None of Washington’s eight regions is ready to progress to Phase 2 of the state’s new reopening plan that began Monday, the state Department of Health said in a report released Friday.

The two-phase Healthy Washington plan requires that the state’s 39 counties, grouped into eight regions, work together to slow the spread of COVID-19 before moving into Phase 2 of the plan, which allows for businesses to open in some fashion.

The state’s initial Healthy Washington report released Jan. 8 showed the Puget Sound region meeting three of the four metrics in the plan to move to Phase 2, falling short only in the rate of new COVID-19 hospital admissions. Friday’s report, the state’s second Healthy Washington update, shows the same.

Before moving to Phase 2, each region will need to meet these four metrics:

  • A 10% decreasing trend in case rates during the previous two-week period
  • A 10% decrease in COVID-19 hospital admission rates during the previous 14-day period
  • An ICU occupancy seven-day average that’s less than 90%
  • A test positivity rate through seven days that averages less than 10%.

Friday’s DOH report shows the Puget Sound region’s 14-day rate of new cases per 100,000 people is down 13% for the two-week period ending Jan. 2 compared to the two-week period ending Dec. 19.

According to the COVID-19 risk assessment dashboard for the two-week period ending Jan. 2 for cases per 100,000 people, King County is at 289, Pierce County at 363 and Snohomish County’s rate was 355.


Dr. Jeff Duchin, Public Health – Seattle & King County’s health officer, said that for the two-week period ending Jan. 2, there was a 27% increase in King County.

Those numbers are likely to change for the worse as new cases rise in the region and across the state. An increase in King County reflects the actions of people during the holidays, said Duchin.

King County is part of the Puget Sound region with Snohomish and Pierce counties. The other regions are the North, Northwest, North Central, West, Southwest, South Central and East.

“The increased number of COVID-19 cases reflects the activities people engaged in during the Christmas and New Year’s holidays, including travel, family and social gatherings and the ongoing spread of COVID-19 in workplaces and other locations across the region,” Duchin said. “At this time, we can’t predict how high the current increasing trend will go or when it will level off.”

All eight regions in the state combined are missing on the hospitalization metric. The state has an 8% seven-day rate of positive COVID-19 tests, two points better than the 10% cutoff.

Washington’s counties will have to work together if life is going to inch back toward something resembling normalcy.


Counties often work together, as has been the case throughout the coronavirus pandemic, said Snohomish County Executive Dave Somers.

“We understand that we are connected by businesses and transportation networks and families across borders. So we understand that we’re part of a larger region,” he said during a Tuesday news briefing.

The pivot to a regional instead of county-by-county approach could lead to pressure from residents and businesses in individual counties if a county meets the state’s benchmarks but its region-mates don’t. The state Department of Health (DOH) will only consider moving a region as a whole.

This comes at a time when political and social pressure is high on health departments and Gov. Jay Inslee to reverse restrictions.

“No individual county will be allowed to move forward unless the whole region meets the four metrics outlined in the Healthy Washington — Roadmap to Recovery phased reopening guidance,” said Ginny Streeter, DOH spokesperson.

Despite the risk of pressure on individual counties, the regional approach makes sense, wrote Nigel Turner, who heads up Tacoma-Pierce County Health Department’s communicable disease division, in a department blog post.


“Disease rates and hospitalizations usually move in the same direction at roughly the same rate across our region,” he wrote. “… Hospital resources are one of our biggest concerns. Pierce County’s hospital systems have facilities in King County, for instance. And many of our residents go to work in King County every day.”

COVID-19 cases peaked in early December while hospitalizations continued to rise through the end of the year after Inslee ordered restrictions on Nov. 15.

The restrictions, which were extended by the governor a number of times, had bars and restaurants shut down indoor service and limit outdoor service to parties of five or fewer. Indoor gyms and fitness centers, movie theaters, bowling alleys and museums also had to shut down.

Schools aren’t included in the Healthy Washington plan. Inslee in December announced new, more lenient benchmarks for opening schools.

Unlike the Safe Start plan that was used to open businesses and counties after Inslee’s stay-home order on March 23, there is no application process for the eight regions. Instead, the state Department of Health will be examining the data every Friday to determine if a region can move forward on the following Monday.

Once in Phase 2, a region can stay there as long as it meets at least three of the four metrics used to determine its moving from Phase 1.