Respiratory Illness Data Dashboard

This page is being reviewed for updates. The Washington State Department of Health has updated its guidance for what to do if you are sick with COVID-19 or were exposed to COVID-19. This page may have content that is inconsistent with the new guidance.

Website Last Updated 3:06 p.m. 3/13/2024
Data shown as of previous day at 11:59 pm PT.
 

These dashboards show trends in Washington state for COVID-19, influenza (flu), and respiratory syncytial virus (RSV). The data on these dashboards help us monitor early signs of disease spread, severity of illness, vaccination rates, virus variants or subtypes occurring in Washington, and hospital bed use due to COVID-19, flu, and RSV.

Instead of showing data by individual counties, these dashboards use larger regional areas called Accountable Communities of Health (ACH). This change was made because sometimes there is not enough data reported from the county level to display publicly while maintaining an individual’s privacy. See which ACH region covers your county.

Additional COVID-19 hospital admission data at the county level is available in the CDC COVID Data Tracker: Maps by Geographic Area.

Learn how to stop the spread of these illnesses by visiting our COVID-19flu, and RSV pages.

Dashboard Data Notes

Wednesday, March 13, 2024: Laboratory data for influenza is current through March 2, 2024. Death data for COVID-19, RSV, and influenza are current through March 2, 2024. All other data on this dashboard are current through March 9, 2024.

Summary Data Tables

Statewide Summary for COVID-19, Influenza, and RSV

Information shown below is for the most recent week with complete data.

Statewide Summary Measure COVID-19 Flu RSV
Percent of All Hospital Admissions 1.3 0.7 0.3
Percent Change in Hospitalization Visits from Previous Week -31.6 -12.5 -25
Percent of All Emergency Department Visits 1.2 1 0.2
Percent Change in Emergency Care Visits from Previous Week -20 -9.1 -33.3
Average Weekly Occupancy in Hospitals and Intensive Care Units

Every day, acute care hospitals in Washington report their COVID-19 patient occupancy to the Department of Health through WA-HEALTH, a hospital data collection system developed in partnership with the Washington State Hospital Association. The table below shows the total number of hospital beds occupied by patients with confirmed COVID-19 and influenza, and a subset of patients who occupy beds in intensive care units (ICUs). Data shown below are the most recent complete data available.

Week Total Hospital Occupancy for COVID-19 ICU Bed Occupancy for COVID-19 Total Hospital Occupancy for Influenza ICU Bed Occupancy for Influenza
03/03/2024 to 03/09/2024 213 20 71 12
Percent of Respiratory Disease Related Emergency Visits by Region

Information shown below is for the most recent week with complete data.

Location COVID-19 Flu RSV
Statewide 1.2 1 0.2
Better Health Together 0.9 1.1 0.3
Cascade Pacific Action Alliance 1.2 0.6 0
Elevate Health 1 0.8 0.1
Greater Health Now 1.3 1.8 0.6
Healthier Here 1.3 1 0.1
North Sound 1.2 0.8 0.2
Olympic Community of Health 1.5 0.6 0.3
Southwest Washington 1 1.2 0
Thriving Together NCW 0.8 1 0.4
Unassigned ACH Region
Percent of Respiratory Disease Hospitalizations by Region

Information shown below is for the most recent week with complete data.

Location COVID-19 Flu RSV
Statewide 1.3 0.7 0.3
Better Health Together 1.2 0.6 0.7
Cascade Pacific Action Alliance 1.9 0.8 0.1
Elevate Health 0.9 0.7 0.2
Greater Health Now 1.2 1.3 0.6
Healthier Here 1.3 0.5 0.2
North Sound 1.5 0.6 0.1
Olympic Community of Health 2.2 1 0.7
Southwest Washington 1.2 1 0
Thriving Together NCW 1 0.3 1
Unassigned ACH Region
Percent of Respiratory Disease Related Emergency Visits and Hospitalizations by Age

Information shown below is for the most recent week with complete data.

Age Percent of All Hospitalizations Due to COVID-19 Percent of All Emergency Department Visits Due to COVID-19 Percent of All Hospitalizations Due to Flu Percent of All Emergency Department Visits Due to Flu Percent of All Hospitalizations Due to RSV Percent of All Emergency Department Visits Due to RSV
Ages 0-17 0.4 1 0.4 2.4 0.7 0.8
Ages 18-34 0.5 0.8 0.1 0.7 0.2 0.1
Ages 35-49 0.6 0.9 1 0.9 0.2 0.1
Ages 50-64 1.5 1.2 0.6 0.8 0.3 0.1
Ages 65-79 1.5 1.6 0.9 0.6 0.1 0.1
Ages 80+ 3.1 2.2 0.9 0.7 0.3 0.2
Unknown Age 0 0 0 0 0 0
Percent of Respiratory Disease Related Emergency Visits and Hospitalizations by Race and Ethnicity

Information shown below is for the most recent week with complete data.

Ethnicity or Race Percent of All Hospitalizations Due to COVID-19 Percent of All Emergency Department Visits Due to COVID-19 Percent of All Hospitalizations Due to Flu Percent of All Emergency Department Visits Due to Flu Percent of All Hospitalizations Due to RSV Percent of All Emergency Department Visits Due to RSV
Non-Hispanic 1.5 1.2 0.8 0.9 0.3 0.2
Hispanic 0.7 1 0.3 1.7 0.7 0.4
Unknown Ethnicity 0.3 1.4 0.1 1.2 0.2 0.4
American Indian Alaska Native 2 0.9 2 1.3 0 0
Asian 1.8 1.7 0.7 1.1 0.3 0.2
Black 1.2 0.9 0.9 1 0.2 0
Multiple Races 0 1.4 0 0 1.4 0.3
Another Race 0.4 1.2 0.3 1.8 0.5 0.4
White 1.5 1.2 0.7 0.9 0.3 0.2
Native Hawaiian Pacific Islander 0.6 0.7 0 1.4 0.6 0.3
Unknown Race 0.3 1 0.1 0.8 0.1 0.4
Percent of Respiratory Disease Related Emergency Visits and Hospitalizations by Sex

Information shown below is for the most recent week with complete data.

Sex Percent of All Hospitalizations Due to COVID-19 Percent of All Emergency Department Visits Due to COVID-19 Percent of All Hospitalizations Due to Flu Percent of All Emergency Department Visits Due to Flu Percent of All Hospitalizations Due to RSV Percent of All Emergency Department Visits Due to RSV
Male 1.5 1.1 0.6 1 0.3 0.2
Female 1.1 1.2 0.7 1 0.3 0.2
Unknown Sex 0 2.1 0 0 0 0
Total COVID-19 Deaths for Current Season

Information shown below is the total count of deaths with complete data. Counts below 10 are suppressed for privacy and shown as blank.

Location COVID-19
Statewide 723
Total RSV Deaths for Current Season

Information shown below is the total count of deaths with complete data. Counts below 10 are suppressed for privacy and shown as blank.

Location RSV
Statewide 90
Total Influenza Deaths for Current Season

Information shown below is the total count of deaths with complete data. Counts below 10 are suppressed for privacy and shown as blank.

Location Flu
Statewide 97

Reports

Report Archive

The following reports have been discontinued. Below are the final published reports.

Report Questions

If you have questions about our reports, email DOH-CDS-Surveillance@doh.wa.gov. If you are a member of the news media, email DOH-PIO@doh.wa.gov.

Technical Notes

The Department of Health (DOH) provides detailed notes to help you understand the Respiratory Disease Dashboard data for COVID-19, Influenza (flu), and RSV. We present information for the following categories of data:

For each category, there may be detailed information on the data source, data lags and limitations, definitions, calculations, and additional resources and references. For more information about the Respiratory Illness Dashboard data, email DOH-CDS-Surveillance@doh.wa.gov.

Emergency Department (ED) Visits

Data Source

  • The data for emergency department visits are obtained from the Washington State Department of Health Rapid Information Health Network (RHINO) program. All non-federal emergency departments and their associated inpatient units report health care encounter data in near real-time to RHINO. Key data elements reported include:
    • Patient demographic information (e.g., age, race, ethnicity, and sex)  
    • Clinical information (e.g., diagnosis codes)
    • Additional visit information (e.g., length of stay, admission information, and discharge information)

Data Limitations

  • Data are not final and may change. Visits reflect unique encounters, not unique persons, and are not considered cases. Additional follow-up is required for every visit in order to determine if a patient meets the appropriate criteria as defined in the ED Visit Definitions section below.

Data Lags

  • Information added to a medical record, such as a diagnosis code, is reported to RHINO within 24 hours. While we typically see a diagnosis code within 2 to 4 days of a visit, diagnosis codes are dependent on the facility workflow and medical coding capacity; therefore, there may be longer delays in reporting that information.

ED Visit Definitions

  • COVID-19: Emergency department visits associated with COVID-19 include records that contained one or more of the following COVID-19 specific ICD 10-CM discharge diagnosis codes:
    • U07.1 (COVID-19)
    • J12.82 (Pneumonia due to coronavirus disease 2019)
  • Influenza: Emergency department visits associated with Influenza include records that contained one or more of the following Influenza specific ICD 10-CM discharge diagnosis codes:
    • J09 (Influenza due to certain identified influenza viruses)
    • J10 (Influenza due to other identified influenza virus)
    • J11 (Influenza due to unidentified influenza virus) 
  • RSV: Emergency department visits associated with Respiratory Syncytial Virus (RSV) include records that contained one or more of the following RSV specific ICD 10-CM discharge diagnosis codes:
    • B97.4 (Respiratory syncytial virus as the cause of diseases classified elsewhere)
    • J12.1 (Respiratory syncytial virus pneumonia)
    • J20.5 (Acute bronchitis due to respiratory syncytial virus)
    • J21.0 (Acute bronchiolitis due to respiratory syncytial virus)

Demographics

Hospital Admissions/Hospitalizations

Data Source

  • The data for emergency department visits are obtained from the Washington State Department of Health Rapid Information Health Network (RHINO) program. All non-federal emergency departments and their associated inpatient units report health care encounter data in near real-time to RHINO. Key data elements reported include:
    • Patient demographic information (e.g., age, race, ethnicity, and sex)  
    • Clinical information (e.g., diagnosis codes)
    • Additional visit information (e.g., length of stay, admission information, and discharge information)
  • Learn more about RHINO data here: RHINO Data Description

Data Limitations

  • Data are not final and may change. Visits reflect unique encounters, not unique persons, and are not considered cases. Additional follow-up is required for every visit in order to determine if a patient meets the appropriate criteria as defined in the Hospitalization Definitions section below.

Data Lags

  • Information added to a medical record, such as a diagnosis code, is reported to RHINO within 24 hours. While we typically see a diagnosis code within 2 to 4 days of a visit, diagnosis codes are dependent on the facility workflow and medical coding capacity; therefore, there may be longer delays in reporting that information.

Hospitalization Definitions

  • COVID-19: Hospitalizations associated with COVID-19 include records that contained one or more of the following COVID-19 specific ICD 10-CM discharge diagnosis codes:
    • U07.1 (COVID-19)
    • J12.82 (Pneumonia due to coronavirus disease 2019)
  • Influenza: Hospitalizations associated with influenza include records that contained one or more of the following influenza specific ICD 10-CM discharge diagnosis codes:
    • J09 (Influenza due to certain identified influenza viruses)
    • J10 (Influenza due to other identified influenza virus)
    • J11 (Influenza due to unidentified influenza virus) 
  • RSV: Hospitalizations associated with Respiratory Syncytial Virus (RSV) include records that contained one or more of the following RSV specific ICD 10-CM discharge diagnosis codes:
    • B97.4 (Respiratory syncytial virus as the cause of diseases classified elsewhere)
    • J12.1 (Respiratory syncytial virus pneumonia)
    • J20.5 (Acute bronchitis due to respiratory syncytial virus)
    • J21.0 (Acute bronchiolitis due to respiratory syncytial virus)

Demographics

Deaths

Data Source

  • The data for COVID-19 and RSV deaths are obtained from the registered death certificates for WA residents, which are housed in the Washington Health and Life Event System (WHALES). 
  • Death Rate is calculated by dividing the number of COVID-19 deaths with a death date within a 7-day period by the state population and multiplying by 100,000:
Number of deaths with a date of death during the 7-day period :over:
Population
X :times: 100,000
  • Potential lab-confirmed influenza-associated deaths are reported through multiple sources including:
    • Registered death certificates
    • Direct report from health care facilities
    • Collaboration with medical examiners
  • Influenza-associated deaths are investigated by Local Health Jurisdictions and information is stored in the Washington Disease Reporting System (WDRS).

Data Limitations

  • COVID-19:
    • COVID-19 death data may be underrepresented due to various factors that currently and historically impact reporting. Only death data reported officially to Washington State through death certificates and positive reported labs into WDRS reporting system are used in the counts in the dashboard. COVID-19 deaths early in the pandemic may not have been captured and reported due to the lack of available testing. Currently, deaths of persons who only tested with a home testing kit, may not have had COVID-19 listed as a cause of death, and are not counted.
    • A small portion of deaths may not have been counted due to coding limitations related to nonstandard naming practices of “COVID-19” and inconsistent use of diagnosis codes for the cause of death on the death certificate. On January 1, 2023, DOH implemented a new classification of COVID-19 death. The new classification aligns with emerging standards; however, probable cases of COVID-19 death are no longer counted and may result in missed counts of COVID-19 deaths.
  • Influenza:
    • Influenza deaths are likely underreported. The reasons for this underreporting vary. Influenza may not be listed as a cause of death, influenza testing may not have occurred in a timely fashion to identify the virus, or may not have been performed at all, and lab-confirmed influenza-associated deaths may not have been appropriately reported to public health.
    • These counts reflect only deaths officially reported to the Washington State Department of Health. Each influenza season is reported as week 40 through week 39 of the following year. Note that due to reporting lag, counts may be different at the county or region level. Only deaths reported by the county as “investigation complete” are included in the official Washington State Department of Health counts.
  • RSV:  RSV death reporting and surveillance has no national standard and relies only on information in the cause of death fields on the death certificate. These data capture any death with a specific mention of RSV, but do not show a difference between deaths where RSV was the underlying cause of death or deaths for which RSV was a contributing factor. Due to coding differences, analyses based on the diagnosis codes assigned to the cause of death fields may result in slightly different death counts, as the diagnosis code assignment algorithm prioritizes terms differently.

Data Lags

  • COVID-19 and RSV: Deaths are typically registered within one week, but deaths relying on post-mortem testing can take months to get the cause of death information updated. This is not usually a huge problem with natural deaths, but it can happen.
  • Influenza: Data are available on Wednesdays for the complete epi week 2 weeks prior (e.g., on Wednesday 8/30/2023 data will be available through epi week 33 ending 8/19/2023). 

Definitions

  • COVID-19: Currently, a COVID-19 death is any mention of COVID-19 or similar term on a death certificate. Before January 1, 2023, a COVID-19 death was any mention of COVID-19 or other equal term associated with a positive COVID-19 test, or a natural death associated with a positive COVID-19 test shortly before death. 
  • Influenza: A lab-confirmed influenza-associated death is defined as a death resulting directly or indirectly from an illness that was confirmed to be influenza by an appropriate laboratory test. There should be no period of complete recovery between the illness and death. 
  • RSV: Any mention of RSV or similar anywhere on the death certificate.

Positive Clinical Tests (Cases)

Data Source

  • The data for reported Positive COVID-19 Clinical Tests (Cases) are obtained from the Washington Disease Reporting System (WDRS), statewide surveillance.
  • Weekly Rate: The weekly trend in case rate refers to the trend in weekly rate of new COVID-19 cases per 100,000 population. It is calculated by dividing the number of cases with a specimen collection date during a given epi week by the state population (or appropriate geographic population) and multiplying it by 100,000.
Total positive clinical cases with a specimen collection date during a given week :over:
Population
X :times: 100,000
  • Influenza testing data is received through the World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) laboratory networks. Public health and clinical laboratories voluntarily report influenza testing data to CDC through this lab network. We display data reported to CDC by clinical laboratories. Influenza A and B are reported separately.

Data Limitations

  • COVID-19: Case data entered into WDRS includes data only for individuals who received a positive test performed at CLIA certified or CLIA waived laboratories. Cases identified only through home tests are not represented in the data. In addition, Washington residents tested in other states are generally not included in the data set. Therefore, case data represented on the dashboard underestimates the true number of people infected with COVID-19 in Washington and may be biased towards certain populations more likely to receive tests in a health care setting.
  • Influenza: Data reported through the World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) laboratory networks is anonymized and aggregated, therefore no information on patient demographics is available. Influenza is not a notifiable condition; the voluntarily reported testing data is not a representative sample of influenza tests performed across the state. Due to the voluntary nature of this network, laboratories are selected for their willingness to participate and are not a representative network across Washington.

Data Lags

  • COVID-19: Data are published on Wednesdays for the previous complete epi/Morbidity and Mortality Weekly Report (MMWR) week (e.g. on Wednesday 8/20/2023 data will be available through epi week 32 ending 8/26/2023). We consider published data to be >90% complete for each epi week.
  • Influenza: Data are available on Wednesdays for the complete epi week 2 weeks prior (e.g., on Wednesday 8/30/2023 data will be available through epi week 33 ending 8/19/2023). 

Definitions

Demographics

  • COVID-19
    • Age (all ages and pediatrics): COVID-19 affects people of any age. However, older age is a significant factor for developing more serious outcomes following COVID-19 infection.  
    • Sex: COVID-19 affects people of any sex. However, monitoring individuals with COVID-19 by sex may reveal differences in testing or in their outcomes following infection.  
    • Race and Ethnicity:
      • COVID-19 affects people of all races and ethnicities, but some racial and ethnic minority groups are unfairly affected by COVID-19 due to systemic health and social inequalities. Health equity means that everyone has a fair and just opportunity to be as healthy as possible.  
      • We present COVID-19 outcomes by race and ethnicity to address health inequalities among different racial and ethnic minority groups. Differences in length of life, quality of life, rates of disease, severity of disease, and access to treatment often expose health and social inequities. These categories allow us to assess our COVID-19 data by race and ethnicity, but the data are incomplete and do not reflect the diversity of people and experiences across the state. Since January 2020, a significant number of reported Positive COVID-19 Clinical Tests (Cases) are currently missing race (about 33%) and ethnicity (about 38%) information.
      • Capturing race and ethnicity information through COVID-19 lab test results is very challenging. The lack of complete data limits our ability to draw strong conclusions. Despite these limitations, the patterns of racial and ethnic health disparities are visible in the data. 
  • Influenza
    • There is no demographic information available for anonymized and aggregated influenza lab testing data. Lab testing data reported into this network are anonymized and reported as weekly aggregate counts of tests.

COVID-19 Variants

Data Source

  • SARS-CoV-2 sequencing data is pulled from the Washington Disease Reporting System (WDRS) Sequence table. Percentages are calculated by grouping the sequence data by assigned variant groups following the CDC Variant Proportion groupings by two-week intervals.

Data Limitations

  • Variant detection depends on sequencing volume. When we have fewer sequences available to test, we are less likely to detect variants circulating at low levels.
  • SARS-CoV-2 sequences are more readily available from urban areas and the Western part of Washington. This means that surveillance sequencing data are not totally representative, and our situational awareness varies by geographic region.

Data Lags

  • Due to the time it takes to complete sequencing, the most recent time period is based on a very small number of sequences and likely to be adjusted over time as more data becomes available; this may affect data from prior time periods. There is about a 2.5-week delay in the time a specimen is collected, sequenced, linked to a case, and made available in WDRS.

Definitions

  • COVID-19 Variants: The original SARS-CoV-2 virus strain has mutated over the course of the pandemic. Some of these mutations resulted in new variants of the virus. Throughout the COVID-19 pandemic, many variants of SARS-CoV-2 have been found in the United States and globally. View the list of Variants on CDC’s SARS-CoV-2 Variant Classifications and Definitions webpage.

Influenza (Flu) Subtypes

Data Source

  • Influenza testing data is obtained through the World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) laboratory networks. Public health and clinical laboratories voluntarily report influenza testing data to CDC through a lab network. Influenza subtype A and B are reported separately. A subset of influenza positive samples is further tested and subtyped at participating Public Health laboratories. We show the result of this subtyping on the dashboard.

Data Limitations

  • Data reported through the World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) laboratory networks is anonymized and aggregated, therefore no information on patient demographics is available. Influenza is not a notifiable condition; the voluntarily reported testing data is not a representative sample of influenza tests performed across the state. Due to the voluntary nature of this network, laboratories are selected for their willingness to participate and are not a representative network across Washington.

Data Lags

  • Data are available on Wednesdays for the complete epi week 2 weeks prior (e.g., on Wednesday 8/30/2023 data will be available through epi week 33 ending 8/19/2023). 

Definition

  • Flu Subtypes: Influenza A and B viruses cause seasonal epidemics of disease in people (known as flu season) almost every winter in the United States.
    • Influenza A viruses are divided into subtypes based on 2 proteins on the surface of the virus: hemagglutinin (H) and neuraminidase (N).
    • Influenza B viruses are not divided into subtypes, but instead are further classified into 2 lineages: B/Yamagata and B/Victoria.
  • The dashboard shows influenza positive tests that had subtype testing performed by a public health laboratory. Data from public health laboratories are used to monitor the proportion of circulating viruses that belong to each influenza subtype/lineage. For more information on the types of influenza viruses, see the CDC's flu virus types webpage.

Hospital Use

Data Source

  • WA HEALTH is Washington’s Healthcare, Emergency, and Logistics Tracking Hub. Acute care hospitals submit data to WA HEALTH daily, dashboard metrics are assigned to the geographic location of facilities, not a patient’s area of residence. Interpret regional data with caution.

Data Limitations

  • Data quality may be impacted when facilities experience power outages or technical difficulties and are unable to report data in a timely manner. Note: Between 10/4/2022 and 12/22/2022, one of Washington's larger health care providers did not report to WA HEALTH due to a cybersecurity attack.
  • WA HEALTH does not collect data for RSV.
  • Data is self-reported by acute care facility.

Data Lags

  • It takes up to 6 days for data collection, quality checks, and reporting.

Definitions

  • Hospital Beds in Use: The hospital occupancy metric refers to the 7-day average number of people hospitalized with COVID-19 or influenza. It is calculated by adding the total number of pediatric and adult COVID-19 hospitalizations during a 7-day period and dividing by 7.
Adult + pediatric confirmed COVID-19 hospitalizations over 7 days :over:
7
  • Percent Hospital Occupancy (tooltip): This metric refers to the percent of acute care hospital beds in use by COVID-19 or influenza patients. It is calculated by adding the total number of pediatric and adult COVID-19 hospitalizations during a 7-day period and dividing it by the total number of beds in use, then multiplying it by 100.
Adult + pediatric confirmed COVID-19 hospitalizations over 7 days :over:
Sum of staffed hospital bed occupancy over 7 days
X :times: 100
  • ICU Beds in Use: The ICU bed occupancy metric is a subset of the hospital beds in use metric. It refers to the 7-day average number of people in an intensive care unit bed (ICU) with confirmed COVID-19 or influenza.
Adult + pediatric confirmed COVID-19 (or influenza) ICU occupants :over:
7
  • Percent ICU Occupancy: This metric refers to the percent of ICU beds (subset of percent Hospital Occupancy) in use by COVID-19 or influenza patients. It is calculated by adding the total number of COVID-19 ICU patients and dividing it by ICU beds in use.
Adult + pediatric confirmed COVID-19 or influenza ICU occupants :over:
Sum of ICU beds occupancy over 7 days

Health Disparities

Health disparities are gaps in the quality of health and health care that mirror differences in social factors such as economic status, racial and ethnic background, gender, age, and education level.

Health disparities on the Respiratory Illness Data Dashboard can be observed when looking at different demographic factors such as age, sex, and race/ethnicity. An explanation of these factors and some of the health disparities observed for the respiratory illness displayed on this dashboard are described below.

  • Age (all age groups and pediatric age groups): Respiratory illnesses affect people of any age. However, older age is a significant factor for developing more serious outcomes following COVID-19, influenza, and RSV infection.
    • Children younger than 5, but especially children younger than 2 years old, are at higher risk of complications from flu illness.
    • Infants up to 12 months, especially those 6 months and younger are at higher risk of RSV.
  • Sex: Respiratory illnesses affect people of any sex. However, monitoring individuals with respiratory infections by sex may reveal differences in testing or in their outcomes following infection. Data for transgender or nonbinary people are not shown on the Respiratory Illness Dashboard. DOH is working on improving data collection practices to be more inclusive of all gender identities and will release more information as this becomes available to improve the overall quality of the health disparities data.
  • Race and Ethnicity:
    • COVID-19, flu, and RSV affect people of all races and ethnicities, but some racial and ethnic minority groups are unfairly affected by these diseases due to systemic health and social inequities. Health equity means that everyone has a fair and just opportunity to attain their highest level of health possible.
    • We present respiratory illnesses on this dashboard by race and ethnicity to better identify health disparities that may exist among different racial and ethnic minority groups. Differences in length of life, quality of life, rates of disease, severity of disease, and access to treatment often expose health and social inequities.
  • American Indians and Alaska Natives (AIAN) 
    • Data show that AIAN populations have greater physical and mental health disparities than other racial and ethnic groups in the U.S. However, the current methods we use to identify race and ethnicity make it challenging to determine the real impact of health outcomes among AIAN populations in Washington state.  
    • The data sources we use to identify race and ethnicity include medical records, laboratory reports, and sometimes, case interviews managed by state, local, and tribal health jurisdictions. To help us further identify AIAN individuals, we cross check COVID-19 cases reported to WDRS against a state-wide list of tribal members to make sure we correctly identify American Indians and Alaska Natives.     
    • The current methods we use to collect information about race and ethnicity often lead to missing or wrong information.  
      • We are missing about 33% of race and 38% of ethnicity information for positive COVID-19 clinical test data. 
      • Our methods often wrongly classify AIAN as other races or ethnicities with up to 25% wrongly classified as white alone. Our methods often wrongly classify AIAN individuals as Hispanic/Latinx and multiple race. 
  • DOH is working with tribes and tribal partners to continue to improve how we identify health outcomes in the AIAN population. We know the cost of missing or wrong information has negative impacts on public health planning, policy creation, and the wider sharing of resources that impact AIAN health.

Data Limitations

  • Influenza: There is no demographic information available for anonymized and aggregated influenza lab testing data. Lab testing data reported into this network are anonymized and reported as weekly aggregate counts of tests.
  • Race and Ethnicity Data:
    • These categories allow us to assess our COVID-19 data by race and ethnicity, but the data are incomplete and do not reflect the diversity of people and experiences across the state. Since January 2020, a significant number of reported Positive COVID-19 Clinical Tests (Cases) are currently missing race (about 33%) and ethnicity (about 38%) information.
    • Capturing race and ethnicity information through COVID-19 lab test results is very challenging. The lack of complete data limits our ability to draw strong conclusions. Despite these limitations, the patterns of racial and ethnic health disparities are visible in the data. 

References for Understanding Health Disparities

  • Du Bois, W.E.B. 2003. “The Health and Physique of the Negro American.” American Journal of Public Health 93(2):272-276.
  • Hood, Carlyn M., Keith P. Gennuso, Geoffrey R. Swain, and Bridget B. Catlin. 2015. “County Health Rankings: Relationships Between Determinant Factors and Health Outcomes.” American Journal of Preventive Medicine 50(2):129-135.
  • Link, Bruce G. and Jo Phelan. 1995. “Social Conditions as Fundamental Causes of Disease.” Journal of Health and Social Behavior:80-94.
  • Phelan, Jo and Bruce G. Link. 2015. “Is Racism a Fundamental Cause of Inequalities in Health?” Annual Review of Sociology 41:311-330.
  • Robert Wood Johnson Foundation. 2014. “The Relative Contribution of Multiple Determinants to Health Outcomes” (PDF). Health Policy Brief, August 23, 2014.
  • Thoits, Peggy A. 2010. “Stress and Health: Major Findings and Policy Implications.” Journal of Health and Social Behavior 51(1):S41-S53.
  • World Health Organization. 2023. “Social Determinants of Health.”

Suppression for Small Numbers

To protect individual privacy, some very small counts and rates in a given category are not shared. Counts for some age categories may be small, especially in small counties. Therefore, we do not report counts if there are less than 10 in a category. We take additional measures to prevent recalculating these small counts by reporting data in related columns and rows. This data is not included in dashboard tables and downloadable files. Our policy for reporting small numbers (PDF) balances privacy protection with the public’s need for data.

Population Denominator Data

Due to the current lack of Small Area Estimates from Office of Financial Management (OFM), the population data used to calculate rates in this dashboard come from the Population Interim Estimates (PIE) developed by Public Health-Seattle and King County (PHSKC). Because we have applied PIE to historic data, some COVID-19 rates will be different from what we published previously.