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Despite positive performance on public health indicators, leaders fear impact of wildfires isn't realized

Clackamas County leaders say wildfires and poor air quality are skewing the Portland metro region's COVID-19 infection numbers that show hope for moving into Phase 2 reopening.

COURTESY PHOTO - At a Clackamas County Red Cross event in May, Brendon Stewart prepares to draw blood from John Parker with Mick Wilson in the background. Clackamas, Multnomah and Washington counties continue to meet only four of the six health indicators laid out by Gov. Kate Brown and the Oregon Health Authority. The region is meeting metrics in the categories of emergency room visits, rate of new cases, rate of hospitalizations and percentage of cases followed up on in 24 hours.

Dr. Sara Present, county health officer, told the Board of County Commissioners on Thursday, Sept. 17, that the region's rate of sporadic cases is fairly steady, but there appears to be a bit of a downward trend.

Present said that despite an increase in emergency room visits for asthma and smoke-related issues, the county and region both continue to show adequate hospital capacity at this time.

"The goal for Phase Two reopening is for that to be 30% or under and we're (at 38%), so I also find that to be reassuring," Present said.

Despite these encouraging metrics, both Present and county Public Health Director Philip Mason-Joyner are skeptical that the county and region's performance on these health indicators will continue, due to uncertainty around the wildfires that have caused mass evacuations and poor air quality, forcing many indoors.

"I would say our metrics related to COVID-19, they look pretty good, but we really don't have good situational awareness or clarity on what the metrics are going to look like from the impacts of everything that we're experiencing right now, and what these metrics could look like in the next several weeks," Mason-Joyner said.

County health officials continue to meet with leaders in the governor's office and Oregon Health Authority on the county's performance on baseline requirements for Phase One and Phase Two reopening and how science-driven changes to those requirements can help different businesses in the region reopen.

"It was helpful that right before the fires they reopened playgrounds and pools, but now we're certainly not recommending those activities," Mason-Joyner said. "But it has been helpful to see the state be a little more flexible in working with us to try to really evaluate what can be opened and what can't be. We're talking about fall activities, and as we get through this air quality and wildfires, what are these opportunities?"

Mason-Joyner and Present are still quite concerned about the impact large gatherings will have on community spread in the coming weeks as the incubation period for Labor Day weekend hits, as well as the coming months with holiday gatherings and other such events. The other top concern is in supporting local school districts as they navigate reopening for instruction and meeting state criteria.

"Our (3.9%) positivity uptrend is consistent with an uptrend statewide," Present said. "This indicator really looks at testing capacity, so this suggests we want to try to increase testing. That's certainly been complicated by the wildfires and access to testing. However, that one is one of the metrics that affects our school reopening to in-person learning."

According to Present, the county is showing positive trends in the case rate per 100,000 — one of the metrics that need to be met for limited, in-person K-3 learning. Present said the county has remained under 30 cases per 100,000 for the past two weeks, and she expects that to continue for a third week. However, if that number goes above 30, schools would have to go back to distance learning, so she's recommending local schools wait and see what happens in two weeks.

"I spoke with our schools, and I wouldn't be surprised if there was a bit of a bump," she said. "So I would recommend waiting just a bit longer to make sure that is a trend, so they don't start for one week and then have to go back down."

The other concern, she said, is that the percent positivity statewide has gotten above 5%, and she believes that the state now has to restart the clock on the metric that calls for three weeks with percent of positive cases below 5%.

County Chair Jim Bernard said that he and the other tri-county chairs held a meeting on Sept. 16 with their public health officials and discussed how the three counties should be working together toward Phase 2 reopening.

"Right now none of us have been successful on the six metrics," Bernard said. "So we're a ways out. The other concern is that testing laboratories and sites have been closed, so we're going to have a backlog of tests that we'll have to deal with. The fact we've had a lot of (evacuees) leaving their homes and going somewhere else, either with family or in a trailer in a parking lot, the impact of that could be two (to) three weeks out."

Bernard said that despite these concerns, the tri-chairs remain committed to getting the region into Phase 2 reopening, but whether or not another unforeseen emergency will cause that goal to be delayed again is yet to be realized.

"We're very much dependent on what the governor determines to be the metrics, because Phase 1 is not exactly like Phase 1 was in the beginning. It's something different," Bernard said.

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