COVID-19 isn’t done with Seattle and King County. But after a three-year run, it’s not the top emerging health scourge anymore. The coronavirus has been officially displaced.

Drug overdoses are now killing more people than COVID.

It started to happen last summer, in August, when more than 25 people died from drugs in a week, mostly from ingesting fentanyl, county records show. In the fall, drugs firmly dethroned COVID, when 339 people died during the quarter — nearly four per day, 70% more than were dying from COVID.

As of Friday, 100 people have already died in 2023 from drug overdoses countywide. Forty-three have died of COVID.

Drugs now are overwhelming the system, in some of the same ways that we all worked to prevent by wearing masks and socially distancing during coronavirus waves.

“A key indication of just how bad things are at the end of 2022 and likely to get worse [in] 2023, the medical examiner’s office is now struggling with the issue of storing bodies because the fentanyl-related death toll continues to climb,” Public Health Director Dr. Faisal Khan, a medical epidemiologist, said at a health board meeting this month.

Paramedics also are straining to keep up. There now are 20 drug overdose calls every day, roughly double from a year ago. (These are predominantly non-fatal overdoses.) Just in the month of December, “King County emergency medical services responded to 156 opioid overdoses in downtown Seattle,” an all-time record, the health department reported.


Inside city limits, Seattle saw twice as many drug overdose deaths last year (541) as COVID deaths (273), health department records show.

It isn’t solely a downtown phenomenon. Kent, Renton and North Seattle near Shoreline also are marked dark red on the county’s overdose map. A week ago there were 11 overdose calls out in West Seattle. Big cities to the north and south of us, Vancouver and San Francisco, also have seen drug deaths surpass COVID.

“The number of overdose deaths has grown on an exponential scale,” the health department’s review of 2022 says. “Exponential” was the word they once used about the coronavirus — the fear that it might spread out of hand to the point it starts crippling the ability to respond to it.

Not long ago the drug crisis was simmering at a lower level; one national news outlet dubbed it “an epidemic in the shadow of a pandemic.” It’s not in the shadows anymore. COVID’s force has waned, especially due to the vaccines. The drug epidemic just keeps maddeningly expanding.

Obviously COVID comes from a virus that could infect anybody; drug addiction is viewed as more of an individual struggle. But the drug scourge is spreading to a degree that it’s having severe effects on the broader community. There’s the fate of downtown, which isn’t going to recover with 156 overdose calls there monthly. And there’s the human costs — the lost lives of those in the throes, but also of innocent bystanders such as 23-year-old student Jaahnavi Kandula, killed Jan. 23 when a police car hit her in a South Lake Union crosswalk as it was heading to the scene of yet another overdose.

So what could be done?

The state Legislature has been locked in a debate over whether to decriminalize hard-drug possession. The latest signs, though, are that lawmakers are headed in the opposite direction. New bills with the backing of influential Democrats would increase the criminal penalties, from a misdemeanor to a gross misdemeanor, though the emphasis still would be to channel defendants into treatment.


Wherever one stands on this — from lock ‘em up on the right, to hand them needles on the left — what’s clearly lacking is the treatment and support part. The main point of sentencing a drug user to jail is to nudge them into rehab instead. (Decriminalization advocates say this justice system coercion isn’t needed, but for now they appear to be losing that argument.) But no approach is going to work if there’s no treatment to go to.

This past week the regional agency on homelessness released its five-year emergency shelter plan. It acknowledged there’s a connection between substance abuse and Seattle’s homelessness crisis (which seems like progress). It recommended something called “recovery housing” — drug-free shelter that also offers rehab counseling and support for people fresh off the streets.

Then it said this: Due to the size of the addiction problem, we need an estimated 2,570 units of this recovery-based shelter. And right now we have … zero units.

How could we be this deep into the drug and homelessness crisis in Seattle and still be at zero?

Seattle and King County were justifiably proud of how they handled the pandemic. We had the lowest COVID death rates of any large metro area in the nation. The morgues and hospitals never reached triage status, as they did in communities from New York to Idaho.

But we’re losing to this shadow epidemic. We’re losing because our political leaders have for years been conflicted and directionless about what to do about it.

It doesn’t have to be. You can “flatten the curve” of addiction, using treatment and other strategies, as surely as with a virus.

What’s needed is that same civic focus — that unity of purpose — that political leaders here so successfully brought to bear on our last biggest public health crisis.