Lake County’s vaccination rates are some of the lowest in the state. What’s behind the numbers? Charlie Tveit, Lake Health District CEO, joins us with details on the region’s vaccination status.
Dave Miller: This is Think Out Loud on OPB. I’m Dave Miller. A few weeks ago, Oregon Gov. Kate Brown laid out what needs to happen for most COVID 19 restrictions on businesses in the state to be lifted. Seventy percent of Oregonians 16 and over have to have gotten at least one dose of a COVID-19 vaccine. We are around 60% right now statewide and some counties are above that and some are way below it. No county has a lower rate of eligible vaccinated residents than Lake County, where only 33% of people 16 and up have gotten a shot. We wanted to get a sense for why that is and what is being done about it. Charlie Tveit joins us to answer these questions and more. He is the CEO of the Lake Health District. Welcome to Think Out Loud.
Charlie Tveit: Thank you.
Miller: How do you explain, first of all, in the big picture, that overall the vaccination rate of 16 and up in Lake County is about one in three residents?
Tveit: Well, first off, a lot of people are anxious about getting vaccinated, whether it’s for COVID or for any kind of vaccine. And there’s a lot of lack of good clear information on the value of that. Lake County has been uniquely blessed in that we had very few cases throughout the last year and we were a late starter in finding any cases that were positive till late in the summer. So for a lot of people that live here, it isn’t quite as impressive as it is in an urban setting.
Miller: So in particular the fact that that people there didn’t see a visible huge outbreak or or a jammed up ICU in the hospital there, that has played a role?
Tveit: I think it helps a lot for people in rural settings to not make it as big of a concern as it is in an urban setting. Yes.
Miller: So I mentioned the one in three vaccination rate for people 16 and up, there are plenty of ways to slice these numbers. One of them is looking at the vaccination rate for the most vulnerable people for people 65 and over. Even so, the vaccination rate is only at 56%.
To put that in perspective, in Multnomah County, it’s 86%. And in Deschutes County it’s 93%. And again, this is for the age group that is most at risk. How do you explain that number in particular?
Tveit: Well, it’s always difficult to try and convince someone to get care that they don’t believe is necessary. The people that are truly most vulnerable have underlying conditions. They’re the ones that are quickly able to get a vaccine and we offer it in lots of locations. I think that for many older people that may live alone or may live out on their ranch, they feel that their risk isn’t as great as it is, say in Multnomah County. So I’d like to see the rates higher, but not all people are anxious to get that.
Miller: How much is access an issue? Lake County has the third lowest population density in the state. And you mentioned that some people are living on ranches or maybe not interacting much with other people. Some people live very far, say from Lakeview.
Tveit: Good point. An amazing thing is that there’s about 8,200 people in our county and about 6,000 live within a 40-mile distance of Lakeview. But a large portion of the population lives in the area of Christmas Valley and that’s 60 miles from La Pine and 100 miles from Lincoln. There are a long ways away. So getting access to vaccines, of course, we worked very hard to provide that in the more remote settings, but it is hard for people to drive a great distance to get a vaccination.
Miller: Another aspect of the demographics here is that Lake County is overwhelmingly white and very conservative. Nationwide, that is a specific demographic that has been much less likely to get vaccinated than for example, white progressives. How much do you think that politics is playing into your county’s vaccination rate?
Tveit: Well, I’m not sure if it is politics per se, as much as a concern for truly getting accurate information about the vaccines. There are a lot of people that are concerned about its efficacy or its long term impacts. Our approach has been to try and provide as much accurate information as we can and not try to frighten people. I think that that seems to work a lot better, especially with hesitancy.
Miller: What do you mean by trying to not frighten people?
Tveit: I think many people in this last year have been very overwhelmingly frightened by wearing masks and being told to hide and stay away from others. That in and of itself causes people to be very concerned about the impact with others. And so people do stay away. We’re certainly seeing that where people have been afraid to come to the hospital for care. And now we’re seeing the results of delayed care. And it’s not pretty.
Miller: That’s actually something that we heard about literally a year ago — concerns that people were delaying regular check-ins about ongoing health problems or mammograms or getting blood work done or making sure that their heart medication was still doing what it was supposed to — and there were fears in April and May of 2020 that that would lead to more serious health issues down the line. You’re saying that that has actually come to pass?
Tveit: Absolutely. A terrifying report from our radiology group that provides service to our health district in our hospital estimated that in Central Oregon, 10,000 patients did not get their mammograms in this last year, 10,000. And now that they’re beginning to come back, the pathologists are saying they’re seeing frightening results from not getting that preventative care. It’s of concern for us.
Miller: I want to go back to what you mentioned about masks and people being afraid when they saw people wearing masks or being afraid because they were told they should wear masks. I got an email just this morning from somebody who said that when he was in Lakeview in the spring, neither patrons nor staff at restaurants were wearing masks and he added that people at one restaurant told him if he wanted to come in, he had to take his mask off. What has mask compliance been like in Lake County throughout this pandemic?
Tveit: Well, I think initially there was resistance to wearing masks and then people became much more comfortable wearing them and now that the CDC has been more relaxed in its approach, people are quick to try and remove them. But yes, there have been instances of people resisting wearing masks sometimes just because they like to resist. But I think most people have been compliant.
Miller: What has it been like for you in the health district in the Lake Health District? It’s sort of a confusing entity that gets public money and has a public oversight and manages the hospital, but it’s not exactly a part of the county. But I can imagine it would be seen as or that you could be seen as connected to the government. Given that, what’s it been like for you to try to tell Lake County residents that they can trust this vaccine if, to some extent, the antipathy towards it is tied to an anti-government sense?
Tveit: As a health district we are a hospital, but we also have many other components. We have a long term care facility and assisted living. We provide home health and hospice service. We took on the responsibility of the county’s mental health and the county public health service. So we deliver a lot of the components of health care in our community. When we think about what the public is interested in knowing about care that they get, they rely on their practitioners to give them good advice. And, as a health district we give our practitioners as much information as we can, but they’re also very, very knowledgeable and do their own research. So the public listens very carefully to what their practitioners say, and that’s a key part of the message.
Miller: But how carefully are they listening to their practitioner? I imagine that many of those practitioners are saying get vaccinated and yet, we’re back to that initial number one in three people, 60 and over have gotten at least one shot. So it seems like the message is not being heeded. Isn’t that a fair way to put it?
Tveit: I’m not sure that the message is not being heeded. I think in many cases, practitioners give patients advice about their care but don’t demand they do one thing or another. Perfect example is smoking. Practitioners always advise people not to smoke and people still smoke. How do you change? That takes time and there are a lot of other complicating factors in it.
Miller: Last week, Gov. Brown and the Oregon lottery announced that vaccinated people are going to be automatically entered into a drawing. People could win upwards of $1 million dollars if they’ve gotten the shot. And there are smaller prizes as well at the local level. Do you think that might encourage people in Lake County who have so far been hesitant to actually get vaccinated? That’s obviously the reason for this lottery. Do you think it’s going to work?
Tveit: Good question. I would hope that it has an impact. I know that it appears to be working elsewhere. If it does, and that’s a reason for people to get vaccinated, great. It’s not a proven fact, given that when the Red Cross started paying people to donate blood, the facts are that donations went down. Most people get vaccinations because they believe it’s the right thing to do for their own health or for the safety of others. I hope any incentive that is a valuable incentive will get more people to get vaccinated.
Miller: What do you see as the likely end point here? I mean, given the numbers now, it seems very possible that Lake County is never going to get anywhere close to a 70% vaccination rate. And in terms of the overall state population, the state can get to that point with or without Lake County’s 8000 or so people. That’s just based on the overall population of the state. So what do you think it could mean for Lake County residents if the overall vaccination rate within the county remains relatively low?
Tveit: I think because we’re such a remote county and people live in lots of to distant locations that you might see more people wearing masks in public settings, but when they’re outside they’re not going to be wearing masks. I would hope that with more and more information available, people will get vaccinated and then we’ll be into the fall and there will be boosters and it will become more of an accepted process. Just like we get other kinds of vaccinations.
Miller: You mean your hope is that if someone’s neighbor has gotten vaccinated, then the unvaccinated neighbor will say, oh it was fine for Billy, it might be fine for me?
Tveit: I think that always helps the process and some people have had reactions and have told others, and so that creates anxiety. But I think most people are rational, make good choices for themselves and for others and that as time goes along and people see that this is a safe vaccination, more people will get vaccinated.
Miller: Charlie Tveit, thanks very much for joining us.
Tveit: Thank you.
Miller: Charlie Tveit is the Chief Executive Officer of the Lake Health District.
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