‘A completely different landscape’

Lane County navigates second full year of COVID-19 pandemic, looks to future

April 6, 2022 — In 2019, a mysterious new illness began to spread, first in concentrated places overseas and then to population hubs, eventually finding its way to the U.S. In Oregon, the first case of the novel coronavirus COVID-19 was detected in February 2020.

Lane County Public Health (LCPH) Public Information Officer Jason Davis has been part of the mitigation efforts “from day one.”

“I remember in January (2020), when people first started talking about the coronavirus, it was a joke. There were those memes with the bottles of Corona and the beer cooler and all that stuff,” he said.

Around then, LCPH began doing community meetings about respiratory health. 

“Everyone wanted to know about the coronavirus,” Davis said. “It was late January 2020 when we started really diving into this. We didn't know anything — the severity and the transmissibility of the illness. There was so little to go off of. Juxtapose that from now, where we're talking about double digit number of variants, genome sequencing on those variants, vaccines, booster shots … I mean, it is a completely different landscape.”

For health officials, the second year of the pandemic “was very dynamic,” Davis said. 

While the first year allowed them to track the spread of the illness and begin research, milestones were reached relatively slowly. In March 2020, there were only 80 reported cases of COVID in the entire U.S. This led to states of emergency as the World Health Organization (WHO), declared the coronavirus to be a pandemic — a recognition that the virus had, or would soon, spread around the globe.

As of today, the U.S. has had 80.1 million COVID cases and 981,000 deaths.

“The first nine to 10 months of the pandemic, we were in a holding pattern,” Davis said. “It was, do everything we can to try to prevent the spread of the illness. Then came the vaccine in the winter of 2020-21. The big push was to see how many vaccines we can get out all at one time. It was the first large-scale vaccination effort that we as the health department have done since 2008 with H1N1. There was quite a bit of dusting off protocols and getting back into that vaccine game.” 

LCPH also had to learn how to notify communities. Many people get their news digitally, as well as through radio and newspapers. 

“We have pockets within the county that actually don't have internet access, or even cell phone access,” Davis said. “How do we communicate to them? How do we get to them? … We had to look at equity and diversity of our county, and how we rolled out these health initiatives for everyone in our county, knowing that rural areas are very different than our urban core. The availability of services is very different.” 

LCPH did 196 press conferences, many through social media, to make news readily available in multiple languages, as well as working with local media. Staff members even put signs up on bulletin boards to help even more people access information on the virus, vaccine, masking and boosters.

In addition, LCPS adapted its vaccination clinics to allow for walk-ins and drive-ups to help people with equitable distribution.

For Davis, the county also got to work with some of its rural partners in new ways.

“Florence is a really good example of a community that is independent in many terms,” he said. “You’re a relatively good sized community, you have a hospital there, you have medical services, you have all the infrastructure that you need. But still, you need the county to be that health department that we are for the for the entire area. Working with your community taught us a lot. I think we learned the dynamics of Florence more than we did as a health department going into the pandemic, which was the silver lining to the pandemic.”

Working with local governments, private partners, news organizations and health services allowed the county to strengthen bonds.

“Everybody was just saying, ‘We're entering in something that is going to be affecting our entire nation all at once, our entire globe, all at once. What can we do to help?’ … Everybody has a job to do. Oftentimes, we really struggle to figure out how we align the different jobs that we have to do in order to accomplish our goals. With the pandemic, from the very beginning, and this goes true with everybody in Florence, people were just saying, ‘O.K., what can we do to help? How do we do our part in this, knowing what our skill set is or what our offering is?’”

Across the county, EMTs were able to become vaccinators and start administering vaccines. Doctors came out of retirement to help with vaccinations and volunteer with the effort. Local service organizations stepped up to staff LCPH’s mass vaccination clinics, provide administrative support and more.

“We saw business owners struggle with loss of revenue while trying to figure out how they could maintain their livelihood, while also protecting the health of their community,” Davis said. “LCPH really looked at how we could bring that altruistic, community-minded desire from our private sector businesses and help them do the right thing and be a part of the solution. Many of those businesses did exactly that. They still had to make a living, but they were very conscientious of what they could do to help prevent the spread.”

While many in the community banded together, there was growing unease about the federal government’s message of “flattening the curve.”

“People had an expectation that this was going to be a relatively fast ordeal,” Davis said. “We were going to be able to get a handle on it. Then we would just have to make small changes to our daily lives and go about life as usual until we get a vaccine. And that wasn't the case. … No one knew, at the time, the links and slowburn nature of COVID, and what we were up against.” 

A lot of day-to-life shifted drastically in March 2020, as people were sent to work from home, in-person school was moved to virtual classrooms, masks were required in public places and people were required to maintain a certain amount of distance. Those measures did help prevent greater spread — at first.

“It was a long time coming in Lane County, specifically, before we started seeing the real ramifications of COVID,” Davis said. “We were spared. I mean, let's make no bones about it. We were so fortunate that we didn't see double digit deaths until months after the pandemic began, that we didn't see triple digit cases until months and months after the pandemic began. We really got a slow start at it. That allowed us a lot of time, both to prepare as a health department, but also for our community to question, ‘Hey, this hasn't affected me personally. I don't know anybody who's even had COVID, much less ended up in the hospital or died from it.’”

He continued, “Regardless of globalization in the way that we all have access to media, what really impacts us is that personal experience.”

Lane County’s COVID numbers began to climb over summer 2021 with the highly contagious Delta surge. 

“A large percentage of our county really did have to face COVID, had to see people that they love pass away, or were down and out and really affected by the illness, to the point where they even had long-term COVID for a couple months,” Davis said.

By then, however, a full year into the pandemic, people questioned the COVID measures.

“Because of the rural nature of our county, because of the space that people have in between us, we had that reprieve early on. And it was harder for us to keep the course and really stay vigilant throughout the entire course of the pandemic,” Davis said.

In addition, people were tired — kept away from loved ones, locked up at home, limited in terms of travel, entertainment and even health appointments.

“I have noticed, even within the most ardent supporters of public health measures and people who really understood the community toll of respiratory illness, they still went through periods where they just got tired,” Davis said. “It's just the same thing for two years. That changed a little bit when we saw different variants like the Delta. Uncertainty is scary. People really paid attention, braced themselves, but then we got more comfortable with it. We went back to being tired of it.”

LCPH and other health services have had to address “cycles of resistance” against the virus, vaccine and other health announcements.

“I think the intersection of politics was really unfortunate, that we saw an entire half of the political spectrum start to weaponize this as a critique, saying public health was a partisan entity, which it is not. Absolutely is not. I think all that was really hard to reconcile for our public,” Davis said. “And then they saw that unfold in real time. Had this been the early 2000s, most of this wouldn't be on public display, and all you would hear is the science behind the virus, and then what you would do to prevent the spread.”

LCPH ultimately wants to preserve health. 

According to Davis, in Lane County, people spend $11 million on outpatient influenza visits every year. 

“That's $11 million on vaccine-preventable illness we could be spending on roads, tech development, or bettering your community, but instead, because we don't all get the flu shot, because we don't take it seriously, we spend that money on the flu, and we don't need to,” he said.

It’s a shortfall in the community’s health literacy, which LCPH is working to address.

It also means that people get their personal health confused with the community’s health.

“Lane County is not population: you, and even the City of Florence is not population: you,” Davis said. “We have tens or hundreds of millions of people who are going to rely on your actions for their health. … We had to tie it back to, ‘You value your tires. Therefore, you pay money to have potholes fixed for everyone — not just you on your driveway, but for all the city streets, even the ones that you don't drive down. That is for the benefit of everybody. You have agreed through social contract to do that, as a citizen of our county, state and country.’ The same thing goes for public health. We agree to take certain actions as an individual to protect the greater good. And people really struggle with that.”

As 2022 continues, it has been a full two years of COVID in Oregon. The pandemic continues, even while certain health measures have lifted. 

“I think one of the one of the biggest uneasy feelings for people is the unknown about what respiratory illnesses can mean to our society, to everyday life, to your health, and that hasn't changed from day one of the pandemic until now,” Davis said. “Those unknowns, they just take a different shape or shift.”

As for the future, health organizations across the world will continue to track diseases and viruses. 

Using information from WHO, LCPH will keep an eye on developing health threats.

“Our health officer is looking at Lane County having a relatively quiet spring,” Davis said. “Right now, we've been averaging around 30 to 35 cases a day. That is a sharp decline from where we were in the midst of Omicron, where we got upwards of 600 cases a day. That was astronomical. Had that been Delta, our hospitals would have been overrun. It would have been just pandemonium. But thankfully, Omicron has better health outcomes.”

Additionally, nearly 75% of county residents have received at least one COVID vaccine, with others already having their first booster dose. As of last week, second boosters have been approved.

“We know, though, that you can still get sick and you can still pass COVID on if you're vaccinated,” Davis said. “It only provides one level of protection. Then we have another level of protection just by virtue of our geography, that we are somewhat spread out, that we don't have people living in super close quarters.”

Another layer of protection is treating communicable illness as something preventable, taking steps to prevent both your own and others’ health.

“We should not go back to 2019. That is not what we should be striving for,” Davis said. “We should look at the pandemic as something that affected us globally, that taught us a lesson about the impacts of respiratory illness, that we should keep respiratory illness as something that we consider on a daily basis.”

He described preventing illnesses like COVID and the flu as wanting to keep teeth healthy. People make it part of their routine to brush their teeth, floss, maybe use some mouthwash. 

“It doesn't need to control your day, it doesn't need to be the focus and center of every decision you make; it just needs to be a consideration,” Davis said. “Just by virtue of inserting that consideration into how we live, coupled with the geographic nature of Lane County and our vaccination rate, we really do have a good chance of being able to weather this storm, and not have the pandemic come back in a point where it completely disrupts our entire life. Even if we have a strain that is more virulent, and causes worse health outcomes. I think that that gives us hope for the summer.”

In closing, he said, “For the folks who are really critical of the pandemic response, I think that's fair. There were missteps. There were things done even by LCPH, by our state, by the CDC of our nation, that we could have done better. Absolutely. Regardless of what activity you're tasked with doing, you're going to make mistakes, especially when you're trying to make decisions for hundreds of millions of people. There's going to be people left out, there's going to be people that don't feel represented. I think we've learned a lot about that. But I would encourage folks to separate the humans that were tasked with doing that job, from the basics and the science of disease prevention, regardless of who's at the helm of LCPH, or OHA or the CDC. The science stays the same. Respiratory illnesses are costly to communities. They are preventable, and vaccines work, masks work. All these things work. 

“Apart from your political affiliation or anything else, it is so valuable for you to take a step back, and to look at how you can protect your family, and how you can protect your community. That is just a fundamental action that is so important, regardless of who you are or what you believe. If you are afraid of vaccines, or you don't believe that they’re working, fine. There are 1,000 other ways you could help prevent the spread of illnesses. 

“If we can all just agree that illnesses are worth preventing, then we will be on good footing. And it goes beyond COVID. It goes to all the other things that hit us every single year, and all the things that we have yet to even learn the name of. But that is what we need to think about. Think about it in a place of preparedness; not fear, not panic, not that we need to change your entire life. But how can I make small changes in my life to help prevent these illnesses and therefore benefit my family and my community? Just agree on that, and we will be in such a better place.”

People can learn more at lanecounty.org/coronavirus and lanecounty.org/vaxclinics.