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Health and Medicine

Everything You Need To Know About COVID-19 Now That Cases Are Soaring And The ‘Freeze’ Is Here

OHSU nurse practitioner Shelby Freed tests a patient for COVID-19 at a drive-up testing station in Portland, Ore., in this file photo
Bradley W. Parks
/
OPB
OHSU nurse practitioner Shelby Freed tests a patient for COVID-19 at a drive-up testing station in Portland, Ore., in this file photo

Oregon was largely spared by the global pandemic, but no longer. Cases mount as the state enacts the strictest social-distancing measures since April. With holidays rapidly approaching, we have answers to all of your questions: just how bad is it? How is this lockdown different from the last? Can I have Thanksgiving?

Lockdown is back. Or, at least, a version of one. Effective Wednesday, Oregon is enacting its strongest COVID-19 restrictions since April. This time, more businesses and parks are open, and there are no restrictions on non-essential travel. But there’s also a lot more of the coronavirus going around and a spike in COVID-19 cases.

Oregon has topped a thousand cases a day. How bad is that?

It’s pretty bad. Yes, plenty of states have higher daily case counts than Oregon, and higher per-capita case counts. It’s more important to look at how fast the number of new cases is rising. Just two weeks ago, on average, 400 new people in Oregon were diagnosed with COVID-19 each day. Last week, Oregon’s daily average topped 1,000 new cases.

That’s exponential growth — that’s everyone’s biggest fear. If it keeps doubling at that speed, by the end of next week Oregon could be seeing 2,000 cases per day.

Of course, that might not happen. But it depends on us. The coronavirus that causes COVID-19 is more prevalent and widespread in Oregon than it has been at any point during this pandemic. If people don’t follow new COVID-19 restrictions — and even if they do — cases could continue to rise. And it will take a few weeks to figure out how well new restrictions work, once they go into effect.

How does this compare to what happened in spring?

It’s hard to compare case numbers to those during the spring: we had so little testing. So instead of comparing the number of sick people, we should look at the number of people hospitalized.

Morning rush hour emptied of cars in downtown Portland, Oregon during coronavirus pandemic, March 20, 2020.
Stephani Gordon/OPB /
Morning rush hour emptied of cars in downtown Portland, Oregon during coronavirus pandemic, March 20, 2020.


In April, COVID-19 hospitalization peaked at just over 300. At that point, the number of cases in Oregon was already declining. Right now, there are over 400 people hospitalized with COVID-19 in Oregon. But the number of cases is still rising. So it’s going to get worse.

How bad is it going to get? Can we stop it?

That’s very hard to say. The situation in hospitals is going to get worse no matter what because a lot of people newly diagnosed with COVID-19 have yet to get sick. They’re baked into our total count.

We’re also going to be in it for the long haul. As far as we can tell, this virus is acting the way new respiratory viruses usually do: it’s less prevalent in the summer, and then returns with a vengeance in fall, winter, and spring. We were lucky — when COVID-19 first hit, temperatures were getting warmer and people were moving outside. But now it’s getting colder, and we’ll be spending more time indoors. There will be more opportunities for the virus to spread.

To get an idea of how bad things could be, we can look to the Southern Hemisphere. After an initial lockdown, cases skyrocketed as winter began. Victoria, one of the coldest and hardest-hit Australian states, enacted very strict lockdowns: people could only leave their houses once a day and weren’t supposed to drive more than a few miles away from their homes. Cases there peaked at about 700 in late July.

The lockdown was hard, but it worked. Since mid-September, Victoria has seen less than 30 cases a day, and on Tuesday it recorded its 18th consecutive day with no COVID-19 diagnoses or deaths. There are only three active cases in the entire state.

Everybody said that we were gonna have a second wave, and we are having a second wave. Why didn’t we do anything to stop it?

It’s hard to say. In a press conference Friday, State Epidemiologist Dr. Dean Sidelinger said that the exponential growth of the virus snuck up on them, and that two weeks ago, it didn’t look likely. Sidelinger also said that potential economic impacts were weighed when deciding whether or not to impose more restrictions.

Initially, Oregon planned to close down individual counties if cases got dangerously high. It was commonly thought that COVID-19 would spike in some places, but not in others, and statewide restrictions wouldn’t be necessary. But it quickly became clear that cases were rising across Oregon, and that every free hospital bed in the state could be needed to take care of people with COVID-19.

We’re in another lockdown. How is this one different?

We have a lot more freedom during this lockdown. We’ve learned a lot since the pandemic started. We know that being outdoors is fairly safe. We’ve also learned a lot about how important social interaction can be to staying psychologically healthy during this pandemic.

In this lockdown, you can still see friends. But in Oregon, gatherings need to be limited to two households, and less than six people. You can still go to some businesses, like salons and physical therapy.

Hair stylist Ceanna Jennifer Lee works with a client on the first day of her salon's reopening following COVID-19 closure on June 6, 2020, Beaverton, Oregon.
Arya Surowidjojo/OPB /
Hair stylist Ceanna Jennifer Lee works with a client on the first day of her salon's reopening following COVID-19 closure on June 6, 2020, Beaverton, Oregon.

How is the lockdown being enforced?

Oregon Gov. Kate Brown said during a press conference last Friday that violating the new COVID-19 restrictions is a misdemeanor, punishable by citations and even arrest. As of Monday, Brown had yet to outline exactly how those citations would be issued or what they would be for but said she is working with law enforcement officials on the logistics.

How long will the lockdown last?

That’s a really tough one. The official “freeze” is for two weeks. But Brown has said that counties could need to extend their shutdown by a further two weeks. Multnomah County already has.

How long these new restrictions will be in place depends entirely on how well they work and how well people follow them. If everyone stayed home for two weeks, Oregon could theoretically identify every symptomatic case of COVID-19 and re-open. But that isn’t possible. Under these rules, people are still going to church, still going to grocery stores, still getting haircuts and massages. And, of course, not everyone follows the rules.

But each individual’s decisions can make a big difference in COVID-19 spread.

Is there anything additional I can do to keep myself and others safe?

Yes! There’s a lot you can do. Unfortunately, it all comes down to the same thing: avoid close contact indoors with other people as much as possible. So even though it’s not required, try to limit your trips to the grocery store like you did in the spring.

Limit your interactions with other friends, and before you hang out with them, have an honest conversation about your potential COVID-19 exposure. And consider quarantining after any potential exposure.

Remember: every time you have contact with someone, you are also essentially in contact with everyone they have met or will meet. Your germs, or theirs, can spread far beyond that one interaction. Also keep in mind that cases are climbing rapidly, and already-overworked contact tracers have a lot on their plates. Before and after I meet with anyone, I ask myself: “if I got sick, how many people would contact tracers need to call?” Keep that number as low as possible.

How do I ask people about their COVID-19 exposure?

You just ask. Or, personally, I like to set the stage by offering my own exposure. For example, in October I helped a coworker move. When I offered to help, I told her that I had met with two friends on separate days outdoors, and one had a recent negative COVID-19 test. I had gone grocery shopping once in the last two weeks. Unprompted, she told me she’d been essentially isolated for two weeks, but had met with her new property managers.

I could have been infected. There was no guarantee I wasn’t. So could my friend. But that gave both of us the information we needed to make an informed choice before meeting face-to-face.

It feels like other people aren’t taking this seriously.

They might not be. Data shows that while some Oregonians go above and beyond complying with COVID-19 restrictions, others don’t.

But peer pressure is a hell of a drug. The more people wear their masks, the more people avoid social gatherings, the more likely other people are to comply. Lead by example: you want it to be normal for friends to show up with masks to spare and a list of past contacts. The fact that you take things seriously could be enough to convince some friends who might be on the edge.

Can we do holidays safely?

No. Or, at least, you can’t do them like you used to.

Oregon’s current rules forbid gatherings of more than six, or gatherings of more than two households. But just because you can have a few members of your friends or family over for Thanksgiving doesn’t mean you should. Every close interaction is a risk. Remember: assume everyone you have met with is infected.

But Thanksgiving is my favorite holiday and I’m lonely.

Me too, my friends. Me too.

So I’ll say it here: If, and that’s a big if, you’re following guidelines, it can be OK to have a Thanksgiving dinner or meet up with friends. That’s not an endorsement of gatherings (they’re never completely safe!) but some of us need to take a little bit of risk in order to stay sane.

The important thing is to take as little risk as possible and to prioritize where you take that risk. You want to have a Thanksgiving dinner? Okay. But it’s a tradeoff. In exchange, maybe you cancel other plans with friends or decide to stay home for Christmas. Avoid having close contact with anyone leading up to the holiday. Your safest bet is to quarantine yourself for two weeks before Thanksgiving (so, starting Thursday!) and ask guests to do the same.

Thanksgiving is a risk. To do it responsibly, you need to at the very least, cut down risks you take in other areas.

Any tips for staying extra safe at holiday dinners?

If the weather is nice enough to gather outside (let’s be honest, we’re in Oregon, it’s unlikely) you should gather outside. You should ask everyone attending about their potential COVID-19 exposure, and let them know that if they aren’t meeting your own safety standards, they will be uninvited. I quarantined for two weeks so I could visit my mother for her birthday in June. I won’t be seeing my parents for Thanksgiving, but if I were, I would quarantine for two weeks first.

Eating indoors is always risky, but there are steps you can take to make it safer. Do anything you can to increase the flow of clean air. Open windows. If you have central air, check and change your air filter and keep the air running on high. If you have air purifiers with true HEPA filters, run them in the rooms where people are gathering.

Everyone should be masked at all times unless they are eating or drinking. This can be a good opportunity to get clever: maybe you socialize indoors and scarf down your dinner outside or in a different room.

The Umbrella Man statue wears a mask in Pioneer Courthouse Square in Portland, Ore., Saturday, April 18, 2020. Public health officials have encouraged people to wear masks to slow the spread of COVID-19.
Bradley W. Parks /
The Umbrella Man statue wears a mask in Pioneer Courthouse Square in Portland, Ore., Saturday, April 18, 2020. Public health officials have encouraged people to wear masks to slow the spread of COVID-19.


Invest in some reusable straws. They can help you drink without taking off your mask.

Assume everyone that you have had contact with is infected with COVID-19, and after Thanksgiving, assume you are infected. You want to avoid getting sick in the first place, but if you do get sick, you want to make sure that you are a virus-transmitting dead-end. Consider quarantining after Thanksgiving, not just before.

Can air filters help keep you safe indoors?

Conceptually, yes: as long as you also wear masks and practice social distancing. Scientifically, the jury is still out: there haven’t been any experiments yet. It’s best to think of them like masks: it won’t protect you totally, but it’s one more thing that can reduce your risk of exposure. And when used in conjunction with other social distancing measures, like masks, the amount of protection you have increases.

Sheila Mulrooney Eldred wrote about air filters for NPR. She interviewed medical experts and virologists, and they all said the same thing: there’s no reason air purifiers shouldn’t reduce the number of virus particles circulating in a room if they are the right type and used properly.

A true HEPA filter will catch at least 99.7% of particles that are .3 micrometers. It will also catch larger particles and smaller particles, but that’s the baseline it needs to meet to qualify as “true HEPA.”

SARS-CoV-2, the virus that causes COVID-19, is smaller than .3 micrometers. But it doesn’t float around in the air on its own, it’s carried in tiny droplets of water and mucus called aerosols. Those droplets are large enough to be caught by filters.

Eldred writes that any HEPA filter you’re purchasing to catch viruses should meet certain specifications. Look on the air cleaner’s box to see if it has a CADR of 300 CFM or more. Ugh, jargon, but that’s how they get labeled. A CADR is the clean-air delivery rate of a filter. CFM is a measure: cubic feet per minute. So: an air filter with a CADR of 300 CFM can circulate all the air in a normal-sized bathroom once a minute, and a 130 square foot living room roughly four times a minute.

And keep in mind: they are not a 100% guarantee. It’s when you couple an air purifier with social distancing, masks, increased airflow, and handwashing that you’ll have the best results.

Are schools safe? Should we close them?

The vast majority of evidence gathered from states and countries around the world suggests that school is safe, particularly for students age 10 and younger, if good social distancing measures are practiced. You can read more about some of the research here.

There are a lot of reasons to keep schools open. Many students learn best by in-person education, and distance learning has opened up a new world of problems for parents who are trying to work from home and educate their students. Schools also provide a ton of benefits to students outside of an education. Closing schools is, therefore, being treated as a last resort.

We are seeing more cases in kids under 18. But here’s the weird thing: we’re seeing more cases in kids who are distance-learning, too. So kids are getting sick, but so far it doesn’t seem like they’re catching the virus at school.

What’s the status on vaccines?

There are a lot of reasons to get excited about the progress different countries and companies have made in developing a COVID-19 vaccine. Most of these are DNA vaccines, a type of vaccine that had never before been tested but was first envisioned to battle cancer. DNA vaccines take much less time to produce than traditional vaccines, which use all or part of sick or dead viruses to trigger an immune response.

Several vaccines are currently in phase 3 trials. Phases 1 and 2 check for safety in small groups. Phase 3 trials involve vaccinating a large number of people, and looking to see if it works. This is also when the less-common side effects of a vaccine will be found.

Some of those trials were paused while illnesses were investigated. That is completely normal and means the system is working. Most drug trials have a pause like this: when you test a new drug on thousands of people, some will inevitably get sick for entirely unrelated reasons. Manufacturers need to be sure that the illness is unrelated, so they pause the trial. In some cases, the illnesses were found to not be related to the vaccine, and the trial resumed. Others were ended permanently: that is also a good thing that means the system is working.

Dr. Anthony Fauci, the nation’s top COVID-19 expert, said that vaccines could begin to roll out early next year, or even in late December. But it could be much longer before they’re available to the general public. There’s going to be a lot of demand and limited supply. We’re in this for the long haul.

Can we trust a COVID-19 vaccine?

In September, public health watchdogs were very concerned that a new COVID-19 vaccine would not be properly vetted by the U.S. Food and Drug Administration. President Donald Trump was pushing for weaker regulations. Ultimately, the FDA chose to continue with their usual, strict vaccine-vetting plan.

Still, SARS-CoV-2 vaccines have become politicized. A recent poll found that only 6 out of 10 Americans said they will get a COVID-19 vaccine, and only if it cuts their chances of getting infected by 50% or more.

Thankfully, the data coming out of the current vaccine trials is promising: both Moderna and Pfizer say their vaccines are over 90% effective. For what it’s worth, Fauci says he trusts the system currently in place to vet the vaccines and will take a COVID-19 vaccine when they become available.

Copyright 2020 Oregon Public Broadcasting. To see more, visit Oregon Public Broadcasting.