6 months since we had the nation’s first diagnosis, here’s how Washington’s COVID-19 fight is going

The main walkway inside Pike Place Market was crowded with visitors and shoppers on July 16. Because of the pandemic, it wasn’t as crowded as it normally would be during peak summer season, but it’s a significant increase from March, when the market was eerily empty. (Alan Berner / The Seattle Times)
Published July 26, 2020

Six months since the first person in Washington — the first person in the nation — tested positive for the novel coronavirus, health officials are saying we’re “in an explosive situation.”

Our health care system isn’t being overwhelmed. But we have not suppressed the virus.

Experts say we may be where Florida — currently one of the hardest-hit states with infections — was several weeks ago. Poised to see all the charts and curves go the wrong way, but not too late to stop them.

On Thursday, Gov. Jay Inslee placed tighter restrictions on certain businesses and gatherings, and announced people must wear masks nearly every time we leave home.

Each update on vaccine advancements piques hope — maybe this weird, horrible pandemic purgatory will be over soon.

But there’s no certain end in sight.

In Washington, more people are diagnosed each day than ever — partly because more people can get a test, but also because the virus continues spreading as we’ve been less vigilant in keeping our distance.

We’re testing two to three times as many people a day as we did back in March, but even on our best day, we haven’t done as many tests as Inslee said we would need.

The pandemic has cast a spotlight on the deadly inequities in our state, as COVID-19 has disproportionately sickened and killed Hispanic people, who account for 43% of cases but just 13% of the population.

Volunteer Martin Strieich, left, hands two packets of masks and a pamphlet to a passenger at a drive-thru distribution site on Monday, July 20, in the parking lot of Harrison Middle School in Sunnyside, Yakima County. The pamphlet provides information about different types of face coverings and how to wear a mask in public places. (Amanda Ray / Yakima Herald-Republic)

In Yakima County, where the virus has spread rapidly through immigrant agricultural communities, the COVID-19 death rate is four times what it is statewide.

Our schools, which already often leave behind students of color and the poor, are poised to exacerbate that divide as the pandemic forces them to continue holding classes remotely, even though many low-income families lack consistent internet access.

Thousands of businesses shut down. Many have reopened; some never will. More than 800,000 people lost their jobs. Fewer than one-third of those jobs have come back.

There’s a dissonance about it all that’s difficult to grasp. Some things feel almost back to normal — traffic is more than double what it was in the spring — but so much of life remains on hold. Movie theaters, live music, the state fair? Nope. Instead, there is takeout and Zoom.

We’ve blown past grim thresholds that once looked shocking, even far-fetched. Roughly 1,500 dead in Washington. Each was more than a number: A family physician. A jeweler. A public television engineer. A postal worker who hosted legendary Thanksgivings. And a man who adored Elvis, ferries and baseball cards.

If we don’t wear masks and stay away from each other, the death toll could skyrocket by November.

Half a year since Washingtonians learned this virus had come to our state, The Seattle Times dispatched reporters to examine critical issues, from COVID-19 deaths to hospitalizations to the havoc the outbreak has wreaked on our economy and our students. The goal: to get a better sense of where we are now and where we might be headed.

— David Gutman

The state of the spread

COVID-19 is on the rise across the state, with significant racial and geographic disparities

Laura Garcia, a public health specialist with the Yakima Health District, places a red flag in the ground on Tuesday, July 21, near Chesterley Park in Yakima. Each flag represents a Yakima County resident who tested positive for COVID-19 from mid-March to a few weeks ago: that totaled more than 8,000. (Amanda Ray / Yakima Herald-Republic)

More coronavirus infections are detected each day across Washington state now than at the initial peak of the pandemic, leading health officials to issue dire warnings.

“Washington state is in the early stages of an exponential statewide outbreak that has zero chance of being reversed without changes to our collective behavior and policies to support that change,” according to a state situation report last week.

Washington had about 129 cases per 100,000 residents over the past two weeks, far higher than the previous peak, in March, of 72 cases per 100,000 people.

To understand where and how quickly the virus is spreading, and where to focus testing, health officials keep a close eye on positivity rates — the percentage of tests that have come back positive.

In May, the World Health Organization said positivity rates should be at or below 5% over a 14-day period before reopening would be advisable. Washington state’s goal is 2%.

At 5.5%, the state’s positivity rate for the week ending July 15 is lower than the national seven-day average of 8.6%. New York, by comparison, has a 1.1% positivity rate; Arizona’s rate is 25%.

However, Okanogan, Kittitas, Douglas and Benton counties, current hot spots, have positivity rates higher than 20% for the week ending July 15. Other mostly rural counties — Franklin, Yakima, Adams, Whitman, Grant and Chelan — were above 10%, although Yakima’s rate has decreased as more people wear masks.

King County, with a cases-per-capita rate hovering near the state average, had a positivity rate of 3.8% for the week ending July 15.

“There is real concern about a potential increase in COVID-19 cases beginning in the fall and through the winter, coincident with influenza season,” said King County health officer Dr. Jeff Duchin.

Around the state, people of color are bearing the brunt of the illness.

Note: Not all cases reported race and ethnicity
Source: state Department of Health (Emily M. Eng / The Seattle Times)

Statewide data, which is incomplete, shows that 43% of cases where race and ethnicity were identified have been among Hispanic and Latino people, though they are just 13% of the population.

“This is something that needs urgent attention and isn’t getting it,” said Dr. Leo Morales, co-director of the Latino Center for Health at the University of Washington School of Public Health, who called the data “shocking.”

Hispanic people, as well as Native Hawaiians and other Pacific Islanders, have higher coronavirus hospitalization and death rates in Washington than white people do, according to a Department of Health analysis.

Structural barriers to health care explain some of the disparities, experts say. And many low-income, essential workers, including farmworkers, have been unable to quarantine or isolate.

“They need to be able to have the freedom to voice their concerns or get access to [health care and labor] resources without fear of retaliation,” said Cristina Ortega, an organizer for the Latino Community Fund in Yakima. “Some of them don’t even know that they have sick leave.”

— Sydney Brownstone

More on the state of the spread:

Essential workers continue to fight on the front lines of a pandemic they never expected to face. Here's what they want you to know about the impact of the coronavirus. (Corinne Chin, Ramon Dompor, Lauren Frohne, Erika Schultz / The Seattle Times)


‘Whack-A-Mole’: Testing expands, but problems with supplies and delays remain

A person at a free coronavirus testing site at 3820 Sixth Ave. S. in Seattle’s Sodo neighborhood tests a driver for the virus on July 17. The site is open Monday through Saturday, 9:30 a.m. to 5:30 p.m., but people without appointments cannot be seen after 4:30 p.m. Results from these tests are expected to be available within 48 hours. The number of people tested at this site varies but is more than 600 per day and, some days, surpasses 1,100. The site opened at the beginning of June. To register, people can go to bit.ly/31rmgdq or seattle.gov/covid-19-testing. The city also offers free testing at 12040 Aurora Ave. N. In Seattle. (Ellen M. Banner / The Seattle Times)

Note: Several dates include multiple days of data and are not shown, as they skewed the graph. Additionally, some dates are missing negative testing numbers.
Source: state Department of Health (Emily M. Eng / The Seattle Times)

More Washingtonians are being tested than in the early days of the outbreak, but despite recent improvements, the state’s testing system still faces significant hurdles.

Access to testing is spotty in parts of the state where COVID-19 now rages, and reduced lab equipment, supply shortages and other pinch points potentially limit further expansion.

Meanwhile, the federal government’s tepid support throughout the pandemic has kept statewide testing on tenuous footing, state officials said.

“It’s sort of like Whack-A-Mole,” said Reed Schuler, a senior adviser to Gov. Jay Inslee. “By the time we’ve knocked out one issue, another comes up.”

Washington was conducting about 4,000-5,000 tests daily in March, mostly of people who showed symptoms and their close contacts, and international travelers.

Since then, testing has more than doubled — 12,000-13,000 tests per day this month — as more clinics and labs operate and people without symptoms are advised to be tested. Nearly 884,000 tests had been performed statewide as of 11:59 p.m. Thursday.

Note: Several dates include multiple days of data and are not shown, as they skewed the graph. Additionally, some dates are missing negative testing numbers.
Source: state Department of Health (Emily M. Eng / The Seattle Times)

Washington overcame early shortages of nasal swabs and other problems, but new supply challenges remain unaddressed as flu season approaches and demand is expected to spike.

A surge in demand nationwide has throttled turnaround times at the country’s two largest commercial testing labs, which have performed about one-fifth of Washington state’s positive test results. Delays of a week or more make it harder to quarantine and trace infections, experts say.

High testing demand nationwide also has hindered UW Medicine’s Virology Lab — the state’s most prolific coronavirus testing lab — as vendors divert crucial materials to labs in other states.

“There is not much use in advertising a very high capacity and accepting additional samples that cannot be resulted in a meaningful time,” said Dr. Geoffrey Baird, the UW Virology division’s interim chair.

Data as of July 24
Source: The Associated Press (Emily M. Eng / The Seattle Times)

Washington initially had ranked among the top five states in per-capita testing, but its current rate — about 116 tests for every 1,000 residents — now ranks 38th.

Strategies to resolve the latest problems include supporting new technologies that don’t rely on limited lab supplies, and encouraging clinics to use labs without backlogs.

But officials in some hot spots said they’ve managed to make testing relatively accessible — so far.

“The only reason we’ve been able to sustain testing is through the staffing and logistic support from the (Washington state) National Guard,” said Lilián Bravo, a Yakima Health District official. “When that concludes at the end of this month, we will be facing challenges to keep that level of testing going.”

— Lewis Kamb

Read more about testing:

  • Coronavirus testing supplies from the Trump administration are arriving unlabeled or poorly packaged, state health secretary says
  • Why Washingtonians are waiting … and waiting … for coronavirus test results
  • Where to get tested in the Puget Sound region
  • Hospitalizations

    Far fewer hospitalized than at outbreak’s peak, but experts worry that could change with spread to older people

    A critical care nurse, right, verifies medication for a hospitalized COVID-19 patient in isolation on the ICU floor at Overlake Medical Center in Bellevue. (Greg Gilbert / The Seattle Times)

    Washington’s hospitals are not currently overwhelmed because of the pandemic, as the number of hospitalizations for COVID-19 hasn’t risen as dramatically as the number of infections.

    But experts warn strong measures are needed to keep it that way.

    *96 hospitalizations are undated
    Source: state Department of Health (Emily M. Eng / The Seattle Times)

    Each week in July, about three in every 100,000 Washingtonians were admitted to a hospital for COVID-19, according to state data. It’s a rise from May, when the rate was around two per 100,000, but much lower than the peak in early spring, when the disease was ravaging nursing homes and the rate was about seven per 100,000.

    Experts warned last week that — as has happened in states such as Florida — the recent jump in cases among young people could lead to spread among older people, who are more likely to get severely ill and be hospitalized.

    Family gatherings can be a major source of this spread, said Ruth Etzioni, a biostatistician with Fred Hutchinson Cancer Research Center.

    King County officials are also concerned to see more infections lately in long-term care facilities and warned that younger health workers with no symptoms could unknowingly spread the virus to residents, who could then be hospitalized, said Duchin. 

    Many counties are seeing more hospital beds fill up, although the trend is more pronounced in Eastern Washington. 

    In Spokane County, about 25 people were admitted in the week beginning June 28 — the first time the county surpassed its previous weekly high of 20 admissions in late March. Similar trends have been observed in Chelan, Douglas, Franklin and Grant counties. 

    Admissions have trickled down along with disease spread in Yakima County, which had seen an explosion in both, particularly among farm and food processing workers. The admission rate remains high compared to other counties, with 14 new admissions per 100,000 people recently.

    In King County, where about two-thirds of recent cases have been among people under 40, the average hospital patient with COVID-19 is about 46, down from about 80 early in the pandemic, Duchin said. And CDC research published Friday shows recovering from even a mild case of COVID-19, even for otherwise healthy young adults, can take weeks.

    — Asia Fields

    Read more about hospitalizations:

  • Washington state coronavirus hospitalizations on the rise, but still far below peak
  • Half of newly diagnosed coronavirus cases in Washington are in people under 40
  • In Yakima County, as cases soar, community spread increasingly drives the coronavirus pandemic
  • Deaths

    Mortality rates are low, but officials warn that could change

    The novel coronavirus has a nasty habit of finding its way to the people least able to fight it off.

    In Washington, the death rate has plateaued at a relatively low level, even as daily infection rates are climbing. But state Health Officer Dr. Kathy Lofy is concerned this pattern won’t last.

    As infections trend up among young people, who are less likely to get seriously ill, health officials anticipate the virus then spreading to older folks and killing some of them.

    “More infections do not always mean more people dying, but it is a big worry,” Lofy said.

    Data as of July 23
    Sources: Johns Hopkins University CSSE, U.S. Census (2020) (Emily M. Eng / The Seattle Times)

    For several weeks early this year, the Evergreen State was among the hardest hit in the U.S., with the first surges of infections and deaths. Over time, Washington has fallen back in the pack as infections and deaths surged in Florida, California, New York, Michigan, Texas, Louisiana and elsewhere.

    Washington’s COVID-19 death rate of roughly 19.5 people per 100,000 residents is about the same as California’s. By comparison, New York’s death rate is 167.5 people per 100,000.

    But at the county level, the data is revealing and frightening. Some counties east of the Cascades — Yakima, Franklin and Benton in particular — are seeing per-capita death rates that rival those in some of the worst-hit areas in the nation.

    Yakima County has seen about 77 people die out of every 100,000 residents. Hard-hit Miami-Dade County in Florida is seeing about 48 deaths per 100,000 residents — roughly the same as tiny Benton County and only slightly above Franklin County.

    King County has a COVID-19 fatality rate of about 28 per 100,000 residents. That figure is likely skewed, though, by deaths that occurred early on in King County’s long-term care facilities.

    — Mike Carter

    More on coronavirus deaths:

    Raymond Lee found himself writing three obituaries for loved ones after COVID-19 spread to his family members. (Ramon Dompor / The Seattle Times)


    Models remain uncertain but can help evaluate strategies for controlling the virus

    Source: University of Washington Institute for Health Metrics and Evaluation COVID-19 Projections (Emily M. Eng / The Seattle Times)

    When a University of Washington model predicted in late March that 1,400 people in the state could die from COVID-19 by July 1, it seemed outrageous. At the time, the death toll was just over 200.

    Now, with 1,495 Washingtonians dead as of Friday, a revised version of that model is predicting about 600 more could succumb by the middle of fall — if almost everyone wears a face mask. Without masks, total deaths could exceed 3,300, the model suggests.

    Another model, with a better track record of accuracy, on Wednesday predicted 2,046 total deaths across the state by Nov. 1.

    As with all models, the forecasts remain highly uncertain. But that doesn’t mean they aren’t helpful as we continue to feel our way through the uncharted terrain of a modern pandemic.

    These days, models are less important for the absolute numbers they project, which have always come with huge grains of salt. Increasingly, government and health officials are turning to models to evaluate different strategies for keeping the virus in check while reopening the economy.

    One of two “E. COVID St.” signs that appeared at East Aloha Street and 19th Avenue East in Seattle’s Capitol Hill neighborhood, as seen on July 16. (Ken Lambert / The Seattle Times)

    The UW model’s attempt to factor in the effect of widespread mask use is one example. Another was an analysis from the Bellevue-based Institute for Disease Modeling that evaluated six different scenarios for potentially reopening schools. That study found that without special precautions, the pandemic was likely to soar again within the first few months of the academic year. (Many schools in King County, as well as Washington State University, announced last week they’ll hold classes online this fall.)

    Next up for the UW model and others: evaluating the idea of periodic or rolling shutdowns to ensure hospitals don’t become overloaded as flu season overlaps with the pandemic.

    — Sandi Doughton

    Read more on pandemic modeling:

  • A second wave of coronavirus infections could begin in September, UW model suggests
  • Mathematical models help predict the trajectory of the coronavirus outbreak. But can they be believed?
  • Economy

    Next few months will be critical to the economy recovering — or not

    Note: Data does not include farmworkers <br> Source: state Employment Security Department (Emily M. Eng / The Seattle Times)

    Four months since Gov. Jay Inslee’s “Stay Home, Stay Healthy” order shuttered many businesses in Washington, it’s still not clear whether the state is coming out of the worst economic slump in living memory or still has further to fall.

    On the surface, things appear to be bouncing back. After massive job losses in March and April led more than 800,000 people to file for unemployment, the job market reversed course. In May and June, Washington gained nearly 250,000 jobs — in line with forecasts for a much-discussed “V-shaped” economic recovery.

    “The data says we are doing better right now than what most people expected,” said economist Hart Hodges, a director at the Center for Economic and Business Research at Western Washington University.

    But beneath the surface, he and other economists warn, huge uncertainties remain.

    Much of that jobs bounce has come not from an actual economic revival but a federal stimulus package worth trillions of dollars. “Paycheck protection” loans paid small businesses to retain workers. Most who did lose jobs have received an extra $600 a week in federal benefits. That relief, coupled with local protections such as eviction moratoriums, helped blunt COVID-19’s worst economic effects.

    But the boost was temporary. As some business loans have run out, a new round of layoffs is possible. And unless Congress extends the $600 weekly benefit, which expires at the end of July, the consumer spending it supported will also disappear.

    That points to the deeper uncertainty in the COVID economy: whether the spike in cases will lead to a second shutdown, as Inslee has warned. Last week, he tightened restrictions on bars, eateries, gyms, entertainment and more. Even without another full lockdown, it’s not clear when consumers will feel comfortable resuming activities such as eating out, catching a ball game or traveling.

    This layering of uncertainty — psychological, political, technological and epidemiological — makes this economic crisis different from any other, and it is toxic for business confidence.

    South Jackson Street, looking east from Pioneer Square, was bustling with cars, buses, a streetcar and pedestrians on July 15. (Alan Berner / The Seattle Times)

    Through the rest of the summer, some struggling employers will choose to close permanently, while even the healthier ones will remain wary of rehiring people, warns Thomas Gilbert, associate professor of finance at the University of Washington Foster School of Business. June’s job growth was already well below May’s, and if that continues into July, it will be another sign of a stalled recovery.

    The next few months will be critical, adds Hodges. Will the crisis be extended by a wave of business bankruptcies or a surge in layoffs from tax-starved state and local governments? Or will the nascent reopening gather momentum?

    Current economic data suggests the potential for a recovery to start by the end of the year, Hodges says. But he warns, “I don’t think that tells us a lot about the next four months.”

    — Paul Roberts

    More about the economy:

  • State agency is slow in sharing data on the pandemic unemployment crisis as weekly claims drop in Washington
  • Photography: Much has changed over 6 months into pandemic

  • "There are businesses that haven't been able to operate at all," says Laura Clise, founder and CEO of Intentionalist. Night Light Nails is one of them. "We've been struggling," says owner Van Nguyen. (Corinne Chin & Ramon Dompor / The Seattle Times)


    As local districts announce remote start to school year, urgent questions loom

    A sign outside of Mt. Rainier High School in Des Moines shows that buildings and fields are closed. Superintendent Susan Enfield posted a letter on the Highline Public Schools website Wednesday, July 22, saying Highline Public Schools will start the fall doing distance learning. She wrote that no one is more frustrated by the decision than she is. (Ellen M. Banner / The Seattle Times)

    Weeks from now, for many, back to school will mean back to screens. Several of King County’s largest school districts, as well as Washington State University and Seattle University, announced last week they intend to hold classes remotely this fall.

    But there’s still a lot we don’t know about how the first round of online learning went this spring.

    When K-12 school buildings closed in Washington, leaders had to make quick decisions in the thick of a pandemic. Families and educators were left to reimagine learning, mostly online and from home, for the last four months of the school year.

    Many parents stepped in —willingly or not — to coach their students through daily lessons. Some didn’t because of work or other commitments, or found that their children checked out after so many months away from classrooms. Teachers tried holding class on Zoom and other conferencing platforms. Others, either frustrated by technology, or cognizant that many students lack devices or the internet, experimented with alternatives. Some students, such as those learning English, had limited or no meaningful contact with teachers and classmates.

    Standardized tests were suspended. Grading systems changed — teachers statewide weren’t allowed to give F’s. Proms were canceled. Graduation ceremonies were virtual or redesigned.

    A patchwork of school district policies across the state makes it tough to generalize about how this forced experiment went. The state’s education department collected some data on instruction, meals and child care. As months went by, that information suggested schools went on in an uneven fashion. In June, most districts that responded reported distributing paper assignments to students, while a little more than one-third reported using video conferencing. Anecdotally, students who count on school for extra support —such as those with disabilities — lost out on key services.

    Unlike the scramble when schools first closed, officials have now had months to prepare for the possibility of not reopening for fall. Despite that time, the recent back-to-school announcements lacked key details, and questions remain: How will schools feed and teach students, train educators to teach remotely, and provide other critical services such as child care? And what will be different this time around?

    What is clear is that students and educators will return to school in a changed world. Amid a national movement over racial justice, many education advocates are calling on districts to not only make school safe, but also equitable for all.

    — Hannah Furfaro

    More about schools:

    When Seattle World School closed during the COVID-19 pandemic, family support worker Rocío Luquero continued to bring food, cash-relief, and other resources to her students who needed them most. (Ramon Dompor & Corinne Chin / The Seattle Times)

    Venturing out

    More people hitting the road, eating at restaurants and wearing masks

    Warmer weather and reopened businesses quickly coaxed people out of their spring isolation, raising questions about whether Washington will backslide in its fight against the coronavirus.

    One area of concern: restaurants. Inslee announced Thursday the state will clamp back down on food service, limiting indoor dining to members of the same household, barring indoor service at bars and breweries and limiting table sizes in some counties.

    Note: Data from seated diners from online, phone or walk-in reservations through OpenTable <br> Source: OpenTable (Emily M. Eng / The Seattle Times)

    In mid-July, nearly 60% of restaurants in Washington were accepting reservations, and daily seating counts were about 30% of normal levels, according to figures from the online reservation site OpenTable. (The data includes only restaurants that use OpenTable and have reopened.)

    That was a change from March and April, when nearly all restaurants were closed or offering takeout only.

    Restaurant dining in Washington is still down more than in some states, such as New Jersey and Alabama, but is almost in line with California, according to OpenTable.

    Some travel has ticked back up, too. Across the state, highway traffic is at about 85% of its normal levels, compared to 37% in late March. But weekday transit ridership across the state is still less than half what it was at this time last year, and King County Metro is hovering around one-third of its usual weekday ridership.

    A customer is seen July 7 exiting a Fred Meyer store with a sign about the store’s face-covering requirement at the entrance. A governor’s order directs Washington businesses to turn away customers who aren’t wearing face coverings inside. (Steve Ringman / The Seattle Times)

    While people are venturing out, they’re also wearing masks more. Businesses are now required to turn away people not wearing face coverings, and Inslee announced Thursday that masks will be required basically everywhere outside the home where people could get within six feet of each other.

    In Yakima County, the health department has observed 95% of people wearing masks, a big jump from 35% in May, and they credit this with turning the tide in what’s been Washington’s biggest hot spot.

    “Yakima County is the only place in the state right now where each person who gets COVID-19 on average spreads it to less than one other person,” trumpeted a Tuesday blog post from the state Department of Health.

    In Benton and Franklin counties, the health district says mask use is also up to 95%, compared to 53% in June.

    Surveys and calculations from the New York Times estimate mask wearing is more common in the Seattle and Spokane areas than elsewhere in Washington but varies by neighborhood and city. Looking at the odds of whether five people you encounter will be wearing masks, the analysis found a 64% chance in downtown Seattle and Capitol Hill, compared to 49% in West Seattle, 39% in Walla Walla or 31% in Centralia.

    Source: University of Washington Institute for Health Metrics and Evaluation COVID-19 Projections (Emily M. Eng / The Seattle Times)

    After months, some people may be getting tired of hunkering down and still not knowing when this will end, a feeling some call “COVID fatigue,” said Dr. Kaye Hermanson, a psychologist at UC Davis Health.

    But she urges people to stay vigilant.

    “We have to think globally: What do your actions mean for other people in your community?” Hermanson said. “That’s a hard message to get across.”

    — Heidi Groover

    More about venturing out:

  • Charts, tips and resources to help you understand the pandemic and get through it safely
  • How to properly wear a face mask
  • Yes, you can wear a mask while exercising. Here’s how 3 options stack up.

  • For Luly Yang and Gustave Apiti, face masks provide both protection and self-expression. The Seattle fashion designers are making couture face masks to prevent the spread of coronavirus. (Ramon Dompor and Corinne Chin / The Seattle Times)
    Extended Seattle Times coverage of the coronavirus crisis, key resources and information.
    Many small groups spaced apart at Seattle's Golden Gardens Park made up the crowd there on July 15. (Ken Lambert / The Seattle Times)

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