Now that Gov. Kate Brown has announced her criteria for reopening public life and the economy, Oregon’s 36 counties are scrambling to complete their proposals and get them approved by the governor’s office.
Brown began accepting applications Friday, and the Association of Oregon Counties said 23 immediately submitted one, though Brown’s office only listed 13. She will process them in the order they are received in consultation with the Oregon Health Authority. Some counties could be approved to reopen as early as May 15.
With that approval in hand, counties can begin to allow bars and restaurants, retail stores, outdoor recreation, salons and other personal service providers to open in phases -- provided they follow industry-specific guidance developed by the state.
Businesses are clearly eager to get back to business, though there is no broad agreement among Oregonians that the state ought to rush ahead. Some protested the governor’s stay-home order on the steps of the capitol, and a few businesses continued operations in defiance of that order, opening themselves up to fines and possible actions by state labor regulators. But there is still a broad swath who think Brown is acting too soon, and should maintain the status quo for a while longer.
What’s clear is this will not be an equal opportunity rollout.
While some smaller rural counties may immediately meet the criteria and reopen May 15, that timeline is harder for more populous urban counties of the Willamette Valley, and particularly around the Portland metropolitan area – the driver of the state’s overall economy and financial health. For counties in the Portland area, reopening is likely to come weeks later, at the earliest.
In order to win state approval for reopening, each county needs to show they can meet seven public health criteria. And because of their size, density and caseload, urban counties may not immediately qualify.
“The more rural a county is…the more likely it is to be in a position to successfully apply,” Oregon Health Authority Director Pat Allen said during a press conference with Brown on Thursday.
The seven criteria include declining levels of COVID-19 hospital admissions over a 14-day period; minimum levels of testing and contact tracing capacity; adequate hospital surge capacity, quarantine facilities and personal protection equipment; and finalized sector guidelines from the state to communicate to individual businesses.
Moreover, some of those criteria – testing, hospital and PPE capacity -- must be met within “health regions” established by the governor, which are groups of contiguous counties.
Achieving adequate levels of contact tracing is one of the most difficult criteria for some counties to meet quickly. It’s one of the disease control methods used by state and local health authorities to track the contacts patients had while they may have been infectious. The state criteria require counties to have 15 trained contact tracers for every 100,000 population and be able to track 95% of a patient’s contacts within 24 hours.
Urban County Challenges
Multnomah County will need 120 contact tracers in place and trained to meet that standard, said Chris Voss, director of county’s Office of Emergency Management. The county has 30 today, having started with supervisory staff to build out the structure.
“It’s going to be about three weeks to get up to speed on that,” he said. “We want to know that that group is effective and efficient to mitigate the spread of any new cases.”
But that’s not a hard date, he said. And there is no definitive timeframe on reopening, Voss said, adding that Multnomah County and the larger metro area face unique challenges.
The county’s higher population density makes it easier for COVID-19 to spread, dictating a more cautious approach. The region needs to prepare its mass transit system to handle an influx of passengers when the county opens up without violating social distancing. There are also public education and social equity issues to consider, as the Portland area is more diverse and home to communities of color that have already been on the front lines of the pandemic and rely more heavily on public transport.
Voss also said county commissioners from the tri-county area would “like to think that we would move as a region.”
Indeed, Washington County has similar issues. Marni Kuyl, the county’s Health and Human Services director, described the planning process for reopening at a meeting of the board of commissioners early this week.
She said the county would need between 90 and 100 contact tracers to meet the state standard, plus another 40 support staff. According to more rigorous national standards the county had been using prior to the release of the governor’s criteria, Washington County may need as many as 180. Today it has about 40 on the team, most borrowed from other departments who will eventually go back to their regular jobs
Kuyl said county might be able to rely on state contact tracing staff – state officials say they are hiring 600 – to bolster its own capacity. The county is in good shape on hospital capacity and protective equipment today, and she told commissioners that she was aiming to provide them a draft reopening plan Friday, and a final version for them to vote on by May 12.
Mary Sawyers, a spokeswoman for Washington County’s emergency operations center, said the county was shooting to reopen in in early June, though public health officials said they still need to launch a broad public education campaign that can reach underserved populations, the homeless, communities of color, and non-native English speakers, who reports show have been disproportionately impacted by the coronavirus.
In her presentation to commissioners, Kuyl also said that once the county reopens, progress is unlikely to be in only one direction.
“If we see a rebound, if our health systems become overwhelmed,” she said, “we may be making recommendations to move backward.”
Tillamook and other North Coast counties are grouped into Health Region 1 along with the Portland metro counties, but their issues are very different.
Tillamook only needs three or four contact tracers to meet the state standard. And it already has those staff on hand.
“We meet all the criteria for Phase 1 reopening except testing,” said County Commissioner David Yamamoto. “It looks like we’re going need about 75 tests per week. We can do that for one week, but where do we get next week’s test supplies?”
In this case, being part of Health Region One may help, as test capacity is one of the criteria being evaluated regionally, and most of the state’s testing capacity is in the Portland area.
But that proximity is a double-edged sword. Yamamoto said Tillamook County residents’ biggest concerns are reopening and being overrun by thousands of beachgoers looking to escape the city. It happened over spring break, he said.
“It was like the fourth of July out here,” he said. “We had to ask everyone to go home.”
They didn’t just ask. County officials closed hotels, motels, vacation rentals, RV parks, campgrounds, beachside parking lots and all beach access points the county owns.
People got the message and went home. But he expects it’s going to be an issue this summer, as there is already pent up demand to get out and many people are reluctant to get on a plane. Many of the county’s businesses, meanwhile, are deeply dependent on summer tourist revenues.
“We are trying to thread the needle on how much is enough business to allow our businesses to remain viable,” he said. “Our business owners absolutely need a portion of those tourists to be here. There’s no doubt.”
Yamamoto said he’s also anxious to see the state release some of the $1.6 billion in federal CARES Act funding it received beyond what was earmarked for counties with populations greater than 500,000.
“The balance of that money, the state is sitting on,” he said. “Congress intended that money to go to cities and local governments including counties. For whatever reason, the state is not distributing the money.”
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Counties say they need the money to backstop some of the COVID-related spending they need to make to reopen. Indeed, U.S. Rep Greg Walden sent a letter to Brown Tuesday telling her that was Congress’ intent, and that further guidance from the U.S. Treasury made that clear.
“Commissioners throughout my district are asking for financial help,” Walden’s letter said. “Every county faces costs to comply with the state’s plan to reopen… I write to ask that you and the Emergency Board of the Legislature reconsider the decision to not share funds with local governments, and instead do what other states are already doing to help their local government partners as was intended by Congress when we voted to send states these funds.”
The state had hoped to replenish its own coffers using the CARES funding, though congressional guidance has made it clear the money cannot be used for that.
Charles Boyle, a spokesman for Brown, said “the governor recognizes that local government revenue and expenditures have been hard hit by COVID 19, and we had hoped for more federal funds in the first few stimulus packages to help address the undeniable needs. “
He said the state was still working to define what the funds could be spent on, making sure the money wasn’t being spent on needs that could be covered by other funds, and that the money was addressing the needs of all Oregonians.
Already Socially Distanced
Social distancing is the status quo of life in Baker County, says Commissioner Mark Bennett, and if the governor is going to pick one county to open May 15, Baker County wants to be the one.
Anxious to get its economy moving again, the county delivered a 14-page “Reopening Plan” to Brown in late April that Bennett says carefully addresses the governor’s criteria. And, he says, there’s urgency to get moving.
“There are two principal legs of our economy: the cattle industry and tourism,” Bennett said. “Both of them are taking a terrific whack. So it’s a tough time.”
Baker County is typical of a number of Oregon’s rural counties, including Harney, Umatilla and Douglas counties, which have written to the governor pleading for permission to reopen. They are also typical of counties where health systems could easily be overrun by an outbreak.
Until this week, there were no confirmed COVID-19 cases in Baker County, which has 16,134 residents, yet is operating under the same strictures as far more populated areas of the state with much higher case counts.
The county seat, Baker City, is home to 61% of residents, with the rest spread over its 3,088 square miles. Early on, the county established a community curbside clinic in cooperation with the medical center in Baker City. It has since been closed for lack of use.
This week, however, Baker County got its first case. The patient is isolated at home.
“We immediately put the tracing team into action,” Bennett said. “They’re actively on it. They said they felt they could put a quick isolation onto it.”
Ready To Go, Maybe
Marion County commissioners voted to approve a Phase 1 plan Wednesday, and are proposing to reopen May 15.
“It is critical for our county’s economic stability to open businesses soon,” according to the plan’s cover letter signed by county commissioners. “We propose a phased, limited reopening to allow those suffering tremendous financial losses an opportunity to slowly reopen their businesses.”
The letter also said “Marion County has seen a decline of COVID-19 cases from a peak on April 19, 2020.”
But that’s not totally clear. The county has actually seen a new spike in reported infections in early May. On May 3, the county saw 24 new cases. On May 7, it was 21 new cases.
Marion County has the second highest number of cases in Oregon and pockets of the highest infection rates in the state. Zip code level data released this week showed that Gervais, a small town in northwest Marion County, has the highest rate of infection in Oregon with about 57 cases per 10,000, with 26 total infections. The neighboring zip code for Woodburn, 97071, is just below that rate at 54 infections per 10,000 people. It has recorded the second-most infections statewide, at 155.
Meanwhile, the county’s Phase 1 plan shows that it still falls short of the minimum contact tracer and testing requirements
County Commissioner Colm Willis said the county is in a good position to meet those criteria with aid from the state and community organizations that are prepared to support both testing and contact tracing. In terms of infection trends, he said, “this has been a confusing issue for people” and what OHA and the governor’s office were really looking at was the level of hospitalizations for COVID-19, and assurance that regional hospitals had adequate surge capacity in the event of an uptick.
That governor’s guidance does call for a 14-day decline in COVID-19 hospital admissions. But it also requires the percentage of emergency department visits for COVID-19-like illnesses to be less than the historic average for flu at the same time of year.
Willis said the number of COVID patients hospitalized had declined, and that while Marion County was likely to have a higher incidence of the disease because of its concentration of vulnerable populations, area hospitals were confident they had the capacity to handle any surge under a limited reopening.
“We’re working very closely with our hospitals,” he said. “We wouldn’t have put forward a plan for reopening if they hadn’t told us it was safe. Our first and foremost concern is the health and safety of the citizens of Marion County."
-- Ted Sickinger; [email protected]; 503-221—8505; @tedsickinger
This story was originally published by The Oregonian/OregonLive and is posted here thanks to a coronavirus content-sharing agreement among more than a dozen news organizations in Oregon.