October 8, 2020

Multnomah County saw a sharp rise in cases of COVID-19 starting in mid-September, but more recent data suggests numbers may be stabilizing, Public Health Director Rachael Banks told the Board of Commissioners during a routine briefing Tuesday on the County’s response to the pandemic.

After a 40 percent jump in cases in the last two full weeks of September, the case rate for the most recent week, beginning Sept. 29, dropped slightly. And that’s not the only good sign, Banks told the Board. Hospitalization rates have remained low, and the disparity in disease rates has narrowed between White residents and Black, Indigenous and People of Color residents.

The County has supported culturally specific and hyperlocal testing events organized by community nonprofits to target continued disparities in some neighborhoods and among some communities, including in the Latine community. 

Public Health is adding two more drive-through testing sites to expand low-barrier testing that’s currently available only at the East County Health Center. Weekly drive-through testing will begin at Latino Network’s office in Rockwood on Oct. 17, and will run every Saturday from 9 a.m. to 4 p.m. A third site is planned at the Immigrant & Refugee Community Organization (IRCO), although the opening date and weekly schedule are not yet final.

Banks said she was hopeful COVID-19’s spread had stabilized after an increase following the wildfires and Labor Day holiday, but Public Health will nonetheless watch counts and hospitalization rates in the coming days before they feel confident they understand the trend.

“We are going to be looking at that very carefully for the next couple of weeks,” she said.

Multnomah County and the City of Portland are controlling the spread of COVID-19 better than most metro areas, but the County still lags in key metrics required for further reopening of the local economy and for returning students to class.

Reopening metrics

One of those metrics, required by the State, is how many tests come back positive.

Below 5 percent suggests an area is doing well, Health Officer Dr. Jennifer Vines told the Board. Between 5 and 10 percent, officials should be paying attention. And above 10 percent means, “you’re probably headed for trouble,” Vines said. “It was over 10 percent positivity reported out of places like Arizona and Florida as they saw waves of severe COVID pass through.”

Multnomah County uses a different method than the state when calculating the percentage of positive tests, Vines said, but both methods show the County’s rate overall remained at or below 5 percent. 

That said, Vines noted, the rate in some weeks exceeds 5 percent.

“Again, you also see it bounce around week to week,” she said.

“Percent positive” is one of multiple metrics Multnomah County and the metro region must  meet to apply to the state for Phase Two reopening (see Oregon Health Authority data, then click on “Oregon’s Public Health Indicators” tab).

In addition to continuing to meet metrics for remaining in Phase One, the County and metro region must show:

  • 100 or fewer cases per 100,000 people per week

  • A first attempt at contact-tracing or case investigation within 24 hours for 95 percent of all new cases, over the previous seven and 14 days.

  • At least 70 percent of COVID-19 cases must be traced to an existing case — an indication of a lower rate of sporadic spread — over the previous seven and 14 days.

  • There cannot be a 5 percent or greater increase in cases over the past seven days

  • There cannot be a significant increase in the percentage of positive cases over the past seven days.

“There are a lot of state metrics. The one that we are probably farthest from at this point is the sporadic case rate,” Vines said. “This is in some ways a measure of just how dispersed the virus is in the community.”

So far, the County can trace just 52 percent of cases to an existing case.

“Is that partly due because people are not responding to the case investigations?” Commissioner Lori Stegmann asked.

Partially, Vines said. When people answer their phones and provide information, case investigators and contact tracers are more likely to identify links. But the rate also reflects the unknown community spread, and that’s not always something Public Health can control or affect with additional contact-tracing. 

A distinct set of state metrics determines when schools in a county can welcome students back to class. Those are county-specific and do not tie the metro counties together.

Test positivity must be less than 5 percent for three consecutive weeks, both for the State overall and any given county. In addition, a county must have fewer than 10 cases per 100,000 people for those three weeks in a row—about 80 cases per week for Multnomah County—before all students from kindergarten through high school can return.

Students in kindergarten through third grade could return sooner, when the state’s test positivity rate is below 5 percent and weekly case counts in a given county rate fall below 30 cases per 100,000 people—or about 240 a week for Multnomah County.

The Oregon Department of Education posts data each week on its health and safety site, while county-specific metrics are updated on this data dashboard.

Multnomah County currently reports well above 200 cases per week. The last time it reported cases at or below 80 was in May. 

“You see that is going to be particularly difficult for us to meet in this County,” Vines said. “I just want to acknowledge the disappointment and frustration among parents, among educators. We are racking our brains in Public Health for how to get our kids a good education this year while also balancing risk of community spread.”

Commissioner Jessica Vega Pederson, a mother of two school-age kids, said she’s like a lot of parents who desperately want their kids back at school.  

“It’s a challenge for so many families, and it’s having a bigger impact on kids who don’t have access to supports, or parents who have to continue to go to work. It’s just really hard,” she said.  

She’s heard  parents who don’t understand why schools in states with higher disease rates have reopened while Oregon’s schools remain closed. She asked why Oregon was using its current standards.

The state modeled its school reopening plan on jurisdictions in other nations that had done a good job controlling the spread of COVID-19, Vines said. It’s safer for students to go to class when there's less disease in the community and when there’s less likelihood they catch the virus and bring it home. 

“That’s why you see the really stringent requirement of less than 10 per 100,000 for K-12, because more data is showing us that teens especially get COVID and spread COVID the same way that adults do,” Vines said. “With younger children you see the slightly looser threshold of 30 per 100,000 because young kids are a little less likely to get and trade COVID, although they certainly can.”