Masks will soon be required at all outdoor events in King County with 500 or more people, regardless of attendees’ vaccination status, the county’s top health official announced Thursday.

The new requirement comes as coronavirus cases and hospitalizations continue to surge across the region, driven to record highs by the highly transmissible delta variant, King County health officer Dr. Jeff Duchin said Thursday. The order, which applies to everyone ages 5 and up, will go into effect Tuesday.

“We will continue to adapt our response measures to the reality of the evolving COVID-19 outbreak,” Duchin said in the statement. “The delta variant is more contagious through the air, causes more severe illness in adults and we have a high level of community transmission in King County and Washington state.”

He added that while outdoor events are much safer than indoor ones, risks still exist when large groups of people are in “close, prolonged contact.”

Before the mandate takes effect, however, Washington football will open its season Saturday at Husky Stadium. While the University of Washington’s athletic department is recommending fans mask up at all times, spokesperson Jay Hilbrands said Thursday that county outdoor mask mandates won’t be enforced until next week.

The county order also mandates face coverings for residents 5 and older in indoor settings, including grocery stores, malls, gyms and community centers — a requirement that aligns with a statewide mandate that went into place at the end of August.

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Masks are also strongly recommended at smaller outdoor events, especially those where people cannot remain at least 6 feet apart from others who aren’t members of their household.

“Layering multiple prevention strategies, including wearing a well-made and snug-fitting face mask when in crowded outdoor locations, is a necessary precaution at this time to limit COVID-19 spread and preventable cases, hospitalizations, and deaths,” Duchin said.

At a Thursday news conference, Duchin said risk increases with the size, proximity and duration of contact. As for the mandate applying to crowds of 500 and larger, the cutoff is “somewhat arbitrary,” he said.

“There’s no magic number, there’s no science or limit to where the risk appears and disappears,” he said. “But we wanted to make sure that large gatherings where people could be crowded together, especially for prolonged periods, were the main focus.”

While the order doesn’t specify the types of outdoor events that will require masking, most fairs, sports stadiums and arenas, as well as many music venues, will likely come under the rule.

Most Seattle-area teams have already been recommending masking up while at games, including at Lumen Field and T-Mobile Park (masks are required in indoor areas of the stadiums). Meanwhile, the Kraken hasn’t officially stated any policies but the NHL team is considering making vaccines mandatory for fans at Climate Pledge Arena.

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Here’s what King County’s outdoor mask mandate means for Seattle sports fans

The Washington State Fair, which reopens in Puyallup this weekend, announced mask requirements earlier this week for both indoor and outdoor spaces. The fair updated its guidance after Pierce County’s health director issued a similar order requiring all attendees to mask up at all times on fairground property.

Despite fears Labor Day weekend events and gatherings will spur a spike in cases, Duchin said the requirement won’t go into effect until next week to give venues time to prepare. Although, he added, people should not wait to begin wearing masks at outdoor gatherings.

“King County is committed to putting people first, and today’s order fully recognizes the risk to communities and our healthcare system if we don’t take action now to further prevent the spread of COVID-19,” King County Executive Dow Constantine said in the Thursday statement.

The county noted that while its vaccination rates are high, about 750,000 residents remain unvaccinated, including children younger than 12 who can’t yet receive shots. About 320,000 eligible residents remain unvaccinated, which has contributed to the “heavy toll” on local hospitals and health care systems, the county said.

“Every day, large numbers of hospitals are reaching out to the Washington Medical Coordination Center,” Dr. Steve Mitchell, director of emergency services at Harborview Medical Center, said in the statement. “In the past few days, nearly 60% of the calls have been COVID-related. Capacity and staffing issues in hospitals are widespread and consistent across the state.”

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The most significant impacts in Western Washington are currently in South King, Thurston and Pierce counties, Mitchell added.

According to Duchin, the county is currently at or near the highest levels for hospital admissions and acute care- and ICU-bed occupancy since the pandemic began.

At this time last year, he said, about four people were hospitalized with COVID-19 per day in the county — compared to the current average of 21 people per day, mostly among young and middle-aged adults. In King County, 12% of acute-care beds and 25% of ICU beds are being occupied by COVID-19 patients.

Local health officials also reported nearly 600 new infections each day over the last week, a nearly 500% increase compared to this time last year.

The virus death rate is also increasing in King County. In the last week, local hospitals saw an average of about 3.5 deaths every day, compared to two deaths per day for “much of the pandemic,” Duchin said.

While new cases have plateaued over the last few weeks, they’ve leveled off at a “very high level,” he said.

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There needs to be a significant and sustained decrease in new cases, he said, in order to relax preventative measures, which are especially important as fall and winter approach.

He added that over the last month, unvaccinated residents were six times more likely than vaccinated people to test positive for the virus, 48 times more likely to be hospitalized and 32 times more likely to die.

“I really believe that over time as more of us are vaccinated or less desirably infected, the threat from COVID-19 and the need for these types of measures will recede and we will get back to a more normal routine,” he said.