‘COVID’s still here’
PeaceHealth talks about masks, vaccinations in preventing further spread
July 31, 2021 — COVID-19 cases in Oregon are now at 218,689 after recent rises in infection statewide. Locally, Lane County has had 14,867 COVID-19 cases since Jan. 1, 2020. Numbers in the county are showing a steep climb since July 15, with daily reported cases climbing from one or two a day to surges of 93 people reported on July 28.
On Lane County’s COVID-19 dashboard at public.tableau.com, the Rolling 7-Day Rate Per 100k chart shows that numbers in July match the higher numbers reported in May.
“COVID’s still here,” said Jason Hawkins, Chief Administrative Officer (CAO) for PeaceHealth Peace Harbor Medical Center. “We still need to continue the education and continue with masking and social distancing when appropriate, especially in healthcare facilities, whether it's a hospital, assisted living or nursing homes. All healthcare facilities are still requiring masking and social distancing. And we're still very much encouraging for folks to get vaccinated.”
He was joined by Dr. William Foster, M.D., PeaceHealth Peace Harbor Emergency Department Medical Director, and Dr. James McGovern, M.D., Chief Medical Officer (CMO) for the PeaceHealth Oregon Network, in a conversation about the state of COVID-19 in Lane County and how PeaceHealth is working in communities to prevent further infection.
The PeaceHealth representatives emphasized the importance of vaccinations in preventing the spread of COVID-19. This is especially important as the government-mandated pandemic restrictions were lifted by Oregon Gov. Kate Brown at the start of July when the state reached its 70 percent first dose adult vaccination rate.
“There are still a good number of people that are not vaccinated,” Hawkins noted. “And the (Delta) variant is starting to surface in Oregon in rather high levels. It's affecting mostly unvaccinated, but it's also affecting some of our vaccinated folks. Thank goodness, most of their symptoms are rather minor.”
Cases are rising locally in the 97439 zip code, with 329 cases reported since the pandemic began.
Hawkins cited the ending of restrictions, combined with the July 4 holiday and increased socializations, as part of the reason for the increased cases.
“We probably saw more COVID activity in the month of April, May and June, then we did at any other time during the pandemic. We're starting to see those levels again surfacing in our ED (emergency department) here at Peace Harbor,” Hawkins said.
According to Foster, “We're certainly seeing some patients coming in with COVID symptoms. Most of them do not need hospitalization. There are a few, and the policy and procedure for PeaceHealth is, if someone does need to be hospitalized for COVID, they are transferred to RiverBend.”
PeaceHealth Sacred Heart Medical Center at RiverBend in Springfield is the region’s central hub for patients with COVID-19.
The Peace Harbor ED is also handling increased patients due to summer conditions and visitors driving through, Foster added.
“Certainly the ED in the hospital is busier right now, not just due to COVID. There are many other factors in play right now that are putting quite a bit of stress on the hospital system, and most hospitals are running near capacity. Every COVID patient doesn't help that situation,” he said. “We are on track to having our busiest month ever. I mean, last year, we were way down. But we're roaring back in terms of ED volume in the last month or two.”
Peace Harbor has enough capacity for current levels for now, though Foster noted that wait times might be a little bit longer than what people are used to.
With PeaceHealth across Oregon, “Our ED volumes are certainly up, as are our hospitalizations,” said McGovern. “I want to say three or four weeks ago, we actually were down to one COVID patient on our medical unit. And this morning (July 29) we are at roughly 15. We've gone from one or two in the hospital to closer toward 20 in the last three weeks.”
PeaceHealth has practices in place to adapt to an even greater increase in patients, with Peace Harbor ready with a three-phased surge plan in place to handle patients locally.
Hawkins said, “While we do send COVID patients that are sick enough to be admitted with COVID diagnosis, we do have the capability of keeping those patients here if we need to, if RiverBend were to be too full. So far that’s not been the case, but our hospitals, physicians and nursing staff are all prepared for that. And we have adequate PPE (personal protective equipment) and isolation procedures for that to happen.”
Peace Harbor is prepared, though it is not an outcome the healthcare officials want.
“Like many cases, our capacity is often limited to personnel,” Hawkins said. “In the ED with Dr. Foster's team, we can sometimes call in extra nurses or doctors that are on call. But you can only go so long by asking people to work extra shifts. So we're very much watching the activity and are very concerned.”
As for what the community can do, Foster has an answer for that.
“The strong message that needs to get out is that people need to get vaccinated. That's the best way to have this pandemic recede to a background level,” he said. “Everything you look at, there's a direct correlation to how many people are vaccinated and how many people are getting hospitalized. Even if you look across Oregon, the 10 counties that are at the highest level — Lane County is just at substantial — are the 10 counties with the lowest vaccination rates. I mean, it's hard to argue that.”
Peace Harbor can facilitate vaccinations for people who need them, as Lane County still designates doses to the facility each week. The medical center has worked with the county, Siuslaw School District, local care facilities and the City of Florence on getting vaccines to the community. Peace Harbor alone administered more than 3,000 vaccines since December. Many of those went to healthcare and frontline workers.
“With staff, PeaceHealth is approaching 80 percent vaccination rate and Peace Harbor is trending in that direction, with close to 77 percent,” Hawkins said. “It’s been a very, very good response from our healthcare workers, for those rates.”
As for the recent outbreaks at senior care facilities in the county, including Spruce Point Assisted Living and Memory Care Community in Florence, Hawkins said efforts have been made throughout 2021 to educate and vaccinate staff and residents.
“As part of that first round of vaccinations back in the early winter, we made available vaccines to all healthcare workers at all facilities. Those facilities in Florence had several vaccine clinics at their site. So those assisted living facilities, skilled nursing facilities and caregivers were all afforded the opportunity by those organizations, with education on vaccines. They still are encouraging their health care workers to become vaccinated. We were working intimately with them to ensure they had a resource, and many of them had their own methods through Lane County Public Health to secure an inventory of vaccines,” he said.
However, people still ultimately get to choose for themselves if they want to get a COVID-19 vaccine.
According to McGovern, “Oregon has an actual statute that prevents some employers from requiring vaccination for employment. So that's a barrier in Oregon right now. … That's an ongoing debate across the country, whether or not we require healthcare workers to vaccinate.”
He had numbers on the staff vaccination rates for Eugene/Springfield long-term care facilities and nursing homes, which were between 70 to 80 percent. The resident vaccination rates were close to 100.
For Hawkins, “It's important to give those organizations credit for encouraging their employees to become vaccinated, especially in Florence. They certainly did their very best to provide that education and to make those vaccines available on site. And then we made it available in our facility as well, then at the event center and now the school. It makes it challenging when the Oregon laws makes it difficult to mandate.”
Foster acknowledged that not all of the population can get vaccinated.
“There are populations that can't be vaccinated, and vaccines are still not approved in children under 12,” he said. “There's a part of the population that is immunocompromised, and even if they get the vaccine, the vaccine probably doesn't work as well in them, and they're still at high risk. It does fall on the rest of the population that can get vaccinated to do so to help protect those who can't.”
Variants of COVID-19 are also on the rise, with the Delta variant especially infectious.
“Even vaccinated individuals can spread COVID,” McGovern stated. “If they get COVID, their disease is much more likely to be limited and mild, but they can still spread. … Masking is an absolutely effective way of preventing or reducing spread of COVID. It's been effective throughout this entire pandemic.”
As of July 27, Oregon Health Authority recommended universal mask use in public indoor settings.
“Today’s reported sharp rise in cases and hospitalizations in Oregon are sobering reminders that the pandemic is not over, especially for Oregonians who remain unvaccinated,” said Dr. Dean Sidelinger, state epidemiologist and state health officer. “The highly contagious Delta variant has increased tenfold in the past two weeks in Oregon, and it is now estimated to be associated with 80 percent of the new cases in Oregon. The use of face masks provides significant protection for individuals who are unvaccinated as well as an additional level of protection from a small but known risk of infection by the virus for persons who have already been vaccinated.”
The PeaceHealth officials spoke about the importance of masks when visiting any healthcare facility.
“Assisted living facilities, nursing homes and hospitals have visitors that are coming in because our risk threshold allows that. But it's very, very important that those visitors maintain wearing their masks, especially in the nursing homes and assisted living facilities, when they go in and visit their loved ones,” Hawkins said.
This is important whether they're vaccinated or not, he emphasized.
According to McGovern, “We understand that having visitors is part of the healing process. Spending time with loved ones is of incredible importance. It really is a difficult decision that we make to balance the safety of our both our patients and our staff, as compared to the risk of spread in the community. It's not something we take lightly. We know the importance of it. But at the same time, we have a lot of vulnerable people in our buildings that we need to keep safe.”
Besides still limiting visitors and requiring masks, PeaceHealth tests patients for COVID-19 as they are admitted, and then again every five to seven days.
“It’s one of the things we do to keep our patients and our caregivers safe,” Hawkins said. “Every credit to my staff at Peace Harbor, our infection prevention teams and infectious disease providers that are really embracing every possible avenue to keep our community safe and healed.”
Foster wants people to be aware of more than just their community.
“Even though we'd like to think on a smaller scale locally, people are traveling through Florence all the time. So we can talk about our vaccination rate in Oregon, or in Lane County or in Florence, but we're not an isolated community,” he said. “We have people traveling through, and that's going to impact what happens here.
“It is important to keep a big picture of what COVID is doing. I think we'd all hoped that COVID would have receded by now. But that's not the case. It's had its ups and downs. And we're in another up right now, and it’s probably going to be several months, from everything that I'm reading and hearing, before we head back down.”
McGovern added, “The numbers haven't gone down without some type of intervention. So we are on a steep rise right now. And the only way that that curve bends, flattens and comes back down is if we enact interventions. Masking is one of those that's been shown to be very effective in slowing down and preventing the spread of COVID.”
For more information, visit healthoregon.org/coronavirus and peacehealth.org/coronavirus.