OHCA The Oregon Caregiver Fall Winter 2021

The Oregon Caregiver FALL/WINTER 2021 www.ohca.com 20 DATA & RESEARCH T he SARS-CoV-2 delta variant struck other parts of the world first before surging across the United States. However, for much of the summer and fall, COVID-19 cases surged nationally as the delta variant drove significant spikes in new community cases, particularly amongst the unvaccinated. Oregon was unable to escape as the delta wave washed across our communities. The strain placed on the health care system—and on our health care workforce—has been exceedingly painful. Oregon’s hospital and intensive care unit (ICU) capacity issues dominated local, national, and global headlines as bed availability reached critical lows. No part of the state remained unscathed. By October, Oregon recorded nearly 350,000 COVID-19 cases since the pandemic began with more than 4,000 fatalities statewide. Thankfully, daily positive cases have dropped considerably. Despite this, the delta variant wave continues to have significant impacts on the long term care sector. From workforce shortages to new outbreaks, long term care is in the midst of one of the most difficult periods of the entire pandemic. Yet, recent impacts on long term care settings look different from previous waves. Similar to the peak in winter 2020, active outbreaks, new cases, and fatalities from COVID-19 increased between July and October of this year. In response to the surge, executive orders (EO) placed on long term care communi- ties by the State of Oregon also increased and briefly surpassed the previous peak reaching a new high of 297 in early September (see Chart 1). While the number of new cases and fatal- ities increased, they never reached the same catastrophic levels as in the winter 2020 wave (see Chart 2). We observed similar trends in other locations where the delta variant struck earlier. In the United Kingdom, for example, while cases continued to surge over the summer and into the fall, fatalities remained low when compared to previous waves (see Chart 3). New COVID-19 cases for the month of September were at about 75 percent of the winter peak, while fatalities were at 12 percent of the previous recorded highs. The lower number of deaths during the recent surge is not yet fully understood and may very well be some combination of interventions, behavior, and biology. However, widespread vaccinations amongst the populations at highest risk, including adults of advanced age, is a notable difference from last winter. In Oregon, the high vaccination rate of older adults, and long term care residents in particular, warrants some further discussion. Oregon’s long term care Unpacking the Data: COVID-19 and Long Term Care By Walt Dawson, D.Phil resident vaccination program began on December 21, 2020, and was completed by April 7, 2021. With an 89 percent vaccination rate amongst Oregon long term care residents, this is likely an important factor in decreased fatalities in these settings and overall statewide. Even with such high vaccine uptake, long term care residents remain at heightened risk of severe illness from COVID-19, and in early October, we saw a troubling rise in cases compared with other groups with fewer age and health-related risk factors. Further, even following the COVID-19 vaccine mandate for health- care workers, long term care staff vaccination rates, though higher than rates for the general population, are lower than ideal in some parts of the state. Religious and medical exceptions are allowed for healthcare workers. While the spread of the delta variant amongst the unvaccinated is the primary Chart 1: Active Outbreaks and Deaths: Dec 2020–Sept 2021 2400 103 12/9/2020 12/23/2020 1/6/2021 1/20/2021 2/3/2021 2/17/2021 3/3/2021 3/17/2021 3/31/2021 4/14/2021 4/28/2021 5/12/2021 5/26/2021 6/9/2021 6/23/2021 7/7/2021 7/21/2021 8/4/2021 8/18/2021 9/1/2021 9/15/2021 COVID Cases - Active Outbreaks Deaths - Active Outbreaks 6000 5000 4000 3000 2000 1000 0