“This is a public health emergency,” Trish Elliott, County Health Department director told the Hood River County Board of Commissioners last week.

Lack of information and access to testing, economic fears, “pandemic fatigue” and simple denial of the problem are fueling a rash of new COVID-19 cases in Hood River County, county officials said Monday.

The county is in the state’s Extreme Risk category and seeing a “sustained surge,” Elliott said in a bracing report to the commissioners. She reported that as of Monday, 14 people have died from the coronavirus, double the number from the previous week.

“Our community does not know that our status is this bad, that our numbers are off the charts,” said Commissioner Karen Joplin. “Our community members do not know that."

Elliott put it starkly: “At this point it is like we assume everybody’s positive (for COVID-19). That’s what it feels like to me. The sheer number of people the county needs to do contact tracing on is rising exponentially.

“We are getting to every case, but not getting to every contact,” Elliott said.

“If our community wants the economy to improve and businesses to open, everyone needs to get on board and I just don’t think that is getting to our community members,” said Joplin, who lauded the videos by Health Officer Dr. Christopher Van Tilburg and other outreach found on the County Health department website.

From billboards and banners to increased newspaper and radio coverage of the topic, the board noted that every information tool needs to be exhausted to reinforce the message the toll is rising, and that people need to rigorously follow recommendations on mask-wearing, limits on gatherings, and adherence to social distancing and other coronavirus prevention measures.

Here are the grim numbers, reported by County Public Health officials as of Monday:

■ 778 — total COVID-19 cases

■ 84 — active cases the department is monitoring

■ 21 — people hospitalized

■ 248 — reported new cases since Dec. 1

■ 400 — doses of the coronavirus vaccine, arriving next week

Van Tilburg said the first 400 doses will be given to Providence Hood River Health employees, and the next batch, in early January, will be dedicated to long-term health care facilities.

“We have a solid plan for distribution, but nothing to distribute yet,” he said.

The severity of the problem, according to county officials Monday, elevates the crisis to the county’s top priority.

The county is considering creating the position of COVID-19 response coordinator. Chairman Mike Oates said he has met with county administrator Jeff Hecksel to start developing a plan to appoint someone to manage information relating to the disease and prevention, and assist with economic recovery.

“This thing is a long way from over,” Oates said.

“It is a busy, busy time.” Elliott said. “It is very hard to us doing contact tracing and it doesn’t feel like it’s heading off any transmission. It feels like every time we have a positive test there are always four our five people testing positive from that case.

"It is disheartening, our staff is out there hearing the fears and hardships of people we talk to, acting in some cases as emotional support for people on a day-to-day basis and getting very attached and close, and it’s very hard on our staff. I think there is going to be a lot of trauma when this is all over and done with, not just here but across the state.”

Commissioner Les Perkins asked Elliott if her agency has been able to determine the cause for Hood River County’s rapid growth in coronavirus numbers.

“Part of it is we may be behind the curve, compared to other counties,” Elliott said. Cooler weather, and people staying inside more is a likely contributor, she suggested.

“We are seeing a big shift from one or two people testing positive to the entire family testing positive, and the number of work place outbreaks and high risk workplace outbreaks is very alarming,” Elliott said.

“We’re spending our our days trying to keep our heads above water and it makes it hard for planning ahead and thinking about what’s next.

“It’s been very difficult,” for the County Health staff, Elliott said.

“It’s disheartening. We are working as fast as we can, doing all we can do. It is, as you can imagine, defeating,” to see numbers rise despite contact tracing and efforts to communicate prevention needs to the community.

Tests and measures

Testing availability and contact tracing are two major challenges facing the county. Elliott said her department has asked for help from the state and has added two key support positions that have helped her staff cope with the work demand.

Elliot described to the board “How we’ve been coping and what we are doing moving forward”:

The department added a temporary administrative assistant who has been a “tremendous help in our office.” Also on board now is a retired nurse who had worked for the county, giving significant relief to regular nursing staff and Elliott has hired a nurse who will start Jan. 4 part-time and another nurse who has expressed interest in helping us with vaccine distribution starting in early January.

For contact tracing support, the department has reached out to the Eastern Oregon Center for Independent Living, one of the agencies recently receiving Oregon Health Authority funds to help with wraparound services for people in isolation and quarantining and assisting with contact tracing.

She said she is alwo working with county Emergency Management and the County Health Council on recruitment and other ways to increase case investigators and contact tracers

The county is doing some testing, but it is limited in how much it can do, and is relying on other care providers to offer the service; however, not all providers offer it and it is hard for people needing a test to get it if they are not connected to a provider who offers the service.

Elliott just learned that one large provider in the community has recently stopped scheduling testing “because the demand is so high.”

“We are doing at least a couple of hours a day (for testing) to respond to people who can’t get into their provider, and that is not sustainable, but felt had to because of the lack of access.”

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