Cases of the coronavirus are on the decline in the Seattle metro area, but hospital leaders warned Tuesday that the omicron variant is gaining steam in Eastern Washington and could ravage already stressed health care facilities.

For the first time during the pandemic, the Washington Medical Coordination Center activated its “guaranteed-acceptance rotation protocol,” which goes into effect when all hospitals are “full to the point of needing to refuse patients” and need help finding beds, Taya Briley, vice president of the Washington State Hospital Association, said in a news briefing. It was active for several days last week.

Already some Washington hospitals have received patient transfer requests from health facilities in Idaho.

In King County, data shows the rise in average omicron infections per day peaked on Jan. 10 with 7,563 daily cases. Since then, the county has charted a significant decline in infections, dropping at least 43% in the past week.

Hospitalizations in King County were also showing signs of slowing or even plateauing, county health officer Dr. Jeff Duchin said in a Tuesday statement.

Still, coronavirus levels remain high with the county averaging about 3,100 daily cases and about 60 daily hospitalizations — figures far higher than those during past waves of the pandemic, he said.


And the state isn’t yet in the clear.

“We are bracing ourselves for the second chapter of the omicron surge as it hits Eastern Washington and Idaho,” Briley said. Omicron first surged in larger metro areas, including Seattle.

Briley added that Washington saw an average of 2,286 COVID hospitalizations within the past week, compared to about 2,148 the prior week — about a 6% increase.

At this point in the pandemic, Briley said the pattern is a “well-worn trend.”

“The number of COVID cases goes up, then the number of hospitalizations goes up, number of folks on ventilators goes up, then unfortunately we see more deaths,” she said. Last week in particular, she said, was an “extremely rough week” for some hospitalized patients.

Two patients were able to receive urgent care as a result of the guaranteed-acceptance rotation protocol, which was in effect for three days before capacity eased, she added. The protocol, unique to Washington state, was designed by hospitals last fall and is used to help the state’s sickest patients find hospital beds.

In Eastern Washington, some hospitals are again beginning to receive requests from Idaho health care facilities looking for open beds, said Jeannie Eylar, chief nursing officer at Pullman Regional Hospital, a 25-bed critical-access facility in Eastern Washington.


Delayed care issues have hit Pullman Regional Hospital particularly hard, Eylar said during the Tuesday news briefing, referencing one patient whose bowel cancer surgery had been continuously pushed back.

“We’re trying to balance getting these people the surgeries they’ve been waiting for for months and taking care of the emergency patients who come into the doors, and then trying to be good neighbors” to Idaho hospitals, some of which declared crisis standards of care Monday, she said.

Health care systems use the term “crisis standards of care” to describe operations that prioritize patients for resources and deny treatment to one patient in order to give it to another. Washington state has yet to declare crisis standards of care since the pandemic began.

The COVID patients pouring into the hospital’s intensive care unit are mostly unvaccinated, Eylar said.

“Eastern Washington is experiencing just exactly what Western Washington experienced,” she said.

The majority of vaccinated staff who have become infected, meanwhile, report milder cold-like symptoms, she said, but quarantine and isolation requirements have posed challenges similar to hospitals on the western side of the state.


“This is definitely not the time to declare the CoV-19 pandemic over (again), but a time to think about how we can transition to managing CoV-19 more effectively over the long term, using the increasing [number] of effective tools we have,” Duchin tweeted last week.

Because omicron’s evolution remains “uncertain,” Duchin said Tuesday, the public should continue getting vaccinated, boosting when eligible, limiting indoor gatherings in crowded and poorly ventilated settings, masking up and isolating and testing if symptoms develop.

“I’m relieved that the trajectory of our (omicron) surge has turned for now and I hope the decline in cases, hospitalizations and deaths continues so that before long we can move to more sustainable, long-term strategies to limit the morbidity from this virus,” Duchin said. “But for now, the course of the pandemic remains unpredictable.”