PORTLAND, Ore. — Nine Oregon counties where COVID-19 cases are on the rise will begin a two-week pause on social activities beginning Wednesday.
The counties include Baker, Clackamas, Jackson, Malheur, Marion, Multnomah, Umatilla, Union and Washington.
On Tuesday morning, Dr. Jennifer Vines joined KGW's Brenda Braxton and Nina Mehlhaf on Sunrise Extra to answer your questions about the two-week pause.
Vines, the health officer for Multnomah County, answered questions about how the two-week pause could impact the spread of the virus, whether restaurants and bars will need to be shut down, the outlook for Oregon schools, the efficacy of face masks and more.
QUESTION: Dr. Vines, let's start with some basics. What is the state of COVID-19 in Oregon right now? We've been talking about that upward trend over the past month. What's happening to keep us going up?
DR. VINES: In the Portland metro area, cases are going up sharply. We saw that heading into the end of last week and over the weekend. Part of that is from expanded testing, but most of it is from increased viral spread in our communities.
It's worrisome. We're seeing spread among younger people, but we're also seeing busy hospitals at the moment, busy with COVID-19 patients but also busy with the day-to-day care that people need. Whether we'll see a wave of hospitalizations from COVID-19 in the two weeks following this increase in cases, which is usually what we look for, remains to be seen.
There's real concern among those of us working in public health and among the hospital systems that we are headed into a very serious time, and that we're essentially climbing the wave or the curve, essentially, that we wanted to flatten and did successfully flatten last spring.
Q: As a state, we were doing so good early on, you mentioned back in the spring we had some of the lowest infection rates in the country, and now, are people just kind of fed up? They're like, ‘I'm done. I'm pent up, I'm cooped up. I can't do it anymore.’ How do you explain it?
VINES: I'm concerned. I'm not particularly surprised by these events. I think heading into the fall and winter, we've been keeping a sharp eye on cases.
We know that COVID fatigue is real. We know that people want to be with their loved ones heading into these darker months and it's really hard to sustain behaviors that don't necessarily come naturally. So I'm concerned that it's happening already in November. I had hoped that we could delay this moment. But we are here.
It's really important that the public understand the times that we're headed into [and] the potential strain on our healthcare systems, whether that's people with severe illness from COVID-19 or people just needing routine care for all of the other things that can happen – car accidents, strokes, heart attacks. The fact that the rest of the country is on essentially the same trajectory means that there's going to be limited resources.
So we need to come together here locally and do the right thing by canceling our social plans, keeping to our households and trying to get this curve down to protect our elders and our loved ones with underlying conditions.
Q: What about schools? It was just two weeks ago that Gov. Kate Brown came out and relaxed some of the COVID metrics for schools to open in-person classes, at least for a lot of the younger grades. About 23% of Oregon school-aged kids would be able to return to school whenever their district feels they're ready to open back up in some form. How do you feel about that now? Just in the past two weeks, we’ve seen where we're going with schools potentially opening up across the state.
VINES: Speaking regionally for the tri-county area, we really supported another look at the school metrics. The state was among the first to come out with metrics for returning to school. They were extremely cautious in their thinking. As you point out, a couple of weeks ago the state came out with metrics that were less stringent. I fundamentally agree with that approach. Unfortunately, we're headed into a more serious timeline right now of just the next two weeks. So as much as I want to see kids back in school, I think right now we're basically asking people to stop mixing completely for at least the next two weeks to try to get our case numbers down.
Q: We also have a question that asks if all COVID patients in Oregon hospitals are people from Oregon?
VINES: I am not aware of any large-scale transfers of patients from other states, but I'm also not involved in the day-to-day resourcing of hospital beds and taking requests like that. But I don't know of any large-scale transfers of patients from out-of-state.
Q: There are people still debating whether wearing a mask works. Dr. Vines, what do you say on that?
VINES: It is one of the most important things people can do as they go about their lives. We know that even asking people to keep to their households and essentially do a voluntary quarantine these next two weeks, that still leaves essential workers out there. And people will still need to do essential things like take care of loved ones and pick up groceries.
Wearing a face mask, covering our face is absolutely one of the most important things you can do when you are out and about. It contains your droplets. We all spray out droplets from our mouths and noses when we talk or speak or laugh. A face mask contains your droplets and keeps them to you. It also filters out a fair amount of other people's droplets. It protects the wearer and it protects the people around the wearer. So I unequivocally endorse using face coverings and masking as much as possible when you can't guarantee that you'll be more than six feet from someone.
Q: One of our regular viewers wants to know if you see bars and restaurants being asked to close again if our case numbers don't go down during this two-week pause?
VINES: We have struggled with the question of restaurants and bars. This viewer is correct in pointing out that this is a state decision and it's essentially state authority that restricts things like bars and restaurants.
We wrestled with this because we don't know if it's better for people to be in a structured environment where people are distanced, where face coverings are the expectation, like in a restaurant, as opposed to just gathering in their homes or in their basements.
I think we also have an obligation to the business community collectively to avoid the kind of whiplash of open-and-close and give them enough lead time so that they're not stuck with inventory or perishable food that they're going to take losses on.
I fundamentally agree with the governor's approach of taking voluntary measures first, and then she has announced a wait-and-see approach. I think we in the Portland metro area really are emphasizing just the next two weeks, because that is essentially a quarantine. So anybody who has potentially been exposed to the virus recently, a home quarantine, essentially for everybody, you could really suppress transmission and get us back on track.
Q: New restrictions start tomorrow with limited capacity for restaurants to 50 people indoors, including employees. Now we have all of these wonderful restaurants and break places that I want to stay open. They’re putting up tents outside, but now they're lowering the flaps on the tents and adding heaters in the tents and they have these plastic flap walls. It's basically an indoor structure outdoors. I know you’re not a state official. You're obviously on the medical side of things. But do the two-week restrictions that begin tomorrow, do they affect the tents that are outdoor/indoor? If we're not as safe indoors, what is the difference between a walled tent outside?
VINES: I have been asked this question before. I can't speak to the regulatory component. I think from just a health standpoint and a risk standpoint, ventilation and air flow matters. So being outside with a three-walled tent is probably better air flow than being completely inside and potentially sharing air space with other restaurant goers. I think a completely enclosed tent, that’s really just your household of people you would interact with otherwise, with a server, just having brief contact. That's probably lower risk than sharing mini hubs.
Q: I don't mean to misquote you, but I was listening to “Think Out Loud on OPB on my drive home from work yesterday. And I do think that you were talking about this with the host, and you said sometimes being in an environment like a restaurant where they're taking lots of precautions and everybody's masked up and they've got partitions or whatever they're doing in their space is probably safer than sitting in somebody's basement outside of your own household, mingling with lots of different people.
VINES: Yeah. At the end of the day, addressing this pandemic is really about influencing health behaviors, which is one of the hardest things to do, especially when it doesn't come naturally. So there are real questions about whether providing a structured space for people to socialize that has precautions built in is a better option, especially just knowing that people want to socialize and want to be with loved ones. Is that better than closing everything and having people kind of go underground, so to speak, and socialize in smaller settings, where they may be fewer prompts to maintain distance or to use a face covering?
Q: I have a personal mantra since this whole thing started back in March. My personal mantra is COVID doesn't care. It's not like I can fool you, Dr. Vines, because you're not looking at me all the time, but if there's something out there that I'm exposed to, it's going to be there, whether I wash my hands because I'm in a hurry or I take that extra time to slip on my mask before I walk around. So that's what I try to remember. This is a virus. The virus does what it's going to do, regardless of what I do. And if I have the misfortune of coming in contact with it without taking precautions, I opened myself up to greater risk. I can't even imagine what your job and your life has been like, Dr. Vines, because you are front and center. People are always asking you things and you always have to really kind of survey the landscape and try and give people the best possible medical advice.
VINES: Thank you. I mean, that's my job. I'm a public servant. I'm here to share the best information I have as I understand it at the moment. And I think it is important to take a look back and remind Oregonians of how successful we were in the spring of avoiding a hospital and health system overload. Over the summer, we had a few bumps. Everyone said, is this the surge, when it turns out in hindsight, those were probably just little spikes.
I think dialing back to the kind of collective energy and spirit of everyone in it together to flatten the curve for the sake of our healthcare workers, our Black and Brown communities, our elders, and anyone you care about with an underlying condition, I think that's the kind of energy we need now heading into fall and winter. And I know it's an extra lift at this particular moment in time, given the short days, the holidays. But I think that's what we're really asking people to do.
Q: A couple of questions from viewers here. Dr. Vines, do you and your family go out to eat in a restaurant or do you get food to go?
VINES: I think every household has to decide what their risk is based on who their household members are, what their personal level of anxiety is around COVID-19 and how that balances against things like the pleasures of being in a restaurant versus getting takeout. My household and I are making those decisions the same as everybody else.
I think what I keep front and center, is I remind people that the definition of a close contact is within 6 feet for at least 15 minutes. And that's regardless of a mask. And so as I go about my day, I ask myself, ‘If the person I'm with tests positive for COVID and I get the call that I've been exposed, am I going to have to quarantine if I meet these criteria?’ And so that's sort of my benchmark of how I'm minimizing my own personal risk in my household.
Q: Can we talk a little bit about mental health? We've been focused on physical health, but mental health is super important as well. One of our viewer questions talks about the isolation and the dark rainy Pacific Northwest that is just catastrophic when you have to physically distance. I know my kids are grown, but my son does not live with us. And we have seen very, very little of him, only outside with a mask on. And as the holidays come, you know, he was asking me, ‘Am I going to be able to come over?’ And now Clackamas County where we live is lumped in with these restrictions. And it kills me to say, ‘I don't think so.’
We've got to come up with some creative ways that we can toe the line healthwise, for the greater good, but I get it. As a mom, it is the hardest thing that I've ever had to do. We're not going to be together on Thanksgiving? No, we're not. I don't know if we're going to Zoom it or if I'm going to drop off a care package in the morning. Can you speak to that kind of mental health dynamic that we're all feeling right now?
VINES: Definitely. We take this just as seriously as we do the pandemic. I think people's need to be with others, especially in these darker colder months, is very real. And there are also real health implications, so-called collateral damage to how we address the pandemic in terms of behavioral health and many, many other things. We are absolutely aware of that.
We are really urging people to tap into their creativity, understanding that this probably is a once-in-a-lifetime global pandemic. 2020 has been an extraordinary year. We are not in this forever. There's good news about vaccines but those are still at least months away. And so what we're asking right now is for people to be creative and to tap into that desire to be together and channel it into creative solutions. Whether that's bundling up outside for a walk, which is great for your mental health, whether it's as you're pointing out, planning a Zoom Thanksgiving, that essentially lower your risk on that spectrum.
Q: I've seen several people ask about the death rate in Oregon and they are putting more stock in that instead of the positivity in test rate. Do you know what is the percentage of people who die from COVID here?
VINES: I don't have that number at my fingertips. I can say overall Oregon has done well. And I say that with humility, knowing that hundreds of people have lost their lives to this virus and hundreds of families are grieving those losses, but Oregon, on the scale of the United States, has actually done quite well.
I think, again, looking back at the measures that people have taken so far, the precautions that people have taken, those have all bought us time, time to learn about the virus, time for our healthcare experts to figure out treatments and what works, time to get our hospitals organized and ready to hopefully expand to accommodate the need. All those things also contribute to saving lives.
So it's partly what we're asking the public and every one of us to do to lower the spread. But it's also acknowledging that we've learned a lot in the last 10 months that also helps us contribute hopefully to fewer people or as few people as possible dying from this virus.
Q: One of the things that people are talking about on the stream, there's a group kind of going back and forth about COVID and protests. And I remember back in May, after George Floyd was killed, everybody came out nationwide, really around the world, during the pandemic to protest. Now that months have gone by and in Portland, we've seen, still some sizeable gatherings. Do we know anything more about that particular link between the protests and COVID? Do you have any more actual data from what people are telling you with the infection?
VINES: We tend to have some of our best understandings in hindsight with this virus. And so as we went through the summer, I got this question a lot and we were very worried when we first saw the protests. We, of course, didn't intervene from a public health standpoint because racism plays enormously into public health.
I think as the summer went by, we worked with protesters, we made sure they knew they could get tested at our county easy testing site. We asked people who were positive if they had been to a gathering and what type of gathering they had been to. So we actually looked for that spread, including encouraging people who had attended to get tested.
In trying to look for it, as we interviewed people with the virus to see if that had been a contributor, we did not find a significant contribution from those protests to our cases. And again, as we look back over the summer, we saw some waves that followed Memorial day weekend, July 4th weekend when people were largely gathering socially. But we never found big contribution to those case numbers from the protests, despite really looking for it.
Q: Dr. Vines, can you set the record straight? One of our viewers is asking why our testing levels have flattened or even decreased? Why is Oregon behind? I understand you said at the beginning of this conversation that we're actually doing more testing.
VINES: Testing capacity has actually expanded in the last couple of months. I'm not sure if this particular viewer has more details about how Oregon compares to other states. It's certainly possible that we are behind other states in our testing capacity, because I know it has been something we have struggled with. But some of this increase, about 20% of the recent increase, is actually from expanded testing.
Q: What can you leave us with, Dr. Vines? Brenda has her mantra of COVID doesn't care and it's out there, so don't let up. What's kind of your personal mantra at your house? What should we kind of leave with as we go into the holidays?
VINES: I would leave you with this idea that our individual choices add up in ways that we can't always see or predict or understand. So this ask of people to voluntarily stick to their households as soon as possible, but officially starting tomorrow, and really limit their social contacts as much as possible for the next two weeks has really far-reaching implications for our elderly, for our healthcare workers or people with chronic conditions and for the communities of color that we're seeing disproportionately burdened with this virus.
So as people head into these next two weeks, please, please take every precaution. Limit your social contacts. Use face coverings. If you have to go out, take at least one step to take your risk down a notch.