COVID-19 cases and hospitalizations are on the rise in Washington state due to the delta variant of the coronavirus, leading officials to once again urge vaccination.

Hospital occupancy is at the highest levels seen so far in 2021. Capacity is filling up for a variety of reasons including falls, gun violence, water accidents and COVID-19 patients. As of last week, around 85% of ICU beds were filled, with 11% COVID-19 patients.

Statewide, there are about 600 hospitalizations — about a 20% increase from last week. The percent of positive tests has also grown to 5%, up from 2% last month.

“We do risk getting overwhelmed in our hospitals right now, and that’s why we’re here pleading with the public to take all the actions possible to not get COVID,” Cassie Sauer, president and CEO of the Washington State Hospital Association, said earlier this week.

FAQ Friday addresses questions about the state of breakthrough infections in Washington and how to navigate the world of changing mask guidance.

What do breakthrough infections look like in Washington?

Vaccines are effective and breakthrough infections are still rare. According to the Washington State Department of Health, more than 94% of all cases, deaths and hospitalizations for those 12 and older have been linked to individuals who were not fully vaccinated.


As for the 4,241 breakthrough cases identified in the state between Jan. 17 and July 24, 86% reported symptoms and only 8% were hospitalized. There have been 52 deaths, among which at least 37 people had underlying conditions and at least 27 were associated with a long-term care facility, according to DOH.

Breakthrough infections are nearly evenly divided between age group and sex, according to DOH. The agency does not identify where these cases occur to protect people’s privacy since there are such a small number of cases in certain areas.

A recent report by DOH includes a breakdown of variants making up breakthrough infections in Washington dating back to Jan. 17. Health officials estimate the delta variant accounts for more than 90% of recent new cases.

It can take more than a month after an individual gets infected for a sample to be genotyped and analyzed by the state and put into a report, said DOH spokesperson Teresa McCallion.

The full picture of infections in June and July may not become clear until late August or early September, she said. Some cases can take even longer if the sample isn't submitted until an individual becomes hospitalized or dies.


Around 23% of cases are sequenced in the state, she said, though the number could change as more samples are processed. Without adjusting for population, only New York, Florida, Texas and California submit more sequences to the federal Centers for Disease Control and Prevention.


Do I have to wear a mask now?

Following the CDC's recommendation, both Washington state and eight counties including King County have urged people to wear masks in indoor settings.

Gov. Jay Inslee has stopped short of making that a requirement. 

Masks are still required in K-12 settings, public transportation and congregate living areas like hospitals and jails.

How should I show proof of vaccination?

In Washington state, food service businesses and restaurants have reported the highest number of outbreaks (aside from health care congregate settings) since the onset of the pandemic.


Some businesses say they can't afford to close again. At least 60 Seattle bars and restaurants have started requiring proof of vaccination. Some workplaces are also requiring their employees to get vaccinated.

Without carrying around the physical card, customers can either keep a photo or a scan of their vaccination card on their phone. As for an official verified record, that will depend on the state in which someone got their vaccination and their provider. These records could be a QR code or a link and can be stored with wallet apps like CommonPass and Clear. 

Do you have questions about the coronavirus that causes COVID-19?

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