Multnomah County has met several key thresholds for reopening, but must have more contact tracers, more personal protective equipment, and strategies in place to monitor and contain COVID-19 among communities of color and other vulnerable groups.
At a press conference Thursday, May 14, County leaders released a dashboard to show how the County’s progress toward meeting state criteria along with additional local requirements — benchmarks that underscore the complexity of lifting restrictions here.
Extra care is needed because the County is the heart of Oregon's most populous region, with more hospitals, more diversity, and the largest number of vulnerable residents. The County has 20 percent of the state’s population, but 27 percent of COVID-19 cases and 40 percent of deaths.
Other metro area counties also have yet to ask to reopen.
"Multnomah County’s reopening proposal must reflect the unique needs of its residents. If we open too much, too fast, this virus will only continue to deepen already unacceptable health inequities, overwhelm the healthcare system and cost lives," Chair Deborah Kafoury said.
Beginning Friday, May 15, some retail services and children's programs can reopen across the state, so long as they adhere to new rules. Once approved, counties can begin “Phase 1” reopening — when dine-in restaurants and bars, gyms and salons can reopen so long as businesses adhere to new rules. Additional services would open as part of “Phase 2.”
Multnomah County must submit a proposal that shows the County meets seven statewide prerequisites and five additional requirements as part of a health region that includes the metro area counties as well as some counties on the Coast.
County leaders say they are still developing their proposal, which will also include public health and equity standards that are specific to Multnomah County.
Rachael Banks, director of Public Health, unveiled a new reopening dashboard that shows the County is meeting three of the seven statewide benchmarks and four of five thresholds for the health region. That region includes Washington, Clackamas, Clatsop, Tillamook and Columbia Counties.
“We have made significant progress,’’ Banks said. “And we are going above and beyond to ensure our community is monitoring three other metrics that affect our communities of color and other vulnerable populations.’’
Those include monitoring the spread of the virus in communities of color, ensuring sufficient testing sites for underserved communities, and making sure community partners, such as social service providers, have adequate supply chains for personal protective equipment.
Banks said contract tracing will remain a key part of the public health response — contacting everyone who has a positive for COVID-19 and finding out exactly where that person had been and whom they might have been near. Contact tracing is a core public health function that County case investigators have used for years to successfully track and contain contagious diseases like measles and HIV.
The County has already quadrupled its numbers to 35, but with this virus, Banks said, the County will need 87 more to meet the state’s per capita requirement. The County will also need to meet a new requirement to begin contact tracing within 24 hours of a positive test.
“We’ve been able to call 75 percent within three days. And we are adjusting our game to the new goalposts,” Banks said.
Because of inequities in exposure risk and inequitable levels of underlying health conditions, residents of color are harder hit by the virus. Banks said the County needs a workforce that knows those communities, can speak languages other than English, and can build trust, so residents will be willing to talk.
Chris Voss, director of Multnomah County Emergency Management, said the County is meeting protective equipment requirements for hospitals with its regional partners, and is close to having adequate protective gear for first responders, as well.
But many community providers, from TriMet to home healthcare workers, rely on Multnomah County for their protective gear, he said, and still request additional supplies when they have less than a week's supply left.
“In the last two days, we have received 33 requests. And in the last two weeks over 300 requests. That means there were 33 organizations in just the last two days that are not able to receive the supplies they need to stay open using the current supply chain,’’ Voss said.
“And while we are happy to help out with supplies we receive from the state, that supply is limited,” he continued. “We wanted to acknowledge that these organizations are also critical and that the normal supply chain is still not able to provide everyone with what they need.”
Chair Kafoury said the County will need more resources to respond to COVID-19, from hiring new contact tracers to isolating ill people in motels. Although Multnomah County is the state-designated public health authority leading the local COVID-19 response, and also the state’s largest safety net provider, the County has received just 2 percent of the $1.7 billion allocated to Oregon’s regional governments through the federal CARES Act. The allocation was based on populations.
“The blunt calculations used to allocate this disproportionately small amount hurt the people of Multnomah County and risk undercutting our ability to reopen and recover safely,’’ Chair Kafoury said.
County leaders said they will update the dashboard every Wednesday and carefully watch what happens in the community as businesses and public spaces reopen.
“The times ahead — and the timing — are uncertain,’’ said Dr. Jennifer Vines, the lead metro area health officer. “It may be helpful to remember what you and I can control:
Stay close to home, but get outside.
Protect your health and the health of those around you by wearing a face covering.
Maintain at least 6 feet of distance from others.
Remember good hand hygiene.”
What Happens May 15?
The state will allow some businesses and programs to reopen across Oregon:
Stand-alone retail stores
Camps and youth programs
The state will begin allowing some counties to enter “Phase I”
Once a county plan is approved, counties can begin reopening, with conditions and limits:
Salons, massage parlors, non-medical spas
Fitness centers and gyms
Malls and businesses within malls
After 21 days in Phase I, counties continuing to meet the prerequisites may further lift restrictions on:
Pools and spas
Visitation to nursing homes and long-term care facilities
Concerts, conventions, festivals, live audience sports won’t be possible until a reliable treatment or prevention is available. It is unknown at this time when this will be. All large gatherings should be canceled or significantly modified through at least September.