Umatilla County has the highest COVID-19 case rate in Oregon. It also has one of the lowest vaccination rates in the state. And the hospitals in the region say they’re seeing a surge in coronavirus cases. Joseph Fiumara, Public Health Director of Umatilla County, joins us.


This transcript was created by a computer and edited by a volunteer.

Dave Miller: From a public health standpoint, all the numbers in Umatilla County are looking bad right now. The County still has the highest overall rate of COVID-19 cases, one of the lowest vaccination rates and increasing hospitalizations. Joseph Fiumara is the County’s Public Health Director. He joins us once again with the latest. Good to have you back on the show.

Joseph Fiumara: Glad to be back. I wish it wasn’t under these circumstances.

Miller: What numbers are you paying the most attention to right now? I’m curious what metrics matter the most to you right now.

Fiumara: There’s two pieces. One is the number of cases last week we identified [which were] 472 cases, the highest we’ve seen since the start of this pandemic. This is higher than we’ve seen in either of our previous surges so far. And then we’re really worried about some of the hospitalization numbers. Specifically in our Region, Region Nine, through yesterday [Monday, August 1], there were only three open ICU beds in our Region.

And along with that [are] reports from providers that as they attempt to do transfers, for a variety of reasons, not all of them being COVID-related, they’re running into barriers. They’re running into complications. There was a media report last week that our local hospital here in Pendleton had to connect with 15 different hospitals before they finally were able to do a transfer out so that a patient would receive the care they needed.

Miller: That was last week. But based on the numbers you’re seeing, that shows no signs of abating. And in fact, it may even be getting worse?

Fiumara: So far it IS still getting worse each day. We watch these numbers and the number of beds available drops and the number of folks who are hospitalized for COVID goes up. And that’s a statewide thing that’s happening. But it’s definitely happening here locally.

Miller: Are patterns emerging in terms of who is getting sick right now?

Fiumara: So it’s not a recent pattern, right? But the pattern is still holding. Most of the cases we’re identifying are in their twenties. And it goes in descending order, 20s, 30s, 40s are the most numerous cases. That matches up with the least vaccinated age group as well. Most of our cases are happening to folks in their twenties and our least vaccinated age group in the County are also the folks in their twenties.

Miller: The numbers I’ve seen statewide or nationwide, in terms of the number of unvaccinated people testing positive, is in the 90′s in Oregon statewide. Is that what you’re seeing as well or, or even higher?

Fiumara: It’s in that ballpark and it’s changing a little bit unfortunately with the Delta-variant, which is not a surprise to us. We knew that number would probably drop a little bit. When we had looked at some analysis previously, we were sitting right at the same level. The State was putting out that around 92% of our cases were unvaccinated. I actually just finished [on Tuesday August 3] pulling some data for our cases from last week. Out of the 472 cases we had last week, it appears that 85% of them are unvaccinated.

Miller: I’m curious about what you attribute to the Whiskey Fest, one of the big events that happened recently? It’s not [Pendleton] Round Up, which is a lot bigger still, but how many people did take part, either traveling there or just went there from the region to Whiskey Fest?

Fiumara: A lot of people. It’s hard to put an exact number. I know the attendance. So if you’re looking at folks who bought tickets and attended in the event area itself, that number is just north of 12,000, which is a reduction. Original goals for that event were around 20,000 plus. Operators did reduce the capacity because of concerns around Coronavirus spread.


But when you add in support staff, staff, kickoff events in the downtown area which do not require a ticket the night before, all the businesses associated and drawing economic benefit from it, it’s a large number of individuals. And I’ve been cleared not to say that all of these cases are directly tied to that event. I do think that event has had a big effect on the cases we’re seeing right now. We saw a big jump in folks becoming sick in the 4-6 day period after the concert took place. And so far that increase has sustained from that point.

Miller: There was a shift after the early days of the pandemic, when the numbers got high enough that people in your position or at the state level said we don’t have the ability anymore to do contact tracing. It’s more like emergency time where we have to put our efforts elsewhere. Are we still in that phase where there can’t be robust contact tracing and you can’t actually figure out where people were and when most likely they actually got infected.

Fiumara: The term that’s been used for that is the surge policies. And we didn’t go to that in the past and we haven’t really moved to it now. And the intention behind that is that it’s going to take so long to do that full in-depth conversation with an individual and we need to get to the next one to notify them, provide the education, notify contacts, make sure people are aware of what to do. I’m not sure we’re in the same scenario where an individual receives a positive COVID test and does not know that they’re supposed to stay home, does not know that they’re not supposed to go about life as normal. And so I’m not certain that that contact from public health is as critical in that short timeframe.

Miller: Let me make sure I understand the double negatives there. So you’re saying that at this point in August of 2021, most people who test positive now, know they shouldn’t go to Walmart?

Fiumara: I want to say that information has been provided, right. A lot of information has been provided whether or not they’re listening to it. I’m not sure [the decision changes] whether they have received that call from my office or not.

Miller: So in other words, at this point, if maybe they’re going to go to Walmart when they’re sick, having a public health expert tell them not to, is not going to change their mind anyway?

Fiumara: Yeah. So we’re still following up on cases and we’re still trying to ask those important questions for that background information. But with the surge, we started two weeks ago and are behind on some of our cases. We have not been able to connect within that 24 hour period, which has been the standard that we’ve been aiming for.

Miller: The State and the County both put out recommendations that people once again wear masks in indoor public spaces regardless of vaccination status. To what extent, based on what you’ve seen or what you’ve heard or on actual clear data, are residents actually following those recommendations?

Fiumara: It’s hard for me to say at this point. What I’ve anecdotally seen as I’ve visited different locations around town has been a mixed bag. I’ve gone to one store where I was not quite the only individual in a mask, but just about. And I’ve seen a couple of facilities where it was about 50% masking versus not masking. One of the things that has come out of this is that as the recommendation went out among folks within social circles, we started getting calls. ‘Hey, so and so told me there was, we have to wear a mask. Is that true? Is there a requirement?’ It’s recommended. It’s not required. And we don’t expect that’s necessarily going to get 100% uptake. But what we DO think is there will be less pushback on the recommendation than on the mandate. And we’re hoping that that will come with more compliance than if we were to put a mandate in place.

Miller: That’s a fascinating sentence. If I understand it correctly, you think that a higher percentage of people will wear masks if they’re told they should, but not told they have to?

Fiumara: That is our hope. And we’re hoping there will be less vocal pushback from the recommendation, making fewer of those uncomfortable confrontations between folks who aren’t going to do it anyway.

Miller: Because what’s motivating the not wearing of a mask, in some cases, is the desire to not have the man tell you what you have to do. And is the thinking [then] that if this is coming from you and you’re being a good neighbor or doing something good, even if you don’t really think it makes sense, it’s still on you, you’re more likely to do it if [that’s] your basic mindset? I’m trying to understand the theory of how a recommendation would get more traction than a mandate. Patrick Allen, the Director of the Oregon Health Authority, singled out Umatilla County recently because of your vaccination rate. It seems pretty clear that the State wants masks to be required in Umatilla County, but they think that a mandate would be more effective if it came from local leaders. They’ve been very clear that if Governor Brown says to residents of Umatilla County, ‘you have to do this’, many residents there would, in a partisan way, just want to thumb their noses at the Governor. But meanwhile, County Commissioners there were quoted in the East Oregonian as being ‘skeptical’, skeptical about their own ability to enforce a mandate. They too have shown no interest in putting out a mask mandate. Where does that leave you?

Fiumara: Well? At the moment, that leaves us with that recommendation. There’s two sides to that coin. Local decision-making DOES carry greater sway with the local population most of the time. But it would not take long for us to lose any of that credibility we have if the sense on the streets is that this mandate is in place because the Governor said for it to be there, even if it came from the County. There really is no good way for the County to enforce it. I mean, even when the State’s mandate was in place, enforcement was a struggle. Enforcement was always a bit touchy. Not that it wasn’t happening at all, but it was a difficult thing to do with more resources, if you will, than the County has available.

Miller: What’s your current goal in terms of increasing vaccinations? These vaccines are extraordinarily effective at preventing severe illness and death. We probably are not saying that enough in the media because it’s sexy to talk about breakthrough cases. What are you doing to increase the vaccination rate that remains so low?

Fiumara: We’re continuing to double down on our messaging in our advertisements. We’re doing our best to make vaccinations available everywhere. We’ve got the County Fair coming up. I am worried about what the fallout from that is going to be, but we’re gonna have vaccinations at the Fair. We’re gonna have vaccinations at the parade. We’re partnering with some community organizations and we’re testing out some town hall types settings if you will. Although this first one can be virtual because of the twist everything has taken, but our health officer is going to make himself available for some questions and answers from folks in the public to try to cut through all of the misinformation that is out there.

Miller: This is either the third or the fourth time that you and I have talked and the situation continues to be grim as we reference at the beginning. What’s keeping you going at this point?

Fiumara: This is still what we think we need to do. The job right now doesn’t look like it did when I took it. But this is still the job we and everybody that works in my department signed up for at some level. And we very much, 100 percent, believe in what we’re doing. You mentioned it’s grim and it is. But there are flickers of hope that we see from time to time. Last week was the second week in a row [in Umatilla County] that we actually saw an increase in vaccination rates across the County. That’s a good thing. It’s disappointing that it takes the hospitals filling up and folks seeing loved ones pass away for some of those decisions to push across the line. But every individual who DOES get vaccinated reduces the chances of additional variants, reduces the chances of additional spread and severely reduces the chances of further death.

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