Multnomah County Health strongly recommends everyone mask indoors as viruses surge

December 2, 2022

Multnomah County Health officials are urging everyone, including in K-12 schools and childcare centers, to wear masks in public indoor spaces until at least Jan. 1, 2023 due to the surge in respiratory winter viruses.

The recommendation is voluntary and there is no expectation that organizations change their masking policy, Health Officer Dr. Jennifer Vines said Thursday. But the action is needed  to slow the flow of ill children into Portland hospital emergency rooms and pediatric intensive care units.

“All of our emergency departments are full,” said Dr. Vines at a press conference, Dec. 1. “Hospitals and emergency level care are at risk of going beyond the supply that we have locally.”

Respiratory viruses like RSV and influenza typically surge in winter. They are particularly virulent this year after shutdowns in schools and childcare in 2020 and 2021 abnormally suppressed the usual cycle of babies, toddlers and young parents being exposed to RSV and developing stronger immunity for the following season.

Instead, children under five who have never encountered the common RSV seem particularly hard hit. And older children and adults are also spreading the disease.

In a Dec. 1 email to Portland school superintendents, Dr. Vines and Public Health Director Jessica Guernsey recommended everyone mask to “support hospitals and keep kids and staff well enough to continue attending school in person.”

Although the number of RSV cases “might be nearing the peak,” Dr. Vines said influenza is still increasing, infecting adults and elderly people. COVID-19 hospitalizations are also up. 

According to the email, Dr. Vines and Guernsey recommend people: 

  • Be up-to-date on flu and Covid vaccines.
  • Wash hands well and often.
  • Disinfect shared surfaces.
  • Stay home when ill. 
  • People at high risk for severe illness, avoid large gatherings.
  • Have ready access to hand sanitizer.

Dr. Vines said everybody 6 months and older should be vaccinated for the flu and COVID, and anyone living with someone less than 6 months old should be vaccinated. “It’s never too late to start your vaccine series.” 

While hand washing and using hand sanitizer have become a familiar practice, now more than ever they play an important role in preventing RSV. Dr. Vines said that RSV can remain on unwashed hands and surfaces, and frequent hand washing and wiping down surfaces can help prevent infection. 

Local pediatricians weigh in 

Dr. Vines was joined in her call to action by two of the state’s top pediatricians, Dr. Wendy Hasson and Dr. Carl Eriksson.

Hasson, medical director of the pediatric intensive care unit at Randall Children’s Hospital, said “Randall [Children’s Hospital at Legacy Emanuel] is seeing historic numbers not only of admissions but also of emergency room visits.”  

According to Dr. Hasson, RSV and influenza are familiar virus disease processes to the pediatric care community, and stressed that the crisis is not of the disease but rather of the resources. 

“What you can do as a community member is prevent needing care altogether.”

As a parent of two young children, including an infant, Hasson said she personally wears a mask whenever she is in a public space and has her preschooler wash their hands often.

Only about 10 percent of the ill children presenting at the emergency room are admitted to the hospital, she said. Many have fevers that can be treated with Tylenol, for instance. But it is often hard for worried parents to know. She recommends parents look for these three things when making a decision to take their children to the emergency room:

  1. Look to see how hard the child is working to breathe; check to see if they are using any muscles between their ribs or under their neck. 
  2. Determine if the child is dehydrated, needing less than three diapers a day.
  3. Check their level of alertness. If the child is not interested in eating or playing between fevers. 

According to Dr. Hasson, if the child meets all three, they should be seen in an emergency room.

Doernbecher Pediatric Specialist Dr. Carl Eriksson said the hospitals are working to do their very best to provide the help that is needed with the resources they have, and parents may experience longer wait times in the waiting room. 

Dr. Eriksson said Doernbecher is using all of the physical beds in the ICU and will start using physical beds outside of the ICU, and they are continually identifying kids who can be well served outside of the children’s hospital, like older teens who can be cared for in adult beds. 

“We want to avoid a situation where we are not able to provide care for kids who need it,” said Doernbecher Pediatric Specialist Dr. Carl Eriksson.