October 21, 2020

After a steady decline in cases of COVID-19 between July and mid-September, cases have risen for three consecutive weeks in Multnomah County, Communicable Disease Director Kim Toevs told the Board of Commissioners during a regular briefing on the virus.

Case investigators received 525 new cases the week of Oct. 11, the most recent week of complete data. That’s a seven-day cumulative rate of 63 cases per 100,000 residents — more than double the state’s 30-per-100,000 threshold that would allow even the youngest students to return to class.

“We are not surprised to see that increase,” Toevs said during the briefing Tuesday.  “We have all been concerned about the increase of people interacting indoors as the weather has gotten colder. We have all been thinking that might happen. There is certainly an increase nationally and in Europe. We are not alone in this increase. But we are watching it carefully.”

Health officials expected cases to go up in the weeks following Labor Day weekend, as the numbers had after the Memorial Day and July 4th weekends, when more people gathered in person. Health officials don’t know how much of the recent increase is caused by last month’s smoke and wildfire evacuations, although Toevs said some people have reported exposures during stays with other households.

Toevs applauded the work of Multnomah County’s case investigators and contact tracers, who have attempted to reach all 8,585 County residents who have tested positive for the virus and the close contacts those people have identified.

Even with case numbers rising, Communicable Disease Services is still able to call about 95 percent of positive cases within 24 hours, and investigators are able to complete interviews with about 75 percent of cases within 72 hours.

“The volume of work is huge, and folks are keeping up with it. I’m really proud of them,” Toevs said. 

The increase in cases mirror a similar increase in people seeking testing. Many of those seeking testing report having symptoms of COVID-19, but many others seek it so they can travel, begin or return to a job, or undergo a medical procedure.

Health systems and labs report they’re able to keep up with demand, turning around test results in 24 to 48 hours on average, Toevs said. That said, officials are concerned that they might see a strain on testing supplies later, when the flu season is at its height, as some of the chemicals required for COVID-19 tests are also used to test for influenza. 

“That may be the next place we see limitations,” Toevs told commissioners, but flu season may be delayed this year. “Usually it moves from South to North. And with a decrease in travel, we may not be getting as many sick people in the way it normally travels across the globe.”

Overall the rate of test positivity in Multnomah County is low, hovering at about 3 percent, with the highest positivity among adolescents and young adults. White residents seek testing at a higher rate than other racial groups, but the rate of positive tests is highest among Latine residents. 

Things look different among those who seek testing at Multnomah County’s low-barrier, no-cost drive-through clinic. That’s because the Public Health Division has focused its testing on people with symptoms and close contacts of people who have tested positive for the virus. 

Of the 1,800 tests administered at the East County site since June, the overall latest positive rate is 22 percent. White residents tested at the site have an overall positive rate of about 8 percent, while Latinx, Pacific Islander and Native American residents had a positive rate of about 35 percent.

“We are focused on testing people with the highest need and likelihood of testing positive,” Toevs explained. “The focus has achieved the goal so far.”

The County last week opened a second drive-through test site for people with symptoms and people who have been in recent close contact with COVID-infected individuals. Focused efforts to promote the site continue to emphasize Black, Indigenous and People of Color communities, as well as residents who do not have a healthcare provider and those who do not have insurance. 

The new site, a partnership between Public Health and Latino Network, is located at Latino Network’s Rockwood site, 312 S.E. 165th Ave., in Gresham. The site will be open Saturdays from 9 a.m. to 3:45 p.m.

The clinic tested 78 people on its opening day, Saturday, Oct. 17.

“Our Rockwood site was a smashing success for the first week,” Toevs said. “It’s awesome to have a weekend day available. Now we have three days a week when we have testing, and in a few weeks, we will open a mid-County site as well, to bring us to four days a week.”

People who have symptoms or were in close contact with someone who had the virus don't have to wait for a contact tracer to call before seeking a test. Officials do recommend waiting at least three to four days after a likely exposure — if the test is taken too early, it may return a false negative.

Chair Deborah Kafoury thanked Public Health staff for its months of relentless work. 

“We remain one of the lowest states in the country in terms of rates per residents, and I know that that is in no small part due to the hard work of Multnomah County's Public Health team,” Kafoury said. “We can always do things better, and we are learning as we go along. This is an unprecedented event, and you all make me proud to be a Multnomah county resident.”