The Oregonian/OregonLive | April 14, 2020
Oregon Gov. Kate Brown on Tuesday announced the state’s initial framework for lifting statewide closures affecting millions across the state, saying she would take a slow, science-based approach to deciding how to move forward, without specifying when it would happen.
“I’m not going to put a date on this,” Brown said.
The governor said she wants five things to be in place before gradually lifting the unprecedented stay-at-home restrictions: A declining growth rate of active cases, sufficient personal protective equipment for healthcare workers, surge capacity in hospitals, increased testing capacity, tracing and isolating positive cases and strategies to protect vulnerable communities including nursing homes and the homeless population.
“This is only a framework,” Brown said in a press conference. “We have to be cautious or it will backfire.”
The announcement was short on details, leaving it unclear how Oregon would define how much protective equipment it needs, how an effective tracing program would be staffed and funded as well as when testing capacity is expected to increase. Brown said she didn’t yet know how much PPE the state needed, something that needs to be determined before lifting the suspension of elective procedures statewide.
The Oregon Health Authority is currently drafting an operations plan that will fill in those details and be ready in “days, not weeks,” Brown’s chief of staff, Nik Blosser, told The Oregonian/OregonLive.
The governor said her next steps include soliciting input from local leaders, consulting with the most affected industries, including restaurants and hair and nail salons, completing metrics for reopening and creating plans for testing, tracing and isolation. Coordinating with other West Coast states, Brown said, she will finalize discrete steps and guidelines for a step-by-step plan to reopen the state.
“It’s not going to be easy and it will take longer than we want,” she said.
State epidemiologist Dean Sidelinger said to reopen, Oregon would need the capability to do 15,000 tests a week, 2,100 a day, not the ability to test every Oregonian. Former Food and Drug Administration commissioner Scott Gottlieb has said the country should be testing 1% of its population each week. That would put Oregon’s target at about 40,000 a week.
Both Sidelinger and Brown incorrectly claimed the state’s testing capacity has been growing when it has plateaued. Sidelinger said Oregon has “substantially and gradually increased our testing capacity in the state.” Oregon has been reporting test results for about 1,300 people a day — for the last three weeks.
A health authority spokesman, Phil Schmidt, said the flat testing “isn’t necessarily a function of capacity,” because the judgment call for whether to test Oregonians lies with medical providers.
But the health authority is still actively discouraging testing of asymptomatic people and those whose symptoms don’t require medical evaluation.
Brown backed away from earlier statements about lifting restrictions once Oregon reached a 10-day stretch with no deaths from the virus. She said she had been citing comments made by Dr. Deborah Birx, a member of the White House’s coronavirus task force.
“We’re using different metrics here in Oregon,” Brown said.
Modeling estimates the coronavirus’ transmission rate in Oregon has plummeted amid the statewide shutdown. But while Oregon’s latest modeling projects that cases have plateaued here, the state isn’t expected to see a drop-off in numbers for at least six weeks. As of Tuesday, 55 people had died from the coronavirus and 1,633 had tested positive.
Researchers with the Bellevue-based Institute for Disease Modeling wrote in an April 10 report that Oregon needs to maintain its current aggressive measures to decrease the number of active infections.
Even if Oregon returned to the moderate restrictions in place in mid-March, which included school closures and bans on gatherings of more than 25 people, “active infections will rapidly increase,” the researchers concluded.
Sidelinger and Brown said a far more robust system was needed to trace the contacts of people who test positive. They did not specify the numbers of new staff that may be needed, but Blosser said it could be between 100 and 150 and possibly more.
“Our assumption is that we need to staff up significantly,” he said.
Chunhuei Chi, director of the Center for Global Health at Oregon State University, told The Oregonian/OregonLive on Monday that to establish a program similar to one successfully used in Taiwan, Oregon needed between 400 and 1,000 people to administer testing and trace the contacts of known positive cases to effectively control the spread when restrictions are loosened.
By comparison, Multnomah County, Oregon’s most populated county, had a pre-pandemic staff of seven people to trace contacts and has since added 15 more. Lane County, which is about half of Multnomah’s size, has seven full time nurses who investigate coronavirus cases; two former staff are assisting in a volunteer capacity.