After an alarming surge in coronavirus cases this summer — leading to new masking and vaccination requirements — COVID-19 hospitalizations are ticking down statewide, hospital leaders said Monday.

This week hospitals counted 1,504 COVID-19 patients throughout the state, compared to 1,673 last week, Washington State Hospital Association CEO Cassie Sauer said during a Monday news briefing.

“Washingtonians are really taking this very seriously,” she said. “We’ve seen an increase in vaccination rates, the governor’s order on masking (and) county actions, like the vaccine verification that’s happening in a number of counties.”

She added, “And it looks like case rates might be going down a tiny bit.”

There is, however, a caveat, Sauer said: Another reason hospitalizations are falling is because death rates are rising. While the state’s death data is incomplete for the past two weeks, 30 people in Washington have died from the virus in the past 24 hours, Sauer said.

“That is a way we do not want to be creating hospital capacity,” she said.

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About 260 people remain on ventilators in the state, a “last-resort treatment” for those who are the sickest, Sauer said.

In an attempt to prevent the state’s COVID-19 patients from getting sicker, many hospitals had started ordering monoclonal antibody treatments directly from manufacturers. Because manufacturers had suddenly become “inundated with orders,” however, Sauer said the federal government is returning to its previous distribution system, where a state gets an allocation of monoclonal antibodies, then distributes it among its communities.

“There might be about a week or two gap, or blip, in how monoclonal antibodies are distributed, so people may have a tough time finding them in the next couple weeks,” Sauer said.

The federal government has approved the use of monoclonal antibodies subcutaneously — through an injection, rather than an infusion — which means places other than hospitals, like pharmacies or clinics, can offer the treatment.

Hospitals near the Oregon and Idaho borders also continue to struggle with capacity, hospital leaders said Monday. In Eastern Washington, Dr. Dan Getz, chief medical officer of Providence Sacred Heart Medical Center and Holy Family Hospital, said COVID-19 hospitalizations remain at an all-time high.

While the Spokane hospitals have not yet reached “crisis standards of care” — meaning hospitals aren’t yet having to deny lifesaving treatment to one patient in order to give it to another — Getz said it “still feels like we’re in crisis.”

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“It’s challenging,” he said. “We really do need the help of the community to get vaccinated and wear masks. … I don’t know if we can continue to care for more and more patients in our community.”

At Harborview Medical Center in Seattle, Dr. Steve Mitchell, medical director of the emergency department, said many larger resource hospitals are still overwhelmed. As of two weeks ago, intensive-care units were about 90.5% filled, with COVID-19 patients making up about 34.7%, according to the state Department of Health’s most recent updated data.

Transfer requests to larger hospitals, however, are seeing a slight decrease, said Mitchell, who’s also the medical director for the Washington Medical Coordination Center, a center housed at Harborview that balances placement of COVID-19 patients requiring acute hospital care throughout the region.

In the past week, the WMCC has counted 77 transfer requests, mainly from small, rural hospitals in Central and Eastern Washington. The high was about 140 requests per week in mid-August, Mitchell said.

“We think this is getting slightly better, but it’s still a significant challenge,” particularly for communities east of the Cascade Mountains, he said.

As hospitals are starting to see adult virus hospitalizations go down, pediatric facilities are noticing a similar trend, said Dr. Danielle Zerr of Seattle Children’s.

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At the hospital’s peak, it had 10 to 13 COVID-19 patients hospitalized at any given time, compared to about six to seven now, Zerr said. But hospital staff are still seeing a high number of patients with respiratory viral illnesses and mental-health concerns, she added.

About half of COVID-19 admissions at Seattle Children’s are among children old enough to be vaccinated, or older than 12, she said.

Fortunately, she noted, Pfizer on Monday said its COVID-19 vaccine works for children ages 5 to 11 and that it will seek U.S. authorization for this age group soon — marking a key step toward beginning vaccinations for younger kids.

Meanwhile, Sauer said, there’s a “ton of concern” about the upcoming flu season and its overlap with the continued surge in virus infections.

While the fall and winter season will likely be unpredictable, she urged Washingtonians to get their flu shots now.

“We don’t know what’s going to happen,” she said.

Mitchell added, “When you do combine (the virus’ unpredictability) with schools reopening and the flu season, which we all believe is going to be significantly worse than last year … we are very, very concerned.”

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