February 17, 2021

Nearly 100,000 Multnomah County residents have received at least one dose of a vaccine. And the number of new COVID-19 cases in the County, the percent positivity, and hospitalizations are down across the board. But Public Health leaders caution it’s not time to let our guard down. 

Officials delivered the promising news   during a Tuesday, Feb. 16 briefing as the Metro area continued to thaw following a weekend ice storm which left hundreds of thousands of residents without power, stalled transportation, and caused health systems to reschedule vaccine appointments. 

Despite the weather-related hiccup, public health experts say there are signs the disease is contracting. Percent positivity has dropped to 2.3 percent and hospitalizations are at the lowest level since spring 2020. Yet disparities continue to exist: the Latinx percent positivity remains at 5 percent which, while being the lowest level since May, is 2.5 times higher than non-hispanic Whites. 

“Our hospitalizations have continued to level off,” Public Health Director Jessica Guernsey told the Board, “So we consider this to be a truthful indicator that we’re continuing to move in a positive direction in terms of the disease overall in our community.”

The disease’s downward trend also allowed Multnomah County to drop from “Extreme Risk” to “High Risk” under Oregon’s reopening guidelines. That allows indoor restaurants to operate at 25 percent capacity, or 15 people — whichever is smaller. Gyms and indoor recreation are allowed at 25 percent, or 50 people. And long-term care facilities can allow indoor as well as outdoor visitors. 

Despite the improvement, Guernsey urged people to continue wearing masks and following public health guidelines to keep the pandemic under control.

“Moving from ‘Extreme Risk’ to ‘High Risk’ does not mean that we stay in ‘High Risk,” Guernsey said. “We could still move back if we see the numbers change. So we’re watching that very  carefully and have to say that, again, we’ve seen really good participation from community members around prevention activities that have helped us suppress these numbers.”

Citing the displacement caused by the 2020 wildfires, Commissioner Jessica Vega Pederson questioned whether the disease could be spread by people needing to relocate due to storm-related power outages.

“Are we concerned at all about the number of cases potentially going up because of the power outages that we’ve experienced?” Commissioner Vega Pederson asked. “I know a couple of different situations where people have had power out and have gone to friends or family in other parts of the city or county or region where they did have power.” 

Despite concerns, Guernsey said, health experts didn’t observe a dramatic increase in cases after the wildfires. The County has consistently encouraged people who need to leave their homes to continue using the same prevention measures they have been using all along.

“We didn’t see a particular jump after the wildfires, so I wouldn’t say I’m not concerned,” Guernsey said. “I think people have done a great job of really integrating prevention practices into their lives, so I suspect that that will continue and we will continue to push out messaging in regards to that.”

One-in-10 people have received first dose

So far, 98,000 people in Multnomah County, representing 12 percent of the County’s population, have received at least one dose of a COVID-19 vaccine. And 37,000, or five percent, are fully vaccinated. 

The State distributes 80 percent of vaccines to hospital systems and the remaining 20 percent to counties. Multnomah County is using those doses to reach people that are likely to face barriers to vaccination due to language, geography, and access to transportation. 

“We’re really working on mobile units that can go out and address some of those barriers that can’t be addressed even by a small vaccination group,” Guernsey said.

The state of Oregon continues to dictate which populations are prioritized including Phase 1A  health workers, first responders, and residents in congregate settings, as well as educators and seniors ages 75 and over. 

Controlling COVID-19 in jails

The Board was also briefed on a COVID-19 outbreak at the County’s largest detention facility, the Inverness Jail. Multnomah County Sheriff’s Office detected its first positive case in a person in custody in December 2020. To date, 172 individuals in custody have tested positive, along with 25 staff or household members; Only one person has been hospitalized, and there have been no deaths of people in custody. 

“While many professions have been able to switch to teleworking during the pandemic, our employees continue their essential in-person work,” Sheriff Mike Reese said. “They risk their personal safety and health of their families in service to this community.”

The County has prioritized vaccinating incarcerated individuals. So far, more than 240 adults in custody at Inverness have been vaccinated. The Sheriff’s Office has taken additional measures to manage disease spread including more testing, enhanced screening at booking, reduced jail capacity, dedicated dorms for adults in custody who have tested positive, and five quarantine dorms. 

Rapid testing has dramatically increased in 2021. In this year alone, Corrections Health has completed 900 tests, compared to 194 in 2020. If someone tests positive in a dorm then everyone else in that dorm setting is to be tested within 72 hours.

“Because we have rapid tests on site, we’ve performed up to 120 tests in a given day,” said Dr. Michael Seele, who directs Corrections Health. “So we’re able to identify individuals in real-time and move them to a more appropriate housing setting.” 

The Health Department has also provided mental health resources to incarcerated individuals and their families. Despite a 30 percent decline in the Inverness population over last year, the number of mental health assessments have remained stable in that timeframe. That translates to at least a 20 to 30 percent increase in mental health assessments. 

“I would attribute that in large part to the pandemic and all the other challenges that we’ve had in the Portland area over the last year,” Dr. Seele said. “We’re trying to provide appropriate access to the people going through this process.”

Commissioner Susheela Jayapal, citing concerns for mask policies among staff and adults in custody, asked about mask wearing in jails.

Every adult in custody is given a procedural mask, and double masking is recommended for staff, Sheriff Reese said. When adults in custody leave single-cell housing, they’re expected to wear a mask. They’re also expected to wear a mask when they leave the facility for medical appointments, for example. 

“The challenge for us if we were to require masking in the dormitory setting much like you saw in the shelter setting, it would be hard to enforce,” Sheriff Reese said. “And we don’t want to get into a situation where we’re using disciplinary processes to make people comply with requirements in the dormitories.”

At the upcoming board meeting on Thursday, Feb. 18, Auditor Jennifer McGuirk will present the first audit on the COVID-19 Pandemic Response. The presentation will include a description of the report, including highlights from an employee survey informing the audit, and 16 recommendations for moving forward.