As surging respiratory cases are overwhelming Oregon hospitals, masks are effective in slowing disease spread, officials say
PORTLAND, Ore. — Cases of influenza and respiratory syncytial virus, or RSV, are surging in Oregon, forcing hospitals into crisis mode as they struggle to manage heavy demand for adult and pediatric beds, health officials said today.
The surge prompted a stark warning from Portland-area physicians who have experienced, first-hand, how patients and the state’s health care system have been affected during the hospital capacity crisis: If people don’t start wearing masks indoors more, they put themselves and those around them – especially young children and older adults – at risk of severe illness, or even death.
“Masking works,” said Wendy Hasson, M.D., medical director of the pediatric intensive care unit at Randall Children’s Hospital at Legacy Emanuel. “Anytime you have to go to an indoor crowded area during this surge, if you and your child can wear a mask, that will help protect the (health care) resources.”
Hasson was one of three clinicians who joined Dean Sidelinger, M.D., M.S.Ed., health officer and state epidemiologist at Oregon Health Authority, today for OHA’s monthly COVID-19 media briefing. The briefing, which focused this month on all the circulating respiratory viruses putting strain on hospitals this season, also included Ray Moreno, M.D, chief medical officer at Providence St. Vincent Medical Center, who has a background as an emergency department physician; and Matthias Merkel, M.D., Ph.D., senior associate chief medical officer at OHSU Health, Oregon Health & Science University.
A recording of the briefing is available via YouTube at this link.
Sidelinger kicked off the briefing by calling the situation facing Oregon’s hospitals “extremely serious.”
“Today, more hospitals are reaching a point of crisis in their adult bed capacity just as our pediatric hospitals moved to crisis care standards in the past two weeks,” he said. “The combination of surging flu, RSV and COVID-19 cases is pushing hospitals past their current ICU bed capacity, which never happened during the darkest days of the COVID-19 pandemic in Oregon.”
According to Sidelinger, Oregon saw an almost five-fold increase in RSV-associated hospitalizations in Oregon’s children between Oct. 23 and Nov. 13. Although RSV-associated hospitalizations peaked during the week ending Nov. 19, rates of hospitalization remain higher than during any previously recorded peak.
“While the worst of RSV is behind us, many sick children will continue to require specialized care during the weeks to come,” Sidelinger said.
Influenza cases doubled each week for five consecutive weeks, with test percent positivity jumping from 1% to 30% between Oct. 18 and Nov. 28. That’s led to a rapid rise in influenza hospitalizations since late October, particularly among people 65 and older, whose hospitalization rate has seen a 10-fold increase.
This year’s influenza season began earlier than normal, with high levels of the virus seen across the country, Sidelinger said.
“We do expect flu activity to maintain its upward trajectory into the winter, particularly as the holiday season and gatherings with loved ones continue,” he said.
And the COVID-19 pandemic clearly “is not over,” Sidelinger explained, as demonstrated by significant increases of cases of the virus this season. Percent positivity and COVID-19 levels in wastewater have risen, signaling increased community spread and spurring a 48% increase in the number of COVID-19-positive patients in hospitals in the past month. ICU hospitalizations have also gone up 30%, but the number of COVID-19 deaths has remained flat.
All four physicians emphasized the critical importance of using the precautions that had proven themselves throughout the pandemic as effective strategies for preventing transmission not just of COVID-19, but also other respiratory viruses. It’s especially important, they said, now that people are considering attending indoor gatherings with friends and family to celebrate the holidays.
“Now is not the time to go to crowded indoor places like indoor birthday parties, play places, restaurants, grocery stores,” Hasson said. “Anything you can do to keep your child out of a crowded indoor area will help.”
In addition to avoiding crowded indoor spaces, Moreno explained, people can help reduce the pressure on hospitals by taking care of themselves and others.
“Get immunized for influenza. Get your booster for COVID. It is not too late. Please get immunized. And don’t gather if you’re sick, even just a little sick. Really, that protects other people.”
Merkel advised people to assess their risk assessment – if they have a loved one at home who is “really likely to not do well with an infection right now,” they should protect that loved one and themselves from the next infection.
“Definitely wear a mask if you go in public places,” he said. “Definitely get all your vaccines to really minimize the risk that you are the next patient in one of our totally full emergency rooms, waiting for the next ICU bed to be made available for you.”
Hasson noted that she has admitted many patients over the last two weeks with the flu, but that she has “not admitted a single patient who has received a flu vaccine.”
“Flu vaccines work. They keep kids out of the hospital, and I cannot stress this enough,” she said. “If you have been on the fence about getting your flu vaccine, now is the time to get one immediately to keep your child out of the hospital.”
OHA is working closely with Gov. Kate Brown’s office to provide relief to Oregon’s strained hospitals, including bringing additional health care providers – nurses and respiratory therapists – from out of state to help ease hospital capacity issues. The agency also is pursuing up to $25 million in additional state funding for supplemental nurse staffing contracts.
He highlighted Brown’s Dec. 7 executive order, which continues and expands her Nov. 13 emergency declaration to provide additional flexibility to Oregon hospitals. This will ensure there are enough health care workers to meet current needs; hospitals can draw on a pool of medical volunteer nurses and physicians; and other critical steps can be taken to care for patients.
In addition, OHA is communicating regularly with the health care, public health, laboratory and emergency preparedness communities through the Health Alert Network, or HAN, to provide updates on the surge response; medical, treatment, vaccination and testing supplies; investigative guidelines and clinical recommendations; and prevention and health promotion messages.
“We know what works to keep our families and our neighbors safe: wear a mask when you’re in crowded indoor places this winter and stay up to date on your vaccinations,” Sidelinger said. “Masks work. During the worst of the COVID-19 pandemic, Oregonians wore masks at higher rates than people did in most other states. Oregon had one of the lowest COVID-19 death rates in the nation. Our hospitals were never overwhelmed. And we saved more than 5,000 lives.”