Multnomah County is making progress toward meeting requirements to start reopening, officials said Wednesday, but they also acknowledged some areas where it’s falling short. Most of the benchmarks they’re struggling to reach disproportionately impact communities of color.
Multnomah County Public Health Director Rachael Banks told county commissioners during a board meeting that there are enough available hospital beds to handle an increase in cases. But concerningly, hospitalizations started to increase on May 31, which is the last day they currently have data for.
“We expected to see an increase in cases,” Jennifer Vines, the lead health officer for the tri-county area, told the commissioners.“The whole premise of reopening was built on the idea that people would be mixing, and we’d need more testing and contact tracing.”
That increase in bed use and transmission is not due to recent protests, Vines said. The data isn’t recent enough to reflect that. Instead, she speculated that nearby counties re-opening could cause cases to increase in Oregon.
Leaders from communities of color have been asking Multnomah County to release data on testing and transmission by race for months. Initially, according to the health department, that data wasn’t good enough. Now that it’s improved, they’ve begun to publish charts that break the COVID-19 pandemic down by race. The data is stark: Initially, most infections and transmission were among white people. But since April, transmissions in white people have stayed particularly low. But cases in communities of color have been rising.
"It's particularly striking if you know the demographics of Portland," said Kim Toevs, who leads the county's infectious disease team. Depending on the metric, about 70% of Multnomah County is white. But only 16% of new cases on the most recent date data is available, May 31, were white.
It’s possible that bump was due to an increase in the availability of tests. But the health department also presented data that broke down testing by race. And while testing has risen for all demographic groups, there are still significant racial disparities.
If cases are rising in Portland’s communities of color, and if those same people still do not have equal access to testing, it raises questions about the viability of reopening.
“Our hope and our plan is to have a good enough mitigation effort in place through contact tracing through the ability of testing,” said Vines. “There’s no perfect time for re-opening.”
Vines said the health department is watching those numbers closely and is prepared to re-evaluate or change their plans should the recent increase in cases be part of a larger trend. She also emphasized that while cases are increasing, the overall numbers remain very low — a few dozen people out of a population of around 800,000.
Toevs added that the virus isn’t the only threat to public health, “The racial and ethnic disparities for COVID-19 are not absent for other health issues.” And some of those health issues have been exacerbated by the economic and social struggles that come with a lock-down.
Some commissioners said the availability of public dollars is also a barrier to reopening.
“If we don’t have the funds to do the plans, we can’t responsibly reopen,” said Commissioner Susheela Jayapal. “The most costly parts of the plan are about equity.” Those are things like testing in communities of color, additional resources for people who can’t afford healthcare or who can’t self-isolate if they are infected, and resources for people who lose income while quarantining.
“I’m really concerned about barreling forward if we don’t have the resources to do what we need to do,” said Jayapal. If that happens, she said, Black and indigenous communities and communities of color will be hurt the most.
Mask use also emerged as a hot topic. Commissioner Sharon Meieran stated her intent to put forward a policy making face masks mandatory.
“We need to decrease the risk so that it is as low as possible as we move towards reopening,” said Sharon Meieran.
Other board members pushed back, saying that requiring masks would require enforcement, and that could lead to more over-policing in communities of color.
“I will not support a policy that will encourage police to stop Black men for not wearing a face cover,” said Commissioner Lori Stegman.
That was echoed by the Multnomah County Health Department. It has been working with communities of color on their reopening plans, and across the board, leaders of those communities have asked that masks not be mandatory.