Ali Mokdad, a professor of health metrics sciences at the University of Washington’s Institute for Health Metrics and Evaluation, said he was convinced the Seattle model could have been replicated, positively affecting the trajectory of the virus across the country.
Instead, he said, state after state reopened sooner than appropriate and members of the public ignored health advice that at times was undermined by conflicting messages from political and business leaders. Seattle, he said, shows what could have been.
“We have so many lessons we have learned here,” Dr. Mokdad said. “Unfortunately, not many people were listening.”
An early warning for the country
Even before the state’s early stay-at-home restrictions were ordered, Seattle residents had shown a willingness to change their lives.
During the very first week of the outbreak, in March, Microsoft and Amazon — accounting for tens of thousands of workers in the region — encouraged people to begin working from home. Other companies followed. The University of Washington became the first large college campus to adopt remote learning. While the rest of the country was humming with business as usual, Seattle’s notorious traffic eased, and buses once packed with commuters were largely empty. Pike Place Market grew quiet.
Those early adjustments may have helped the region avoid some of the havoc seen in New York, where Mayor Bill de Blasio was saying as late as March 13 that “we want people still to go on about their lives.” The New York region soon surpassed Seattle in coronavirus deaths and still maintains the highest deaths per capita among large metropolitan areas.
Dr. Thomas R. Frieden, the former head of the Centers for Disease Control and Prevention and former commissioner of New York City’s health department, estimated that New York could have cut its spring death toll by more than half had it adopted widespread social distancing a week or two earlier. He said the city continued to have poor messaging about the virus.
As the year went on, after an initial round of lockdowns were ordered across the country, many states rushed to reopen against the advice of experts, triggering a rise in new cases. The Seattle area, where many restrictions remained in place, kept its numbers low through the summer. Although restaurants reopened in June, they were limited to 25 percent capacity indoors.
Other parts of Washington State had more trouble. In the more rural areas east of the Cascades, the virus spread among farmworkers, pushing Yakima County’s death rate to more than double that of King County, which includes Seattle, although Yakima County’s numbers were about on par with death rates seen in many other states.
As case numbers rose around the nation in the fall, John Wiesman, who was then Washington’s secretary of health, and Dr. Kathy Lofy, the state health officer at the time, monitored the area’s case counts. When cases jumped suddenly in November, he said, they advised Gov. Jay Inslee that there was no time to be lost.
“The governor was very clear as well: We’ve got to move now,” Dr. Wiesman said. Mr. Inslee’s renewed restrictions included the closure of restaurants once again. The state’s numbers remained lower than much of the country.
Researchers at the University of Oxford determined that Washington State’s suite of restrictions through the year, all told, were among the most stringent in the nation. Others with strict control measures, including Maine and Vermont, are also among the states with the lowest coronavirus numbers. Some smaller metropolitan areas, including other cities in Washington, Portland, Ore., and Raleigh, N.C., have performed better than the Seattle area; they also embraced broad restrictions.
But there were other states that imposed stringent controls that had serious outbreaks after initially keeping the virus under wraps. One of them was California.
Public health experts have cited a variety of potential factors in California, including more crowded households and the arrival of new virus variants that appear to spread more rapidly. Mixed messages emerged as Gov. Gavin Newsom and Mayor London Breed of San Francisco, who had promoted containment efforts, attended separate birthday parties at the French Laundry restaurant in the Napa Valley, ignoring their own best practices and angering a public weary of restrictions.
The cost of the crackdown
The push to reopen in many states was a response to the devastating economic consequences of long lockdowns, and Seattle has paid for its low virus numbers. These days, the city’s downtown retail areas are largely quiet, with many storefronts boarded up. Streets that were once packed with Amazon workers during lunch hours are now largely empty. Some businesses have shuttered for good.
Dr. Jeffrey Duchin, the health officer in Seattle and King County, said the city was still grappling with the right balance between managing the virus and allowing people to live their lives with more normalcy.
The consequences emerging are not just economic ones, he said, but depression, domestic violence, deferred medical care, a drop in other kinds of immunizations, the long-term impacts of children out of school. Still, he said, he is convinced they made the right decisions.
“The other unintended consequences can be addressed and mitigated over time, but you can’t bring people back from the coroner’s office,” he said.
While the industries built around tourism and services are struggling, others have flourished during the pandemic, including the health sector, grocery stores and the tech industry. Construction workers have been able to return to work, as have manufacturing workers at places like Boeing.
By the end of last year, the unemployment rate in Washington State was at 6.3 percent, a bit lower than the national rate, and many business leaders have accepted the governor’s extended lockdown orders without major objection.
“We all want to be able to open sooner,” said Rachel Smith, the chief executive of the Seattle Metropolitan Chamber of Commerce, “but we all want to do it when it’s safe.”
Ethan Stowell, who runs a namesake group of restaurants in the Seattle area, said the company began last year with about 400 employees. The number plummeted to just a handful early in the pandemic, then slowly climbed, with fluctuations during the fall restrictions, to about 140 now.
The restrictions have lasted far longer than anticipated, and Mr. Stowell said he still had concerns about the future of Seattle’s downtown, but he expected this summer to bring a resurgence, with pent-up demand and restrictions easing further. He expects to be back at prepandemic employment levels by the end of the year.
Mayor Durkan said the consequences of the protracted lockdowns weighed on her every day. She said she had heard from business owners who have lost everything and laid-off workers who could not pay their rent. But the city simply did not have a choice, she said.
“It was so profoundly difficult because you knew what the human consequences would be,” she said. “There was no course in which there wouldn’t be devastating human consequences.”