States, Oregon counties consider reopening strategies


Douglas, Coos, Curry, Jackson and Josephine counties seek to reopen

April 29, 2020 — Now passing three months since Oregon’s first reported case of COVID-19, state and county governments are strategizing a cautious reopening of public and business life.

Balancing the trade-off of risks to public and economic health has proven a point of contention for many and has prompted certain county governments to begin pushing for easing the restrictions handed down since Gov. Kate Brown’s March 23 executive order.

On April 22, the Douglas County Board of Commissioners authored a letter imploring Brown to consent to the first phase of reopening in Douglas, Coos, Curry, Jackson and Josephine counties effective April 25 under federal guidelines. The letter, with all five county commissioners’ signatures, was set to be sent to Brown on April 24, though the governor’s office has not responded to the letter as of press time.

While the commissioners stated that they “understand the concern of an increase in COVID-19 cases once restrictions are eased,” the letter makes the case for all five counties meeting the state’s proposed criteria for reopening.

 

State Criteria

Brown has expressed favor for a regional approach in reopening the economy depending on certain criteria being met.

On April 13, the governors of Washington, Oregon and California jointly announced a “Western States Pact” which outlined a shared approached to restarting public life and business. The pact agreed on the principles of prioritizing residents’ health, guiding reopening decisions by science rather than politics and working together effectively among states.

Colorado and Nevada have since joined the pact as well.

“I’m honored to have the State of Nevada join the Western States Pact and believe the sharing of critical information and best practices on how to mitigate the spread, protect the health and safety of our residents, and reopen responsibly will be invaluable as we chart our paths forward,” said Nevada Gov. Steve Sisolak in a statement.

Goals of the pact now include:

  • Protecting vulnerable populations at risk for severe disease if infected.
  • Ensuring an ability to care for those who may become sick with COVID-19 and other conditions.
  • Mitigating the non-direct COVID-19 health impacts, particularly on disadvantaged communities.
  • Protecting the general public by ensuring any successful lifting of interventions includes the development of a system for testing, tracking and isolating.

The State of Oregon has identified three broad criteria for considering reopening, namely: slowing the spread; gathering enough personal protection equipment (PPE) and tracking and containing cases.

On April 20, the state released a more detailed framework for reopening Oregon and, though parts of the framework are subject to change, a final version is scheduled to be released the week of May 4.

Lane County Health and Human Services Director Karen Gaffney stated during an April 28 county commissioner meeting that Brown will likely make decisions regarding county requests to reopen following the release of this version.

The framework closely follows the White House’s “Opening Up America Again Guidelines,” which lists three necessary steps to be in place before regional restrictions could be eased.

The steps involve meeting a litany of standards, including three components of “gating criteria,” three components of “core state preparedness” and a three-phase reopening strategy.

Gating criteria refers to the public health front of fighting COVID-19, calling for a declining number of people with symptoms, a declining number of cases and adequate hospital capacity.

Secondly, core state preparedness refers to the degree of communities’ readiness to handle future outbreaks. The step includes: robust testing and contact tracing; healthcare system capacity including PPE and surge capacity; and plans for health and safety pertaining to high-risk workers and the general public’s social habits.

Lastly, a general reopening strategy has been divided into three phases.

Phase One would begin at the governor’s direction only after all gating criteria and core preparedness items were met. The phase would continue to encourage the public to practice good hygiene, to use face coverings when around others and to maximize physical distance when in public.

Oregon’s proposed Phase One modifications, which are still under review, are less restrictive than the federal proposal in that certain childcare services may reopen and work groups would propose Phase One strategies for bars, restaurants and personal services (e.g. hair solons, tattoo parlors, etc.).

The limit to 10 people in social gatherings would stand but be subject to review by state and local public health officials.

Following 14 days of passing gating criteria again, Phases Two and Three would then go into effect. While both phases are still in need of health authority review, Phase Two proposes to allow for an increase to 50 people for social gatherings, the resumption of non-essential travel and the reopening of schools and gyms under social distancing guidelines.

Phase Three would further increase gathering sizes, ease restrictions on workplace staffing, allow visitors back into nursing homes and allow restaurants and bars more seating.

Sector-specific discussions about reopening in Oregon also began on April 20, which are expected to yield clearer paths forward for restaurant, retail, personal service, childcare, transit and outdoor recreation industries.

Furthermore, rural counties with no cases and the ability to meet testing and contact tracing standards may begin Phase One sooner than more urban counties, according to Brown's chief of staff Nik Blosser.

 

County Readiness

The Douglas County commissioners’ April 22 letter to Brown makes the case that certain counties have already met Phase One reopening standards.

“In Southwestern Oregon, there have been very few cases, but where we have seen the most cases, there certainly has been a reduction in reported cases since the peak,” states the letter in reference to gating criteria. “We have seen a decline in the number of tests being administered as the number of people with symptoms has decreased. We also believe that we have adequate testing and hospital capacity, as well as thorough contingency planning should cases begin to increase at any point.”

On preparedness, the letter addresses reopening standards as well.

“As you know, Douglas County implemented the first drive-through testing opportunity in the state,” reads the letter. “Douglas County has also funded a team of epidemiologists who have worked diligently to trace contacts of all cases of positive test results. Coos, Curry, Jackson, and Josephine Counties each still have very few cases and capacity to test anyone with symptoms in the foreseeable future.”

The letter goes on to state that “all five counties currently have healthcare capacity to manage the case load and beyond,” but warns that hospitals may have limited ability to bear their own financial burden.

Meanwhile, Lane County’s Senior Public Health Advisor Dr. Patrick Luedtke outlined his own seven criteria in consideration for reopening in a press conference on April 13, several of which echoed the state’s guidelines.

Those criteria included:

  • A decrease of infections or deaths over two of the coronavirus’s incubation periods, which would be 28 days. As Lane County cases have plateaued to a case or two per day, Luedtke stated on April 28 that the county was on its way to meeting this standard.
  • Local testing capacity which is able to scale back up for a second wave. The county is currently equipped to conduct about 500 tests per day, with a goal of reaching around 1,000.
  • Adequate contact tracing resources, which Luedtke characterized as “doing well.”
  • Plans for the healthcare community to scale back up in case of a second wave.
  • Sufficient supply of PPE to hospitals, which officials have identified as less of a concern of late.
  • A blueprint for easing restrictions on public life and business.
  • A statewide view which aligns Lane with other counties’ ability to deal with the virus.

“For me, those are the seven main criteria that I would like to see visioned and assessed appropriately before we consider relaxing these restrictions,” said Luedtke. “I suspect that there are a few other criteria or nuances of these criteria from others in the public health space.”

The county has stated that an online resource which tracks the progress of these criteria in real-time will shortly be available to the public. As of press time, no date has been set for the release of the county’s online resource.

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