The Nugget Newspaper - News and Opinion from Sisters, Oregon

Deschutes County currently leads the state in COVID-19 cases.

The New York Times daily tracker reports our county had 159 average cases per day in the seven days ending December 31, an average of 80 per 100,000 population. Multnomah County (Portland) has half that at 41 per 100,000. As with all things COVID-19, context is important and often missing as case counts still dominate headlines.

The Deschutes County COVID-19 Dashboard, as of December 30, shows a less dramatic picture. Sadly, 215 deaths have been recorded in the county since the onset of the pandemic, but that is 0.82 percent of cases, meaning the survivor rate is 99.18 percent. Sisters Country has clocked 756 cases, or 2.9 percent of the county total.

Deschutes County deaths fall heaviest among our oldest citizens: 47 percent over 80 and 74 percent over 70. Nobody under 40 has died with COVID in the county. Oregon Health Authority (OHA) tabulates that 83 percent of all statewide deaths with COVID presented one or more underlying conditions (co-morbidities).

Omicron, Wave 4, has created headlines and some fast-moving decisions by health officials. Twenty-three percent of Oregon cases for the week ending December 26 are classed as Omicron. More attention is now being given to the number of breakthrough cases, incidents of COVID among the vaccinated. As of the end of 2021, OHA says the percentage of breakthrough cases was 36.7 percent, a number that some use to challenge the efficacy of the vaccines.

However there is unanimous agreement among federal, state, local, and hospital authorities that vaccines lessen the severity of the disease and statistics show that hospitalization rates and lengths of stay have a much better outcome among the vaccinated. Oregon is in the top tier of vaccination rates nationally with 80.8 percent of 18+ having received one dose; 73.9 percent the series; and 32.8 percent the booster dose.

Eighty percent is the statewide goal and Sisters has attained that. Redmond is the prime holdout for getting to 80 percent in the county, with 5,373 still to be vaccinated.

More reports in the media and from the CDC itself are beginning to emphasize hospitalizations and deaths as being a better gauge of the severity of COVID-19. Omicron is generally believed to be more transmissible, but not as deadly, a key driver in changing the narrative from case counts only to ultimate outcomes.

In Sisters Country, where we are under the care of a single hospital system — St. Charles — The Nugget has reached out to Dr. Doug Merrill, the hospital’s chief medical officer, to get an update on the effect of Omicron on preparedness and impact.

First, the numbers: Every day OHA gives an update on available ICU beds in the state and lately they report about 8 percent, meaning 92 percent are occupied. The broad assumption without careful reading is that these are all COVID-19 and that the hospitals are being overrun with the disease. In fact, ICU beds, as has long been the case, are occupied with a range of patient illnesses. Hospital business models stipulate that 80 percent of all beds must be full just to break even.

St. Charles is a good example. Of their 36 ICU beds, only three on December 31 were COVID patients, all of whom were unvaccinated. In total, on Saturday, St. Charles was caring for 24 COVID patients, 23 unvaccinated. In other words, St. Charles was faring well in this regard.

The overlooked story with St. Charles is the worker shortage, especially now that the tour of approximately 150 Oregon National Guard support staff on loan has ended. The four-hospital system has 911 job openings, although 250 or so are in late stages of the hiring process, which still leaves some 650 position unfilled.

More troubling are the approximately 4,000 deferred surgeries or other essential medical procedures, a backlog crisis of its own that Merrill says could take many months to rectify.

With respect to Omicron, Merrill said: “We anticipate seeing here what we see in the east and northeast. We typically are a week to two weeks behind.” He anticipates a build-up of cases and hospitalizations.

He repeated his recurring theme, saying, “We still have a significant percent of our population unvaccinated or boosted.”

He further predicted increased loads as a result of timing.

“We had the Christmas and New Year holidays, with lots of gatherings where we know folks were not careful with masking or testing before getting together… We’re now indoors more, due to weather, all of which plays a role.”

Compounding Merrill’s woes is the early onset of RSV, a common winter virus that is hardest on kids. It typically peaks in February but he sees it already at 100 cases a week, double the average.

“We do not have pediatric ICU,” Merrill said, so “we have to ship those kids off to Portland, which is already strained.”

You can hear the frustration in his voice and see the sadness in his eyes when Merrill talks about staff fatigue and burnout. He is frankly surprised that morale is as high as it is. He has lost so many of his most experienced caregivers, who took early retirement, unable to cope with the daily

grind.

Almost every question posed to him has included in the answer the admonition to get vaccinated and mask. Otherwise, he appears resigned to a long slog in fighting COVID-19.