Five Oregon counties are pushing full speed ahead to reopen at the end of this week despite sudden surges in their reported coronavirus cases.
Clatsop, Jefferson, Polk and Umatilla counties each have seen their known COVID-19 infections more than double in the last two weeks, even as statewide restrictions aimed at slowing the spread of the virus remained in place.
Marion County, which has Oregon’s highest rate of coronavirus infections, reported nearly 270 new cases during that time — more than any other county, including the Portland metro area’s three counties.
Yet elected and public health officials in all five counties said they meet the infection criteria issued by Gov. Kate Brown to enter the state’s “Phase 1” for reviving public life and the economy, which begins Friday.
On their own, the state’s guidelines are weaker than the “Opening Up America” guidance circulated by the White House and promoted by Dr. Anthony Fauci, the nation’s leading infectious diseases expert who on Tuesday warned U.S. senators against moving to open the country too quickly.
Oregon’s criteria, for example, require a declining level of COVID-19 hospitalizations or a lower percentage of emergency department visits for COVID-19-like illnesses than the average for flu at the same time of year.
The national guidelines are broader — and seemingly stricter. They don’t 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 within a 14-day period.
All five counties would not meet those guidelines.
But in an irony, they may meet one more state benchmark — a threshold to halt reopening.
Brown’s so-called “stop, wait and redirect” guidelines govern when counties may need to halt further opening, or perhaps close back up, including if they’ve seen a greater than 5% increase in their overall positive case counts in the previous seven days.
It’s unclear where the state’s evaluation process will end up, but a spokesman for the governor’s office said the determinations will be made “holistically,” taking all factors, including infection rates, into account.
“The worst-case scenario would be for us to have to backtrack,” said Joe Fiumara, the public health director for Umatilla County. “I’m pretty confident that we won’t.”
That county’s recent coronavirus data paints a less optimistic picture.
Though a three-hour drive east of the state’s population center in Portland, Umatilla County reported one of Oregon’s first known cases back on March 2 — an employee at the Wildhorse Resort and Casino in Pendleton.
Additional known infections in the county, home to about 78,000 people, continued to trickle in over the next eight weeks, reaching 37 cumulative cases on April 27, figures provided by the Oregon Health Authority show.
In the last two weeks, however, that number has more than doubled.
As of Tuesday, Umatilla County reported 85 coronavirus cases — or 110 confirmed cases per 100,000 people.
That’s now Oregon’s third highest COVID-19 infection rate, trailing only Marion (215 per 100,000) and Multnomah (115 per 100,000) counties, an Oregonian/OregonLive analysis of statewide data shows.
Fiumara said increased testing has helped public health officials identify more coronavirus infections in Umatilla County. But he also said residents are beginning to shelter in place less.
Several confirmed outbreaks, Fiumara said, were traced back to small family gatherings where one participant wound up infecting several others.
“We’re starting to see people less interested in complying with the state’s restrictions,” Fiumara said. “The weather’s been nice and people are getting a little stir crazy. They’re out and about.”
Polk and Clatsop counties, with 86,000 and 40,000 residents respectively, also reported dramatic increases in coronavirus cases since the last week of April.
During that time, Polk County saw its known infections rise from 38 to 89, a 134% increase, while Clatsop County’s infections jumped from six to 34, a more than fivefold uptick.
At least 17 of the new Clatsop County cases were workers at Bornstein Seafoods, a food processing plant in Astoria that briefly shuttered its facilities due to a coronavirus outbreak, county health officials said.
Health and elected officials in Polk County said their recent coronavirus increase was because of an outbreak at a nursing home, which have been hotbeds for COVID-19 infections throughout Oregon and the rest of the country.
State officials on Tuesday identified the facility as the Prestige Senior Living Orchard Heights in Salem, where at least 41 people tested positive. Four of them have died.
“This is an isolated incident and not indicative of a greater prevalence of cases within the population as a whole,” the Polk County officials wrote in their proposal submitted to the governor’s office.
In Jefferson County, where coronavirus infections rose from six to 24 in the last two weeks, nearly two-thirds of the cases are tied to the Confederated Tribes of Warm Springs, said the county’s public health director Michael Baker.
About 25,000 people live in Jefferson County.
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 Tuesday showed that Gervais, a small town in northwest Marion County, had the highest rate of infection in Oregon with about 100 cases per 10,000 population and 38 total infections. The neighboring ZIP code for Woodburn, 97071, has the second-highest infection rate in the state, at 60 infections per 10,000 people. It has recorded the highest number of infections statewide, at 174.
Over the past 14 days, Marion County had seen 267 new positive cases, a 37% spike in its overall case count, now at 723. Only Multnomah County has more cases total, at 908.
On Saturday, Marion County reported 43 new cases, its largest daily increase to date, as well as one of the highest rates of positive tests in a day — 21%. On Tuesday, it had 28 new cases, its second highest daily total.
Katrina Rothenberger, the county’s public health director, said she doesn’t want to read too much into a single day event and that the percentage of positive tests has jumped around quite a bit.
In fact, the county’s seven-day rolling average case count is at a new high and its seven-day rolling positive test rate of 12.3% is near its high from April 26.
By comparison, Oregon’s positive test rate is 4.2%.
“It’s hard to pinpoint why Marion County cases are so high,” Rothenberger said, while acknowledging that “there is something definitely happening in Marion County.”
Marion County had an early case, so transmission was taking place well before the governor issued her stay-home order on March 23, Rothenberger said. The county has lots of industry and congregant care sites and its incidence of cases appearing in clusters versus through 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 make sure it’s providing culturally appropriate information to residents, she said.
Despite the trend in cases and positive test rates, Rothenberger said she’s comfortable with the county’s plan to reopen May 15. Local health care providers have certified that they have capacity to handle a surge, and the county can meet the governor’s hospitalization criteria.
“We’ve been ramping up since March 8. COVID-19 is going to be in our community for a very long time and I don’t think we can afford to keep our economy closed until it’s eliminated,” she said.
“I’m comfortable with the plan that was submitted by our commissioners, understanding that it’s up to OHA and we need to meet those gating criteria.”
Brown’s office said the governor, senior staff and policy advisers will evaluate plans submitted by individual counties in consultation with the Oregon Health Authority and let county officials know their decision before Friday.
Charles Boyle, a spokesman for the governor’s office, said science, data and the recommendations of health experts will dictate the decisions.
Oregon’s prerequisites were based on the White House guidelines, but with significant input from the Oregon Health Authority and the Governor’s Medical Advisory Panel, a group of doctors, infectious disease experts and medical professionals from across the state.
“It is incorrect to infer that counties will be judged solely on a decline in hospitalizations of COVID-19 patients to meet the first prerequisite,” Boyle said. “Each county’s metrics will be analyzed holistically to determine if they have satisfied the requirement of showing a decline in the prevalence of COVID-19.”
He added that the Oregon Health Authority’s approach will not be to immediately close a county that shows a growth in cases after reopening, but to “stop, watch and redirect” resources to address the increase.
“A growth in positive cases connected to a single community event that can be effectively traced and contained, for example, calls for a different level of intervention than a growth in positive cases that shows community spread,” Boyle said. “They will use that same approach in evaluating county applications for reopening.”
Other criteria for opening up in Phase 1 include 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.
In the end, public health officials said it’s tough to pinpoint why counties have such a variable experience with the virus.
Jackson County, with 220,000 residents, is one of Oregon’s most populous counties, but it has also been experiencing one of the lowest rates of infection, with no new cases reported since April 20, barring a resident that moved home from another county this week.
Jim Shames, the medical director for the county, said “the bottom line is, I don’t know why, but I can tell you what I think we’ve been doing well.”
He said community organizations have had especially good communications as a foundation. They promptly set up testing and screening, with a well-staffed nurse triage line, a telemedicine clinic and drive-through testing capability. That testing identified positive cases quickly and the county was able to promptly launch its contact tracing team to follow up.
He said a good deal of it is probably luck. The county hasn’t had an outbreak in a nursing home or jail and is working hard to maintain that status quo. If it does, it could change Jackson County’s numbers overnight.
Shames said the day-to-day statistical deviations mean less to him than the bigger picture message to residents about how to safely open up while convincing them that “this is not business as usual.”
“We’re all taking a chance, “ he said. “We’re going into unchartered territory, so we’ll see how it works out for all of us.”
©2020 The Oregonian