Gov. Kate Brown and the Oregon Health Authority announced new COVID-19 restrictions Friday, following several weeks of unprecedented spread. They’re the strictest measures state has created since the initial “stay home, save lives” measures were implemented in March.
Brown said Oregon has done a good job limiting the spread over the past seven months but now needs to go back “on the offensive” against the virus. One big challenge: The recent increases are not the result of large workplace or school outbreaks, but instead suggest there’s widespread community transmission of the virus, in small social gatherings or one-on-one meetings.
Thus, counties with exceptionally high COVID-19 rates will have a two-week “pause” placed on social gatherings, from Nov. 11 through Nov. 25. Businesses in those counties are encouraged to have employees work from home when possible, restaurants and bars are asked to limit dining to outdoor seating or take-out whenever possible, and businesses are asked to cap their total capacity at 50. Visits to long-term care facilities will be paused. People are also asked to limit their private gatherings, too.
“The data is showing that not all Oregonians are listening,” the governor said. “... Let me be very clear: For this two week pause, please, please, please limit your social interactions to your own household.”
Brown said more restrictions could be coming in two weeks if cases continue rising. State leaders worry if people do not change their behavior, the spread of COVID-19 could grow out of control.
“The two-week pause is intended to be a wake-up call or a call to action,” said Charles Boyle, the deputy communications director in the governor’s office.
The new restrictions come into effect once a county has a rate of 200 infections per 100,000 residents for two weeks or more. There are separate metrics for smaller, rural counties. Currently, five counties — Umatilla, Malheur, Marion, Jackson and Multnomah — have crossed the 200-case threshold and will be put under the increased restrictions.
Five other counties — Washington, Baker, Clackamas, Union and Linn — are also seeing cases rise at a rapid rate. OHA plans to reevaluate its numbers on Monday and state leaders it’s likely some or all of those counties will also be added to the pause list.
Just because a county isn’t on the pause list doesn’t mean people should continue their lives as normal.
“Those policy changes are meant to model the changes we’d like to see Oregonians make with social gatherings as well,” Boyle said.
In the past, officials have raised concerns that looser COVID-19 restrictions in public could cause people to take fewer precautions in their private lives. They hope that imposing new public restrictions will convince people to take more precautions in their daily lives.
A handful of other states announced new COVID-19 restrictions starting this week.
Rhode Island and Massachusetts have enacted curfews that forbid all non-essential travel after certain hours. Connecticut announced tighter restrictions on private gatherings and, although there is no curfew, they are encouraging residents to stay home after 10 p.m. Other states have announced new restrictions on bars and restaurants and strengthened mask mandates.
On the edge of exponential growth
The new call for action comes as cases climb across Oregon, with a record of 805 new cases reported Thursday. On Friday, 770 new cases were reported.
For the week of Oct. 26-Nov. 4, Oregon recorded 3,542 new cases of COVID-19. That’s the highest number yet. More concerning, it’s 34% higher than the previous week’s report. While weekly totals have been trending upward for over a month, this is the largest increase from one week to the next seen in recent months.
“It’s definitely concerning in terms of potential for exponential growth,” said OHA public health director Rachel Banks.
State epidemiologist Dean Sidelinger doesn’t think we’ve hit that tipping point yet, but “as more people are out there with the virus, that exponential piece will happen.”
The numbers Oregon is seeing are far beyond what OHA was expecting, even in its worst-case scenarios.
Every two weeks, OHA releases a disease model in conjunction with the University of Washington’s Institute. This model isn’t a prediction, but it is useful for planning purposes. Public health officials use it to plan for things like surges in hospital capacity.
The latest model was released on Oct. 29, and based its projections on cases and trends occurring up to Oct. 10. That model expected case counts to continue to rise. But it didn’t include data for the last few weeks of October, a period that included several days of record-breaking case loads. When it was released, the modelers cautioned that it could underestimate future cases.
That fear seems to have been realized. The worst-case scenario presented in the model assumed that transmission would rise by 5%, and Oregon would be seeing 520 new diagnosed cases each day by Nov. 19.
On Nov. 5, 805 new cases were diagnosed: far more than a 5% increase in transmission. Sidelinger isn’t sure where that puts the current effective reproduction rate (Re) in Oregon, but he acknowledged that it’s likely higher than the model predicted, which was an Re of around 1.2. That means that each person who gets infected will pass the virus on to more than one person.
“We expected increased numbers,” Banks said, but not numbers this high. She said that the way these cases are rising is “definitely concerning.”
Banks said the state’s hospitalization numbers are even more concerning.
One of the goals of Oregon’s epidemiological models is to predict hospital capacity needs. But when cases are rising this fast, models can be outdated by the time they’re published. That can pose additional challenges for public health officials, who want to impose restrictions before full hospitals are inevitable.
Oregon officials think there’s still time to slow the progression of the pandemic in Oregon. But with little ICU capacity left, they need to see results fast. “If we don’t stop the spread, further closures are imminent,” said Brown.
“Our hospital census is the highest it’s been since the start of the pandemic,” Banks said. “In the metro area, hospitals are reporting that they are at or above 90% capacity.”
The hospitals are meeting with OHA Friday to discuss how to address the rapidly-filling ICU beds.
Correction: Nov. 6, 2020. An earlier version of this story incorrectly attributed quotes from Charles Boyle to a different person. The story has been updated.