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As testing becomes more widespread, health officials anticipate spike in number of positive results for the novel coronavirus

PMG PHOTO: DARRYL SWAN - Signs posted on the Scappoose Public Library message board announce the closures, meal services and other messages associated with the novel coronavirus outbreak. As of Wednesday, March 18, at 12:30 p.m. no cases had been reported in Columbia County. Despite the lack of a confirmed COVID-19 case in Columbia County as of the Spotlight's press time Thursday, March 19, the novel coronavirus and the respiratory disease it causes is present in the community, the county's leading public health official said.

"I want to caution people that we in this case, as public health ... we are considering the community to be bigger than the county. We know many, many people in Columbia County travel back and forth to Portland, they travel to Seattle, they travel across the state," said Mike Paul, Columbia County's public health director. "Right now, I would consider we have a case in our community even though we don't have a resident in the county who has tested positive."

In Oregon, the total number of COVID-19 cases climbed to 88 as of press time Thursday, March 19, with a death count of three. Cowlitz County, Washington, reported its first case on March 15.

With the number of cases expected to exponentially rise over the coming weeks and months, federal, state and local officials are urging social distancing measures to slow the rate of infection so as not to overwhelm the regional health care system, including a governor's decree to restrict gatherings less than 25 people and a ban on dine-in service at restaurants and bars.

Most — 80% — of those infected with the novel coronavirus develop mild to moderate symptoms and don't require outside medical care or hospitalization. In the event of a rapid spread and a spike in cases, there are simply not enough health care resources available to provide the higher level of care to those who need it, especially the elderly and those with underlying health issues who are more susceptible to serious complications from the disease.

"We really need people to understand why we need to limit our gatherings," Paul said. "It really just comes down to the fact that we can't overwhelm our health system. Those 20 percent who have more than moderate to mild will need higher levels of care."

Paul said overwhelming our health care system would be a "worst-case scenario," potentially resulting in scenes such as those in Italy where scant medical resources are being rationed to the COVID-19 infirm who have the greatest likelihood of survival. Oregon's total staffed hospital bed capacity was reported at only 6,601 in 2018.

Despite social distancing measures and the governor's orders, some groups continue to gather. At the national level, college-age spring break revelers had flocked to beaches near Tampa Bay, Florida, seemingly disregarding calls from top-level public health experts about the highly contagious coronavirus that can run asymptomatic for some people and be fatal for others.

Health officials warn that the new coronavirus has an incubation period of 2-14 days. For those who are younger and infected but not showing symptoms, they run the risk of transmitting the virus to older relatives and associates whose immune systems are less likely to fend it off.

"As government, we always want our recommendation to be voluntary, but as you've seen in other places, other counties and countries have moved to basically shelter in place," Paul said. "We don't make those orders lightly. Those are only done when we are certain we need to do that to protect people's lives."

"If we don't do social distancing, we can end up more like Italy," he added. "It's hard for people to understand that they, themselves, have the ability to save lives. I think that's really the point where we're at."

Testing

Nationally, testing for COVID-19 is expected to radically increase, including test results from a backlog of samples. As a result, Dr. Deborah L. Birx, response coordinator for the White House Coronavirus Task Force, said in a briefing Wednesday morning, March 18, that she anticipates a spike in the number of cases over the next 4-5 days due to more proficient testing.

Paul said anyone who believes they might be infected should prioritize halting spread of the virus.

"The first thing they should do is take precautions to protect everyone else in the household. They should be doing that anyway, but especially if they have these symptoms," he said.

Symptoms include coughing, shortness of breath and fever.

Next, Paul recommends those with infection concerns to contact their regular healthcare provider, either via phone or the internet. Clinicians have been authorized to order tests absent public health approval, and Paul expects that authorization to be further expanded.

Paul additionally urged residents to continue preventative practices, including social distancing by maintaining six feet of distance from other people, repeated and correct washing of hands with soap and water for at least 20 seconds or, in the absence of soap and water, use of a hand sanitizer with at least 60% alcohol content and to not touch your face, especially eyes, nose and mouth.

He also said residents should prepare their households for the possibility they will need to isolate a sick person and to shelter in place.

"We need to be able to continue to do that," he said of the preventative and preparation measures. "The other thing I want people to know is that, although these things sound probably very alarmist to a lot of people, we really want people to know that their actions, and the actions we take as a community, have the ability to save lives."

For more information about the novel coronavirus or COVID-19, visit the Oregon' Health Authority's website.


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