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OHSU forecast sees increase of virus cases rivaling 'darkest days' of Oregon's winter surge.

PMG FILE PHOTO - Oregon hospitals could see an increase in COVID-19 cases, according to an OHSU forecast.The COVID-19 delta variant is spreading so fast that it will hit most of the state's unvaccinated population before the six weeks needed to be fully immunized if they were inoculated now.

"We are looking at a giant wave that is all taking place over the next four weeks," said Peter Graven, a top data scientist at Oregon Health & Science University.

Graven presented a forecast Tuesday, Aug. 10, showing about 1,100 people with COVID-19 will need hospitalization by the time the current wave of infections peaks around Sept. 7. Oregon could be as many as 500 staffed hospital beds short of what will be needed to treat patients hospitalized for any reason.

ocbOregon on Tuesday reported 635 COVID-19 cases in state hospitals, setting a new record for the pandemic. The previous high was 584 people on Nov. 30, 2020. The current wave has already set new records for infected patients in Intensive Care Unit beds. On Tuesday, there were 164. About 90% of those hospitalized are unvaccinated, Graven said.

Gov. Kate Brown said she will have an announcement about "statewide indoor mask requirements" on Wednesday, Aug. 11.

The speed of the delta variant has astounded health officials, who said each infected person infects eight other unvaccinated people. Previous versions of COVID-19 didn't exceed a 1-to-3 infection ratio.

COURTESY PHOTO - Dr. Renee Edwards is chief medical officer of Oregon Health & Science University. "Being vaccinated now is too late for this surge," said Dr. Renee Edwards, chief medical officer of the Oregon Health & Science University.

Edwards said observation of patients suggests the delta variant makes unvaccinated people sicker than earlier versions. Even though many patients admitted to the hospital are in a younger 30 to 50 age group, the overall result has been rapidly increasing numbers of cases requiring more and longer medical care.

Exceeding the 'darkest days'

Brown announced late Tuesday that all executive branch employees of the state must be vaccinated by Oct. 18. This includes state agencies under the governor's control. She said she hoped the legislative and judicial branches would follow suit.

While other states and cities have recently reintroduced mask requirements, Brown has steadfastly stuck to a voluntary effort. OHA officials have said in recent weeks that efforts seen as coercion in communities that have opposed Brown's earlier actions or don't support vaccination and masking, would not make additional inroads at this point in the pandemic. The runaway hospitalizations and spillover of effects across the state have led to a reassessment by Brown and OHA staff.

"Oregon is facing a spike in COVID-19 hospitalizations — consisting overwhelmingly of unvaccinated individuals — that is quickly exceeding the darkest days of our winter surge," Brown said. "When our hospitals are full, there will be no room for additional patients needing care — whether for COVID-19, a heart attack or stroke, a car collision, or a variety of other emergency situations."

Because the main vaccine used in Oregon, made by Pfizer and Moderna, requires two shots a month apart and a two-week waiting period afterward to ensure full immunity, medical experts said it is already too late for the unvaccinated to rely only on shots. They need to stay at home and keep social distance efforts in place. Everyone should wear masks indoors to tamp down the spread.

Brown's planned announcement could mean the end of her policy since June 30 to let each of the state's 36 counties monitor public health and for county commissioners to impose restrictions if needed.

The policy stayed in place in recent weeks despite increasing infection rates in counties with low vaccination numbers. OHSU officials said infections were swamping hospitals in Josephine and Jackson County, while a country music concert in Pendleton fueled a spike in new infections.

Despite the spike in cases, the only county to impose mask requirements has been Multnomah County, where the infection rate last week was half of the state average.

Vaccine numbers slow

Brown has sharpened her criticism of inaction by local officials in areas with spiraling COVID-19 caseloads, especially as patients in eastern and southwestern Oregon had to be transferred to hospitals in Portland, Salem, Bend and out of state. Brown on Monday, Aug. 9, confirmed reports from around the state that she had contacted local officials in areas with rising cases to ask what they planned to do to slow the spread.

"We have a finite number of staffed hospital beds in Oregon," Brown said in a statement Monday. "If local leaders continue not to act and their regional hospitals exceed their capacity, it will impact hospitals all across the state."

OHSU has had to reject some requests for transfers in order to keep a minimum number of beds available for emergency needs, including the "normal" mix of heart attacks, traffic accidents and other medical issues requiring hospitalization.

Oregon has the lowest number of hospital beds per capita in the nation, according to a 2018 report from the Kaiser Family Foundation. Edwards, the medical director for OHSU, would only say the state has fewer than most states per person. Staffing hospitals and other health care has become a major issue during the pandemic.

OHA reported Monday that 9.5% of all COVID-19 tests were turning up positive. That's nearly twice the 5% level OHA has said is the highest rate that keeps infections from growing out of control.

Only Grant, Lake and Sherman counties were under the 5% mark. Multnomah County, the state's most populous county with 829,560 residents, was at 5.3%. Nine counties showed positive test rates above 18%, with Morrow at 29.2%. Umatilla County was at 26.4%. Infection rates topped 18% in Crook, Douglas, Curry, Jackson, Josephine, Malheur, and Union counties.

Despite an uptick this month, vaccination levels in Oregon have slowed to an average of less than 6,000 shots per day. That's down from a peak of 45,000 per day at some points in April.

Anti-vaccination measures have also hamstrung efforts in the state. The Kaiser Health Network, a health news agency, reported Tuesday that Oregon is one of seven states with some kind of law that slows or prohibits the ability of health officials or medical supervisors to require vaccination of workers.

Oregon legislators passed a law in 1989 that specifically barred employers from requiring medical and health workers to be vaccinated. Officials and state lawmakers have been debating over the wording of the original legislation and whether it extends to statewide orders by government officials in an emergency. Democratic lawmakers said they would introduce legislation in the 2022 session to remove the ban.

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