Oregon鈥檚 COVID-19 hospitalizations could peak over the course of next week 鈥� and possibly, begin to decline, according to a new model out of Oregon Health and Sciences University. But that will only happen if Oregonians continue to wear masks and take precautions.
But while hospitalizations might be peaking, that means they鈥檙e higher than ever before. In a press release on Friday, Oregon Gov. Kate Brown asked Oregonians to avoid risky activities over Labor Day weekend to keep hospital emergency departments empty.
Oregonians fought previous surges by wearing masks and abiding by strict social distancing measures. This time around, the masking is helping to flatten the curve -- but another big reason is that there aren鈥檛 as many people left for the virus to infect.
鈥淭his is the exact place that we were trying to avoid, with 1,200 hospitalizations, and nearly all hospital systems feeling overwhelmed or having to postpone or cancel other types of care. This is what we were trying to avoid. We are in that crisis,鈥� said Dr. Peter Graven, lead data scientist at OHSU.
Oregon鈥檚 hospitals are full and have been for several weeks. That isn鈥檛 going to change any time soon.
鈥淩ight now, we鈥檙e at a flattening point where, you know, frankly, it鈥檚 probably going to bounce around a little bit. We鈥檒l probably see some up and down yet before it really starts going down,鈥� Graven said, 鈥淚s it slowing down? Yes, but it鈥檚 far from better. I think we have two months of pain to go through before this is manageable again.鈥�
Any progress the state has made combatting the delta variant of the coronavirus is fragile. There are still a lot of people in Oregon who don鈥檛 have immunity. Graven said that Oregonians have been wearing masks, and have been avoiding large crowds and indoor dining at bars and restaurants, and that鈥檚 really helped flatten new infections. But he expects to see an increase in transmission tied to people鈥檚 socializing this Labor Day weekend. And as fall comes people will be spending more time inside, which could change transmission rates, too.
鈥淚t鈥檚 not like we鈥檙e past anything. Vigilance is obviously key, every bit of transmission we prevent now clears out the hospital a little quicker. And it doesn鈥檛 matter if [cases are] going up or going down, it still prevents the transmission,鈥� Graven said.
And then, of course, there are kids: thousands of children under 12, who have not yet received a COVID-19 vaccine, are returning to school.
In the spring, few outbreaks were linked to in-person learning. But now cases are much higher, and that means there鈥檚 a bigger chance of outbreaks in school. And the delta variant wasn鈥檛 a factor in the spring of 2021: now it鈥檚 a game-changer.
鈥淚 think [schools] that are taking all of the precautions can feel pretty good about that. But it鈥檚 something we need to monitor and maybe make changes as we go,鈥� Graven said.
As schools have opened around the country, some states have seen a spike in cases in children. Others haven鈥檛. It鈥檚 still not clear if the delta variant of the coronavirus is more dangerous to children.
Still, the St. Charles Health System in Bend and Redmond is currently doubling the size of its pediatric intensive care unit.
鈥淛ust in case,鈥� said Dr. Doug Merrill, chief medical officer at St. Charles.
Some Regions Are Still Hot Zones
The modeling Gravens has done focuses on the state of Oregon as a whole. And that鈥檚 important because when so many people are sick, hospitals rely on each other to transfer patients and find available beds.
But the model鈥檚 predictions are an average taken across the state. 鈥淐ases will continue to go up in some places and down in others,鈥� Graven said.
Hospital region 7, which includes Bend, Redmond, and several counties to the south and east, is one area where cases could keep going up.
鈥淥ur folks are estimating a peak 11 days later, with September 17 being our projected peak,鈥� St. Charles鈥� Merrill said.
Three weeks ago, about 50 people with COVID-19 were hospitalized in the St. Charles system, and the patients were already waiting 鈥� sometimes for days 鈥� to be admitted from the emergency room to the hospital. Today, there are over 80 people hospitalized, down from over 90 a few days ago.
Most of the people who left the ICU did so in body bags.
Merrill said their modeling expects the health system to peak locally with about 120 patients hospitalized for COVID-19 at a time.
鈥淲e鈥檙e at 220, 225 adults hospitalized right now. And normally that number is in the 180s when we are full,鈥� Merrill said.
Despite the record-high numbers, things aren鈥檛 quite as dire as Merrill had worried they would be previously, but that鈥檚 because traveling nurses and doctors have arrived from other states to help, and the Oregon National Guard was deployed to the region鈥檚 hospitals to help manage the surge of cases, too.
鈥淲e are loving the guards folk who are with us, and we鈥檙e so grateful for the staff we鈥檝e gotten from the state and through our own contracts,鈥� Merrill said.
Staff is still working overtime and extra shifts, and many COVID-19 patients are currently placed two-per-room.
鈥淚t鈥檚 just such a stressful environment. It would be wonderful if we could say, you know, hang in there for another couple of weeks and things are going to get better,鈥� Merrill said. 鈥淎nd the fact that we can鈥檛 say that just adds to the stress.鈥�
Health Care Workers Brace For The Long Haul
Although the Portland metro area has been less hard-hit than other parts of the state, due in part to high vaccination rates, the metro area hospital system is also overwhelmed. Both Providence Portland Medical Center and Providence St. Vincent Medical Center ordered 鈥渇atality management trucks鈥�: temporary morgues.
鈥淲e still see our COVID-19 numbers increasing. And we want to be ready for that,鈥� Rosa Cone, the director of nursing at Providence St. Vincent said.
Hospital morgues usually have room for fewer than 10 deceased people at a time. But the delta variant is killing people so fast, the morgues can鈥檛 keep up.
鈥淚t鈥檚 so difficult for the staff, it really takes a toll on them emotionally and physically, especially because these patients are much sicker than our first or second surge of COVID-19,鈥� said Amanda Hanley, the nurse manager of Medical Unit B at Providence St. Vincent. The number of people needing supportive respiratory care has about doubled, and the hospital filled up much faster than in previous surges.
Medical Unit B has been turned entirely into a COVID-19 ward. It鈥檚 the first place many COVID-19 patients go when they are admitted to the hospital.
Abigail McDonald, a charge nurse in Medical Unit B, said the last few weeks have been incredibly difficult.
鈥淥ur patients aren鈥檛 as sick as they are when they go to the ICU. You build relationships and know them from the beginning, to when you see them enter intensive care, and know they might not come back,鈥� McDonald said.
Health care workers at multiple hospitals told OPB that pre-pandemic when patients entered the ICU, there was a good chance they would be discharged. There was reason to be optimistic. That鈥檚 not the case now, they say.
鈥淲e do normally care for some patients at the end of life, but it鈥檚 much different when the patient has lived a full life, and it鈥檚 something they鈥檝e expected and planned for,鈥� McDonald said. Now she鈥檚 transferring patients in their 30s to critical care. These are people who never thought they鈥檇 be in this position, who haven鈥檛 made decisions about resuscitation or end-of-life care.
Now, McDonald and Hanley sometimes hear the last conversations patients will ever have with their family: conversations had over the phone or over Zoom, without anyone they knew before the hospital nearby.
This surge has hit health care workers particularly hard. Some of it is that many cases are preventable: people who would not have needed to be hospitalized if they had received the COVID-19 vaccine.
But more than that, they say, it鈥檚 the ebb and flow of hope that鈥檚 getting to them. Even if cases and hospitalizations and deaths start to decline, it鈥檚 hard to feel optimistic.
鈥榃e鈥檝e seen the light at the end of the tunnel so many times throughout the pandemic. And then to come to a surge like the one we鈥檙e facing now, it鈥檚 a roller coaster of emotions,鈥� Cone said. 鈥淚t makes me hold my breath at the light.鈥�
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