Oregonian/OregonLive: Best Way To Track Coronavirus Severity? Hospitalizations. Oregon Stopped Reporting Them.
As Oregon prepares for a surge of seriously ill coronavirus patients, state health officials have stopped disclosing vital information that would tell Oregonians how bad the outbreak is.
The Oregon Health Authority this week stopped publicly reporting how many patients are hospitalized with the deadly virus, making it impossible for the public to track the growing severity of the novel coronavirus.
With testing still severely limited, an expert told lawmakers Friday that hospitalizations are the state’s best way to track the outbreak’s trend.
“Hospitalizations don’t lie,” Peter Graven, Oregon Health and Science University’s lead data scientist, said in a legislative hearing. “Whether or not you’ve been tested, if you get sick enough, you’re going to show up at the hospital. The number we want to watch is our hospitalization rate.”
After questions from numerous media outlets, the Oregon Health Authority said late Friday that it would resume posting hospitalizations on Saturday.
On Thursday, authority spokesman Jonathan Modie said the agency stopped sharing it because of an increase in commercial lab testing. That left health officials unable to determine whether the patients were in hospitals when they tested positive, he said.
Still, hospitals across the state are coordinating their responses with the authority, which closely tracks influenza and other disease outbreaks, making it highly unlikely the state officials leading Oregon’s response to a global pandemic couldn’t say how many COVID-19 patients are in hospitals.
By Friday, Modie said Oregon would start posting the hospitalization numbers again the next day. He said the authority was aware of 40 people being hospitalized among the 115 coronavirus cases identified in Oregon.
Gov. Kate Brown on Friday deflected a question about disclosing hospitalizations, repeating what she has said before: That she’s concerned about the privacy of people who’ve tested positive. People connected to the veteran’s nursing home in Lebanon, where 14 patients have tested positive, were kicked out of a restaurant and school, she said.
Oregon is giving the public less information about its test results than neighboring Washington. Though Brown pledged transparency in the state’s response, the Oregon Health Authority isn’t saying how many people older than 80 have tested positive, the group experts consider the most at risk. Oregon instead lumps together everyone older than 55.
In Washington, 60% of the deaths are in people older than 80, even though that age group represents just 16% of reported cases.
Oregon health officials did not answer repeated questions this week about how many beds are open in the state’s hospitals -- a vital issue with a possible surge coming.
Though Oregon tracks occupancy and hospitals report it, health authority officials won’t say how full the state’s hospitals currently are, even with an unprecedented effort underway to free up beds. Its officials didn’t answer repeated questions about how many hospital beds are currently available.
Oregon has 6,821 beds and 655 ICU beds statewide. The state’s hospital beds are typically 68% full, according to an Associated Press analysis of Centers for Medicare and Medicaid cost reports data. It’s among the highest occupancy rates in the nation.
Oregon also has the fewest hospital beds per 1,000 residents in the nation, the result of a concerted effort to keep people from being hospitalized.
OHSU’s Graven created a model to determine how many of those beds would be needed if Oregon didn’t close schools and limit gatherings.
Without any social distancing efforts, he found, Oregon would need 1,000 beds and 400 ICU beds just for coronavirus patients by April 16.
Brown issued an executive order this week canceling elective procedures and surgeries statewide -- things like hip and knee replacements -- starting Monday, March 23. It will help conserve dwindling supplies of personal protective equipment including masks, gowns and gloves and increase the number of ventilators available.
It will also free up staffing and beds at 104 ambulatory surgery centers around the state. Oregon Health Authority officials told The Oregonian/OregonLive those centers would significantly increase capacity. But they said they did not know by how much. The Oregon National Guard has helped build a 250-bed facility at the state fairgrounds in Salem to create room for people who are ready to be discharged from hospitals but not to go home.
“We basically don’t know exactly what the effects of our efforts to slow the tempo of the outbreak will be,” said Richard Leman, the authority’s chief medical officer. “If you’re thinking about this from a society and public health point of view, we hope for the best and prepare for the worst.”
OHSU’s data scientist, Graven, told the Legislature Friday that it won’t be clear whether social distancing measures have worked for at least two weeks. Lawmakers and top OHSU officials said they worried that not all Oregonians are taking seriously the need to stay home.
Brown has resisted calls to order Oregonians to stay at home. The governor said Friday that if she feels like Oregonians aren’t abiding by her “aggressive” social distancing orders, she would enact a stay-at-home order.
Without widespread testing and evidence that Oregon is flattening the demand curve, “the hospital community has a moral imperative to prepare,” Renee Edwards, OHSU Health’s chief medical officer, told lawmakers Friday.
OHSU has been clear about where it stands in terms of capacity. Beds at its three hospitals, which include Hillsboro Medical Center and Adventist Health Portland, are 95% full, Edwards said. The halt in elective procedures could free up about 20% of OHSU’s beds, she said.
“If we don’t manage a significant slowing of COVID-19, Oregon will not be able to serve the entire hospital needs of our citizens without creating more hospital beds,” Edwards said.
State health officials have received an analysis of the anticipated effects of the state’s social distancing techniques from the Institute for Disease Modeling, a Bellevue-based research center that is part of the Global Good Fund, a collaboration that involves Bill and Melinda Gates.
The institute’s research, a summary of which was obtained by The Oregonian/OregonLive, estimated that if Brown had not closed schools or limited social gatherings, the coronavirus would infect 5,000 Oregonians -- and potentially as many as 8,800 -- by April 11.
The modeling showed the biggest reduction in infections are expected to result from school closures and bans on large public gatherings -- cutting the 5,000 estimate down to 1,100. Keeping schools shuttered longer than the initial two-week closure dropped it to 790 infections in the model.
Closing all non-essential businesses further reduced the projected number to 340 infections.
If schools stay closed, the institute concluded, 60 people would need hospital beds by April 11 -- including 10 ICU beds. If all non-essential businesses closed, 31 people would be hospitalized then, including seven in the ICU.
But those figures, which the health authority would not discuss, depend on a key factor: How seriously Oregonians take the widespread effort to make people stay home.
Staff writer Jeff Manning contributed to this report.
— Rob Davis