Spokane County has passed the 20,000-case mark for COVID-19 infections confirmed in the county. In the last month alone, the Spokane Regional Health District has confirmed 8,992 cases, predominantly in residents ages 20 to 59.

Interim Health Officer Dr. Francisco Velázquez said Tuesday’s record-high case count of 692 was in part due to the explosive outbreak at Airway Heights Corrections Center.

He said 238 of the 692 confirmed cases were in people affiliated with the prison. The incident rate is 823 cases per 100,000 residents in the last two weeks, more than ten times the recommended incidence rate set for potentially opening up some parts of the economy or bringing more kids back to school.

The health district confirmed 230 new cases and an additional two deaths. There have been 295 Spokane County residents who have died from the virus. There are 128 COVID-19 patients hospitalized in Spokane hospitals, and 93 of them are county residents.

Velázquez said cases continue to be traced to social and extended family gatherings, although it is still a bit too early to see how Thanksgiving will affect local data. He said they expect to see cases as a result of Thanksgiving gatherings.

State health officials could not tell how Thanksgiving will impact COVID-19 case and hospitalization trends just yet, but State Health Officer Dr. Kathy Lofy said that outbreaks connected to gatherings as well as workplaces continue to contribute to the steep increase in cases.

“We continue to see a large number of outbreaks in workplace settings, so it’s important that people don’t let down their guard at work,” Lofy said.

Modelers at the Institute for Disease Modeling projected what hospitalizations could look like if the state’s case counts continue on the same trajectory they were on before Thanksgiving, and Lofy said that would equate to a doubling in total cases that would need to be hospitalized in the next two to three weeks. This surge would likely overwhelm hospitals or at least create the need to make more space in intensive care units.

There are currently 1,114 COVID-19 patients hospitalized statewide, and if that number doubles, hospitals could be close to capacity.

There are 294 COVID-19 patients in intensive care units, and if that number doubles, ICUs would be close to being overwhelmed, Lofy said. The Department of Health is surveying hospitals this week about surge planning and how many potential COVID cases they could take in that scenario.

“Hospitals expressed a lot of concern about being able to handle a doubling of cases right now, so we’re hoping we’re not on that trajectory because that could be very concerning,” Lofy said.

There is still capacity in Spokane hospitals, but availability, especially of intensive care unit beds, is getting tighter. In northeastern Washington, 82% of staffed intensive care beds are occupied. There are 27 COVID-19 patients in intensive care unit beds in the region, and if those numbers continue to increase, hospitals might have to expand their ICUs.

“We’re tracking that very, very, very closely,” Velázquez said.

If the Food and Drug Administration grants emergency use authorization to the Pfizer vaccine this week, doses will begin arriving at 17 sites in 13 counties in Washington state next week, Michele Roberts, acting assistant secretary at DOH, said Wednesday.

Washington will receive about 400,000 doses of both the Pfizer and Moderna vaccine by the end of December, if both are approved by the FDA. These doses will go to 400,000 high-risk health care workers as their first doses of the two-dose vaccines. Roberts said the state does not have estimates on how many more doses they will receive in January yet.

“(The federal government is) planning to hold enough vaccine for second doses in addition to our allocation, so second doses will be matched to providers within two to three weeks after the first dose,” Roberts said.

The first shipment of the Pfizer vaccine will equate to about 62,000 doses targeted to the specific 17 sites around the state.

Roberts said the department is not disclosing the specific sites where the vaccine is being shipped, citing security concerns, but some of those doses will arrive in Spokane County.

Providence Health Care in Spokane is expecting doses of the vaccine, although there is no set date next week for their arrival.

Providence does not have a known quantity they are set to receive yet, as of Monday, but the health care system that operates Sacred Heart Medical Center and Holy Family Hospital is expecting receive additional doses later in December as well.

COVID-19 cases in the Idaho Panhandle continue to climb as health officials confirmed 419 more cases on Wednesday and 11 more deaths.

There are nearly 4,000 active cases in the five-county region and 71 COVID-19 patients hospitalized at Kootenai Health.