COVID-19 Outbreak Strikes Oregon State Hospital 

Oregon State Hospital in Salem by Ben Botkin TLR WEB.jpg

Oregon State Hospital has stopped accepting new patients after 29 patients at its Salem campus were diagnosed with COVID-19 since Dec. 29.

The patients are quarantined in three units of the hospital. Hospital Superintendent Dolly Matteucci, in a Tuesday letter to stakeholders, said the state-run psychiatric residential facility expects the number to rise due to the high-risk exposures involved in the cases.

The hospital also has 32 staff who have tested positive since Dec. 27. 

A little more than half the patients are symptomatic, Matteucci said in the letter. Many of the  patients who tested positive were vaccinated but did not have booster doses, Matteucci said. Patients on the units with the most COVID-19 cases who had boosters did not test positive, Matteucci wrote, saying this points to the “effectiveness of boosters.”

“All eligible patients had been offered booster doses before this outbreak,” Matteucci wrote. “Physicians and nurse practitioners are

encouraging their patients to get vaccinated or boosted if they refused the first time around.”

In one unit, called Leaf 3, 64% of patients have tested positive. In another unit, Bird 1, 35% of patients have tested positive. Flower 3, a third unit, has three patients who tested positive. All those units are now converted to units for patients with COVID-19 or who are under investigation for possible exposure.

“Given the spread with which this infection has been spreading, we are making the assumption that if there are three positive patients, there are likely more (or will be soon, given the number of patients exposed),” Matteucci wrote in a separate memo about the outbreak to staff.

The hospital has not yet received gene sequencing results, but hospital officials expect the outbreak is tied to the omicron variant.

The hospital has paused admission to “provide further protection to our patients,” Matteucci wrote in the letter, which did not say when the pause will end.

At this point, the hospital may pause admissions for a week or two, depending on case numbers, said Aria Seligmann, a spokeswoman for the Oregon Health Authority.

The hospital has a smaller Junction City campus, but due to its cohort admissions procedures, Oregon State Hospital doesn’t directly admit patients to Junction City. As a result, “a pause on admissions in Salem means a pause on all admissions to OSH,” Seligmann said in an email. The Junction City campus has had several staff members test positive for COVID-19, but not any patients.

The outbreak is only the latest in a string of challenges facing the hospital. Disability Rights Oregon warned Gov. Kate Brown and Oregon Health Authority Director Pat Allen that the hospital was in dire condition and that it had heard repeated warnings from hospital staff and providers about a facility stretched to the breaking point that fails to care for patients. 

The hospital has also struggled in recent years to admit patients facing criminal charges from jails who need treatment so they can recover and assist in the defense of their case, called “aid and assist” cases.

Aid-and-assist cases have long dogged the state hospital and led to a federal lawsuit after it was failing to admit patients within the required seven-day time frame. That meant patients languished in county jails instead of receiving prompt treatment at the hospital.

The court-ordered seven-day requirement was loosened during the pandemic, but a federal judge in September gave the state hospital until Dec. 3 to hasten admissions and boost capacity so the system can quickly admit patients who are awaiting trial. On Dec. 10, Oregon State Hospital reached an interim settlement agreement with Disability Rights Oregon, an advocacy group, and Metropolitan Public Defender to hire an expert to help both sides reach a compliance plan. A plan for short-term compliance is due Jan. 31 and a report with recommendations for long-term compliance is due April 29, with a May 4 conference to resolve any outstanding disagreements.

In Matteucci’s memo, she wrote that the hospital notified the Department of Justice and Disability Rights Oregon about its need to pause admissions.

In a statement, Emily Cooper, legal director of Disability Rights Oregon said: “We think this pause makes sense to mitigate the spread of COVID. That said, Oregon State Hospital should have more aggressively prioritized boosters for patients last month. We believe taking more mitigation steps is key — we’d like them to explore all options to keeping patients safe — like the use of PPE, and looking at community placements. We’re still worried about the people waiting in jail — and wonder if any of them can be discharged to the community while they wait for admissions.”

Oregon State Hospital officials said the source of the outbreak is most likely staff, since the affected units are not admissions units. 

“This is why booster vaccinations were offered to staff first,” the hospital said in its fact sheet.

Steps To Contain COVID-19

Matteucci outlined steps the hospital is taking to protect patients and staff. They include:

  • The hospital has “fully closed” its three units with COVID-19 patients. This means those units are used as COVID-19 units and for patients under investigation that may have the virus. That’s due to the rapid rise in cases and the significant number of patients who are positive but don’t have symptoms. 
  • Staff on those units have to wear N95 masks, including a face shield, gown and gloves. Locks will be changed to facilitate medical isolation where necessary, the memo says.
  • Patients are expected to quarantine in their rooms and the hospital encourages those who have tested negative to wear masks.
  • Patient movement is also restricted. The hospital is not transferring patients from other units to those three units, with limited exceptions related to bed capacity on two other units. The hospital has halted comingling of patients at its Salem campus among different units and rescheduled non-urgent medical and dental clinic appointments. Patients of both campuses are not allowed to leave hospital grounds on outings.

You can reach Ben Botkin at [email protected] or via Twitter @BenBotkin1.

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