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As the United States passed a grim milestone Feb. 22—half a million deaths from COVID-19—there was some bright news.
Cases of the virus have fallen sharply over the past month in Portland and in Oregon, in a drop that reflects similar trends across the country and around the world. After a slow start, Oregon has administered the coronavirus vaccine at a faster clip than many states; more than 540,000 Oregonians have received at least one dose. That’s 13% of the state.
And yet the pandemic is not over. Portland still has so many cases of COVID-19 it remains in a “high risk” category for the spread of the virus. There’s a new threat on the horizon: a highly contagious variant first found in the U.K. (Only nine such cases have so far been documented in Oregon.)
In essence, Oregon now hosts a race between vaccines and how quickly the coronavirus can spread. If the state wants to emerge from COVID without another surge of deaths, it needs to inject vaccines faster than the virus’s mutations spread, or convince residents to respect the virus’s continued capacity to kill. What happens in the next few weeks, experts say, will tell whether Oregon succeeds.
We spoke to four four academics and policymakers about what’s at stake in the coming weeks, and how smooth a journey out of the pandemic Oregon should expect.
Here are the key questions we still face.
When will you get the vaccine?
Let’s start with the question that’s central for more than half of adults—those who aren’t COVID deniers, anti-vaxxers or people with concerns specific to the coronavirus vaccine.
When Oregon finishes vaccinating its health care workers, teachers and seniors, who’s next? And how soon can most of us expect to enjoy a needle in our arm?
The answer will come Feb. 26.
That ’s when Gov. Kate Brown decides who goes next after everyone over 65. The next group could amount to more than a million Oregonians, including those who have health risks, work frontline jobs, or live in low-income housing. They could get vaccinated as soon as April.
But for healthy, young people, says Dr. Anthony Fauci, the White House chief medical adviser, it may take until the end of the summer.
Oregon officials say they’re not ready to commit to that. They expect many healthy, low-risk adults will have to wait until autumn.
“I’m really mindful of being careful with people’s expectations, but we’re very optimistic,” says Connie Seeley, chief of staff and chief administrative officer at Oregon Health & Science University, and Gov. Brown’s special adviser for COVID-19 vaccination implementation.
The next key decision point? Whether the federal government approves the Johnson & Johnson vaccine, in addition to the two vaccines by Pfizer and Moderna already approved for emergency use. Approval of another vaccine could rapidly increase the nation’s supply.
What dangers remain in the state right now?
Peter Graven, lead data scientist at Oregon Health & Science University, whose forecasts last spring moved the governor to shut down the state, says he has modeled two divergent forecasts for the coming months. Which of the two fates we get depends on how quickly the virus’s mutations become dominant in Oregon—because if they arrive and take over before the most vulnerable people get vaccinated, the state is in for a spring surge of hospitalizations and deaths.
If the more highly contagious variants dominate, Graven says Oregon will see another surge on an order of magnitude similar to this fall, meaning 600 patients in hospital beds on any given day. (He doesn’t project deaths.)
“My instinct is that we should expect the same growth that they saw in the UK,” says Graven—which would result in a new peak in hospitalizations.
The not-so-bad scenario would mean the new, more contagious variants of the coronavirus, including the one that overwhelmed the U.K. this winter, does not become the dominant strain, and we’ll get to June—when he projects something like half the adult population will be vaccinated and the coronavirus will spread less readily.
“I think we’re going to be fine by summer,” Graven says. He projects half of adults will have vaccines by then, which would help halt the spread. “So I’m not worried about that. I’m worried about the next period of time.”
In other words, Oregon and the country are racing against the coronavirus variants, both those we know of and ones that may yet come.
“Given the nature of the virus, it will continue to mutate, and the speed of mutation will be faster when you have more people infected,” says Chunhuei Chi, director of Oregon State University’s Center for Global Health. “We are racing against time.”
The next three to five weeks could show how fast the variant is picking up, says Graven. “If we’re getting any sequences back,” he says, “we should be able to see if it’s popping up.”
What can Oregon do to stop another surge?
In December, after a freeze, Oregon adopted a system to set the level of social activity—whether, say, restaurants could reopen—based on the prevalence of the virus within a county. That system allowed indoor dining and movie theaters and gyms to reopen a little on Valentine’s Day weekend.
No one, not President Biden or Gov. Brown, is willing to talk freeze, lockdown or a new stay-home order, at least not yet.
“You can only put up the fight so many times, so that’s hard,” says Graven. “I do think we have a good policy in place in terms of a framework.”
The governor’s advisers say Oregon’s “framework” for risk will help identify a problem if a more contagious version of COVID-19 takes over the state, because the state system monitors how widespread the disease is.
So if the variants get to Oregon before enough people are vaccinated, the governor’s system will be stress-tested to see if it can spot another surge fast enough to stop it.
“If we were to see cases go up,” says Tina Edlund, Brown’s health care finance adviser, “as soon as we see them cross that threshold for extreme risk, those restrictions kick into place.”