Oregon is Getting Ready to Ease Its Stay-At-Home Order. Is It Still Too Soon?

It’s been nearly eight weeks since Governor Kate Brown issued her stay-at-home order in Oregon, and barring any surprise setbacks, the state is expected to take its first baby steps toward easing the lockdown on Friday.

But are we actually ready for what comes next?

Last week, a Harvard study found that Oregon is one of only nine states that’s meeting the minimum testing threshold for reopening safely (and social media did rejoice.)

But testing is only one of the benchmarks that public health experts have advised states to consider — and that I’ve been tracking in Oregon since mid-April.

The others? Well, here’s the full report…

Goal #1: Increase testing capacity

Harvard kind of stole my thunder here, but let me share a few numbers anyway: As of May 13th, Oregon is testing about 2,280 people per day, which is up from 1,350/day just a month earlier.

The Oregon Health Authority also plans to monitor 100,000 residents for symptoms over the next 12 months, and to randomly test 10,000 of those people to identify asymptomatic cases.

That’s a smart plan and while some public health experts would like to see those testing numbers go even higher, it’s good news that testing capacity is now a point of relative strength for Oregon, and no longer a glaring liability.

Goal #2: Reduce the number of new cases

It’s easy to look at the raw number of new cases per day in Oregon which is down just 14 percent from its peak five weeks ago — and think we haven’t made much progress.

But here’s why that number doesn’t tell the whole story:

  • Oregon is now testing 75 percent more people than in early April — and if all else was equal, you’d expect the number of new confirmed cases to have risen 75 percent, too. The fact that new confirmed cases are actually down, despite all that extra testing, means Oregon’s outbreak has fallen a long way from its peak.
  • The data on hospitalizations for Covid-19 backs that up. On April 8th, 156 Oregonians were hospitalized with confirmed coronavirus infections. By May 13th, that number was down to 53 — a decline of 66 percent.
  • The most important number to track going forward is the percentage of tests that come back positive. Nationally, that number is still above 7 percent. In Oregon, it’s below 3 percent, which is a really good sign. 

My takeaway: The few Oregon counties that are seeing a significant surge in new cases this month should probably slow-roll their reopening plans. But most other counties appear to be over the hump, at least for now. 

Goal #3: Increase hospital surge capacity

Week after week, I asked state officials about their plan to scale up hospital capacity if Oregon ever experiences a statewide outbreak as severe as the one in New York. And week after week, their answer was basically the same: We’re not going to let it get that bad. 

Here’s the most recent response I got from Paul Cieslak, MD, a senior health advisor for the Oregon Health Authority:

The governor’s plan for reopening is based on the idea that regions can certify that they have surge capacity. If there were to be a statewide surge later in the year, OHA would recommend steps to the Governor to mitigate—before hospital capacity were overwhelmed. These could include closing regions or counties back down. Meanwhile, the testing, case identification and isolation, and contact tracing should significantly suppress the spread of COVID-19. Through this work and with other data streams like hospitalizations for COVID-19 at a regional or county level, we’d anticipate having early warning if the cases start to trend upwards.

I obviously hope Oregon does avoid a more severe spike this fall or winter, and based on the precautions laid out in Governor Brown’s phased reopening plan, I think that’s likely to be the case.

But pandemics are unpredictable, and even the best-laid plans sometimes go awry. So I’d still like to hear more from the governor about her plan for a worst-case scenario.

Goal #4: Improve containment strategy

The governor’s containment strategy checks many of the boxes that experts have been laying out for weeks now:

  • It advises Oregonians to wear face masks whenever they’re around other people, especially indoors.
  • It requires counties to have a plan for offering shelter to people who test positive and can’t self-isolate at home. 
  • It requires counties to have a plan for contact tracing, plus enough staff to execute that plan. 

I could quibble with a few of the details, especially when it comes contact tracing. (I’d like to see the state push its goal of 800 contact tracers even higher, to meet the high-end public health recommendations.)

But as long as Oregonians continue to limit their social contacts and comply with wearing face masks, the odds of the outbreak spiraling out of control statewide seem pretty low.

That said, even small spikes in cases can cause serious damage if they happen at nursing homes or other long-term care facilities that account for more than a third of all Covid-19 deaths in the U.S.

That’s why need to keep the pressure on public officials to make sure all vulnerable people — from seniors in nursing homes to workers at Amazon warehouses — have the protections they deserve.

And it’s why all of us need to do our part by wearing masks, avoiding large groups, washing our hands, and practicing social distancing, even after this stay-at-home order is lifted.