Umatilla County currently has the highest number of COVID-19 cases per capita in Oregon. And this week, the Pendleton Round-Up is bringing an influx of people. The rodeo and surrounding events are requiring people to wear masks, but anecdotal evidence suggests that compliance is low and enforcement minimal. We hear from Umatilla County Public Health Director Joseph Fiumara about hospital capacity, case numbers and the outlook for the next few weeks.
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Note: The following transcript was computer generated and edited by a volunteer.
Dave Miller: From the Gert Boyle Studio at OPB. This is Think Out Loud, I’m Dave Miller. The Pendleton Roundup started last Saturday, it finishes this coming Saturday. Meanwhile, Umatilla County still has the highest overall case rate in the state and one of the lowest vaccination rates. Joseph P. Fiumara Jr. is the Public Health Director for the county and he joins us once again. Joseph, welcome back.
Joseph Fiumara: Thank you. Thanks for having me.
Miller: Let’s start with the overall situation in Umatilla County right now. In terms of case counts, how’s it looking?
Fiumara: Case counts have been up in the last couple of weeks they’ve somewhat plateaued, still at a much higher rate. We’re still seeing over 400 cases a week, which is really just not sustainable from a workload standpoint. There is some indication that over the last week or two that they’re very slowly starting to drop, which is a good direction we want to go in. Obviously the elephant in the room is what, if any, impact will stem from Roundup.
Miller: We’ll talk about that as we go. For now, it seems like, as predicted in some of the modeling weeks ago, the Delta surge there seems to have crested?
Fiumara: It does, it’s still early. And so it’s hard to say you’re in a trend, right as that’s beginning, but last week’s numbers were up a little from the week before. We had a couple of weeks where we kind of went up and down a little bit, and this week, so far, numbers are coming in slower day by day as they have been in previous weeks. Hospitals are reporting less urgency with how full they are. There’s some days where they’ve got more availability than we’ve seen in the past. and so those are good indicators.
Miller: Hospital beds as we’ve been hearing for a year and a half, that’s a kind of lagging indicator. It takes a little while for hospital beds to fill up following case rates going up. But you’re saying even already with hospitalizations, you have started to see a slight decline?
Fiumara: We’ve been at pretty much at capacity for weeks. The last week or so, there seems to be a little bit of breathing room starting to develop. Again, it’s early. It’s hard to say with certainty, and of course we’re all hopeful that it’s going to go in this direction.
Miller:So let’s turn to Roundup, then. Starting with preparations, were you able to do anything public health-wise to prepare for either a bunch of people coming to town or many people who are in the region going out and enjoying themselves?
Fiumara: So unfortunately, not really. That probably sounds odd and it sounds like maybe we’re not doing our job. I had a few folks reach out as we were getting close, ‘hey, what’s the plan for Roundup?’, and unfortunately, with where the case rates are at, we were already at capacity before Roundup began.
Miller: In terms of Public Health Workers doing stuff, you mean?
Fiumara: Correct. You know, for the last three or four weeks, we have not necessarily been able to connect with every case at the same time line that we try for. We always aim for a 24 hour connection with every positive case that’s reported. But when you’re getting 80 cases a day, it doesn’t happen; and you have to triage the priority. You have to decide who you’re going to follow up with first, based on risk factors, and who’s going to be kind of moved to the back of the line and hopefully you’re able to get to them. And that’s even with Oregon Health Authority providing case investigation support, and they’ve been providing that to us for about a month now.
Miller: But, another way to think about this is let’s say that you didn’t have a people power problem and you had a ton of extra resources, what would you have done?
Fiumara: What we’ve done here, and it’s worked so far, although it was not enough for this surge that we’ve dealt with, but we staffed up early in the pandemic. We staffed up basically a call center for case investigation and contact tracing. There’s been ups and downs and we’ve maintained capacity knowing there were going to be ups and downs. There were actually times where we were providing this work for other counties, because we had excess capacity.
Miller: I was thinking more about Roundup, if you knew this thing was coming and you know, tens of thousands of people were going to be going to watch a rodeo some afternoon or going to be partying in the street. Is there anything you can do anyway?
Fiumara: Only so much, right? We’ve been in talks with the Roundup Directors, we’ve upped our messaging, we were putting messaging out around the recommendation that was from CDC around wearing masks outdoors even before there was a state mandate to do so, trying to draw awareness to that and as well as increasing the vaccination rate. A lot of our messaging in the planning stages before Roundup was around trying to improve the vaccination rate, because we really felt that was going to provide the best benefit long term, as far as protection from spread, but of course it takes time to build that immunity once you’ve received your vaccination. And so that was really our focus around our fair timeframe, a month to month and a half ago where we were really trying to push and promote vaccinations to support Roundup.
Miller: For the County Fair. And I should say, just ballpark figures for vaccination rates for 18 and above, it’s around 50%, last I looked in Umatilla County, which is, I think, third or fourth lowest in the state…
[Voices overlapping]
Fiumara: Not...a bit higher…
Miller: Compared to around 80% in the Portland Metro area.
Fiumara: Our data put it a little higher, about 54 or 55% who are risking their first dose. But yeah, it’s not nearly as high as it needs to be to stem the spread of Delta.
Miller: What have the crowds been like this year at Roundup?
Fiumara: So I think we won’t really know until we get on the back side. I know for the parade, last Saturday, the dress up parade, which is kind of the kickoff to Roundup, it seemed as if the crowds were lower than in previous years. That being said, in talks with some of the folks who work there, they are anticipating sell-out for the Friday, Saturday as the event finishes out, and pictures I’m seeing on social media looks like it’s being pretty well attended.
Miller: What are the COVID-related rules at Roundup this year?
Fiumara: So It’s supposed to be, wearing a mask is really kind of the big one.
Miller: I feel like we’ve got an answer to my next question, your answer, the way you said it, it’s supposed to be, and we can talk about what that means, but I think we all heard that not everyone’s wearing a mask, so number one, it’s supposed to be, everyone wears a mask.
Fiumara: Yeah. You know, we even did a walkthrough as in, myself and our Health Officer, Dr. Hitzmen did a walk through with some of the staff from Roundup over last weekend before the grounds opened up for folks to start coming in, and they showed us they’ve got signs up encouraging masks, they’ve got the official OHA signs up around all the gates, the entrance points, they’ve got throughout the facility almost everywhere, they could reasonably put an 8 ½ by 11 signs up for ‘mask up, y’all,’ and we had talked through what their procedures were going to be, how they can require masks for entry when they’re checking tickets, if they don’t have the mask, they don’t come in, it’s like not having a ticket. Well, at the same time, once you’re in, I don’t think it’s really reasonable to expect that somebody is chasing everybody down because somebody pulled their mask off, and food and drink vendors are throughout the facility and of course you have to have the mask off to partake in those activities. So we had talked through the procedures. It has become apparent as things have started that at least the checking at the gate is not really happening.
Miller: And that was the biggest check that there was.
Fiumara: It really was. You know, the signs are up, staff are supposed to be wearing masks. They were even going to occasionally have some announcements through the P. A. system as was appropriate when they were giving updates and so forth between events. But really, if you’re running an event, and the staff and the volunteers and everybody associated with that event aren’t wearing masks, it’s really hard to expect the attendees to also do the same.
Miller: So you have seen noncompliance even among staff and vendors?
Fiumara: I have. I think the vendors are more compliant. I’m told by my Environment Health Inspectors who were there, that most of them were doing a pretty good job as far as doing the food service piece and of course that’s part of what we check when we’re there. But you know, even going by yesterday, everybody manning the gate checking tickets and making sure people don’t come in the exit. I didn’t see a single mask.
Miller: There was a tent at the Oregon State Fair recently in Salem where people could just walk up and get vaccinated. From what I read and from what I saw on a tv news segment, it wasn’t a particularly popular part of the fair, but there was a trickle of people who were going there because it was convenient, theoretically. Is there anything similar at Roundup?
Fiumara: There is. The organizers worked with us well and we were able to get a very prominent spot in the corner of the park where a lot of activities get set up and actually a lot of those get set up really kick off today. But we’ve been set up there since Monday with the tent offering both COVID vaccinations as well as testing and Oregon Health Authority has partnered with us for helping to staff that and it really is from a convenience standpoint. The goal is to make these so easy to obtain that even the individual who doesn’t want to go out of their way to go get the vaccination says, well I’m here, it’s here, I may as well. I do know on Monday, which is the first day they were set up, and I think they only gave about 6 doses of vaccine that day. I did hear one individual use that phrasing. When they walked by I was like, well I’m here, I may as well.
Miller: One which is better than zero. But I imagine it’s not close to the numbers you’re hoping for.
Fiumara: It’s not in, our numbers have been up the last four or five weeks, we’ve been over 1,000 doses a week being given out. Even when we did the same thing at our County Fair about a month ago and I think we gave about 30 doses [or] 40 doses at the fair through the duration of that week. We’ll see how this goes. We think it’s important to have it available - have it convenient, have it easy to access, and obviously we hope people choose to participate. I don’t expect it will be the busiest vendor at the Roundup.
Miller: What are you expecting in terms of case counts in the coming weeks as a result of Roundup?
Fiumara: It’s hard to say what I’m expecting. I can tell you what I’m hoping; and the difference is that some of that is probably some desperation. We did not see a big change in our case directions and increases in cases associated with our fair and rodeo. Obviously there’s not the same number of people who attend, and it doesn’t pull from the same geographical, as large of an area, but it is a multi-day event. There are a lot of attendees and it is mostly outside and those items do apply to Roundup in a lot of settings. And so I am hopeful that outdoor aspect is going to provide a lot of protection and stunt any spread that would be there. But there are a lot of indoor portions for Roundup. There’s a lot of, whether it’s the Let ‘er Buck Room on the grounds, or whether it’s all the various businesses throughout town who have various functions going on throughout the week. So I’m hoping not to see a large jump and increase. I’m also very nervous about it. I think if I had to make a forecast, I’d say that the rates are probably going to jump. I’m just really hoping that they don’t.
Miller: Joseph Fiumara, thanks for joining us, once again, I appreciate it.
Fiumara: Not a problem. Thanks for having me.
Miller: Joseph Fiumara is a Public Health Director in Umatilla County.