County health officials urge wearing masks indoors regardless of vaccination status

Snohomish County’s Chief Health Officer Dr. Chris Spitters provided an update, July 26 via Zoom, on masking recommendations amid increasing COVID-19 case counts and hospitalizations.

COVID-19 case rates have increased in recent weeks and Snohomish County health officials are recommending that all residents wear masks when in indoor public settings such as grocery and retail stores, restaurants and entertainment venues where the vaccination status of other people is unknown.

Snohomish County’s Chief Health Officer Dr. Chris Spitters — along with the health officers of King, Pierce, Snohomish, Kitsap, Clallam, Jefferson, San Juan, and Grays Harbor counties — issued a statement July 26, reiterating the importance of vaccination and also advocating for the facial coverings, regardless of vaccination status, in light of the rising case counts, hospitalizations and the highly transmissible delta variant of the virus.

“Together with other health officers in the region, I recommend that we all wear a mask when we go to indoor public places, regardless of whether we’re vaccinated or not, and especially where the vaccination status of those around you is unknown,” Spitters said. He noted that the advice was a recommendation, not a requirement, but one that wasn’t made lightly.

Doing so can help reduce the risk of spreading COVID, including the highly contagious delta variant, in the community, including among businesses’ customers and workers, and help steady the recent increase of confirmed cases and hospitalizations.

“We are now on our fifth wave of transmission here in Snohomish County,” Spitters said during a media briefing Monday afternoon. “For the week ending last Saturday, July 24, a total of 634 new cases were reported — a 20% increase from the prior week, and a 125% increase from the 280 cases reported just four weeks ago at our low point after the fourth wave.”

He added that the rolling two-week case rate per 100,000 residents is currently at 140, which places Snohomish County in the CDC’s (Centers for Disease Control and Prevention) high transmission risk level, and the number of patients needing to be hospitalized in the county “has increased 50% in the past week with now 34 active COVID-hospitalizations at this moment.”

Spitters said the return to increasing rates of transmission and hospitalizations is “largely preventable” and has mainly been driven by three factors. “One, stalling vaccination that leaves approximately 240,000 eligible adults uncovered countywide, in addition to the 125,000 children under 12 who are not yet eligible for vaccination,” he noted. “Two, reduced mask wearing by unvaccinated individuals in public and private settings. And three, the far more contagious delta variant that now accounts for the majority of cases in the state and country.”

Because people who have been vaccinated can still get ill, local officials continue to recommend masking up in public indoor spaces. They warn there remain many in the community not yet vaccinated including children under the age of 12, who do not yet have a vaccine authorized for them, and immunosuppressed residents whose response to the vaccine is compromised. Universal masking helps protect these populations and also serves as an extra layer of protection with highly contagious variants circulating in the community.

“The overwhelming majority of data from experimental and real-world settings shows the safety and effectiveness of cloth face masks in reducing airborne transmission of COVID,” Spitters said.

“It’s not a coincidence that the recent increase in cases is associated with reduced practice of prevention measures in the community including reduced adherence to the state’s ongoing requirement that unvaccinated people wear masks in indoor public places,” he noted. In addition, state masking requirements remain in place, regardless of an individual’s vaccination status, in health care settings, public transportation and institutions such as schools, jails and homeless shelters.

While many business owners may be reluctant or unwilling to confirm the vaccination status of customers and/or ensure that those who are unvaccinated are wearing masks for the safety of others in that space, Spitters asked for their assistance. “Given the delta variant, the incomplete vaccination effort and rising cases and hospitalizations this is only more of a concern in the present moment,” he said. “The most straight-forward way to verify that all unvaccinated people are wearing a mask in such settings is for everyone to wear a mask in those settings,” which will also help protect those populations who have not received or been eligible for the shot.

“We wouldn’t make the (masking) recommendation if we didn’t think it was needed,” Spitters said. “I encourage proprietors and organizers in such public settings to support the recommendation, especially if they do not have a robust system in place for ensuring that all unvaccinated staff and patrons present in the building are masked.” Additional benefits to masking include that it’s not expensive or difficult and also serves to protect and reassure its wearer along with other people present.

He acknowledged that the change in recommendations may be confusing or frustrating to many people — including those who have already been fully vaccinated. “But things are sliding backwards,” Spitters added. “The reality is that a higher price can and likely will be paid if we do not rally and up our game on masking in public places now.”

In addition to wearing masks, the importance of proper ventilation was touted to help remove airborne droplets of the virus present from people coughing or sneezing and even talking or breathing. Spitters said that COVID is chiefly spread among people through airborne methods. “Good ventilation dilutes the virus and blows it away,” he added. “Poor ventilation leaves it hanging there for all of us to breathe in.”

Besides mask wearing, vaccination and ventilation, health officials also continue to recommend handwashing and indoor social distancing measures as other strategic measures that can be taken to help prevent the virus from spreading.

Anyone who experiences symptoms of the virus is urged to stay home and get tested. “Don’t forget about testing,” Spitters said, also adding, “early self-isolation by symptomatic people can help reduce new infections.”

He noted that the rates of breakthrough infections have also been rising recently, “However, this is not unexpected nor is it a failure of the vaccine program,” he said. A breakthrough case is someone who tests positive more than two weeks after receiving their last dose of COVID-19 vaccine. Breakthrough cases tend to have a less severe illness than people who have not been vaccinated and are an expected event as more and more of the population is vaccinated.

“All vaccines have breakthrough cases, more so as coverage of the population of the vaccine increases,” Spitters said. “It’s just the intersection of high vaccination coverage and the occasional but much, much, less common occurrence of cases in that vaccinated population. The COVID vaccines are highly effective, but not perfect, in preventing infection – no vaccine is.”

Even with the delta variant circulating, the vaccines’ effectiveness “really are enough to control COVID if we get everyone vaccinated,” he added.

There have been 507 total breakthrough cases reported in Snohomish County from February to July 20. In Snohomish County during the month of July, reported cases of people contracting or dying from COVID has been nearly 10 times higher for unvaccinated people compared to those who are fully vaccinated Spitters noted.

Breakthrough cases tend to have a less severe illness than people who have not been vaccinated. “Most breakthrough infections are mild or asymptomatic,” he said, “although hospitalizations and deaths can and do occur rarely among breakthrough cases.”

People who have not yet been vaccinated were urged to do so as soon as possible. Those with questions or concerns about the vaccines’ safety and effectiveness were recommended to consult with their health care provider and look to reliable information sources including county health districts, the Washington State Department of Health, CDC, and other reputable sources that are well-established such as the University of Washington and other leading medical research universities including Medscape and the Mayo Clinic.

“Much information disseminated or forwarded on social media platforms is inaccurate or even deliberately intended to discourage vaccination and other COVID-prevention measures by broadcasting false information or misrepresenting data,” he said.

“The bottom line is that vaccination remains our number-one tool in preventing COVID and reducing its impact on our health and our lives,” Spitters said. He encouraged those who are vaccinated to “talk with people in your life who have not been vaccinated to let them know how it went and how you feel now that you’ve got it done.”

Clinical trials for vaccine access to children under the age of 12 remain ongoing. “Experts involved in that work suggests that application for an emergency use authorization in children would occur at some point late in this year or early next year – with CDC recommendations for use of that vaccine to follow shortly after that,” Spitters said.

He added that current CDC data indicates people who have been fully vaccinated, even those with compromised immune systems, do not benefit from receiving an additional dose in the form of a “booster shot.”

Residents eligible for vaccination who are interested in getting the shot but experiencing trouble obtaining a dose can reach out to the Snohomish Health District at or by phone at 425-339-5278 for help.

Anyone who has been exposed to or who develops symptoms of COVID-19 can contact their health care provider or go to one of the drive-thru testing sites to get tested. They should also stay isolated at home until they receive their test results. This week there are drive-thru testing site locations open in Everett and Lynnwood.

Appointments are recommended for those who wish to get tested and registration is available at Those without internet access or needing language assistance can reach the Snohomish Health District’s call center at 425-339-5278 to schedule a testing appointment. The call center is staffed 8:30 a.m. to 4:30 p.m. Monday through Friday. Callers after hours or on weekends can leave a message, which will be returned on the next business day.

— By Nathan Blackwell