June 3, 2020

Multnomah County is on track to submit its proposal for reopening Friday, June 5, pending a Board vote.

Meanwhile, public health officials said during a Wednesday briefing that they will watch to see whether recent large demonstrations to protest a police officer’s killing of Minnesota resident George Floyd result in an uptick in cases of COVID-19.

Demonstration in Portland June 2, 2020

The briefing highlighted the County’s progress toward safe reopening by leading inclusively with race through culturally specific strategies created in partnership with communities of color, as well as plans to expand testing and contact tracing. The County also updated its reopening metrics for Wednesday, June 3, to include a link to the County’s Reopening Priorities and Strategies for Support for Black and Indigenous communities and People of Color. [Read here]

Contact tracing

The County plans to employ a total of 133 employees to work on cases of COVID-19. As of June 3, the team investigating cases and tracing contacts of those cases had expanded from seven in February to 63. To round out its team, the County plans to hire 30 additional staffers at the Public Health Division while also contracting with culturally specific community organizations.

Communicable Disease Director Kim Toevs told the Board that once the full team is in place, 78 percent of employees should have specific language or cultural skills. That hiring, however, won’t be complete by the time Multnomah County submits its proposal to reopen on June 5, she said. 

“We have a whole HR team working on this really hard,” Toevs said. “They have been very dedicated for weeks now.”

Beginning in March, Public Health reassigned County employees who already have the necessary training, language and cultural skills and also brought on public health graduate students trained in case investigations. Last month, the Public Health Division posted three one-year limited-duration positions, seeking to hire 20 to 30 additional staff. That will allow employees in other divisions to return to their work as restaurant inspectors and case investigators for other diseases.

By the time the job postings closed this week, the Division had received 1,600 applications. 

“People are excited to help with our public health effort,” Toevs said, calling the surge in interest “fortunate.” “I am sure we will have extensive skills and resources to draw on to meet all our criteria for language and cultural capacity.”

Testing

Multnomah County Public Health has also teamed up with the County’s primary care clinics to launch drive-through testing in mid- and east County, starting Monday at the East County Health Center in Gresham. That site will be open 9 a.m. to 4 p.m. Mondays and Tuesdays. 

The sites are reserved for symptomatic people who lack health insurance, who are residents of color, or who do not have a regular healthcare provider. The County asks people who can access testing through their own health care provider to do so instead if they can.

A second site is not yet final, but is likely to be hosted by a community organization with a spacious parking area.

“We’re super excited about that and a second site in mid-County. We want to focus on community health partnering to promote low-barrier testing,” said Tasha Wheatt-Delancy, interim director of Integrated Clinical Services. “We have been working with the BIPOC community and community health workers as part of that plan. We’re also going to focus on culturally specific media and town halls. We have started some of that already.”

Each site expects a team of 14 people — greeters, swabbers, lab technicians and logistical support — with capacity to test 80 people per day. 

It’s a big team, Wheatt-Delancy said. “We can reevaluate,” she said. “But we also want to get people through pretty quickly.”

Demonstration in Portland June 2, 2020

The drive-through sites add to regular testing provided at the County’s primary clinics, as well as other testing sites such as a low-barrier clinic at the Portland Expo Center coordinated by Oregon Health & Science University. Public Health and Integrated Clinical Services are also working with community groups to offer smaller testing clinics at culturally specific nonprofits.

“This plan was really developed in concert with community,” said Chair Deborah Kafoury. “There was a real focus on realizing the safety of our staff is of the utmost importance. This is such a key element in our plan going forward. You have done a tremendous job.” 

Outbreak and reopening

Commissioner Lori Stegmann praised the work to expand a diverse team of contact tracers and add low-barrier testing across the County. But she asked whether Public Health was concerned about the impact that recent demonstrations could have on the County’s plans to reopen June 12. 

It’s too soon to tell, Toevs said. 

The State or Oregon’s standards for when regions can reopen are largely driven by rates of hospitalization. So if the County does see outbreaks, Toevs said, and if enough people do get sick enough to need hospitalization, it could jeopardize plans to reopen. But she said it’s unlikely the County would see that trend before June 12.  

It takes four to five days to develop COVID-19 symptoms, if they develop at all. Then it could take up to two days for someone with symptoms to seek testing and up to two more days beyond that for lab results to come back. It usually takes longer still for someone who is ill to become sick enough to go to the hospital.

Dr. Jennifer Vines, the lead health officer for the Portland metro region, agreed. “We might be seeing early signs of consequences in test results. But hospitalizations would potentially come later,” she said. “We’ll be looking very carefully at the numbers and revisiting the topic next week.”

Chair Kafoury said she would look to Public Health leadership for guidance as June 12 approaches. She asked members of the public to take precautions when they demonstrate, including wearing face coverings, keeping some distance from others, using hand sanitizer and watching for symptoms in the coming days. 

“We don’t know yet what the implications will be for COVID-19,” she said. “We have, since the beginning, put health and safety at the forefront. While we are still planning to go ahead with a plan for reopening June 12, we are closely monitoring what is occurring and if we have to make the difficult decision to postpone.”