The Dalles — Wasco County continues to see growth in COVID-19 infections and remains classified as being at extreme risk for COVID-19, and a real-world consequence of that is that there are currently COVID-19 outbreaks in all five of its long term care facilities, Mimi McDonell, health officer with North Central Public Health District, told the Wasco County Board of Commissioners Dec. 16.

“When there are outbreaks in those facilities, their ability to take new residents, either permanent or part time, is significantly diminished,” she explained. As a result patients in the local hospitals who are in need of additional nursing care in the short and long term, whether it is from COVID-19 or other health needs, are very hard to place into local facilities. “There are very few places for patients to go within the county,” McDonell said.

McDonell said that according to Mid-Columbia Medical Center, eight patients currently at the medical center are looking for long term placement. They may not be infected with COVID-19, but nevertheless cannot be placed locally due to outbreaks. The only facility accepting new and returning patients is the Oregon Veterans Home.

An outbreak at a long term care facility can represent a single staff or patient testing positive for the virus, McDonell noted.

“Long term care facilities are an issue all over the state,” she noted. “This is a statewide issue, this is a big issue, and this is a crucial time,” she said. “We need this issue of placement into long term care facilities to be a high priority in the state. We need to recognize this is a statewide issue, and it’s not clear the state is giving the guidance we are hoping for in public health. We need something put up, in case we do run out of hospital beds,” McDonell said.

As of Dec. 16, Wasco County has had a total of 706 cases of COVID-19 to date, 397 recovered, and 19 deaths. Sherman has a total of 27 cases, 23 recovered, and Gilliam has a total of 26 cases, 19 recovered and one death.

Cases in Wasco County continue to be trending up since September, although in the last two weeks the increase has been slightly less than previous weeks, McDonell said.

She noted that statewide, 1,214 deaths have been reported, and 96,000 cases. Fifty-four deaths were reported Dec. 15, the highest single day death toll in Oregon so far. “On Dec. 1, there were 24 deaths, the highest so far. On Dec. 8, there were 36, and on Dec. 15, there were 54.

“This is an indication of the severity of where we are at, in our county and in the state,” she said.

In the U.S., there have been more than 16 million cases, and more than 300 thousand deaths, she said. “To give that perspective, fewer people died in combat in the four years of World War II,” she said.

Guidelines

Under extreme risk guidelines, social gatherings are restricted to a maximum of six people from only two households; offices are to require remote work if able, and close to public if possible; indoor dining is prohibited, take-out is encouraged; outdoor dining is allowed to an 11 a.m. curfew.

Indoor recreation, fitness or entertainment is prohibited; retail is open to 50 percent occupancy; faith institutions are limited to a 25 percent occupancy or 100 people, whichever is smaller, and are recommended to limit services to no more than one hour; and outdoor visitation only is allowed at long term care facilities.

“Fifty percent occupancy is still a lot of people,” McDonell said of retail spaces. She recommended people shop off peak hours, if possible, to avoid exposure. “That’s the way to stay safe. These are the rules we will be under for at least the next two weeks.”

McDonell said the district was still able to do contact tracing. “We are still doing really well, that’s been helpful. We are fortunate in that,” she said. “I am incredibly fortunate to work with an amazing, dedicated staff.”

Vaccines

On a hopeful note, 35,000 doses of vaccine have arrived in Oregon and are being given to health care workers, McDonell said.

An additional 19,500 doses will be arriving this week, with more than 10,000 of those doses going to skilled nursing facilities.

“I don’t think anyone will be vaccinated in Wasco County this week,” she said. “Maybe next week.” She said rural counties will likely rely more on the second vaccine, expected to be approved for emergency use this week. That vaccine does not require the extreme cold temperature storage the first one does, and will be less complicated to distribute.

McDonell explained to the board how various forms of vaccines work, and said the two COVID-19 vaccines being distributed first use mRNA technology. How do they work? A tiny piece of the genetic code which makes the “spike protein” was isolated and is what goes into your arm as a vaccine, she said. “That (spike protein) goes into your cells, turns on the machinery that makes a bit of the protein — and the body attacks it, and builds up our defense system.

“The next time our body sees this spike protein, it has the ability to attack the virus right away.” She noted that it stays away from the cells DNA. “It can’t get into the cell nucleus, it can’t alter your DNA.

“You can’t get COVID from the vaccine,” she added.

The vaccine does have side effects, she said. “Absolutely these vaccines do have side effects. They happen because your body is making an immune response, mostly with the second dose. With the first vaccine, 50 percent of people receiving the second dose experienced fatigue, 1/3 headaches, and 1/4 got chills and body aches,” she said. “If you feel crummy, that means your body is responding to the vaccine and building a defense.”

The vaccine will not cause people to test positive for the virus later, she added. “Those tests do not look for the spike protein,” she explained.

“We cannot promise there will not be long term side effects,” she added. “If there are any they would be exceptionally rare, based on the science. The potential is very small.”

She said vaccine distribution has begun with hospitals, specifically employees at first who are most exposed, and then will go to those living and working in long term care facilities. “Both are expected to be happening next week or the week after,” she said.

It’s hopeful, McDonell said. “It’s not quite sunrise yet, its still pretty dark out. Stay home if you can. Be safe at work and in public, and look out for those who are vulnerable. Think about the people who have done so much for us, who fought for us — we can do this for one another.”

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