Public Health Officials Brace For More COVID-19 Cases In Oregon
The epicenter of Oregon’s response to COVID-19 is a team of about 60 people in the Oregon Health Authority’s agency operations center.
They are working seven days a week, often 12-hour days or longer. The team isn’t operating 24 hours a day, but it may. Like COVID-19, it’s difficult to predict what’s on the horizon as Oregon grapples with the spread of the new respiratory disease and learns more about fighting it.
This much is known: The outbreak will grow worse before it becomes better. Oregon has three presumptive positive cases so far, two in Washington County and one from Umatilla County.
Two of the three positive cases, one from each county, have an unknown source in which the patients didn’t travel to mainland China or other high-risk nations or come into contact with infected people. For public health officials, two cases in Oregon -- also in different geographical locations -- is a sign that more cases are out there.
“There likely are many more cases here in Oregon we haven’t detected yet,” Dr. Dean Sidelinger, state health officer and epidemiologist for the Oregon Health Authority, told reporters on Tuesday. “I think we will continue to detect those cases.”
No one has died from COVID-19 in Oregon. Oregon’s three cases that have tested positive in the state’s lab are awaiting a second round of confirmation tests from the Centers for Disease Control & Prevention. Tests results for another eight people are pending in the state lab for people who may have COVID-19. Seventeen people have tested negative.
Another 101 people without symptoms are being monitored for a two-week period when they are supposed to stay at home to avoid potentially infecting others.That group includes people who have traveled to mainland China or may have come into contact with a positive case.
Sidelinger said the state is following CDC guidelines for administering the tests, which include testing people who have traveled to affected nations, had close contact with someone who tested positive or is hospitalized with symptoms and no other obvious cause of illness.
He stressed that the guidelines for testing can quickly change as more capacity for testing builds up and health officials learn more about COVID-19.
“What we say today may change in a week as we learn additional things,” he said.
For patients who are tested, he said, there is no cost because the state lab handles the test.
“No one should receive a bill,” he said.
Sidelinger said the state is currently working with insurance carriers and coordinated care organizations to provide guidance on how to remove any barriers that prevent people from receiving care.
In neighboring Washington state, there have been nine deaths, including the first in the U.S. Washington also has 27 confirmed cases and 231 people under public health monitoring who may have been exposed.
The first Oregon case involved a worker who lives in Washington County but works at a Lake Oswego school, which shut down for deep cleaning. Shutting down a school is also a tool that other states and have completed as health officials try to halt the spread of COVID-19.
Sidelinger said that is a “certainly a tool we have if the situation gets worse.”
“We do that on a case-by-case basis,” he said. “We take it very seriously.”
The Board of Commissioners in Clackamas County, where Forest Hills Elementary School is located, delared a state of emergency on Monday. The declaration allows the county to see more resources from the state.
Meanwhile in Northeast Portland, employees in the operations center huddle around computer screens, monitoring data about the spread of COVID-19. On overhead screens, maps show the national trends. They also track needed supplies and coordinate communciations with private and public agencies, such as local health departments, public schools and nursing homes.
Sidelinger said students and families shouldn’t cancel their spring break plans. It’s still safe to travel and check with the U.S. Department of State if traveling abroad is part of your plans, he said.
He’s also urging everyone to follow cleanliness guidelines: frequent hand-washing and not touching your face or eyes. If you feel sick, call your doctor or clinic first and find out if you should go in first before showing up unannounced, he said.
There’s also the question of supplies and infrastructure needed for Oregon’s health system to face the spread of COVID-19. The state lab should get more tests if the 1,500 test kits run out, Sidelinger said.
“We’ve been assured by the CDC that they’ll replenish those as needed and we’ll be able to get them,” he said.
Negative pressure isolation rooms in hospitals -- used to prevent airborne contaminants from drifting and infecting health care workers and other patients -- are another tool that can prevent the spread.
“We know there’s a limit on the negative pressure rooms we have, and that that’s one of the constraints our health care partners have,” Sidelinger said, adding that health officials are working on guidelines for health care providers if rooms are unavailable.
“We know health care providers are exposed to sick people all day, not just intermittently, and we need them to be on the front lines helping to take care of people,” he said.
The supply of protective N95 masks that health care providers use could become an issue, but it’s not currently a problem, he said.
“Our health care partners have their usual supply chain ordering and for the most part they seem to be getting kind of what they need,” he said, adding that the health care industry can submit requests to local public health agencies that go to the state.
“Right now, we don’t anticipate any problems overall with supply,” he said. “We’re able to meet requests as they come in. But we know that as this continues, that that could be an issue and that’s why we’re very grateful the federal government has stepped up to try and increase the supply of N95 masks in Oregon.”
You can reach Ben Botkin at [email protected] or on Twitter @BenBotkin1.
Mar 3 2020