The number of COVID-19 cases in Western Washington is rising at “an alarming rate” and health officials say we might be joining the rest of the nation in a “fall surge” of the pandemic, the Washington State Department of Health said in a Tuesday news release.

Statewide, confirmed cases are trending upward. Case counts in King, Pierce and Snohomish counties have been rising sharply since mid-September.

In King County, the seven-day average for new positive COVID-19 tests had dropped to a recent low of 77 cases on Sept. 17. About three weeks later, on Oct. 9, the most recent day for which complete data was available, that figure had doubled to about 154, according to state data.

Health experts have long feared a seasonal rise in cases could strain the capacity of the region’s health-care system.

“We are seeing a surge,” said Ali Mokdad, a professor of health metrics sciences at the University of Washington’s Institute for Health Metrics and Evaluation (IHME), which produces modeling of the pandemic. “In December and January, we are going to have a difficult couple of months.”

IHME predicts a spike in estimated COVID-19 infections that continues into February.

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If projections hold true and without further preventive measures, Mokdad said the need for intensive-care-unit beds could stretch beyond the state’s current supply in mid-January.

Confirmed cases, hospitalizations and deaths are increasing in Snohomish County, Dr. Chris Spitters, the county’s health officer, said in a weekly briefing. He added, “We could end up back where we were last March, both in terms of hospital capacity and then consequently the measures that would need to be taken to bring things back under control.”

The rising COVID-19 caseload is particularly concerning because it aligns with influenza season, which can put added strain on hospitals, said John Wiesman, the state secretary of health.

Janet Baseman, a professor in the Department of Epidemiology at UW, said health experts are concerned over several factors accompanying the change of season. Baseman said she is concerned about public fatigue over the pandemic’s restrictions and disruptions, increased travel during the holiday season and colder weather pushing gatherings inside.

“We’ve dipped a toe into fall. We are concerned about multiple circulating viruses, increases in indoor activity, and if there’s holiday travel thrown into the mix — it’s a recipe for an even more burdened health care system and seeing a repeat of some of the things we saw in the spring in certain parts of the country where hospitals and health-care systems were overwhelmed,” Baseman said. “We haven’t seen that happen yet. It’s why everyone is messaging: Get vaccinated for the flu to try to head that off.”

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Health officials want people to mask up, keep groups small, avoid indoor gatherings, wash hands and stay home if they’re feeling ill.

Nationwide, cases of COVID-19 have been rising sharply for weeks. The New York Times reports a 34% increase in cases over the past two weeks. But the effects are uneven across states with different public policies and weather patterns driving public behavior.

“Washington is lagging behind the nation a little,” said Jerry Cangelosi, a UW professor in the Department of Environmental and Occupational Health Sciences.

When weighted for population, “hospitalizations and new cases, we’re about half to two-thirds of the national average. Nationwide that’s going to go up over the next two to three months. Washington will rise up with it,” Cangelosi said.

Cangelosi attributed Washington’s relative success to the state’s higher mask usage, lower mobility and strong testing and contact tracing.

Washingtonians’ mobility is down about 19% since last January and about 74% of Washingtonians are using masks, said Mokdad, of IHME, which incorporates cellphone mobility and online survey data into its modeling for COVID-19.

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Many respiratory illnesses, including influenza, spike in the fall. A surge of COVID-19 fits the “natural rhythm of respiratory pathogens,” Cangelosi said.

School and college attendance typically are among the biggest drivers of transmission.

“Those are places with a lot of spread of respiratory disease,” Cangelosi said. “When you have a classroom of 20 children in it, you’re not just sharing the virus with 19 other children, you’re sharing it with 19 other families.”

Cangelosi said Washington could be faring better than some other states because most classes are being held online.

Mokdad said the virus’s pattern in Southern Hemisphere countries like Argentina — where cases spiked from July through September — provides evidence the novel coronavirus is a “seasonal virus.” He said COVID-19’s pattern correlates with pneumonia, a disease that does not disappear in the summer and spikes in the winter.

Stringent adherence to the measures that slow transmission will help brunt fall and winter’s impact, Mokdad said, but he still expects cases to accumulate.

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“Mask use was very high in Argentina, social distancing was very good, mobility went down,” Mokdad said. “They did a good job in terms of public health and awareness. Still, they had a rise in COVID-19.”

Seattle Times staff reporter Ryan Blethen contributed to this report.

Editor’s note: A comment thread was erroneously appended to this article when it first published. It has since been removed, in accordance with our policy on COVID-19 stories.

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