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Oregon Coronavirus Update: Oregon's numbers are rising, not enough tests, good vaccine news.

Writer's picture: Lisa Reynolds, MDLisa Reynolds, MD

Lisa Reynolds, MD, pediatrician and Representative-Elect for Oregon House


Summary: Oregon’s COVID numbers continue to rise, more quickly than most any other state in the US. Our testing is insufficient. Gov Brown has hit “pause” in several counties in an attempt to slow the spread. We need to hunker down. Again. Herd immunity explained. There is good news about the Pfizer vaccine.


COVID in the World

Cases: 51m

Deaths: 1.2 million

(pace: 500,000 cases/day)


COVID in the US

Cases: 10 m Deaths: 239,000

(pace: 130,000 cases/day; our 14 day case count is up 64% compared with previous 2 wks)

So while the US makes up 4.4% of the world’s population, we make up about 20% of the world’s deaths. And we are the richest, most advanced country in the world. (Although the US has the highest degree of wealth inequality in the world.)

Cases are increasing: 64% over a two week period, especially in the upper Midwest and Rocky Mtn areas, with some uptick on the east coast.


COVID in Oregon









Cases: 51,000 (1200/100K) - we are averaging >700 cases/day; up 95% and the highest daily cases we’ve seen since the beginning of the pandemic. Oregon’s rate of increase in cases (ie spread) is among the top in the US (4th in the US). Our Rt is 1.25, which means for every case of COVID, 1.25 people catch COVID. Goal is to <1 (then our case counts go down). [https://rt.live]

Deaths: 738 (17/100K); up 63%





Testing: 7 day average- about 6K tests a day (the number of tests performed has been higher this past month than previous months, tho not markedly and not the “double” the capacity promised a month ago). We are seeing an uptick in % positive tests (goal <5%, currently close to 10%). Testing is insufficient.

Hosp: 250-300/day, rising.


Governor Brown hits “pause” on several counties effective 11/11/20 until 11/24/20 in an effor to slow the spread of COVID.

  • Counties: Multnomah/Clackamas/Washington, Baker, Union, Marion, Malheur, Jackson and Umatilla.

The new guidelines

  • prohibit indoor visits at long-term care facilities;

  • mandate working at home to the extent possible;

  • set new capacity limits at restaurants and gyms to 50 people, including customers and staff;

  • recommend not gathering with people outside your household, or capping group sizes at six for Oregonians who do gather (except houses of worship).

Not happening in Oregon that needs to happen:

[Caveat: We must acknowledge: FEDERAL failure.]

Contact Tracing - inadequate retrospective tracing and informing of contacts of COVID+ people

  • Opening criteria in May required 15 contact tracers/100,000 population and to trace 95% of cases within 24 hours.

  • As of Oct 29, Mult has 77 tracers, 94 investigators (should have 122 [met])

  • Wash county has 68 tracers, 20 investigators (should have 90 [not met])

  • Clack county has 13 tracers, 25 investigators (should have 63 [not met])

Testing Testing Testing - We continue to have inadequate testing supply for reasons that are inexplicable.

Masking/Face Shields

  • Needed: Better Public Education and Enforcement of Masks and social distancing (Oregon Nurses? Weiden+Kennedy?)

  • SHIELDS alone are not adequate but are still allowed (tho discouraged) by OHA (CDC does not allow shield alone as sufficient protection from COVID).

  • Masks with vents should not be allowed in Oregon

PPE- decentralized - there is no state level action and counties are competing with each other or even with places like CA. There continues to be a PPE shortage in Oregon. This impacts health care and the ability for schools to reopen.


Schools in Oregon

Oregon: metrics for school reopening have been updated so that the bar is easier to clear.

  • OLD Metrics: metrics to be met three weeks in a row (county):

Case Rate ≤ 10 cases/100K people in county in preceding 7 days

Test positivity ≤5% in preceding 7 days

  • NEW Metrics:

    • If >200 cases/100K over 14 days: remain remote learning

    • If 100-200 cases/100K over 14 days: transition

    • If 50-100 cases/100K over 14 days, test 5-8% pos: hybrid of in person + remote

    • If <50 cases/100K over 14 days, test <5% positive: on site learning

    • Multnomah County is at 245/100K over 7 days (ending 11/7), with 10.6% pos rate

    • Washington County is at 190/100K over 7 days with 10.2% positive rate

    • Clackamas County is at 195/100K over 7 days with 10% pos rate.


There are risks to virtual learning, so I welcome the loosening of restrictions for return to school

  • School closures are especially difficult for working class families who cannot afford tutors, pods, or private schools.

  • Mental health issues - isolation, toxic stress

  • Achievement Gap - those already falling behind are most affected

  • Less active/less outdoor time.

  • Attendance is less than par. (Dr Hayes - 2 kids hadn’t registered yet)

  • WIFI and hardware challenges.

  • Is there a way to open schools to the most vulnerable (how to define?)

  • Can we shore up our schools NOW to prepare for in person learning sooner?




COVID Therapies (recycled from Oct newsletter)

Remdesivir: Shortens the course of illness in hospitalized patients with pneumonia.

Steroids (Dexamethasone): Helps blunt inflammation in hospitalized patients.

Monoclonal antibodies (investigational): Mass produced antibodies that are mimics of the molecules the body produces against the COVID virus. These molecules work in a variety of ways, including preventing the virus from infecting cells, or tamping down the number of virus in an infected patient. MAY EVEN BE USED as a preventative: giving the antibodies to those who have been exposed.

  • Eli Lilly product - paused clinical trials 10/13/20 d/t illness of a patient

  • Regeneron product - given to Trump

Hydroxychloroquine: not useful in treating COVID.


Herd immunity

  • Thru vaccine + illness/recovery or both

  • We need (estimated) 60-70% herd immunity to slow or eliminate community transmission.

  • A 90% effective vaccine (see below) needs to be administered to 70% of the population to confer immunity to 60% of the population. There will be additional (presumed) immunity for people who have been sick and recovered from COVID.

  • If we continue with safety measures (handwashing, masks) we can achieve adequate protection from community spread with a lower % “immune”.



COVID Vaccine News: Pfizer Vaccine

  • Pfizer (Phase ⅔): Announced that early trials (44,000 patients) suggest their vaccine is 90% effective! This is above the bar of 50% effective that the FDA has set for advancing the vaccine toward the production line.

    • How it works: Vaccine delivers viral genetic material (mRNA) into our own cells which then produce viral proteins, ie spike proteins found in the coat of COVID. The immune system reacts to the (“foreign”) spikes with antibodies and other responses. The antibodies then get activated when a COVID virus (with its spikes) enters a body and the antibodies disarm the COVID virus, preventing infection. There has never before been a successful mRNA vaccine.

    • Hoping for 30-40 million vaccine doses produced by the end of 2020. Two doses of the vaccine are required to confer immunity. Difficult issue: the vaccine needs to be shipped/stored frozen.

    • Priority for first vaccines: Health care workers and those with highest fatality rate from COVID.

    • Funded: $2B from US govt as “pre-purchase” of 100 millions doses; no fed money for research and development.

    • This is good news for all of the different vaccines being tested, especially those that use spike protein, or the mRNA model.

  • Oregon has a plan to procure, distribute and administer COVID vaccine, using pop up clinics, Emergency Medical Services,


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This website is written by Lisa Reynolds, MD, Portland, Oregon Pediatrician on the front lines of the coronavirus epidemic. Mom and daughter. Candidate for Oregon HD36.

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Lisa Reynolds, M.D., Announces COVID-19 Pandemic Recovery 

Legislative Framework

Proposed framework prioritizes health of all Oregonians, with phased restart of state’s economy

 

April 17, 2020 (Portland, OR) - Lisa Reynolds, M.D., a physician and candidate for Oregon House of Representatives-District 36 (NW/SW Portland), released a legislative framework called the Oregon Pandemic Recovery Act, with the goal of making this the first bill of the 2021-22 legislative session (HB-1). 

 

“In the next weeks and months ahead, I plan to work with state leaders, as well as community and business leaders, to help design Oregon's transition and recovery from the pandemic,” said Reynolds. “If we do this right, Oregon can come out better than ever. And of course, I will continue to reach out to Oregonians about what they need right now so we can help.” 

 

The Oregon Pandemic Recovery Act, a bold response to COVID-19’s unprecedented threat to Oregonians lives and livelihoods, consists of three major components:

 

  1. A large-scale and ongoing public health response that utilizes universal testing, contact tracing, and isolating the ill and the exposed.

  2. The moonshot goal of achieving widespread (“herd”) immunity (80-90 percent) to COVID-19 through demonstrated antibodies and/or vaccination. This is a prerequisite to full economic and societal opening.

  3. Post-pandemic massive investment to modernize Oregon’s healthcare system, schools and infrastructure through the sale of Oregon COVID Bonds.

 

Oregon COVID Bonds would allow Oregonians, as well as others around the country and the world, to invest in Oregon. “This will allow the state to build a healthcare system that improves the health of every Oregonian, to complete long-neglected infrastructure projects and to modernize our schools,” stated Reynolds.  

 

“I want everyone to understand that the 2021-22 legislative session must be focused entirely on pandemic response and recovery,” said Reynolds. “I believe we can rebuild Oregon and make us stronger and more equitable in the process.” This legislative framework also accounts for a lack of federal leadership, positioning Oregon as a national leader.

 

The latest numbers in Oregon show that the state is predicted to peak on April 26. As a result of Governor Brown’s Stay Home Order, Oregon’s hospital systems have sufficient capacity to care for those sickest with COVID-19. Reynolds says that eventually, the cumulative number of new illnesses and deaths will plateau. Oregon will then enter a period of transition, and once sufficient herd immunity is achieved, we can move into post-pandemic recovery.

 

“As a physician, I have prepared my entire career for this moment,” says Reynolds. “We cannot rely on the status quo or politics as usual. We need leaders with medical expertise who can work across the aisle and bring fresh perspectives at this critical time in our history. We need courageous and bold action to make sure that Oregon comes out of this crisis stronger and more equitable than before.” 

 

Reynolds, who was recently endorsed by the Portland Tribune “[for] her invaluable insight for these troubling times”, also says that, “every state policy and every state agency will need to prioritize spending and services through the lens of the pandemic.” 

 

Read the full legislative framework here. Visit Reynolds’ COVID-19 website at oregoncoronavirusupdate.com or her campaign website LisaForOregon.com. Follow Dr. Reynolds on Facebook, Instagram, Twitter (@lisafororegon).

 

###

 

Oregon Pandemic Recovery Act Legislative Framework

 

Following is a legislative framework for a successful and equitable recovery from the COVID-19 pandemic called the Oregon Pandemic Recovery Act (HB-1). This legislative framework was drafted by Lisa Reynolds, M.D., candidate for Oregon State House of Representatives-District 36. Dr. Reynolds, who will solicit feedback from voters about what the Oregon State Legislature needs to focus on in the upcoming 2021-2022 legislative session. 

 

Dr. Reynolds will also work with state leaders, as well as community and business leaders, to identify the most impactful and cost-effective steps to get Oregonians back on solid ground. The Oregon Pandemic Recovery Act is a bold response to COVID-19’s unprecedented threat to Oregonians’ lives and livelihood. The framework consists of three major components:

 

  1. A large-scale and ongoing public health response that utilizes universal testing, tracing of all contacts, and isolating the ill and the exposed. Extensive, if not universal, testing, both for the presence of the virus, that is, contagiousness, and presence of antibody, or immunity, is necessary before any significant reopening of the economy. Testing must be followed up with tracing of the contacts of all COVID-19 cases, and isolation for those infected or exposed.

  2. The moonshot goal of achieving widespread (“herd”) immunity (80-90%) to COVID-19 through demonstrated antibodies and/or vaccination. This is a prerequisite to full economic and societal opening. True economic reopening requires widespread immunity, either through previous COVID-19 illness or through widespread vaccination.

  3. Post-pandemic massive investment to modernize Oregon’s healthcare system, schools, and infrastructure through the sale of Oregon COVID Bonds.

 

Any full scale ‘re-opening’ in the near future would risk Oregonians’ lives. Rather, restrictions must be lifted methodically and incrementally. The state needs to start planning for a massive vaccine campaign as soon as the vaccine is available. Oregon should be the first state with demonstrated ‘herd immunity’ so that Oregonians can resume safe interactions with friends, family, and neighbors. 

 

HB1: The Oregon Pandemic Recovery Act of 2021-2022 Outline

 

Intra-Pandemic: Stay Home, Save Lives

  • Goals

    • Primary Goal: Save as many lives as possible

    • Secondary Goal

      • Educate and feed children

      • Protect the vulnerable from economic damage

  • Strategic Initiatives

    • Test/trace/isolate - build a public health workforce 

    • Tech for schools - provide robust learning for every Oregon student

    • Table - feed the hungry, allocate unemployment benefits, provide rent relief and continue to ban evictions

 

Transition: reopening (gradual and partial)

  • Goals

    • Primary Goal: Save as many lives as possible

    • Secondary Goal:

      • Safe return to economic life (incremental, methodical)

      • Safe return to school 

  • Strategic Initiatives

    • Universal testing/tracing/isolation - database

    • Statewide Alert system for Oregonians for disease hot spots

    • Build a vaccine fund - and a system to vaccinate all Oregonians

 

Post-Pandemic (herd immunity; post-vaccine) - a stronger, more equitable Oregon

  • Goals

    • Economic recovery 

    • Prepare Oregon for its greatest decade of economic growth

    • Improved lives for all Oregonians

  • Strategic Initiatives

    • Oregon COVID Bonds - to raise and invest $4B/year for 5 years

      • Basics

        • Modernize public health and healthcare systems

        • 21st-century schools from PreK-post secondary

        • Build Infrastructure - bridges, public transport, bike lanes

        • Build Housing - affordable & supportive housing

      • Boosts: Climate action

        • Give preference and priority for projects that reduce carbon, increase climate resiliency, and increase economic opportunity equitably. 

 

The proposed funding would be through COVID-19 Bonds. This approach would allow Oregonians, as well as others around the country and the world, to invest in Oregon. This will allow the state to build a healthcare system that improves the health of every Oregonian, to complete long-neglected infrastructure projects and to modernize our schools. 

 

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