March 3, 2021

COVID-19 hospitalizations are steadily declining in Multnomah County as residents continue to follow public health guidance, health leaders told commissioners Tuesday, March 2, during a routine briefing on the pandemic. By March, 15 percent of county residents had received at least one dose of the COVID-19 vaccine and nearly 10 percent were fully vaccinated against the virus. 

The continued downward trend is welcome news, coming almost exactly a year after the first case of COVID-19 was reported in Oregon. It was a year during which more than 500 people in Multnomah County—and more than 2,000 people in the State—died from the disease.

It was a year in which more than 32,000 people in Multnomah County—and more than 155,000 people in the State—have tested positive with the virus. 

And it was a year that saw three vaccines come to market that offer strong protection against the disease.

Today Multnomah County is providing vaccines to some of its most vulnerable residents through pop-up community clinics and directly to patients in exam rooms at the county’s primary care clinics. The clinics, which make us the state’s largest Federally Qualified Health Center, expects to vaccinate up to 1,600 residents each week, Deputy Director of Integrated Clinical Services Adrienne Daniels told the Board Tuesday. 

As with clinics coordinated through the Public Health Division, primary care clinics prioritize vaccine for residents at greatest risk and most impacted by the pandemic. Almost 70 percent of patients vaccinated at a Multnomah County health clinic identify as Black, Indigenous, or a person of color, and more than 50 percent of patients requested language interpretation.

Nearly 40 percent of those vaccinated identify at Latinx, a critical demographic to support as positivity rates for Latinx residents have remained more than twice that of nonhispanic whites since the beginning of the pandemic, even as total cases have begun to drop.

“This is of particular importance because we still see that population disproportionately impacted by adverse effects of coronavirus including higher rates of positivity when going to testing,” Daniels said.

Tracking the pandemic

A year after the pandemic took root in Oregon, cases of the virus in Multnomah County have dropped to their lowest levels since summer, falling sharply from a peak in November, 2020, regional Health Officer Dr. Jennifer Vines told the Board. That trend is also measured by hospitalizations, which are near all-time lows. 

It’s too early to say whether the decline in cases of COVID-19 are directly related to the introduction of vaccines, Vines said. 

“I think this is people taking precautions and taking them seriously and sticking with them,” Vines said. “I think it’s too early to say this is the vaccine, even though we’re making great progress there.”

Commissioner Susheela Jayapal observed that, while both hospitalizations and percent positivity are low, fewer people are hospitalized now compared to when the virus was at similar levels in the summer. “I’m just wondering if there is some good news there, as well,” Jayapal said.

Vines said that while she didn’t have hard evidence, she suspects that broad vaccination among residents of long term care facilities is protecting those people at greatest risk of serious illness who would require hospitalization. 

While the trends are hopeful, Vines urged people to continue taking precautions, as variants of the virus threaten to slow progress. 

Vaccinations ramping up in Multnomah County

In Multnomah County, about 15 percent of residents have received at least one dose of the COVID-19 vaccine and nearly 10 percent are fully vaccinated against the virus. 

Health officials reminded Commissioners of the Public Health role: to identify vaccination gaps, then work with partners to bridge them. By prioritizing those most at risk for severe illness, health officials believe fewer hospitalizations will follow.

“Things are moving forward and we’re beginning to see some progress in real numbers,” said Public Health Director Jessica Guernsey. “We’re hopeful that getting some of these vaccines out early to the right populations that were suffering extreme illness and death is really making a dent in those hospitalization numbers we’re seeing.” 

The County’s vaccine strategy centers equity, adjusting access to reach those most impacted by the virus. The County held a series of listening sessions with Black, Indigenous and people of color communities to develop distribution plans that were accessible and culturally responsive, expanding language access, on-site interpretation and working with trusted community partners in locations that feel welcoming.

Through vaccine drives in community spaces, Public Health has vaccinated more than 2000 thousands of elders and health workers representing Black, Indigenous and people of color. These events are located in parts of the County that have a greater proportion of Black, indigenous and people of color. 

“These are just some of the beginning stages of the events we’ve been able to staff,” Guernsey said. “We cannot do this work without partnerships with community-based agencies.” 

Promoting equity through community clinics

In a typical year, the County-operated Community Health Centers serve 60,000 to 65,000 patients. Given that capacity, the County is well-positioned to vaccinate people at a large scale. Integrated Clinical Services The goal is to vaccinate 1,500 to 1,600 people a week, Daniels, of Integrated Clinical Services, said Tuesday. 

Last month the state and federal government selected the Multnomah County Community Health Center for vaccine allocation, allowing the clinics to vaccinate some of their most vulnerable patients. As part of the pilot project for federally-qualified health centers, the County anticipates it will soon receive an additional 1,100 weekly doses to vaccinate eligible adults. 

“We were selected specifically, not just because we see those patients, but because there was an acknowledgement that we had proven that we can remain open and operational during the pandemic and we have the flexibility and ability to provide vaccination services that might be unavailable otherwise,” Daniels said. 

By staying open during the pandemic, these centers provided ongoing preventative care and gave patients the chance to learn more about vaccine options, directly from their providers.

Commissioner Jessica Vega Pederson asked about transportation support for patients during the pandemic.

As part of the Oregon Health Plan, Medicaid members have access to non-emergency transportation services, Daniels explained. That allows patients to receive transportation to a County health clinic. And patients can also use that if they need help getting to a vaccine appointment. 

For now clinic staff are calling eligible patients to schedule those appointments. That eligibility will broaden quickly. Beginning March 29, many more people will be eligible as part of Group 6 in Phase 1B of the state’s vaccine plan. That will include:

  • People ages 45 to 64 with certain underlying health conditions

  • Seasonal frontline workers including migrant farm laborers and food processing workers

  • Displaced victims of the 2020 wildfires

  • Wildland firefighters

  • People living in low income and congregate senior housing

  • People experiencing homelessness

“These are very aggressive timelines with staggering numbers of people and they are obviously all contingent on us actually receiving enough vaccine to push out into the community,” Guernsey said. “But this is the general  framework that we’re starting to use to recalibrate our own plans as we move into needing to serve additional groups.”

Also this week, the state received 35,000 of the new single-shot Johnson & Johnson vaccine, with a portion allocated to Multnomah County. The County is closely reviewing handling and usage recommendations by both the company and the Centers for Disease Control and Prevention. It will work closely with its local public health ethics board, county leadership and neighboring counties to determine the best protocols for using a one-dose versus a two-dose vaccine. 

“Everyone is working very hard,” Chair Deborah Kafoury said as the briefing wrapped up. “I just am so appreciative of our Public Health team for pushing the state to reflect the same values that we articulate and that we espouse and deeply believe.”