The blue rubber gloves and N95 masks in a Seattle senior living community used to mark a time of isolation, fear, loss.
Yet on a recent afternoon at Merrill Gardens in Ballard, these medical supplies are more like ornaments of the past, strung across the ceiling as an almost whimsical ode to how far we’ve come.
It’s been five years since the mysterious respiratory virus responsible for an emerging pandemic was identified in Washington state and the U.S., and forced millions of us, including hundreds of Merrill Gardens residents in the Northwest, to shut in, avoid physical contact and distance from one another for months.
Not today. On this particular gray Friday, residents and staffers are celebrating. Along with the PPE garlands, a colorful banner is pinned up in the window: “Heroes Work Here.”
“We didn’t lose a single person during COVID,” general manager Lisa Palm said, speaking just of the Ballard living facility, to a room of cheering residents. All were unmasked.
She raised a glass of Champagne. “Cheers to all that being in the past.”
At some point or another in the last 1,800 days, many of us might have had a similar realization, that we’ve started to move on. Maybe it was on the day vaccines first became available. Or when your office reopened. Or when the national emergency proclamation ended.
It’s natural, infectious disease experts say as they watch the world’s gradual return to normalcy. This is what happens in pandemics.
But maybe you’ve also realized the virus still permeates everyday life in big and small ways.
COVID-19 continues to kill people every month, though in far fewer numbers. Memories of crowded hospitals and dying patients might always haunt some Puget Sound-area medical providers, the first in the country to treat the disease. Public health workers, stunned at recent federal blows to science and medical funding, fret over future outbreak responses.
Remote work, shopping habits, vaccine politics and overall mental and physical health have transformed from their prepandemic versions.
Despite a collective desire to put the worst of COVID behind us, it’s hard to forget that five years ago the novel coronavirus first killed someone here, and decisively changed the way we live and die.
Early days
Since February 2020, COVID has killed about 18,000 people in Washington. More than 1.2 million Americans have died nationwide, and more than 7 million globally.
“The scholars are still untangling all the ways that COVID-19 has shaped us as a society,” said Jennifer Nuzzo, director of the Pandemic Center at Brown University School of Public Health. “I don’t think it’s possible to overstate how profound of an event in our history this pandemic was.”
Even now, the first death “seems like yesterday” to Dr. Francis Riedo.
Riedo, who works at EvergreenHealth hospital in Kirkland, was the physician in charge of the first person reported to die of COVID, a King County man in his 50s. Riedo also saw many patients in the first outbreak in the state, at Life Care Center, a nearby long-term care facility.
(Health officials later determined the first person in Washington to die was a Snohomish woman in her 30s, who tested positive for COVID postmortem and died Feb. 24. Where the first U.S. COVID deaths occurred remains, and might always be, hard to pin down given initial testing restrictions, but officials believe they happened sometime in January or early February 2020.)
At the time, the region leapt into action, Riedo remembers.
Then-Gov. Jay Inslee declared a state of emergency on Feb. 29, 2020, the day after the state’s first COVID death was reported. He announced our first stay-home order on March 23, 2020.
Schools, restaurants and businesses shuttered. Streets emptied. When the Seahawks began their 2020-21 season, fans were absent from Lumen Field. At the Seattle Flu Study, along with Fred Hutchinson Cancer Center and the University of Washington’s virology lab, researchers started analyzing thousands of COVID tests a day.
A team from the Centers for Disease Control and Prevention arrived in downtown Seattle, crowding into King County’s public health offices to support testing and tracking.
“We were in an especially unique and challenging position,” said Dr. Jeff Duchin, who led Public Health – Seattle & King County as its health officer. “We didn’t have a lot of guidance at the time. It didn’t exist.”
For local nurses like Lindsey Kirsch, those memories have never completely faded. She has permanent hearing loss from wearing her protective helmet and face shield — known as a Controlled Air Purifying Respirator, or CAPR — 12 hours a day in early 2020, she said. Kirsch went to an audiologist, who suspected the CAPRs’ constant ringing in her ears contributed, she said.
“The stress level for us was a different kind,” said Kirsch, who works in Seattle Children’s urgent care. “A lot of us still live with that trauma.”
At Merrill Gardens at Ballard, residents hunkered down in their apartments, though the building continued to buzz with activity.
Mary Webster, an 82-year-old resident, began a walking routine, managing 11,000 steps a day inside her studio apartment. Sally Morgan, 104, played the organ. Micki Babcock, 86, worked on her fiction writing, while her husband, Norm, wrote his memoir.
“It was time well-spent,” Micki Babcock said.
How we fared
When the vaccines rolled out to the wider public in April 2021, thus began a bit of a mass frenzy: the dash for appointments, the collapse of online sign-up portals, the long waits for a single shot.
Throughout it all, amid the confusion and chaos, people got vaccinated. Relief, joy, hope.
Although a turning point, that scientific milestone also made way for further political divisiveness, all while the state slowly lifted broad COVID restrictions and the infectious delta and omicron variants emerged. In Washington, 2021 was COVID’s deadliest of the last five years.
Notably, our state, especially King County, fared much better than other parts of the country — which national and local health researchers largely attribute to high vaccination rates, swift safety orders and a well-connected disease surveillance network that was already in place.
“We owed Seattle a lot, by being at the tip of the spear,” said Nuzzo, of the Pandemic Center at Brown, who also teaches epidemiology at the Rhode Island college. “There was a lot to model there.”
From March 2020 to March 2023, King County’s COVID death rate ranked lowest among 15 U.S. counties with at least 2 million residents, including Los Angeles and Miami-Dade counties, according to Public Health – Seattle & King County. Washington also has the fourth-lowest cumulative COVID death rate in the country, per the CDC.
With access to vaccines and medication, the virus has become much less deadly. But risk of long-term symptoms, serious illness and death continue to threaten many populations, including older adults and people with existing health conditions.
Last year, the state saw its lowest number of COVID deaths since the pandemic began. The count still surpassed 1,000.
As of this month, about 70% of Washingtonians — or 5.4 million people — are vaccinated against COVID with a full primary or initial series, meaning they’ve received at least two doses of Pfizer or Moderna shots. About 82.6% of King County residents have received their primary series.
How many in the state are up-to-date with the newest dose? About 18%.
Because COVID infections are now generally more common and mild, national and state public health teams no longer track them individually. Instead, they use hospitalization and emergency visit data to follow trends in spread.
In Washington, the state Department of Health has stopped publicly sharing COVID hospitalization and death data from before 2022, and has also combined its COVID data with influenza and RSV numbers to provide a statewide outlook on general respiratory illness. A spokesperson for the health department said in an email that 2020 and 2021 COVID data — which was available and included in daily DOH updates for several years — was temporarily removed to “lessen the IT and staff demands.”
DOH is working on a solution and in the meantime is “happy to answer questions” about those years, the spokesperson wrote.
Nuzzo said she’s “completely sympathetic” to all the demands on already strapped state health departments, but “from a societal perspective, it is unacceptable that that’s OK.”
“These data are an important intervention in themselves, and we need to appropriately resource our health departments,” the pandemic expert said.
And yet urgency is waning and attention is elsewhere — in part because in many ways, COVID has become endemic, infectious disease experts say. This means the virus is consistently circulating within the community.
“We no longer have significant change in variants, causing peaks and valleys,” state epidemiologist Dr. Scott Lindquist explained. Instead, “there’s a low-grade level of cases of COVID in the background.”
At the same time, COVID does not behave exactly like other common endemic diseases, such as the flu.
While other respiratory viruses have predictable “seasons” in the U.S., usually during the winter, COVID has not developed a consistent routine, said Dr. Eric Chow, King County’s chief of communicable disease epidemiology and immunization. Last year, he said, many parts of the country, including Washington, saw a surprising summer surge, which likely contributed to a light COVID winter.
“COVID continues to take twists and turns that are hard to kind of predict,” Chow said. “It still makes me a little bit concerned.”
The next pandemic
The last five years continue to weigh heavily on many medical workers, said Dr. George Diaz, at Providence Regional Medical Center in Everett. He was the first physician in the U.S. to treat a known COVID patient in January 2020.
“A lot of health care workers have gotten burned out,” Diaz said. “They’re demoralized.”
The strain on providers puts the medical field in a precarious situation pending another public health crisis, local experts say.
“We’re one step away from another pandemic,” said Dr. Helen Chu, a UW Medicine physician who runs the Seattle Flu Study, the first lab to detect community COVID spread in the state and country.
She and other Seattle-area infectious disease experts share deepening concerns about the country’s ability to handle coming health threats, especially as pathogens like bird flu circulate and mutate. In the last three months, the Trump administration has announced a number of funding cuts to some of the nation’s most important health and science research and programs, further crippling response systems.
“There’s a world of difference between learning lessons and translating those lessons into improved preparedness and more effective responses for the future,” said Duchin, who retired from Public Health – Seattle & King County last summer.
We learned the value of strong health care and community collaboration, he said, but is the country able to more equitably distribute vaccines and treatment in the next public health emergency? Are we prioritizing accurate data collection? What about long-term improvements to indoor air ventilation?
“SARS-CoV-2 is going to be with us forever,” Duchin said. “We have to adapt to it. We will experience additional pandemics, which can be more severe than COVID-19 was.”
At Merrill Gardens, the pandemic fundamentally changed some spaces and behaviors, said company President Tana Gall. The Seattle-based organization, which has 12 living communities in Washington and more than 60 total, now always stocks personal protective equipment. Companywide communication improved. So did residents’ tech skills.
Many of these changes “never would have happened without COVID,” said Palm, general manager of the Ballard living facility.
As the recent celebratory happy hour came to an end, Palm returned to her office to finish the latest edition of her now weekly newsletter to staff and residents. Another pandemic change that started with daily COVID updates, but has stuck around in an attempt to inform the community, which has remained remarkably resilient, she said.
For their sake, these efforts continue.