Acting State Health Officer Dr. Scott Lindquist has gone from “cautiously optimistic” to just “cautious” about COVID-19 in Washington state after a disturbing plateau in cases and the detection of new variants.

His caution, in part, relies on case counts no longer declining in the state, replaced instead with an ominous flat trend, with the possibility of increasing transmission in some parts of the state.

Lindquist is also concerned about the spread of variants. Labs have confirmed the presence of eight variants in the state, including those from Brazil, South Africa and the United Kingdom, and now including stateside variants from New York and new strains from California.

There are 422 cases of two California variants confirmed in Washington, making the two strains the most detected of all variants by the many labs doing sequencing statewide.

The California variants are thought to be about 20% more transmissible than the original virus strain, and the Centers for Disease Control and Prevention has identified both variants as ones “of concern” because they could reduce the effectiveness of some therapeutics used to treat the virus, as well as the vaccines themselves.

There are five California variant cases confirmed in Spokane County to date, according to state data.

The new California variants have not resulted in more hospitalizations or deaths proportionally compared to all confirmed virus cases in the state, so far. State data show that more than 75% of the California variant cases were found in residents under the age of 50.

Health officials asked younger Washington residents, many of whom are still not eligible to get vaccinated, to continue to wear masks and be cautious.

“We’re still (confirming) an average of 654 cases a day. This is still relatively high; (it) is where we were in October,” State Secretary of Health Dr. Umair Shah told reporters Thursday. “That plateauing is very concerning to us in public health and really underscores the importance of preventive measures.”

State health officials have also confirmed breakthrough cases in the state, which occur when a person is fully vaccinated, or two weeks beyond their last dose of a COVID-19 vaccine, and then tests positive for the virus.

These breakthrough cases are expected, especially when the vaccines are not 100% effective at preventing infection and when some variants might weaken vaccine effectiveness.

Lindquist said these cases are a large reason the state has amped up its genotyping capabilities, to be able to detect if someone who is vaccinated and then gets COVID-19 is infected with a variant strain.

“We’re working with every local health jurisdiction to identify any epidemiology that would point to things like: Is it more common with a certain vaccine, a certain lot, anything that would show us trends,” Lindquist said.

The possibility of breakthrough cases and the confirmation of eight different variants in Washington should not dissuade residents from getting vaccinated, health officials said.

“Breakthrough infections happen, but they are rare,” Shah said.

There have been no breakthrough COVID-19 cases reported in Spokane County, according to Interim Health Officer Dr. Francisco Velázquez, but he expects that to happen eventually.

“I would like us to be aware, not alarmed that that can happen,” he told reporters Wednesday.

Health officials said getting vaccinated when eligible is an important part of decreasing virus (and therefore variant) transmission.

“We have worked so hard as a nation to get to this point where we have a way out of this pandemic, which is the promise of vaccine, but vaccines are only as effective as being in the arms of people,” Shah said.

Next week, the state will receive its largest allocation of vaccine doses to date, with more than 400,000 doses going to providers, including more than 40,000 one-shot Johnson & Johnson vaccines.

On Wednesday, about 2 million more Washington residents will become eligible to get vaccinated, including everyone 60 and older, people with two or more underlying health conditions that put them at risk for developing severe disease with COVID-19, people working in congregate settings, and restaurant, food service and construction workers.

There are about five weeks left of prioritizing more at-risk Washington residents for vaccines before May 1, when all residents 16 and older will be eligible.

Public health officials again emphasized that those who are eligible now, including pregnant women, people with disabilities and high-risk critical workers, should get vaccinated soon, before more people become eligible for the shots.

A look at local numbers

The Spokane Regional Health District updated its data after discovering an error in data Wednesday.

On Thursday, the district confirmed 57 new COVID-19 cases. On Wednesday, the district confirmed 48 new cases.

There are 45 people with COVID-19 hospitalized in Spokane County.

After adjustments to death data, the district has confirmed 606 COVID-19 deaths in Spokane County.