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Multiple doctors and public health officials highlight COVID impact in Crook County, local response

PHOTO COURTESY OF ST. CHARLES HEALTH SYSTEM
 - Crook County Health Department Director Katie Plumb speaks at the online forum.

In an effort to improve communication about the COVID-19 pandemic, local health leaders teamed up to host a virtual forum last Monday evening.

The event was presented by Crook County Health Department, St. Charles Health System, Mosaic Medical, and Crook County Fire and Rescue. It was broadcast via the health department's Facebook page and was shown on St. Charles' YouTube channel.

"We are joining together this evening to increase local communication regarding how the pandemic is affecting us and what's being done in response," said Katie Plumb, the health department's director.

The online forum covered several different facets of the pandemic, highlighting current and past Crook County caseloads, vaccination rates, positive test rates, hospitalizations and deaths, and available COVID treatments. Several different local health experts spoke during the first 45 minutes of the hour-long session, before the event was opened to a Q&A portion.

Plumb led off the session with data that suggest the recent delta variant-fueled COVID surge has not yet hit its local peak. She noted that on the week prior to the forum, Sept. 26-Oct. 2, Crook County had 152 new or presumptive cases, the highest weekly total since the pandemic began in March 2020. In addition, Crook County had the highest positive test rate in the Central Oregon region during that timeframe (16.7%), exceeding the second-highest rate in Deschutes County by more than 5% and nearly doubling the overall state rate of 8.7%.

"While there is talk that the surge is on a down trend at the state level, we are not seeing that down trend yet in Crook County," Plumb said.

Dr. Maggie King, with St. Charles Health System, later added that in Central Oregon, September was "the worst month of the pandemic in nearly every respect." During that month, the region had the most COVID-related deaths (56), the highest number of positive cases, the most hospitalizations, the most hospital patient days, the most COVID-related emergency department visits, the highest vaccine breakthrough rate (23%), and the highest number of COVID-related pediatric hospital visits.

"We are certainly not slowing down," she said.

While the breakthrough case rate has risen from 12% of all COVID hospitalizations in August to 23% in September, Plumb the rate is still "very low." Consequently, local health leaders still consider vaccination the best way to slow spread of the coronavirus and ultimately put an end to the pandemic.

Dr. Natalie Good highlighted vaccinations rates across the Central Oregon region, noting that Crook County has the lowest rate in the tri-county area at 54.4%. Deschutes and Jefferson counties are nearly equal at 74.2% and 74.8%, respectively, although all three counties are lower than the overall state rate of 76.3%.

Locally, the age group with the highest vaccination rate is 70-79, and the younger the age group, the lower the rate.

Although vaccination rates in Crook County are lowest in Central Oregon, the community appears poised for a substantive increase.

"We have had a lot more people in the last month seeking the vaccine," Good said.

The surge in cases and subsequent hospitalizations has strained the St. Charles system. According to King, hospitals are dealing primarily with COVID patients to the point where elective procedures have been put on hold.

Health officials later took time to explain the COVID vaccines in greater detail, explaining how they work. Dr. Cynthia Maree said that mRNA vaccines such as Moderna and Pfizer "teach cells how to make a harmless piece of the spike protein for SARS-CoV-2."

"Cells display this piece of spike protein on their surface and an immune response is triggered inside our body," she continued. Maree added that the vaccines are not live viruses, so they would not cause COVID, and stressed that they don't affect or interact in any way with DNA.

The Johnson & Johnson vaccine is known as a viral vector vaccine, Maree went on to explain. It uses deactivated adenovirus vector with genetic code for spike protein. Host cells then encode the mRNA to use cell machinery to make the spike protein.

Plumb also highlighted a newly available treatment for certain COVID patients who are at risk for serious illness. St. Charles Prineville is partnering with Crook County Health Department to provide monoclonal antibody therapy. The therapy mimics the immune system's ability to fight back against harmful antigens, enabling the body to fight back against the COVID virus earlier, which may prevent them from getting sicker and needing to be hospitalized. It has emergency use authorization from the FDA.

The therapy is provided to people who have a positive COVID test and have a higher risk for moderate or severe COVID-19 disease. It is administered via four consecutive injections. It has been shown to reduce the risk of hospitalizations, emergency department visits and deaths by about 70%.

The injections are currently being administered by health care staff at Crook County Fire and Rescue.

Following the presentation portion of the forum, health leaders answered several questions posed by audience members, who were able to either submit questions in advance or type them into the live feed's chat box.

One person asked what would trigger a school closure and wondered at what point masks will no longer be required in schools. Plumb said that no current metric exists for triggering a school closure.

"At the local level, the health department works daily with our schools to monitor the situation," she added.

Regarding masks, Plumb said conversations are primarily taking place at the state level and at this point, local health leaders have not received any indication or clear statement of when the school mask requirement might get removed.

Another person said that they have already contracted COVID, and they wonder if they should still get vaccinated.

"The short answer is yes," Maree said. "We still recommend vaccination even after infection. The reason for that is that the evidence is really showing that vaccination with infection is much better protection than infection or vaccination alone."

Health leaders later fielded a question about why no COVID patients are getting treated with Ivermectin, an anti-parasitic medicine to treat animals but also given to humans in specific doses to treat certain ailments. The drug has recently received attention as a potential COVID treatment but that use has spurred controversy.

"It has not been FDA approved to use it in that way," Good answered. "There are some studies looking at Ivermectin use, but we are only using medications that are approved and shown to be effective for our patients."

A final question asked whether health leaders recommend vaccinating children once emergency authorization is granted to kids ages 5-11. Maree said that vaccination for that age group will be reviewed by the FDA on Oct. 26 and could receive authorization by the end of the month. If that happens, she does recommend vaccinating children, adding that she has already gotten her older children vaccinated.

"Yes, I definitely encourage you to vaccinate your children," she said.

Those who were unable to watch the health forum live can access the forum in its entirety by visiting St. Charles Health System's YouTube channel or on the Crook County Health Department's Facebook page.


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