understand the burden on public health.

Yes, most people are not getting as sick as they were during past peaks, Cassie Sauer, president of the Washington State Hospital Association, said in a Monday news briefing. And doctors and scientists have a better understanding of the disease now, as well as better access to antiviral drugs. Vaccination rates are also higher and new variants have, so far, been less severe.

That doesn't mean people aren't dying from COVID or suffering from long-term symptoms, hospital leaders said.

"It's all the same stuff we've been doing all along. ... And yet the community's not feeling that at this point," said Dr. David Carlson, chief physician officer at Tacoma-based MultiCare. "I don't have a magic understanding of why that is other than there is just this enormous amount of fatigue, and COVID is not continually the story on the news today."

Dr. Chris Baliga, infectious disease specialist at Virginia Mason Franciscan Health, added that people should not be surprised when they test positive for the virus now.

"[Washingtonians] are just not as aware of it as perhaps they could be," he said.

Fortunately, Sauer said, current infection and hospitalization levels are still lower than they were during the state's last omicron surge. At the end of last week, health care systems counted about 600 COVID patients in hospitals across the state — an increase of about 10% from the previous week, though nowhere near the peak of 1,700 COVID hospitalizations in a given week in early February, she said.

The state is seeing less than one death a day, but several per week. About 20 to 25 COVID patients are on ventilators per day, compared to 100-plus in January.

At the end of last month, however, the state Department of Health recorded about 265 infections per 100,000 people, up from about 40 per 100,000 in mid-March and likely an undercount.



Last week, King County public health officer Dr. Jeff Duchin said on Twitter, "It's likely we'll continue to experience intermittent surges (with) increases in cases & lesser increases in hospitalizations & deaths for many months."

Hospitalizations could be slowing in some parts of the state, including in Clark, King and Snohomish counties, said Dr. Steve Mitchell, medical director of Harborview Medical Center's emergency department. He added, though, that those rates are still rising in Pierce, Skagit, Spokane and Benton counties.

Mitchell also leads the Washington Medical Coordination Center, a system established when the pandemic began that serves as a clearinghouse for placing patients around the state when their nearest hospital can't take them. In recent months, requests to the WMCC had been going down, but have doubled in the past few weeks, Mitchell said.

"This doubling of requests to our team represents that stress, which is rising in our health care system," he said.

Although DOH reports average hospital capacity is about 91% full, several individual health care systems are overfilled — including MultiCare, which is operating at 120% capacity at all its Puget Sound area locations, according to Carlson.

While only a fraction of patients are admitted for COVID — most are in for delayed care and might test positive at the hospital — high community infection levels mean hospital staffers are regularly calling out sick, exacerbating worker shortages, he said.

Rising infection and hospitalization rates prompted Washington's public health officials, including state Secretary of Health Dr. Umair Shah, to renew a push for indoor masking two weeks ago, but they stopped short of announcing new statewide mandates. On Monday, hospital leaders urged people to continue masking inside, staying socially distant and getting vaccinated.

Masks have become a "political problem as opposed to a public health problem," Carlson said. "I think our public health officials need to think through what the most appropriate behaviors are, the things to do, as a mandate as opposed to a suggestion."