Snohomish County officials discussed the plan for COVID-19 vaccine's arrival in Washington while concerns about rising case numbers continue.
The two-week daily average case rate through Dec. 12 has increased again to 448 cases per 100,000 population for the county.
Cases numbers continue to be much higher than they were in the spring, which reached a peak of 129 cases per 100,000 population.
"That's a smaller increment [increase] than we have seen in recent times," said Snohomish Health District Health Officer Chris Spitters during the Dec. 15 briefing.
That could be the first signs of turning the case trend downward or it could be a momentary pause, he said.
"We've had a couple of those episodes where the curve bent a little bit and then continued going up. So sometimes that's an artifact of the timing of when the cases come," said Spitters.
Other points of data aren't as encouraging though. "Just about every other indicator has tended to go in the wrong direction," said Spitters.
Workplace outbreaks have increased and there were 65 ongoing outbreaks in workplaces, said Spitters.
Hospitalizations remain high, although they are relatively stable with 95 confirmed cases and 12 suspected cases in hospitals.
"That number is about 15 percent of total hospital capacity with the threshold of concern for 10 percent," said Spitters. "It's not a crisis, but they're still having to stretch their resources for all the COVID cases and all the other acute care cases."
While the vaccine could mean the beginning of the end for the pandemic, officials are urging continued practice of all safety measures.
"We will have to continue wearing masks and practice physical distancing protocols. While the vaccine does protect yourself, it doesn't really mean you can't transmit the virus to others," said Snohomish County Executive Dave Somers.
Vaccines will not be an instance solution and it could take 9 to 12 months to vaccinate the entire population.
"It's a good point not to prematurely declare victory," said Spitters. "It's an incredible milestone and a great sense of psychic uplift and relief, certainly for us in the health district. But we still have miles to go. It's probably reckless to consider us out of the woods."
Even vaccinated people should continue to practice caution, said Spitters.
The vaccine trials were designed to measure the effectiveness of preventing transmission to the vaccinated individual and not whether that individual is no longer contagious.
"I believe that will eventually be shown," said Spitters, but right now it is an unknown.
The first wave of vaccines to the county is expected to be about 5,000 to 6,000 doses. Spitters said production is expected to increase significantly in the coming months.
The Snohomish Health District's plan will follow CDC's vaccine guide that prescribes "planned phases to provide the greatest benefit to society and the most vulnerable," said Spitters.
Urgent care, doctors, nurses, staff in hospitals such as janitors, first responders, emergency medical technicians and long-term care facility staff and residents are 'Phase 1A' and are expected to be the first to receive the vaccine.
The Tulalip Health Clinic also expects to receive vaccines from the Washington state Department of Health in late December.
Tulalip chief medical officer John Okemah said in a Tulalip update that they are largely following the same phases as the CDC.
"Because tribes are sovereign nations we are going to vaccinate our elders," as well, he said.
"We will set up appointments and a scheduling system so we can do that in an orderly fashion instead of having hundreds of people here," said Okemah.
Older at-risk individuals are a priority demographic for the CDC's plan as well, but they will be vaccinated in 'Phase 1B' after the initial wave that largely targets hospital workers and first responders.
The Snohomish County Department of Emergency Management is working on sites to help distribute vaccines when they are going out to the general public.
"It may not look exactly like it did for the folks that remember H1N1," said Jason Biermann, director of the department.
"These will be places decentralized and outside the normal healthcare system where people can get vaccinated," he said.
Agencies are also working on improving trust in the vaccine.
"We know there are some challenges with the concerns that people have," said Biermann.
According to the county's current surveys about 50 to 60 percent of people are planning to get the vaccine, he said. They hope to get that number higher.
"There's a multi-agency team that's working on getting the word out on vaccine availability and vaccine safety," said Biermann.
Spitters said the COVID vaccine was produced in record time but it went through the same regulatory process that all vaccines go through.
"While the COVID vaccine is new, the clinical trials and the review and approval process, the regulatory aspect of their approval is not new at all," he said.
"The speed of the development process may have made some people wary, but there were multiple layers of safety and quality assurance," he said.
Washington state is part of the Western States Scientific Safety Review Workgroup which provided a further level of review over the CDC and FDA.
A successful vaccine roll out could mean the first steps to returning to a world without the threat of COVID-19.
"We know a lot of people have been looking forward to this day knowing that vaccines are the best way to end the pandemic," said Somers.
"We're all very excited with the news this week that the first vaccine doses have arrived today in Washington state and we expect them in Snohomish County in the next few days," he said.
The health district's full interim plan for vaccine distribution is available at snohd.org/564.