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Oregon health department grapples with how to confront COVID-19 threat from Idaho
Idaho Statesman - 9/20/2020
Sep. 20--Before the coronavirus, the state border separating Payette County, Idaho, from Malheur County, Oregon, was little more than a few signposts on opposite sides of the highway. Residents from either side crossed freely between states for work and recreation, part of a thoroughly intertwined community.
But when the COVID-19 pandemic began, stark differences in management of the coronavirus between the two states became apparent. Whereas Oregon Gov. Kate Brown enacted a statewide mask mandate and imposed strict caps on event attendance, Idaho Gov. Brad Little turned mask policies and regulations over to individual health districts.
Events like the Payette County Fair, held while Payette County was under a red level health alert the first week of August, are not permitted in Oregon. But officials from the Malheur County Health Department say they fear events of this sort -- and Idaho's district-by-district- approach to the pandemic -- is heightening community spread on their side of the border.
Both counties have become hotspots in their respective states. Payette County's case rate is over 5 per 10,000, placing it under red health level alert from Southwest District Health, where it's been since Aug. 5. About 24% of tests in the county are positive.
Malheur's testing positivity rate for the past week was 38.2%. The county reported it's seeing 19 new cases daily.
County fair linked to surge in Payette cases
Payette County has found itself under red alert since Southwest District Health began publishing color alerts Aug. 5. Under a red alert, SWDH advises against large crowds and gatherings of people from different households and recommends that event coordinators limit the density of people in confined areas to 1 person per 64 square feet.
Despite these guidelines, hundreds of community members packed bleachers at the county fair to watch the rodeo on Aug. 8, photos taken by the Argus Observer show.
The proper incubation time for COVID-19, according to the CDC, is 14 days. So when Dr. Daniel Morris, an epidemiologist working as a consultant for MCHD, saw a dramatic increase in Payette County COVID-19 cases two weeks after the fair, he flagged the fair as a spreading event.
The week of the fair, the county reported 40 new COVID-19 cases, Two weeks later -- the week of Aug. 23 -- there were 107 new cases reported. The week of Aug. 30, 102 new cases were reported in Payette County.
"It's hard to conclude anything other than that the fair was a big spreading event," Morris said. He pointed to data showing that surrounding counties -- Gem County, Canyon County, Washington County -- did not exhibit the same spike in cases during these weeks as evidence that the spreading event must have been localized in Payette.
Payette County Fair organizers did not respond to requests for comment.
Since the fair, Payette County has remained under a red health alert. As of Sept. 10, it was the only county in the district still in the red due to a "high COVID-19 incidence rate" and "evidence of sustained community spread," according to a SWDH press release.
Epidemiologists from SWDH have only been able to definitively link one case in Payette to the fair itself, according to Katrina Williams, spokesperson for SWDH, but Morris said that a definite linkage is not necessary to identify the fair itself as a spreading event.
"The absence of evidence is not the same as the evidence of absence," Morris said. "Just because you may be not able to connect all the dots between the people who got sick and their attendance at the fair, that shouldn't rule out the fair as the major spreading event."
Williams wrote SWDH was "aware of the assessment made available by Malheur County," but didn't say if SWDH was in agreement. She said that SWDH epidemiologists were also examining cluster outbreaks in workplaces and outbreaks resulting from people commuting to areas with heightened community spread as other potential causes for the county's high case count.
SWDH will not cancel events similar to the fair in the future, Williams wrote.
Lack of Idaho statewide mandates hurt Malheur
Despite the statewide measures enacted by Gov. Brown, Sarah Poe, director of MCHD, said the shared border with Idaho leaves Malheur County extra vulnerable to the pandemic -- which has already spread widely throughout the county.
As of Sept. 16, Malheur County had 1,467 total cases with a 23.9% test positivity rate. The county had 783.6 cases per 100,000 people the week of Aug. 23 -- over double the second highest case rate on the Oregon County Watch List.
Poe said that coordination between her department and SWDH has been positive, despite differing approaches to handling the virus. For Poe, the challenge has not been inter-department coordination, but rather the difference in statewide mitigation strategies between Idaho and Oregon.
"I have had very strong encouragement from the state level, both the governor's office and the Oregon Health Authority, to be mitigating the risk from Idaho," Poe said. "And it's been very hard."
Gov. Little's local approach to combating the pandemic has placed health districts in the position of having to make politicized decisions with little back-up from the state, Poe said. While other Idaho districts, like Central District Health, have enacted mask mandates and limited gathering size, SWDH has taken a more hands-off approach, providing recommendations and guidance rather than mandates.
"We are not against Southwest District Health," Poe said. "And they have not failed or done a bad job. They're actually working extremely hard in a very hard climate. My job is so much easier because I don't have to personally try and force through political measures. Oregon really made those decisions for us."
In response to an email from the Statesman, Marissa Morrison Hyer -- Little's press secretary -- said Idaho's health officials have been mindful of the challenges of mitigating spread of COVID-19 in border communities since the onset of the pandemic.
"We remain committed to working with bordering state partners to ensure healthy communities," she wrote. "The positivity rate is mirrored on both sides of the border. We advise citizens to follow the laws and recommendations of their state."
Poe also appealed to Little and Idaho lawmakers to understand the unique public health challenges facing Malheur County.
A major outbreak in the county has taken hold at the Snake River Correctional Institution, a medium security prison roughly ten miles from Payette County. 71% of SRCI employees reside in Idaho.
At the facility, the testing positivity rate among adults in custody was 48% as of September 8, she said. 128 staff members and 383 adults in custody have tested positive at SRCI, according to Oregon Department of Corrections data. The facility is currently under a 14 day quarantine.
Poe also pointed to the county's precarious financial situation.
"We have so many hardships in Malheur County," Poe said. "We have a 31% childhood poverty rate, and that's what keeps me up at night. I have to try and make things better for families who are hurting so much. We're just asking Idaho to think about those families and help us get there."
(c)2020 The Idaho Statesman (Boise, Idaho)
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