As COVID-19 trends in Washington state continue to plateau at high levels — with some “mild” decreases — state health officials said Wednesday morning there’s growing concern more patients are becoming sick with other respiratory viruses now that colder weather is nearing.

The state recorded a seven-day coronavirus case rate of 174.2 infections per 100,000 Washingtonians as of the last week of October, the most recent complete data. The rate was down from about 200 cases per 100,000 in mid-October.

COVID hospitalizations also continue to decrease slowly. As of late October, there was a seven-day rate of 9.1 hospitalizations per 100,000 people, down from 10.6 per 100,000 the week before. At this time last year, hospitalization rates were about the same, ranging from 9.3 to 10.9 per 100,000 people.

“When it comes to cases, particularly to hospitalizations, we are still seeing numbers higher than any of us want to see,” state Secretary of Health Dr. Umair A. Shah said during the Wednesday news briefing. “… It continues to be a difficult time in our state.”

Hospital occupancy also remains high, which is common this time of year, state epidemiologist Dr. Scott Lindquist said.

“A lot of this is due to the start of our respiratory virus season,” he said.

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This year, in addition to COVID, Lindquist said he’s concerned about the flu and respiratory syncytial virus, or RSV, which causes cold-like symptoms. King County, which tracks respiratory virus season every year, has reported that the percent of positive RSV tests in late October was much higher than past levels this time of year — 13% of tests are positive compared to the average of less than 2%.

“I’m seeing patient after patient with respiratory viruses that are not COVID,” Lindquist said. “This is really complicating the picture.”

Kids are tending to have “very high” coronavirus case rates, particularly in northeast Washington, Lindquist added. In late October, the seven-day infection rate for children between ages 4 and 10 was 224.37 cases per 100,000 people, about 22% higher than the general population.

Fortunately, Lindquist said, the state is seeing some increase in community immunity, from both vaccination and natural immunity. He referenced Washington’s current R-effective estimate — the average number of new people that one person with COVID-19 infects — which is at about 1.07.

In late July, during the recent surge of the delta variant, the R-effective was at about 2.02.

To reduce virus cases and hospitalizations, the R-effective needs to remain substantially below one for a “sustained period of time,” the state Department of Health has said.

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“Our community immunity is rising, and this is the perfect time to get vaccinated,” Lindquist said.

The state last week surpassed a milestone of 10 million COVID-19 vaccine doses — at least 600 of which were given to children between ages 5 and 11 after the kid-sized shots were approved federally last week, DOH acting assistant secretary Michele Roberts said Wednesday. Roberts acknowledged a “significant” data delay for those shots, since it takes a few days to process vaccination numbers, and said she expects the number to “rapidly increase” in the next few weeks.

Roberts reminded families to be patient as pediatric doses continue to roll out. It’ll likely be a couple more weeks before the childhood vaccination supply stabilizes, she said.

So far, more than 265,000 pediatric doses have been delivered to the state.

More than 79% of Washingtonians 12 and older have received at least their first dose.

Because of Washington’s high rates of vaccination, the winter season could look a little different this year, said Lacy Fehrenbach, the state’s deputy secretary for COVID response.

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State health leaders this year are OK’ing small holiday gatherings, as long as attendees are vaccinated or have tested negative for COVID, a shift from last year when they were urging people to limit get-togethers to one household.

“You can still get a J&J vaccine within the next day or so and be fully protected in time for Thanksgiving or Hanukkah,” Fehrenbach said. “You can also start any vaccine series … and be fully vaccinated by Christmas, Kwanzaa or New Year’s if you get vaccinated this week.”

For the unvaccinated, she recommended people bundle up and spend time outside. If you’re indoors, wear masks and open windows, she said.

“We are not out of this pandemic,” Shah said. “We are still having far too many people testing positive, far too many people getting hospitalized and far too many people losing their lives in our state from this virus. … This continues to be a race against this virus.”