COVID-19 bursts into Oregon, disgusting young adults and forcing back to restrictions

For months, Susannah Sbragia waited her turn for a COVID-19 vaccination while Oregon teachers, older adults and others with higher priority got theirs.

The city’s 55-year-old finance director was meticulous in wearing a mask and washing her hands during the pandemic. She worked at home and kept fit with daily walks and dancing lessons on YouTube with her husband.

But a week before her shooting date on April 22, she felt exhausted and started aching all over. A test confirmed COVID-19. She gasped during an ambulance ride to Samaritan Lebanon Community Hospital, a 25-bed medical center in a former logging and sawmill town 80 miles south of Portland.

Sbragia became one of hundreds of patients hospitalized in a COVID-19 outbreak that hit Oregon, alarming officials, who criticized the open-state measures in reverse. Doctors say the patients they see are younger, sicker, and often without underlying medical conditions, suggesting potent variants may be partly to blame.

Governor Kate Brown on Friday placed 15 counties in an “extreme risk” category, banning indoor dining at restaurants and limiting the number of patrons at gyms. She said returning to restrictions could save hundreds of lives and prevent up to 450 hospitalizations over the next three weeks.

“What I cannot do is bring back the life of someone lost to this virus,” Brown said at a press conference on Friday. “That’s why, as difficult as it may be, we need to act immediately. It really is a race between variants and vaccines. “

She imposed the restrictions after cases rose 51% in two weeks, the fastest increase in the country, and hospitalizations jumped by more than a third. As cases declined in much of the rest of the country, Oregon swung in the opposite direction.

The situation is far from dire. The state’s average daily case count over the past week was 19 per 100,000 population – half of what it was during the state’s peak at the end of last year and in the middle of range at the national level. In Michigan, where a record number of children have been hospitalized, the average daily number of cases is now 45 per 100,000.

But the worry is that the situation in Oregon could quickly escalate.

Officials were particularly concerned that more than 300 people remained hospitalized with COVID-19 in a state with relatively few beds available.

The causes of the outbreak in Oregon – a state that had the third-lowest cumulative case rate in the country and the fourth-lowest death rate – are something of a mystery. Experts are trying to determine what are the state’s own factors.

Variant B.1.1.7, first identified in the UK, accounts for more than half of recent cases in Oregon. Hearing about the circumstances of the Sbragia infection, Chunhuei Chi, director of the Center for Global Health at Oregon State University, said in an interview that she may well have this variant, given its highly contagious nature.

But he noted that B.1.1.7 is widespread, as the coronavirus spreads around the world. Instead, he said, the seeds for Oregon’s push may have been sown months ago, when the state slowly began vaccinations.

“I suspect it might have helped,” he said. “We are looking at several factors contributing to this surge, including variants and people slacking off due to pandemic fatigue and feelings of security or hope associated with vaccinations.”

In another anomaly that Chi says could be partly to blame, Brown shifted school teachers ahead of citizens 65 and older for vaccines in January. She said she decided to speed up the opening of schools, but critics saw it as proof of her loyalty to the teachers’ union.

Oregon state epidemiologist Dr Dean Sidelinger said Brown’s success with the restrictions may help explain the outbreak. Keeping the number of cases low has left the state with a larger population without natural immunity to COVID-19, he said.

“The success we have had in preventing disease and serious illness means we have to compensate for that with vaccination, and that takes time,” he said.

But Chi and Dr. Katie Sharff, an infectious disease specialist at Kaiser Permanente in Portland, were skeptical. “I think that’s a small part of why cases are increasing in Oregon,” Sharff said.

She pointed out that the Upper Midwest, including Michigan and Minnesota, have seen previous surges and yet they are seeing another big wave. Vermont, Maine and Hawaii have had low infection rates throughout the pandemic, yet their case rates continue to drop, she noted.

Sharff noted that frail seniors remain largely healthy during Oregon’s current push, indicating that the vaccines have been effective. “Unfortunately, there is a fraction of the population who have not had access to the vaccine or who have chosen not to be vaccinated, and this is what we see in our hospitals,” she said. .

She believes that the push comes in part from the too rapid lifting of certain restrictions by the authorities. Allowing the resumption of wrestling and other indoor contact sports for young people was premature, she said.

But business owners have been pushing for the reopening, and the Oregon Restaurant & Lodging Assn. opposes Brown’s new restrictions. “This is an incredible setback for thousands of companies in our industry,” said Jason Brandt, president and CEO of the association.

Lebanon, a city of 17,000 people located at the foot of the hills of the Cascade Mountains, was the site of some of Oregon’s first coronavirus infections in March of last year, a week before Brown issued a statewide stay-at-home order. The disease killed eight residents of a veterans long-term care facility near the hospital.

The hospital, which serves a population with high rates of diabetes, lung disease, addiction and mental health issues, admitted its first COVID-19 patient on June 18. said Dr Bill Barish, the hospital’s medical director.

“We’re used to doing things and helping people, rather than just watching them go around the drain,” he said.

But the staff were resourceful, said Barish, describing a team of five who rushed into the intensive care unit at the start of the pandemic to pump air into the lungs of a COVID-19 patient in the in their sixties they had intubated. “It was like trying to ventilate concrete,” said Barish, who saw the man’s oxygen levels drop shortly after telling his family he was recovering.

Schyler Sprague, a young respiratory therapist, ran to her office and came back with a “PEP,” a valve that increases pressure from the airways to the lungs.

“She saved his life,” he said.

The highest COVID-19 hospital admissions occurred in the summer, with five or six patients hospitalized at a time, months before the number of cases in the state peaked. Admissions have been comparable during the current outbreak.

Sbragia, who was released from hospital on Friday, belongs to the age group between 50 and 64 who saw the largest increase in hospitalizations statewide during the outbreak.

“You’re seeing a decrease in how older people are affected,” because a lot of them have been vaccinated, Sidelinger said. “But we have also seen an increase in the number of younger adults, in the 18-34 age group.”

In Portland, for example, a previously healthy woman in her 30s was admitted to hospital this week with severe illness from COVID-19 after being infected by her child.

In the town of Bend, in central Oregon, the St. Charles Medical Center exceeded 90% of its capacity during the surge. But Blue Mountain Hospital in Grant County, which had the third highest case rate in the country this week, has not been busy as people are managing to recover at home.

Oregon has little margin for error, being the state with the fewest hospital beds per capita. In good times, the ratio is seen as a plus, indicating efficient use of resources.

Now the race is on statewide to vaccinate as many people as possible, hoping to make the current surge the latest in the state. But the campaign is meeting resistance, especially in rural areas, and counties with the lowest vaccination rates have the least demand for vaccines.

At the Lebanon hospital, doctors and administrators defended vaccines. But not all staff are interested. Two housekeepers who clean and disinfect rooms where COVID-19 patients are treated said they had no plans to be vaccinated.

“I see people getting sick after being vaccinated,” said Barbara Strassman.

“I feel like we were born so healthy that there is no reason to put things in our bodies like that,” said Heather Atterberry.