A large coronavirus outbreak on the Oregon coast has quickly overwhelmed the local public health department, offering a glimpse into how even a community well-equipped to combat the virus can struggle to contain a sudden surge.
Health officials in Lincoln County have needed to turn to neighboring counties, a local tribe and even a community college to build up a team of contact tracers big enough to match the more than 100 workers at Pacific Seafood in Newport who tested positive Sunday for COVID-19.
And yet it may still take up to two weeks to identify and reach all of those who came into close contact with the sickened workers, said Rebecca Austen, the health director for Lincoln County.
The delay raises fears that the virus could continue to spread unchecked in the county of 50,000 people.
“To be able to stop the transmission, we need everybody to stay home,” Austen said of people exposed to the virus.
Dr. Paul Cieslak, Oregon’s medical director for communicable diseases, appeared surprised to learn Thursday that the county was in such dire straits.
“Only time can tell how fast we’re able to do the work and contain this outbreak, but I’m very concerned,” Cieslak said.
The success of contact tracing hinges, in part, on how quickly public health investigators can complete the painstaking task before them.
They must track down and speak to anyone exposed to an infected person, urge them to quarantine for up to 14 days and then monitor those people to see if they get sick.
The Oregon Health Authority has set a goal that county health officials initiate contact tracing for 95% of new cases within 24 hours of discovering them.
Lincoln County seemed to be in a good position to keep on top of infections — it had seen only 15 coronavirus cases through the beginning of June.
The state wanted the county to have seven public health investigators based on its population. It had twice as many.
“But that did us very little good when the outbreak hit,” Austen said.
Pacific Seafood saw its first worker test positive for COVID-19 on June 1 followed by three more employees a couple of days later, the company said in an email.
It began meeting with officials from the Oregon Health Authority and the Oregon Department of Agriculture to discuss preventative measures.
On June 4, the seafood plant suspended operations at all five of its Newport facilities, which process shrimp and other seafood. It then paid to have 376 employees and contractors tested the following day through Signature Health and Kashi Laboratories, the company said.
Pacific Seafood received the results Sunday: 124 of the tested workers — or 33% — were infected with COVID-19, currently the largest workplace outbreak in the state outside of the Oregon State Penitentiary, where 167 inmates and staff have fallen ill.
The company said it began notifying its workers of the results immediately.
Lincoln County did not receive the names and contact information of the infected workers until late Monday morning, according to Austen and Pacific Seafood.
“In a typical outbreak of this magnitude public health would be involved from the very start,” Austen said. “Nothing is common in this pandemic. All of this novel territory.”
It was clear that Lincoln County alone could not handle the sudden surge in infections, which quintupled the county’s total number of cases nearly overnight, even after reassigning additional staff within the health department to work on investigations.
More than 40 health workers from Benton, Tillamook and Coos counties, the Confederated Tribes of Siletz Indians, Oregon Coast Community College, among other places, have stepped in to help with contact tracing.
All received training Tuesday, Austen said.
Still, it remains a slow process reaching all of the infected workers, many of them Spanish-speaking, and then all the people that the workers have recently been around. Interviews can sometimes take a couple of hours, even with bilingual health investigators.
Adding to the delay is that a number of the Pacific Seafood workers speak Mam, a language indigenous to Guatemala, and are not fluent in Spanish or English. None of the bilingual health investigators working on the outbreak speak Mam.
Austen said she hopes the county will be able to reach all of the workers by Friday.
As for their close contacts?
“It could be a couple of weeks before we get to everybody,” she said.
Meanwhile, Lincoln county health officials have reported an additional 15 coronavirus cases this week on top of the sickened seafood workers — as many as they’d logged during the first three months of the pandemic. Most, but not all, of the cases are people linked to the outbreak, the county said.
County health officials also said they are monitoring six new potential workplace outbreaks but did not provide additional information.
They said the Oregon Health Authority will release the names of any business with 30 or more employees where at least five of the workers test positive for COVID-19. Otherwise, the business will not be named.
Gov. Kate Brown’s office is watching to see what happens next.
“As the governor has said, reopening comes with risks,” said Charles Boyle, a spokesman for Brown. “We are monitoring the situation closely to see if additional measures or interventions will be necessary in Lincoln County.”
Cieslak also sounded a note of caution.
“There’s certainly going to be more COVID-19 in Lincoln County than I had hoped for a week ago,” he said. “A lot of people are walking around the virus.”