31 Fall/Winter 2021-22 continues important steps in helping us to live with this virus. Right now, we can’t live with this virus at the current level, but those two tools will help us get to a level where this isn’t impacting people’s daily lives the way they are now with hospital constraints and other things. Should we shift our focus away from infection rates towards the metrics that you mentioned, hospitalizations and deaths in how we think about policy? I think that’s the broad framework that I have and most of my state colleagues across other states have. This disease, particularly for those who are vaccinated, shouldn’t be front of mind. People who are vaccinated are very protected from disease, and if they do get sick with COVID they’re not going to be hospitalized. But if you’re not vaccinated or if you’re immunecompromised or have underlying conditions or are elderly, you’re still at risk so you may be changing your behavior. But it’s those hospitalizations that we worry about. We’re not going to prevent every disease with COVID, the vaccine really helps protect individuals from disease and definitely from serious disease. Effective oral antivirals will also help protect people from severe disease and so that’s where I think we need to focus is to keep people from getting severe disease and making sure that hospital capacity is available for everyone. Because even if you’re protected with COVID vaccines, and you’re not going to get sick or need a hospital bed to treat your COVID, you may still get influenza or have a heart attack or get into a motor vehicle crash. So, we need hospital beds with skilled staff who are not operating at crisis levels to take care of you. In Oregon and in many states, we are not in a place where our disease rates of COVID are low enough that we can remove that as a major impact of our equation on hospital capacity. So, I think focusing there makes sense, but hospitalizations of people with COVID is a late indicator. We still want to look at case rates, we still want to look at percent positivity, but they mean different things now. With higher case rates in a highly vaccinated population, many of those folks aren’t going to go on to need a hospital bed. Percent positivity may not have the same meaning as it did in the middle of 2020 when we didn’t have an effective vaccine and we weren’t doing screening testing for example in some of our K-12 schools with screening of students and staff, in some of our long term care facilities who have been doing screenings for staff and residents for a while, and some other settings where people are getting tested not because they’re sick but because they’re part of a screening program. So, the percent positivity may not have as much meaning, but if testing volumes stay the same and percent positivity goes up, that’s worrisome and could indicate a surge in cases, but having a low positivity rate doesn’t necessarily mean the same thing now. Those are still useful upstream approaches, but we need to change the way we think about them, and following those that are in the hospital, their family and loved ones are the people most affected by COVID. How difficult has it been to create guidelines and protocols with a pandemic that is constantly evolving? I think it is challenging as we learn new information and get new tools, we want to change the way we approach this virus. We know that different communities have been on board with rules at different levels, and we know that vaccination has gone much quicker in some parts of our state than other parts. Looking at data and looking at the most recent research can be challenging because they are changing so communication management becomes important. But at the same time, we are managing maybe changing messages from us because we’ve “If you look at our cumulative numbers, we’ve done well as a state. We’ve saved thousands of lives.” Dr. Dean Sidelinger, State Health Office & Epidemiologist
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