The ongoing surge COVID-19 , driven by the highly contagious delta variant, appears to have peaked in Oregon and the Columbia River Gorge, but hospitals, healthcare workers and emergency responders continue to see an increase in patients needing emergency and critical care.
“Overall, the trend (of infections) is heading down. That is really good news. Things have hopefully peaked and are beginning to head down,” said Martha McInnes, clinical program supervisor for North Central Public Health District, speaking before the Wasco County Board of Commissioners on Wednesday, Sept. 15. “We are mirroring the state quite closely,” she said, and Oregon statewide has seen a peak and downward trend in new cases.
According to state forecasts, it will take as long to get down from the crest as it took to get there, about two months.
“I’m happy to deliver some promising news — daily cases and hospitalizations are slowly coming down from record highs,” said Dr. Dean Sidelinger, the state epidemiologist, during a Thursday press call. New infections and deaths also remain high but are trending down the past two weeks after eight weeks of rising numbers driven by the highly contagious delta variant.
But it will take as long to get down from the crest as it took to get there, about two months, according to state forecasts.
“The Delta variant remains a formidable threat,” Sidelinger said.
Significant numbers of new cases are still being reported in the Gorge area, McInnes noted, with about 20 cases per week being reported in Wasco county. In Gilliam county, one in three people reporting symptoms have tested positive, she added.
All three counties in the district, which includes Wasco, Sherman and Gilliam counties, have reported at least 1 COVID-19-related death in the past month.
Emergency services throughout the region continue to be impacted by the high rates of infection from the delta variant of COVID-19 as well.
Mid-Columbia Fire & Rescue (MCF&R) in The Dalles reported earlier in the week a record number of ambulance calls for known or suspected COVID cases in August, with 21 calls for service, compared to a previous high of 17 in January, and a low of just 2 in July.
“Our personnel are responding to a lot more COVID calls now than we were at any other previous time in this pandemic,” said Joel Brown of MCF&R. “Delta has really caused an uptick in our run volume,” and it’s continuing into September, Brown said.
Local hospitals are also continuing to see significant impacts from the surge, as the number of people needing hospitalization lags behind reported cases.
On Wednesday, Oregon Health Authority reported Region 6 hospitals again had no available Intensive Care beds available. Region 6 includes the entire Columbia River Gorge region of Oregon and Washington. Bed availability can fluctuate very quickly, noted McInnes.
Testing in the district has increased, as well, with testing done primarily for symptomatic individuals and close contacts of presumed or confirmed cases. In the first week of September, Wasco County reported a positivity rate of 8.4%; Sherman County 6.1%; Gilliam County 33.3% and Oregon statewide, 12%. “We are testing a lot of people, and only some of them are coming up positive,” McInnes noted, although she added that the rate in Gilliam County indicates not enough testing is being done in the county, and cases are likely going undetected. During the same week, Wasco County identified 97 positive cases of COVID-19, down from 150 the week prior.
McInnes noted the virus is spreading in a variety of ways, including school activities, the workplace and social gatherings, there are no currently active outbreaks in long term care facilities locally, although some are still in a waiting period for official clearance post outbreak.
“Delta is incredibly contagious,” she noted, and spread very rapidly. She noted that recent studies, although not yet conclusive, have suggested that although those who are vaccinated and are infected by the delta variant (breakout cases) can carry a high amount of virus, “we aren’t necessarily seeing much transfer in real life,” she said.
NCPHD has increased testing services, and with community partners has expanded testing at Celilo Village and the In-Lieu sites along the Columbia River, as well as the Community Meals and shelter sites in The Dalles, and are also offering vaccinations during testing events.
NCPHD is also offering testing clinics. “Our testing is daily, and completely filled up,” she said.
Vaccine efforts now include a miss-information campaign on social media sites, in addition to readily available vaccinations throughout the district.
Currently, Wasco County is 66.8% vaccinated; Gillaim 45.9%; Sherman 61.9% and Hood River, 79.1%.
For kids under 12, vaccine approval is a moving target, McInnes said. Estimates keep moving, but approval should happen by November through January. “Those estimates are conservative, this may happen faster than we expect,” she said.
The District is working to prepare for vaccination of kids under 12 in “a comfortable space,” including pediatric offices and clinics.
McInnes noted that federal drives to increase at-home testing will have to include an increase in the supply of tests, as locally home testing kits sell out very quickly.
She also noted the federal government is supporting free monoclonal antibody treatment.
The treatment, which now can now be given in a series of 4 injections over a period of days as an outpatient procedure, is currently available at Mid-Columbia Medical Center for those at high risk of complications, but with only mild to moderate symptoms.
“They are going to be putting up a tent, to offer this in a safe way,” she explained. Other clinics may also make the treatment available.
She noted offering free treatment was a classic case of how public health can work: Although at $2,000 a shot the full treatment can cost $8,000, offering it free to those most likely to need acute care makes sense. “We save hundreds of thousands of dollars in hospital COVID care,” she said of each successful intervention.
COVID long haulers
Asked about “long COVID,” in which symptoms can continue for months, McInnes said there was not a lot known about the condition. “We think it might impact 5% to 20% of those with COVID, so it could be very prevalent. But it is very variable. It involves symptoms that can continue for months...and can fluctuate, coming and going. Random fevers, joint pain, fevers. It is a big cluster of symptoms that we are trying to understand, we are trying to figure out.”
“It can be very debilitating for some people,” she added.
She noted that vaccinated people, if they do get a breakout infection, they seem to be about half as likely to experience long COVID symptoms.