New COVID-19 prediction models forecast a potential fourth wave and how to minimize it – GeekWire

In a bootcamp that launched in January, University of Washington School of Nursing students train other UW students and faculty who hope to help in COVID-19 vaccinations. (Kiyomi Taguchi / University of Washington Photo)

Lets start with the good news. The number of new COVID-19 cases in the greater Seattle area, Washington state and the national level have all been declining since early January, showing a recovery from whats known as the third wave of infections.

The potentially bad news? New models predict that a fourth wave could be on the horizon but if, when and how it crests is uncertain.

Were in a race against time, health officials warn, pitting our ability to quickly vaccinate as many people as possible against the emergence of more infectious and possibly more deadly variants of the COVID virus. They include strains from the United Kingdom, South Africa and Brazil.

Im yo-yoing between pessimism and optimism on a daily basis. I do think that there is a window where the worst of this is behind us, but there are too many open variables to be sure of it, said Dr. Joshua Schiffer, an infectious disease modeler at the Fred Hutchinson Cancer Research Center.

Depending on how the different factors play out, between 28-to-40% of the King County population will have been infected by the virus by the end of the year, according to a study from Schiffer and colleagues that posted Wednesday on medRxiv. Thats including verified cases and those that go undetected. (The scientists estimate that roughly 15% of the county, which includes tech hubs of Seattle, Bellevue and Redmond, have been infected to date; the official number of confirmed cases is less than 4%.)

Fred Hutch researchers ran 3,888 simulations in which they altered vaccination rates, vaccine effectiveness in preventing infection and transmission, and what level of infections would trigger the government to enforce a partial lockdown of business and social interactions. They wanted to know which measures matter most in controlling the virus.

Their conclusion: under all plausible scenarios, rapid vaccination and early enforcement of partial lockdown are the two most critical variables to save the greatest number of lives.

The research has not yet been peer-reviewed.

Washington so far has given more than 728,000 vaccinations. The state is averaging 28,000 doses administered per day, with a goal of 45,000. About 8% of the population has received one shot, and almost 2% are fully vaccinated. On Monday, eight Washington counties, including King and other populous Puget Sound area counties, were permitted by the state to ease their partial lockdowns.

Late last week, the Institute for Health Metrics and Evaluation (IHME) shared its updated COVID projections that run through the end of April. The IHME, a research center at the University of Washington, makes predictions at the global, national and state levels.

Heres what the two organizations forecast:

When it comes to a spring COVID surge, I dont think any state will allow this to happen, said Ali Mokdad, an IHME professor and chief strategy officer for Population Health at the UW.

If the downward trends in infections and deaths started reversing, lockdowns would quickly follow, Mokdad predicted. [States] will go and hit the breaks as fast as they can. As soon as we start hearing that the new variant is taking over, that its more likely to be transmitted and its deadlier, mask wearing will go up.

Mokdad had less certainty for fall and winter, which is when the U.S. and Washington saw its biggest wave in case numbers last year. He expects an increase when cold weather sets in, but the severity will depend on what percent of the population has been vaccinated or already infected, which variants are predominant, and how the vaccine performs against them.

Information is still emerging on the variants. B.1.1.7 has been found in multiple cases in the Puget Sound area and is estimated to be roughly 50% more contagious than the original virus. Last week the first cases of the Brazilian variant and the South African strain were found in the U.S.

The currently approved vaccines appear largely effective against B.1.1.7 and the Brazilian variant, but less so against the South African mutation. That said, the vaccines provide a tremendous benefit and the new variant makes vaccinations more urgent, particularly in the Pacific Northwest.

While Washington, Oregon and Hawaii have done a better job than many other states in terms of controlling the spread of COVID, when it comes to reaching herd immunity, that success puts these Western states at a disadvantage at least temporarily compared to states where the infections raged.

Eight states including North and South Dakota, Utah, Arizona and Tennessee have all had case totals of more than 10,000 per 100,000 residents, while Washington has tallied slightly more than 4,000 per 100,000. Epidemiologists estimate that the actual number of infections could be four times higher. That means some states are getting close to 50% infection rates, even before vaccinations are added in.

States with fewer total infections dont have nearly as many cases contributing to herd community, Schiffer said. And so the burden of vaccination is higher.

Heres more on what the COVID experts are thinking about, and want you to know:

Editors note: This story has been updated to correct that the state is averaging 28,000 vaccination doses daily, not weekly.

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New COVID-19 prediction models forecast a potential fourth wave and how to minimize it - GeekWire