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Nov. 28, 2021

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Washington’s COVID hospitalizations drop, but optimism is measured: ‘I just don’t know what the winter will bring’

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While COVID-19 hospitalizations continue to drop in Washington, state hospital leaders said Monday they’re wary of feeling too optimistic because of so much uncertainty about what the pandemic — and flu season — will bring this winter.

Infection and hospital admission rates “look better,” Cassie Sauer, CEO of the Washington State Hospital Association, said during a weekly news briefing. While hospitalizations are still on the decline, the numbers remain “really high,” Sauer said.

Deaths continue to rise — an expected trend that often comes two to four weeks after a surge of hospitalizations, she said. She added Monday morning that about 30 Washingtonians are dying of COVID-19 per day.

As of two weeks ago, the state Department of Health’s most recent, complete COVID-19 data, Washington’s average hospitalization rate was about 14.7 admissions per 100,000 people, down from 17.7 admissions per 100,000 people in late August.

Although hospitalizations are dipping, the hospital association also remains concerned about the state’s lack of monoclonal antibodies — a treatment shown to be highly effective in preventing hospitalization among people with mild to moderate COVID-19 if given within seven to 10 days after symptoms appear.

Hospitals and other providers used to order the treatment directly from the manufacturer, whereas now the manufacturer is giving allocations to states through the federal government. The allocations are based on a state’s level of COVID-19 cases and hospitalizations, meaning many southern states with higher infection and hospitalization rates are being prioritized over Washington.

The Biden administration moved earlier this month to distribute the treatment more fairly across the country after seeing seven states — Alabama, Florida, Texas, Mississippi, Tennessee, Georgia and Louisiana, where vaccination rates are low — had been using 70% of the monoclonal antibody supply in recent weeks.

Still, Washington state is “not getting as much as we’d like to get here,” Sauer said.

Fortunately, she said, because the Food and Drug Administration has approved the use of monoclonal antibodies through an injection, the state is working with other providers besides hospitals, like clinics and pharmacies, to administer the treatment, which should speed up distribution into communities.

Staffing shortages, especially among nurses, continue to worry hospital leaders, who say workers are still “pretty discouraged” despite some optimistic hospitalization trends.

“They’re going through all the emotions, all the hard work required to take care of COVID patients,” Dr. Radha Agrawal, pulmonologist and critical care medicine specialist at Overlake Medical Center in Bellevue, said Monday. “… But at the same time, they’re not seeing the positive (long-term) results they’re hoping for. There’s definitely a demoralizing effect.”

Agrawal added that Overlake is seeing “so many younger people” this year, including those who are eligible for vaccination.

Adding to concerns for younger patients, Dr. Chris Ladish — chief clinical officer of pediatric behavioral health for Mary Bridge Children’s Hospital in Tacoma — said during the news conference another recent challenge is an influx of behavioral health patients.

“We’re certainly seeing that on the pediatric side in the majority of our ERs that treat children,” said Ladish, who also oversees pediatric behavioral health for MultiCare Behavioral Health Network.

“In general, we’ve certainly seen an increase in kids struggling with suicide, presenting with anxiety and depression,” she added. “I think we’re going to see increased rates of that with kids going back to school, not necessarily because the incidents are increasing related to school, but because there’s a more rapid route to identification.”

As the winter season approaches, Sauer said she’s not sure what to expect.

“I feel better right this minute that hospitalizations are starting to go down. … However, in late June, early July, we would not have predicted we were going to be in the worst shape ever as we are now,” she said. “It’s hard to hold really serious optimism because this disease is so tricky and so opportunistic.”

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