Five Oregon counties are rushing forward to reopen at the end of this week despite sudden increases in their reported coronavirus cases.
The counties of Clatsop, Jefferson, Polk and Umatilla have each had their known COVID-19 infections more than double in the past two weeks, although statewide restrictions to slow the spread of the virus have remained in place.
Marion County, which has the highest rate of coronavirus infections in Oregon, reported nearly 270 new cases during this period, more than any other county, including the three counties in the Portland metropolitan area.
Yet elected officials and public health officials in the five counties said they met the infection criteria issued by Governor Kate Brown to enter the state’s “phase 1” program to revive public life and l economy, which begins Friday.
State guidelines alone are weaker than the “Open America” guidelines issued by the White House and promoted by Dr. Anthony Fauci, the country’s leading infectious disease expert, who warned on Tuesday American senators against a decision to open the country too quickly. .
The Oregon criteria, for example, require a decrease in the number of COVID-19 hospitalizations or a lower percentage of ED visits for COVID-19 illnesses than the average for influenza same time of year.
National guidelines are broader – and seemingly more stringent. They do not focus solely on hospitalizations or emergency room visits, but on a downward trajectory of documented cases and positive tests as a percentage of total tests over a 14-day period.
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All five counties would not follow these guidelines.
But, ironically, they can meet another state benchmark – a threshold to stop the reopening.
Brown’s “stop, wait and redirect” guidelines govern when counties may need to stop reopening, or perhaps close, including if they have seen their numbers increase by more than 5% positive cases in the previous seven days.
It is unclear where the state assessment process will end, but a spokesperson for the governor’s office said the decisions will be made “in a holistic manner,” taking into account all factors, including rates. infection.
“The worst-case scenario is that we have to go back,” said Joe Fiumara, director of public health for Umatilla County. “I’m pretty confident that we won’t. “
“PEOPLE HAVE A LITTLE CRAZY”
Recent data on coronaviruses in this county paint a less optimistic picture.
Although it is a three-hour drive east of the state’s population center in Portland, Umatilla County reported one of Oregon’s first known cases on March 2 – an employee from the Pendleton Wildhorse Resort and Casino.
Other known infections in the county, home to approximately 78,000 people, continued to spread over the next eight weeks, reaching 37 cumulative cases on April 27, according to figures from the Oregon Health Authority.
In the past two weeks, however, that number has more than doubled.
Umatilla County reported 85 cases of coronavirus on Tuesday – 110 confirmed cases per 100,000 people.
This is the third COVID-19 infection rate in Oregon, with only Marion (215 per 100,000) and Multnomah (115 per 100,000) counties, according to Oregonian / OregonLive analysis of data at statewide.
Fiumara said the increased testing has helped public health officials identify more coronavirus infections in Umatilla County. But he also said residents were starting to take less shelter there.
Several confirmed epidemics, said Fiumara, were traced in small family reunions where one participant ended up infecting several others.
“We are starting to see people less interested in complying with state restrictions,” said Fiumara. “The weather was fine and people are going a little crazy. They are on the move. ”
Polk and Clatsop counties, with 86,000 and 40,000 inhabitants respectively, also reported a dramatic increase in coronavirus cases since the last week of April.
During this period, Polk County saw its known infections go from 38 to 89, an increase of 134%, while Clatsop County infections went from six to 34, an increase of more than five times.
At least 17 of the new cases in County Clatsop were workers at Bornstein Seafoods, a food processing plant in Astoria that briefly shutdown due to a coronavirus outbreak, county health officials said.
Polk County health and elected officials said their recent increase in coronaviruses was due to an epidemic in a nursing home, which was a hotbed for COVID-19 infections throughout Oregon and the rest of the country.
State officials on Tuesday identified the establishment as the Prestige Senior Living Orchard Heights in West Salem, where at least 41 people tested positive. Four of them died.
“This is an isolated incident and does not indicate a higher prevalence of cases among the population as a whole,” wrote Polk County officials in their proposal to the governor’s office.
In Jefferson County, where coronavirus infections have gone from six to 24 in the past two weeks, almost two-thirds of the cases are related to Confederate tribes in Warm Springs, said the county’s director of public health, Michael Baker.
About 25,000 people live in Jefferson County.
“I don’t think we can afford to keep our economy closed”
Marion County has the second highest number of cases in Oregon and pockets of the state’s highest infection rates.
Postal code level data released Tuesday showed that Gervais, a small town in northwestern Marion County, has the highest infection rate in Oregon with about 100 cases per 10,000 population and 38 infections. total. Woodburn’s neighboring postal code, 97071, has the second highest infection rate in the state, with 60 infections per 10,000 population. He recorded the highest number of infections in the entire state, at 174.
In the past 14 days, Marion County has registered 267 new positive cases, a 37% increase in its total number of cases, now to 723. Only Multnomah County has more cases in total, to 908.
Marion County reported 43 new cases on Saturday, its largest daily increase to date, as well as one of the highest positive test rates in a day – 21%. On Tuesday, he recorded 28 new cases, his second highest daily total.
[See map of Oregon coronavirus infections mapped by ZIP code]
Katrina Rothenberger, county public health director, said she did not want to read too much in one day and that the percentage of positive tests had increased significantly.
In fact, the county’s seven-day rolling average number of cases has reached a new high, and its 12.3-day positive test rate of 12.3% is near its highest since April 26.
In comparison, Oregon’s positive test rate is 4.2%.
“It is difficult to determine why the cases in Marion County are so high,” said Rothenberger, while acknowledging that “there is definitely something going on in Marion County.”
Marion County had an early case, so the transmission took place long before the governor made his stay order on March 23, Rothenberger said. The county has many congregational health care industries and sites, and its incidence of clustered cases relative to community transmission is higher than the state average.
Northern Marion County, with a concentration of Latino residents, also has higher incidence rates, highlighting the need for the county to work with community partners and ensure it provides culturally relevant information. appropriate for residents, she said.
Despite the pattern of cases and positive test rates, Rothenberger said she was comfortable with the county’s plan to reopen on May 15. Local health care providers have certified that they have the capacity to manage an outbreak, and the county can meet the governor’s hospitalization criteria.
“We have been making progress since March 8. COVID-19 has been in our community for a very long time and I don’t think we can afford to keep our economy closed until it is wiped out, “she said.
“I am comfortable with the plan that has been submitted by our commissioners, knowing that it belongs to the OHA and that we must meet these trigger criteria. “
“WE ALL TAKE A CHANCE”
Brown’s office said the governor, senior staff and political advisers will assess the plans submitted by each county in consultation with the Oregon Health Authority and notify county officials of their decision by Friday.
Charles Boyle, spokesperson for the governor’s office, said the science, data and recommendations of health experts would drive decisions.
The Oregon prerequisites were based on guidelines from the White House, but with significant input from the Oregon Health Authority and the Governor’s Medical Advisory Panel, a group of doctors, infectious disease experts and professionals. state health.
“It is incorrect to infer that counties will be judged only on a drop in hospitalizations of COVID-19 patients to meet the first prerequisite,” said Boyle. “The parameters for each county will be analyzed holistically to determine if they have met the requirement to show a decrease in the prevalence of COVID-19. “
He added that the Oregon Health Authority’s approach will not be to immediately shut down a growing county after the reopening, but to “stop, monitor and redirect” resources to keep up with the increase.
“A growth in positive cases linked to a single community event that can be effectively traced and contained, for example, requires a different level of intervention than a growth in positive cases that shows the spread of the community,” said Boyle. “They will use this same approach to assess requests to reopen counties.”
Other opening criteria in phase 1 include minimum levels of testing and contact tracing ability; adequate peak capacity for hospitals, quarantine facilities and personal protective equipment and has finalized state sectoral guidelines for communication to individual businesses.
Ultimately, public health officials said it was difficult to determine why the counties have such variable experience with the virus.
Jackson County, with 220,000 residents, is one of the most populous counties in Oregon, but has also had one of the lowest infection rates, with no new cases reported since. April 20, except for a resident who moved from another county this week.
Jim Shames, the county medical director, said, “At the end of the day, I don’t know why, but I can tell you what I think we did well. “
He said that community organizations have had particularly good communications as a foundation. They quickly set up tests and screenings, with a well-equipped nurse triage line, a telemedicine clinic and a capacity for driving tests. These tests quickly identified positive cases and the county was able to quickly launch its contact tracing team to follow up.
He said a lot of it was probably lucky. The county has not experienced an epidemic in a nursing home or prison and is working hard to maintain this status quo. If so, it could change Jackson County numbers overnight.
Shames said the daily statistical discrepancies meant less to him than the overall message to residents on how to open safely while convincing them that “it is not as usual”.
“We are all taking a chance,” he said. “We’re going into unknown territory, so let’s see how it works for all of us. “
– Shane Dixon Kavanaugh; [email protected]; 503-294-7632; @skavanaugh
– Ted Sickinger; [email protected]; 503-221-8505; @tedsickinger
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