Gov. Brown pleads ‘Get your booster,’ warning Oregonians have three weeks to prepare for omicron wave

Oregon Gov. Kate Brown joined top state public health officials and leaders from OHSU at a press conference Friday to sound an alarm.

The omicron variant of COVID-19 is spreading very rapidly in other parts of the world and is capable of infecting people who’ve been fully vaccinated.

The latest pandemic modeling from Oregon Health & Science University predicts the state has about three weeks until a surge of COVID-19 infections due to the highly transmissible omicron variant. By February, hospitalizations from that surge could peak at numbers far higher than the delta variant’s September surge.

OHSU’s modeling takes into account a lower hospitalization rate due to the new variant, because it typically causes milder infections. However, the model still shows the potential for Oregon’s hospitals to be overwhelmed.

“What is clear from the experiences of the UK and other countries is that we only have a few weeks to prepare before omicron hits our health care systems and communities in full force,” Gov. Brown said.

“We are going to do everything we can to maximize that window.”

In response to the dismal forecast, Brown and the Oregon Health Authority announced a major, immediate overhaul of the state’s pandemic strategy.

The focus is now on measures intended to blunt the potential for hospitalizations: Getting booster shots to one million more Oregonians; focusing those shots on older, vulnerable people; creating new medical sites to deliver monoclonal antibody therapies and antiviral drugs; and adding health care staff.

Brown said she was calling on one million Oregonians to step up and get their booster dose by the end of January and directed OHA to expand the state’s distribution capacity to reach that goal.

“Get your booster shot,” Brown said. “Boosters work and are incredibly effective at continuing your protection against this virus and hospitalization.”

Booster doses have been relatively available in the Portland metro area, though figuring out how to find and schedule one can be a challenge. It’s a tougher situation in some rural Oregon counties, where booster locations are few and far between.

The arrival of the new variant is a “gut punch” for health care workers and hospitals, which have very little capacity to absorb extra patients, according to Dr. Renee Edwards, the chief medical officer for OHSU Health. Hospitals are just starting to work through a backlog of surgeries that were postponed during the delta surge, and are treating patients whose illnesses are more acute due to delayed care during the pandemic.

“OHSU and other health systems in the Portland metro area are completely full,” Edwards said.

Edwards said metro-area hospital capacity is still so constrained, they are periodically turning away transfer patients from rural areas who need a higher level of care than is available in their local hospital.

An Uncertain Forecast

OHSU’s Dr. Peter Graven, the lead data scientist in the hospital’s business intelligence unit, has developed a data model and forecast that OHA and others use to estimate the impact of case surges — and policy measures — on hospitalization rates in Oregon.

Graven’s forecast isn’t peer-reviewed science, but it’s influential in part because it’s been accurate in the past, predicting the peak hospitalizations during Oregon’s delta surge.

Graven released an updated forecast Friday predicting the omicron variant will drive a wave of severe illness that will eclipse previous surges of hospitalizations in Oregon. The detailed model shows COVID-19 hospitalizations could peak at over 3,000 some time in February. That compares to a peak of about 1,200 at the height of Oregon’s delta surge.

Graven said he’d drawn on recently published hospitalization rates in Denmark.

But Graven noted that there’s an unprecedented degree of uncertainty in the numbers he’s using to estimate the potential for spread and the virulence of the new variant, and that his forecast could be less accurate than his others as a result.

“There is more speculation here. We are trying to anticipate parameters that are not fully known,” he said.

Graven said given how quickly omicron is spreading, he felt it was imperative to release his best estimate of the coming wave to give people time to act in response.

Graven said he’s most confident about the timing of the upcoming surge — that it will begin in about three weeks, given the variant’s well-documented rapid spread elsewhere. He’s less confident in his estimate of the peak number of hospitalizations.

And an omicron surge is unlikely to be a simple repeat of the delta surge, but worse. Instead it could impact hospitals in different but still sweeping ways.

For example — omicron infections according to Graven and others, still cause people to require hospital care — but they may be less likely to need intensive care. Their hospital stays may be shorter, alleviating some strain on the health system. So far the death rate from the variant is also dramatically lower.

By contrast, vaccinated health workers who were largely protected against infection with the delta variant may be at higher risk of mild infection from the omicron variant, due to its greater immune escape ability. If large numbers of health care workers need to quarantine or call in sick, that could add new strain on the health system.

Oregon’s five-part response

In response to the highly uncertain situation, OHA announced a new five point strategy to take advantage of boosters, testing, and treatments, to try to blunt the impact of hospitalizations.

“Today, I want every Oregonian to know: the weeks between today and early January are critical,” said OHA Director Patrick Allen. “We are not powerless — the actions we take in the next few weeks will determine how many Oregonians survive the Omicron tide.”

OHA’s action plan for booster shots includes trying to at least double the number of weekly booster vaccinations administered statewide, adding three new high capacity vaccination sites, and deploying mobile vaccination teams to long-term care facilities in the next two weeks.

On the treatment front, the state is working to develop a high through-put site to speed up access to treatments aimed at reducing the severity of COVID-19 infections through early intervention in a person’s illness. That includes currently approved monoclonal antibody therapy, which is effective against the delta variant. In the future treatments could include a new antiviral drug made by Pfizer that doesn’t yet have FDA authorization, but is considered a promising therapy against omicron-variant COVID-19 infection.

The state is also extending its temporary staffing contract to bring more nurses and other health care staff from out of state to work in hospitals and vaccination clinics.

Gov. Brown said that she remains committed to keeping schools open in person, and said that mandatory business closures aren’t likely. But she cautioned that “all options are on the table” if more steps are required to rein in the virus.

The governor said she will delay a plan to return state employees to the office in early January. She also said she’s meeting with business and labor groups to discuss how they can help bend the curve, as the state confronts another wave of COVID-19.