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Not out of the woods yet: 'It's looking increasingly like we will have to contend with a new wave'



Even though the rollout has been rocky, COVID vaccines are here. The number of new COVID cases is dropping. Is it safe to feel a little optimistic about the future?

Not just yet, say researchers at Fred Hutch.


The U.K. variant, which is believed to be anywhere from 30% to 70% more transmissible, is here in Washington. This mutation is also thought to be more deadly.


A new study from Fred Hutch makes the case that we all need to try a little harder these next few months to keep the virus at bay. 


Dr. Joshua Shiffer is the study’s lead author. He spoke with KNKX’s Jennifer Wing. Below is an edited transcript of their conversation.


Jennifer Wing: The study uses data from King County to try and predict the next few months of the pandemic. It focuses on what has led to spikes in cases and what flattens them down. Like the rest of the country, King County experienced a surge in the spring, summer and late fall but to a much lesser extent.

Joshua Shiffer: And while it's an achievement to celebrate, it unfortunately puts us in a more vulnerable position. I think now it's looking increasingly like we will have to contend with a new wave. But I think there's still a huge amount of uncertainty and on good days optimism, on bad days pessimism about what that wave might look like. 

Wing: The analogy I've heard that makes a lot of sense is that there's a lot of wood in the forest to burn here, wood being people. There's a lot of fuel here still. 

Shiffer: Yes. 

Wing: Based on your research and how you crunch the numbers, what does this look like? Say best-case scenario, worst-case scenario for Washington state in particular?   

Shiffer: Yeah, I think that the best-case scenario is, as I described, that we have a fourth wave that is associated with far fewer infections than the way we just endured and that those infections are spread out over a longer period of time because it's slower growing. The one thing that's very positive and optimistic is that because we are vaccinating the most vulnerable first, that the proportion of people who die will be lower because the majority of infections will be in a less vulnerable population, which to me is still very concerning because of the long-hauler phenomena

The worst-case scenario is that the wave comes before we've vaccinated sufficiently and that we lose some efficacy against the new variant. So it doesn't seem likely that the vaccines will fail altogether. But the efficacy might go down from 90 percent to 50 percent. The other critical variable would be that if we have the early signs of a partial lockdown and the government does not react quickly enough or the government does react quickly enough and there's COVID fatigue and people ignore it. Then we could really have a substantial wave of cases.  

Wing: The U.K. variant is so much more contagious. And knowing that it's here and that people are eating in restaurants again, what's your reaction to that, given the research that you have in hand?  

Shiffer: The bottom line is that the conditions for what allows this infection to spread are really well known and obvious at this point. And it's indoor conditions when people aren’t masked. Restaurants worry me because when you're in a restaurant, you have to take your mask off to eat. And part of the enjoyment of going out with friends is speaking, and speaking is clearly an aerosolization mechanism, particularly if people are speaking loudly. So the restaurants are very risky. Casinos are open. It’s very risky. In an ideal world, I would be very much in favor of loans to support these businesses in the interim but to keep them closed while we get through this. But it’s complicated, obviously. 

Wing: So far, several cases of the U.K. variant have been confirmed in King County. It’s here in very low numbers right now. Growth starts out slow. But it is expected to be the dominant strain in the United States by summer.  

Shiffer: When you're going from one to two and two to four and four to eight, it's all under the radar. And that each of those steps occurs every five days or every seven days. But once you get to 1,000 to 2,000, it's also over five days. So it hits like a tsunami when it hits. And that's why acting early is very, very important.  

If there's a real surge in cases, then we must have another partial lockdown. That experience has been vetted over and over throughout the world, that the later you act -- the tragedy of New York City is had they acted 10 days earlier, you know, it's hard to think about that, how many lives lost, they could have avoided.

Wing: That’s incredible, that if they had acted 10 days earlier to shut things down, that thousands of lives would have been saved?

Shiffer: Oh, yeah. We had a pretty horrible first wave, but it never hit that threshold where emergency rooms felt out of control. I'm sure you saw the videos of Queens, and it never happened here. And that was quick decision-making. It easily could have. And keeping in mind that it arrived here first. So it's sort of a quiet sense of pride that we've we've accomplished this as a state, keeping in mind that at that point in time, there was very little federal oversight. It's quite remarkable in Oregon as well has largely avoided a huge outbreak.  

Wing: And again, just to clarify the fact that because we did such a good job with the first, second, and third waves, respectively, this leaves us more vulnerable because of the arrival of this new variant. 

Shiffer: Yes. If, mathematically, the old variant now has an effective reproductive number, less than one, it's going down and the new one's going up, which is kind of a perfect example of why whatever it is you're doing to prevent the spread of infection, you need to do it more effectively. So opening restaurants is not doing it more effectively but wearing an N-95 in the supermarket is.  

Wing: What do you want to make sure people understand? 

Shiffer: You know, you can play sports now. You can go outside and play sports with a mask. You can have people over in your backyard with masks. It's not ideal by any means, but it's something. And you can support your local restaurants. You just don't have to eat there. And just continuing to do that for hopefully the next few months, maybe a little bit longer, I think is so critical. The ideas that push us in the right direction spread very much like a virus. So if we can keep up with that and, you know, these little things I think will make the difference between whether we sustain something pretty difficult in the spring and summer or whether it's a manageable situation that really paves our way out of this.   

There are a few other points Dr. Shiffer and his colleagues make in this study. One is that rapid vaccination will blunt any future waves of COVID. The other is for local governments to have lower case thresholds of COVID for triggering a lockdown.


Jennifer Wing is a former KNKX reporter and producer who worked on the show Sound Effect and Transmission podcast.