For a brief moment, it seemed the worst of the pandemic might be behind us. At a press conference with the Washington State Department of Health (WSDOH) Tuesday morning, Secretary of Health Dr. Umair Shah said he would have loved to announce the pandemic is over, but it’s just not. King County has seen a sharp increase in cases in the last two weeks: from 270 new cases on Dec. 9 to 925 new cases on Dec. 17, the most recent data.

The omicron variant first arrived in the U.S. at the beginning of the month. As of this week, the new variant is considered the most dominant version of the virus, accounting for about 73% of new infections last week in the U.S. on average. In the face of this new challenge, public health officials across the country have, for the most part, put responsibility on the individual – get vaccinated, get boosted, and assess risk as you move through life in the pandemic. At today’s press conference, Shah also recommended employers accommodate remote work when possible.

The pandemic has exacerbated tensions between the people and governing institutions: is it individual choice that continues to draw out this nearly two-year-long crisis or systemic failures? The U.S. government took a firm stance last Thursday when President Joe Biden warned of “a winter of severe illness and death for the unvaccinated — for themselves, their families and the hospitals they'll soon overwhelm.” He added, “But there's good news: If you're vaccinated and you have your booster shot, you're protected from severe illness and death.”

WSDOH focused on the vaccine and other precautionary measures as “empowerment,” rather than assigning harsh blame to the unvaccinated, many of whom fell victim to a vicious disinformation campaign propagated by former president Donald Trump. He’s tiptoed back his anti-vaccine sentiment since – he recently got booed for saying he got the booster.

While State Epidemiologist for Communicable Diseases Dr. Scott Lindquist predicted a “very difficult winter” with omicron, influenza, and an already exhausted healthcare system, today’s briefing emphasized the tools at our disposal.

Omicron may be the most prominent variant in the U.S., but it has yet to overtake the delta strain in Washington. Lindquist reported 400 omicron cases in the state as of this morning, but with its rapid expansion, it could overtake delta within a week.

The transmissibility, severity, and effectiveness of the vaccine in regards to omicron is still unfolding. So far, omicron is not associated with more hospitalization, but Lindquist said he did not feel comfortable making a solid prediction just yet. The fate of hospitals is nothing to leave up to early predictions: medical director of UW Medical Center Northwest Santiago Neme said hospitals have been operating at full or overflow capacity for months in many areas of the state.

With so much unknown, state health officials reaffirmed previous recommendations. As we gear up for this surge, they recommend everyone eligible to get vaccinated immediately. Around 82% of Washington state residents 12 and up have received at least one dose of the vaccine and over 75% have completed the initial series, and data shows the efficacy of these bad boys. As of Dec. 15, COVID-19 hospitalization rates were 23 times higher for unvaccinated people compared to vaccinated people in the 12-34 age range, 17 times higher in the 35-64 ages range, and then 11 times higher for unvaccinated people over 65.

But state officials said in the press conference that the effectiveness of the initial vaccines is waning. They recommend everyone 16 and older receive a booster as soon as they are eligible, which is six months after a second dose of Pfizer or Moderna or two months after getting the single shot of Johnson & Johnson. As of Dec. 18, almost 1.7 million additional doses have been administered statewide, including boosters and third doses, which are usually given to people with moderate to severely compromised immune systems.

However, getting boosted is easier said than done. Right now, the bottleneck for getting more people boosted is less about individual choice and more about the systems that do not have capacity to meet demand.

To help with this bottleneck, Shah first recommended that people cancel appointments if they are holding multiple. He also told the public not to “wait for the perfect booster,” but rather be open to mixing and matching because he said “the best booster is the one that is being offered to you.” On a systemic level, Shah said the governor has directed WSDOH to “work with its partners to look at vaccine capacity as well as take aggressive steps to increase that capacity across the system.” Shah said the department is “doing just that,” but when asked about the potential next steps for increasing appointment capacity, he said he did not have anything specific to share.

While challenging, the increased demand is “a good thing,” Shah said.

“We want to see an increase in people excited about and interested in getting boosters, and that's something we're going to continue to support,” he said.

The responsibility of employers did not come up until a reporter from Geekwire asked about it. Shah recommended that employers “encourage, incentivize, or require” their workers to get vaccinated. He asked businesses to encourage employees not to expose others and that employers support teleworking as much as possible.

The health officials did not call for lockdowns in the press conference nor did the president in his COVID-19 remarks today. Regardless of official calls to hunker down, we are already seeing the signs of spotty self-imposed shutdowns as workers get sick, businesses close, and nightlife grinds to a halt with performers canceling shows.

As far as social behavior, especially during the holiday season, Shah’s advice to vaccinated families – including his own – is to “keep on with what we’ve been doing.” All the adults in his family are boosted, and all the kids are fully vaccinated.

“Where you make a decision, whether it's to go out to eat or whether it's to go into a park, whether it's going to the movies, whether it's going to a sporting event, there are things you can do to reduce your risk and it is up to us to do that,” Shah said.

Of course, even if you follow the rules to a tee, you can still get COVID-19. It is not a moral failing. If you test positive, the CDC currently recommends isolating for 10 days. Please be sure to loop in the people you have interacted with recently.

If you live with others, stay in your own space if possible. Not everyone can get a roomie to bring them meals, so if you need to access shared spaces, wear a high-quality mask. Anyone else in the same room as you should also mask up.

State health officials said at-home testing is good, but not perfect. They recommend you use common sense: if you get a negative when you are experiencing symptoms go get a more accurate read at a testing site.

The impact of omicron is rapidly unfolding. More information to come.