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| ‘We’re Not an Island’: Rural Outbreaks Challenge Oregon’s Virus Success | ‘We’re Not an Island’: Rural Outbreaks Challenge Oregon’s Virus Success |
| (1 day later) | |
| HERMISTON, Ore. — Jose Garcia reached into the bed of his pickup truck and gingerly withdrew a sealed plastic bag. Inside was a homemade mask Mr. Garcia had been given by a worker in one of the sprawling agricultural fields that surround his home in northeastern Oregon. The mask was made of a single, neatly folded paper towel with a rubber band stapled to each end. | HERMISTON, Ore. — Jose Garcia reached into the bed of his pickup truck and gingerly withdrew a sealed plastic bag. Inside was a homemade mask Mr. Garcia had been given by a worker in one of the sprawling agricultural fields that surround his home in northeastern Oregon. The mask was made of a single, neatly folded paper towel with a rubber band stapled to each end. |
| “When I saw this, I kind of cried,” Mr. Garcia said. | “When I saw this, I kind of cried,” Mr. Garcia said. |
| In an effort to prevent the spread of the coronavirus, Mr. Garcia, an addiction counselor, spends his days off volunteering to deliver masks from the local health department to field workers. Like many residents of rural Oregon, Mr. Garcia is bracing for a spike in coronavirus cases that feels all but inevitable as local farms and food processing facilities transition into harvest season. | In an effort to prevent the spread of the coronavirus, Mr. Garcia, an addiction counselor, spends his days off volunteering to deliver masks from the local health department to field workers. Like many residents of rural Oregon, Mr. Garcia is bracing for a spike in coronavirus cases that feels all but inevitable as local farms and food processing facilities transition into harvest season. |
| Oregon, once one of the most successful states in managing the pandemic, is now undergoing a viral surge in rural areas. Agricultural areas like Umatilla County, where Mr. Garcia lives and works, now have some of the highest rates of cases in Oregon. | Oregon, once one of the most successful states in managing the pandemic, is now undergoing a viral surge in rural areas. Agricultural areas like Umatilla County, where Mr. Garcia lives and works, now have some of the highest rates of cases in Oregon. |
| “I know it’s going to get worse,” Mr. Garcia said. “It’s almost like we’re on our own.” | “I know it’s going to get worse,” Mr. Garcia said. “It’s almost like we’re on our own.” |
| The coronavirus struck Oregon early, with cases emerging in February. But unlike two of its neighboring states, Washington and California, Oregon was not quickly overwhelmed by the pandemic. The state has recorded more than 12,000 infections, far fewer than most of its neighbors. But as the state reopens after an early lockdown, cases are spiking. The state set a grim record on Thursday with 389 new infections. | The coronavirus struck Oregon early, with cases emerging in February. But unlike two of its neighboring states, Washington and California, Oregon was not quickly overwhelmed by the pandemic. The state has recorded more than 12,000 infections, far fewer than most of its neighbors. But as the state reopens after an early lockdown, cases are spiking. The state set a grim record on Thursday with 389 new infections. |
| If the spread of the virus continues at its current rate, Oregon Health Authority models predict that Portland hospitals will hit capacity in a month, and hospitals throughout the state will be overwhelmed within 90 days. | If the spread of the virus continues at its current rate, Oregon Health Authority models predict that Portland hospitals will hit capacity in a month, and hospitals throughout the state will be overwhelmed within 90 days. |
| “We’re sandwiched between California and Washington,” Gov. Kate Brown said. “We’re not an island, and the virus knows absolutely no jurisdictional boundaries.” | “We’re sandwiched between California and Washington,” Gov. Kate Brown said. “We’re not an island, and the virus knows absolutely no jurisdictional boundaries.” |
| The increase has been most drastic in rural parts of the state where outbreaks have been spurred on by large gatherings at churches, food-processing facilities, funerals and graduation parties. | The increase has been most drastic in rural parts of the state where outbreaks have been spurred on by large gatherings at churches, food-processing facilities, funerals and graduation parties. |
| Ms. Brown ordered Oregonians to wear masks in public buildings, starting July 1. She also introduced a spending package to fund protective equipment and quarantine pay for farm workers. | Ms. Brown ordered Oregonians to wear masks in public buildings, starting July 1. She also introduced a spending package to fund protective equipment and quarantine pay for farm workers. |
| And on Monday, Ms. Brown said she was issuing a statewide ban on indoor social gatherings of more than 10 people, saying the state needed to crack down on social events that were spreading the virus. The ban would limit things such as birthday parties and book clubs, but it would not apply to businesses or churches “at this time,” she said. | And on Monday, Ms. Brown said she was issuing a statewide ban on indoor social gatherings of more than 10 people, saying the state needed to crack down on social events that were spreading the virus. The ban would limit things such as birthday parties and book clubs, but it would not apply to businesses or churches “at this time,” she said. |
| Oregon public health officials expect that recent Fourth of July festivities will soon produce new cases, as happened after Memorial Day gatherings. But despite contact-tracing efforts, public health officials are encountering more and more people who are not able to determine how they were infected with the virus, a worrying indication of community spread. | Oregon public health officials expect that recent Fourth of July festivities will soon produce new cases, as happened after Memorial Day gatherings. But despite contact-tracing efforts, public health officials are encountering more and more people who are not able to determine how they were infected with the virus, a worrying indication of community spread. |
| “Our biggest concerns are these household and backyard gatherings where people are getting together with a bunch of other households,” said Dr. Paul Cieslak, a state epidemiologist and a senior health adviser for the Oregon Health Authority. | “Our biggest concerns are these household and backyard gatherings where people are getting together with a bunch of other households,” said Dr. Paul Cieslak, a state epidemiologist and a senior health adviser for the Oregon Health Authority. |
| “Oregonians, in general, have a ‘We’re all in this together’ mentality,” he said, noting that the public had generally followed public health advice. But he added: “I think we’re starting to see a reversal of that trend now.” | “Oregonians, in general, have a ‘We’re all in this together’ mentality,” he said, noting that the public had generally followed public health advice. But he added: “I think we’re starting to see a reversal of that trend now.” |
| Dr. Cieslak said his staff had observed the public in recent weeks engaged in more of what they have nicknamed “F.I.B.s” — flagrantly infectious behaviors — like attending indoor events without wearing masks. | Dr. Cieslak said his staff had observed the public in recent weeks engaged in more of what they have nicknamed “F.I.B.s” — flagrantly infectious behaviors — like attending indoor events without wearing masks. |
| “We have people who are very concerned about the virus and doing everything under their control,” said Bill Elfering, a commissioner for Umatilla County, which has recorded a spike in cases, partially driven by a local food-processing facility. “We have other people who say, ‘Ah, I’ll survive it and don’t tell me to wear a mask, because I won’t.’” | “We have people who are very concerned about the virus and doing everything under their control,” said Bill Elfering, a commissioner for Umatilla County, which has recorded a spike in cases, partially driven by a local food-processing facility. “We have other people who say, ‘Ah, I’ll survive it and don’t tell me to wear a mask, because I won’t.’” |
| In neighboring Union County, more than 300 coronavirus cases have been linked to the Lighthouse United Pentecostal Church, which held large gatherings in late May and early June. | In neighboring Union County, more than 300 coronavirus cases have been linked to the Lighthouse United Pentecostal Church, which held large gatherings in late May and early June. |
| John Howard, a Union County resident and former county commissioner, said his brother, Paul, was not a member of the church but had contracted the virus as it spread from the church through the rest of the community. | John Howard, a Union County resident and former county commissioner, said his brother, Paul, was not a member of the church but had contracted the virus as it spread from the church through the rest of the community. |
| Mr. Howard said he ached at being separated from his brother while he was hospitalized, and was only able to catch a brief glimpse of him as he was being transferred from the local hospital to one in Idaho that has a ward dedicated to virus patients. | Mr. Howard said he ached at being separated from his brother while he was hospitalized, and was only able to catch a brief glimpse of him as he was being transferred from the local hospital to one in Idaho that has a ward dedicated to virus patients. |
| “We were able to see him on the gurney,” Mr. Howard recalled. “He saw us and recognized us.” | “We were able to see him on the gurney,” Mr. Howard recalled. “He saw us and recognized us.” |
| On the morning of July 1, his brother died. He was 62 years old. “This didn’t have to happen,” Mr. Howard said. | On the morning of July 1, his brother died. He was 62 years old. “This didn’t have to happen,” Mr. Howard said. |
| The recent outbreaks have exacerbated tensions in Oregon’s rural communities, and between the governor, who is seen as representing the state’s big population centers in western Oregon, and county leaders in rural eastern Oregon. | The recent outbreaks have exacerbated tensions in Oregon’s rural communities, and between the governor, who is seen as representing the state’s big population centers in western Oregon, and county leaders in rural eastern Oregon. |
| Umatilla County commissioners have seen their economy battered by the shutdown. The county normally hosts one of the largest rodeos in the United States every fall, which pumps millions of dollars into the local economy and generates significant tax revenue. But the event has been canceled, leaving county commissioners worried about their budget, just as they are spending more to combat the pandemic. | Umatilla County commissioners have seen their economy battered by the shutdown. The county normally hosts one of the largest rodeos in the United States every fall, which pumps millions of dollars into the local economy and generates significant tax revenue. But the event has been canceled, leaving county commissioners worried about their budget, just as they are spending more to combat the pandemic. |
| Updated July 7, 2020 | |
| The coronavirus can stay aloft for hours in tiny droplets in stagnant air, infecting people as they inhale, mounting scientific evidence suggests. This risk is highest in crowded indoor spaces with poor ventilation, and may help explain super-spreading events reported in meatpacking plants, churches and restaurants. It’s unclear how often the virus is spread via these tiny droplets, or aerosols, compared with larger droplets that are expelled when a sick person coughs or sneezes, or transmitted through contact with contaminated surfaces, said Linsey Marr, an aerosol expert at Virginia Tech. Aerosols are released even when a person without symptoms exhales, talks or sings, according to Dr. Marr and more than 200 other experts, who have outlined the evidence in an open letter to the World Health Organization. | |
| Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. | |
| Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles. | |
| A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico. | |
| The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth. | |
| The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave. | |
| So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. | |
| Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. | |
| A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. | |
| If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) | |
| If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. | |
| “I think a lot of the issue is, the metro areas are driving the bus,” said John Shafer, one of the commissioners. “They are dictating what happens out here.” | “I think a lot of the issue is, the metro areas are driving the bus,” said John Shafer, one of the commissioners. “They are dictating what happens out here.” |
| He added that the county would follow Ms. Brown’s health guidance, but said communication about state health orders had been poor and worried that the realities of rural life — such as a lack of high-speed internet access that made remote learning difficult — were not being contemplated as the state drew up its guidance for the school year. | He added that the county would follow Ms. Brown’s health guidance, but said communication about state health orders had been poor and worried that the realities of rural life — such as a lack of high-speed internet access that made remote learning difficult — were not being contemplated as the state drew up its guidance for the school year. |
| Rural leaders said they felt neglected by the state as they watched their urban counterparts appear at news conferences alongside the governor. Some said they were reassured that a mask order was not in the works, only to hear days later that masks would, in fact, be required throughout the state. The sense of neglect was heightened by Oregon’s decision to hang on to some emergency federal funding, rather than sending it directly to rural communities. | Rural leaders said they felt neglected by the state as they watched their urban counterparts appear at news conferences alongside the governor. Some said they were reassured that a mask order was not in the works, only to hear days later that masks would, in fact, be required throughout the state. The sense of neglect was heightened by Oregon’s decision to hang on to some emergency federal funding, rather than sending it directly to rural communities. |
| The state used some of its federal relief funding to buy protective equipment for the counties, reasoning that it could more easily purchase and distribute supplies in bulk. But the decision meant that rural counties did not receive the cash they had hoped for to fund their public health efforts, including the hiring of contact tracers, and to provide relief grants for local businesses. | The state used some of its federal relief funding to buy protective equipment for the counties, reasoning that it could more easily purchase and distribute supplies in bulk. But the decision meant that rural counties did not receive the cash they had hoped for to fund their public health efforts, including the hiring of contact tracers, and to provide relief grants for local businesses. |
| Umatilla County expected several million dollars for virus response, Mr. Shafer said, but has received only about $725,000 so far. Other states did not follow Oregon’s approach, giving funding directly to counties. | Umatilla County expected several million dollars for virus response, Mr. Shafer said, but has received only about $725,000 so far. Other states did not follow Oregon’s approach, giving funding directly to counties. |
| The governor, in an interview, acknowledged that it has been difficult to manage the virus in a state with so many competing regional priorities. | The governor, in an interview, acknowledged that it has been difficult to manage the virus in a state with so many competing regional priorities. |
| “It honestly is tense with everyone right now and has been,” Ms. Brown said. | “It honestly is tense with everyone right now and has been,” Ms. Brown said. |
| She said Congress should have guided the states on how to spend relief money. | She said Congress should have guided the states on how to spend relief money. |
| “We did something different,” she said. “I honestly don’t know that it was the right thing, but we thought it was better that we as a state bought and paid for personal protective equipment.” | “We did something different,” she said. “I honestly don’t know that it was the right thing, but we thought it was better that we as a state bought and paid for personal protective equipment.” |
| As serious as the recent caseload has been, many fear that the upcoming harvest season could make things even worse, as additional agricultural workers pour in and processing plants kick into high gear. | As serious as the recent caseload has been, many fear that the upcoming harvest season could make things even worse, as additional agricultural workers pour in and processing plants kick into high gear. |
| A recent outbreak at one of Hermiston’s largest employers, a facility that cuts potatoes into french fries, added 37 cases to Umatilla County’s total. | A recent outbreak at one of Hermiston’s largest employers, a facility that cuts potatoes into french fries, added 37 cases to Umatilla County’s total. |
| “That is what our public health department is hammering: if you’re sick, stay home," Mr. Shafer said. “If you’re in that situation where you’re trying to provide for your family, you might suck it up and go to work. That’s going to be a huge spike.” | “That is what our public health department is hammering: if you’re sick, stay home," Mr. Shafer said. “If you’re in that situation where you’re trying to provide for your family, you might suck it up and go to work. That’s going to be a huge spike.” |
| On a recent afternoon, Mr. Garcia handed out masks and boxes of groceries from a local food bank at an organic watermelon and cantaloupe farm just outside of town. Marta Cernas, a worker there, said her crew would double in size once the harvest begins in a few weeks. To prepare, the farm has ordered a thermometer to check workers’ temperatures and installed extra sinks so workers can wash their hands more often. | On a recent afternoon, Mr. Garcia handed out masks and boxes of groceries from a local food bank at an organic watermelon and cantaloupe farm just outside of town. Marta Cernas, a worker there, said her crew would double in size once the harvest begins in a few weeks. To prepare, the farm has ordered a thermometer to check workers’ temperatures and installed extra sinks so workers can wash their hands more often. |
| Still, she said she was worried about getting sick. “It affects all of us,” she said. “Everybody here and the whole world.” | Still, she said she was worried about getting sick. “It affects all of us,” she said. “Everybody here and the whole world.” |
| Mike Baker contributed reporting from Seattle. | Mike Baker contributed reporting from Seattle. |