3D rendering, coronavirus cells covid-19 influenza flowing on grey gradient background as dangerous flu strain cases as a pandemic medical health risk

3-D rendering of the novel coronavirus

A steep surge in COVID-19 cases will likely lead to the shutdown of indoor dining and other severe restrictions in at least 12 counties, Gov. Kate Brown said Friday.

Oregon on Friday reported over 1,020 new infections, more than double two weeks ago — the sharpest spike of any state.

The spread of more contagious variants is outpacing vaccinations, which now top 1.1 million out of the state's 4.3 million residents.

"In the race between vaccines and variants, the variants are gaining ground and have the upper hand," Brown said during a Friday morning press call.

There are 11 counties that currently have infection levels that would place them in the extreme risk tier: Baker, Clackamas, Columbia, Crook, Deschutes, Jackson, Josephine, Klamath, Linn, Marion, and Polk.

During a period last month when cases were dropping, Brown ordered an exemption from the harshest restrictions if the state was under 300 hospitalizations for COVID-19. There are currently 305 confirmed or presumed COVID-19 patients hospitalized in Oregon, although only 276 have tested positive. 

The rising infection rates will almost certainly pass the threshold this weekend. Brown said she would announce Monday if she was re-imposing limits that include a ban indoor dining and cutbacks on gathering sizes, business hours and other public activity.

If a return to extreme risk levels is warranted, it will occur at the end of next week, without the prior "warning week" to give counties more time to prepare for changes in the rules.

"Essentially this is your warning," she said.

Oregon Health Authority Director Pat Allen said the drive to vaccinate Oregonians has varied widely across the state. Over 50% of the adult population has at least one shot of vaccine in Hood River, Lincoln, Benton, Deschutes and Multnomah counties.

The counties with the lowest vaccination rates are Lake, Umatilla, Gillam and Douglas, where less than 35% of adults are vaccinated.

Increasingly the "undervaccination gap" is driven by personal choice instead of availability of shots, Allen said. 

Softening demand could be caused by vaccine hesitancy or outright opposition. The one-shot Johnson & Johnson vaccine was again approved for distribution on Friday after a pause ordered by the Food and Drug Administration.

The agency and the Centers for Disease Control investigated a small number of incidents, including the death of an Oregon woman, among the 7.5 million people vaccinated with the shot. The renewed use of the Johnson & Johnson vaccine will now come with a warning of extremely rare blood clots.

Health officials across the nation have worried that Americans would become too focused on a tiny number of adverse outcomes instead of the larger and more lethal threat of COVID-19. Vaccination delays give the virus time to spin off more variants, including those that started in Britain and South Africa, driving up infection and death rates.

Allen mentioned concerts, family gatherings and seeing loved ones without masks as parts of life that everyone — including himself — wanted to return to as soon as possible. The fastest way of getting "back to normal" was to be vaccinated soon, he said.

Brown said she realized any new restrictions would whipsaw Oregon's already turbulent business environment during the pandemic. The $1.9 trillion American Rescue Plan approved by Congress would be tapped to soften the economic impact on proprietors and companies affected by a new order.

The number of new virus infections in Oregon has risen 58% in the last 14 days, the steepest of any state, the New York Times reported Friday.

Dr. Dean Sidelinger, the state's top contagious disease expert, said the upswing in infections exceeded the state's most pessimistic scenarios.

"If that spread continues unabated, our hospitals risk being swamped by virus-stricken patients," he said.

The "fourth surge" of the pandemic has some reason to be less pessimistic than earlier spikes, said Dr. Renee Edwards, chief medical officer at OHSU Healthcare at Oregon Health and Science University and advisor to Brown.

"This will be different," she said.

The vaccination of three out of four people 65 and older, who made up the majority of people who were killed by the virus, means this spike will impact a relatively younger and healthier group of unvaccinated people. The result will be that while infections and illness could climb steeply, deaths will not.

Edwards said the restrictions would likely be needed for no more than three weeks, when the increasing vaccination levels will cap the usual exponential growth of the COVID-19 spikes.

While hoping that COVID-19 cases can be low enough to lift most restrictions by July, Brown said that would not be the end of the fight.

After California Gov. Gavin Newsom announced this week that students at the massive University of California and California State University systems would have to show proof of vaccination before being allowed to return to classes in the fall, Brown said Oregon would most likely follow suit, but said she was not yet ready to issue the order before consulting with university and community college leaders.

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