Oregon Coronavirus Update (Part 1) Cases/Deaths/Vaccines

Lisa Reynolds, MD, pediatrician and Representative-Elect for Oregon House District 36.

12/31/20

Lisa’s Oregon Coronavirus Update Summary: Oregon is seeing a slow in the spread of COVID! There is overall a downward trend in COVID cases everywhere. This is good news although we brace for a spike in cases due to Christmas travel. Not good news? The vaccine roll out is slow.

COVID in the World

Cases: 82 million; Deaths: 1.7 m (trend is downward)

COVID in the US

Cases: 19.5 m; Deaths: 339,000 (trend is downward)

(pace: 200,000 cases/day; 3,600 deaths/day; our 14 day case count is down 11% compared with previous 2 wks)

There will invariably be an uptick in cases and deaths due to holiday travel, which was brisk.

The US makes up 4.4% of the world’s population, but we make up about 20% (19%) of the world’s deaths. And we are the richest, most advanced country in the world. Our public health system is broken and has failed miserably. And yes this in part due to Trump’s politicization of masks and of social distancing and the underfunding of COVID testing and control measures.

COVID in Oregon

Oregon COVID Cases: 111,000 (2600/100K) - we are averaging 1000 cases/day; down 30%. Our Rt is 0.88, which means that for every case of COVID, fewer than on person catches it from that person! This is a huge success! Let’s hope it’s not a statistical glitch (under-reporting cases/tests/etc). [https://rt.live] Furthermore, our hospitalization count is down. Long story short, the restrictions placed on high risk counties seem to be working!

Oregon COVID Deaths: 1500 (35/100K); down 43%. We continue to be among the 10 best in the nation for cases and for deaths.

We need to prepare for an increase in cases and deaths resulting from holiday travel, which was brisk. Portland International airport had its busiest travel day on Sunday Dec 27 since the March stay home orders.

Governor Brown’s Framework for County COVID risk and Associated Restrictions

Starting Jan 1, five counties in the extreme risk category have been downgraded to high risk. This means some of the restrictions in those counties have been loosened. The Tri-county area continues in the Extreme risk category. Here is a list of counties and their statuses.

TriCounty area (Extreme Risk):

• Limiting restaurants and bars to take-out and outdoor dining only.

• Closing gyms and other indoor recreational facilities, museums, and indoor entertainment like theaters.

• Outdoor recreational facilities, zoos, gardens, and entertainment venues with strict numbers (<50). City parks and playgrounds will remain open.

• Requiring all businesses to mandate that employees work from home when possible, and to close offices to the public.

• Limiting grocery and retail stores to 50% capacity and encouraging curbside pickup service.

• Prohibiting visits at nursing homes and other long-term care facilities.

• Limiting social get togethers, whether indoors or out, to no more than six people from two households.

• Limiting worship services (worship/funerals) to 25% or 100 people when indoors and 150 people when outdoors.

• WA, CA and OR have asked folks to refrain from non essential travel and to quarantine for 14 days upon arrival from out of state.

Vaccine News

First, I received my COVID vaccine last night. I am incredibly grateful. (Moderna, dose #1).

Second, I am dismayed, but not too surprised, at the lackluster rates at which we (US and Oregon) are getting vaccines into people’s arms. We must do better - at these rates, it will take 3-4 years to provide sufficient immunity to save lives, livelihoods, and get kids back into school.

• US: 2.8 million doses of COVID vaccine had been given out of 12.4 million doses sent to states (Moderna and Pfizer/BioNTech vaccines combined). 22% CDC Covid Vaccine Tracker

• Oregon: As of 12/29 (31,380/131,575) we are at 24%. While OHA has a vaccine plan, they do not have goals of vaccines administered per day. OHA tracker.

• Administering the vaccine strains an already stretched public health system. In Oregon, we have seen challenges in doing sufficient testing and contact tracing. And now we are adding this new job. Fortunately, state and federal resources (dollars) are being allocated as well. Still we need a robust system to quickly accelerate our vaccine rates. This is an all hands on deck, need-to-think-out-of-the-box moment. Stay tuned.

• The federal government has contracted with pharmacy chains to help with vaccine distribution (Costco, Walgreens, etc). They will send teams of pharmacists and staff into nursing homes to administer the vaccines.

Moderna v Pfizer (article): note: states do not have control over which vaccine they receive at this time.

• Both Moderna and Pfizer vaccine show 94-95% effectiveness at preventing severe COVID disease. It’s not clear if a vaccinated individual could still get mild or asymptomatic COVID. If so, even a vaccinated person may shed COVID virus. As we know, our precautions (masking/handwashing/distancing) must stay in place for a long time (at the very least, until we have 80-90% vaccination rates).

• Cold Chain Storage

• Moderna: Ship at -4 degrees Fahrenheit (regular freezer); after thawing, can be stored in refrigerator for 30 days, room temperature for 12 hours

• Pfizer/BioNTech: Ship at -94 degrees F (ultra cold freezer). Pfizer (with the help of UPS) has a specially designed dry ice box, which, when kept sealed, will keep the vaccine at the required temperature for 10 days. This box also has a temperature monitor and a GPS tracking device. After thawing, vaccine must be used in 5 days.

• Minimum Order

• Moderna: 100 doses; distributed in 10 dose vials (each dose 100 mcg of vaccine)

• Pfizer: 975 doses (a more cumbersome process); distributed in 5 dose vials (each dose: 30 mcg)

• Second doses (first dose confers approx 50% protection, vs 94-95% for two doses)

• Moderna: 28 days after first dose (can be longer)

• Pfizer: 21 days after first dose (can be longer)