Oregon officials: Omicron could overwhelm state hospitals; response to focus on boosters, testing and treatment

In August, OHSU data scientist Peter Graven predicted — accurately — that the state was going to be hammered by the delta variant of COVID-19, and would come perilously close to running out of staffed hospital beds. That wave peaked in early September with 1,178 COVID-19 patients in Oregon hospitals. Hospitals in Oregon are still understaffed and struggling to recover from it.

Graven’s latest forecast indicates that an omicron surge could peak with between two and three times the number of COVID-19 patients hospitalized as during the delta surge, according to public health officials who briefed OPB in advance of a noon press conference with the governor.

Watch that briefing live here:

Sobered by those numbers, the Oregon Health Authority is rolling out a five-point plan with the goal of getting booster doses to one million more Oregonians by the end of January and blunt the impact of omicron. The effort to more than double the number of Oregonians with booster shots is part of plans Oregon Gov. Kate Brown announced Friday.

Public health officials say getting booster shots to more older adults and other high-risk individuals in the next three weeks will be critical to averting disaster. They offered the first details of a stepped-up effort to distribute the shots. The state also committed to, before mid-January, providing hospitals with clearer guidance for triaging patients in a crisis “to equitably prioritize care if doctors and nurses are forced to make heart-breaking decisions in the face of limited intensive care beds, ventilators and other life-saving resources,” according to prepared remarks from health officials.

Sidelinger notes that the course of the pandemic remains highly uncertain, and the forecast is just one prediction of a possible outcome. Getting booster shots to more older adults, the potential availability of a new treatment, and changes in people’s behavior like increased mask wearing could all help blunt the number of hospitalizations triggered by a new wave of infections.

And omicron is likely less virulent than previous variants — a lucky break, but not by itself enough to protect the state against a wave of hospitalizations given the variant’s extreme transmissibility and immune escape, Sidelinger says.

Seventy-four percent of Oregonians have completed their initial two doses of vaccination, ranking Oregon 12th in the nation. Approximately 26% of Oregonians have received a booster or third dose. Among people age 65 and older, who are at higher risk for severe COVID-19 infection, 51% have received a booster or third dose, according to OHA.

Below is a summary of the Oregon Health Authority’s plan, provided by the agency:

1. Oregon will urge one million Oregonians to get boosters by the end of January:

• In coming weeks, we believe our 1 million booster goal is in line with the number of Oregonians who will be eligible to receive one, due to the time that’s passed since they completed their initial COVID-19 series.

To reach our 1 million booster goal, we will:

• Support our partners in the health care system and in local public health departments to at least double or triple their current weekly booster vaccinations for the next month.
• Add three new high-capacity vaccination sites (in addition to the 6 current ones operating around the state) and resume mobile vaccination clinics, with support from FEMA, our contract with Jogan Health, and local public health and community partners.
• Add and deploy contracted health care staff to vaccination clinics to expand appointments and clinic hours. The lack of staff to put shots in arms is our primary constraint that’s led to scarce appointments in some Oregon communities.
• Expand our supply of mRNA vaccines – we’ve asked for and received a supplemental quantity of vaccine from the federal government, enough to administer 140,000 booster doses. They have also agreed to our request for increased doses on an ongoing basis because of high demand statewide.

2. Oregon will focus boosters on people who are most vulnerable to becoming hospitalized if they catch the Omicron variant:

• Deploying mobile vaccination teams to skilled nursing facilities and other long-term care facilities in the next 2 weeks.
• Working with long-term care facilities to implement their vaccination plans and provide staffing solutions.
• Providing incentives to get more residents and staff vaccinated.

For under-vaccinated communities, we will:

• Augment staffing at Federally Qualified Health Centers and other clinics to help them vaccinate approximately 800-1,000 people per day.
• Work with community-based organizations and trusted community leaders to stand-up 35 vaccination events for communities of color around the state, with an additional 93 events scheduled in coming weeks.

3. Rapidly deliver new COVID-19 treatments and expand needed testing. New and coming monoclonal therapies and antiviral drugs offer the promise of protection against hospitalization. For some drugs, they are effective within a narrow window of time after infection. OHA is:

• Working to develop a high through-put site for Monoclonal antibody therapy in the Portland Metro area. This site will be open seven days a week, 11 hours a day and have the capacity to treat 350 people per week.
• Registering Oregon health care providers with federal agencies so they will be able to quickly receive newly approved antiviral drugs to treat COVID-19.
• Connect patients to treatment and testing to maximize the effectiveness of these new drugs.

4. Support health care workers and hospitals in the face of the coming omicron surge.

• We are extending our staffing contract to bring more nurses and other health care staff from out of state into Oregon’s already hard-pressed hospitals and vaccination clinics.
• We’ll continue to work with long-term care facilities to provide alternative step-down beds to move patients who can be safely discharged out of hospitals and free desperately needed beds.
• Before mid-January, we’ll provide hospitals an interim crisis care tool they can use to equitably prioritize care if doctors and nurses are forced to make heart-breaking decisions in the face of limited intensive care beds, ventilators and other life-saving resources.

5. Connect more people to boosters, treatments and testing.

• More outreach messages focused on boosters, from billboards to spots on social media.
• For example, next week we’ll begin running ads on social media aimed at informing Spanish-speaking older adults that they’re eligible for boosters and letting them know where they can get a shot.

This is a developing story. Watch for updates.