AGENDA COVER MEMO

Memorandum Date: October 5, 2020

Order Date: October 6,, 2020

___________________________________________________________________________

TO: Board of County Commissioners

DEPARTMENT: Health & Human Services

PRESENTED BY: Karen Gaffney, Director Health & Human Services

AGENDA ITEM TITLE: REPORT TO BOARD REVIEWING STRATAGIES AND

ADDITIONAL ACTIONS TO CONTAIN THE SPREAD OF COVID-19 IN
LANE COUNTY

I. MOTION

None, informational item.

II. AGENDA ITEM SUMMARY

The Board is being asked to review strategies recommended by staff in an effort to reduce the
transmission of COVID-19 in Lane County.

Ill. BACKGROUND/IMPLICATIONS OF ACTION

A. Board Action and Other History

The World Health Organization, the President of the United States, the State of
Oregon and Lane County have declared COVID-19 a global pandemic and public
health emergency. The Board's emergency declaration, Board Order 20-03-17-06,
also authorized the County Administrator to spend up to $750,000 to respond to the
effects of COVID-19. The funding authorization for COVID-19 response was increased
to $5,000,000 via Board Order 20-03-31-09. Board Order 20-03-31-10 approved the
purchase of 100 River Avenue for use in response to the COVID-19 emergency. Lane
County moved to Phase II of reopening based on the Governors Guidance, June 5,
2020. The emergency declaration was extended a second time for an additional 60
days on 20-05-12-08 and again on 20-07-07-14. The most recent extension to the
 emergency declaration was made via Board Order 20-09-01-03, which extended the
emergency through January 1, 2021.

B. Policy Issues and Board Goals

This addresses Strategic Priority 1: a Safe, Healthy County

C. Financial and/or Resource Consideration

Options 1, 2 and 3 listed below will require an increase in Lane County staff time. It
is anticipated that State or Federal COVID-19 specific funding will be available to pay
for the staff time required to implement any or all of these strategies. There is no
immediate financial impact of implementing option 4. The implementation of Option 5
could impact local businesses by limiting hours and/or access.

D. Health Implications
The County must continue to manage its response to the COVID-19 pandemic
including care of at-risk individuals, prevention of the rapid spread of illness, reducing
the peak load on medical facilities, and fulfilling the County’s public health obligations.

E. Analysis

Lane County has seen a significant increase in the number of new cases the last several
weeks, with the following reported by OHA, and even higher numbers projected for the
week of 9/27/20:
 Week of 9/6/20 15.8/100,000 (60 cases)
 Week of 9/13/20 30.1/100,000 (114 cases)
 Week of 9/20/20 64.9/100,000 (246 cases)

These numbers are reflected on the below epi curve for Lane County, and while hospital
cases are staying around 11 at any one time, as the number of cases continues to
increase one can expect that the hospital numbers are also likely to climb.
While the recent cases (prior 2 weeks) certainly cut across all demographics and regions of the
County, there are significant concentrations in particular geographic areas, with the largest
numbers in the Eugene/Springfield area, followed by numbers in South Lane County.

Similarly, when looking at the age distribution for cases in the last 2 weeks, there are
significant increases in both the young adult age range (18-27 year olds) but also the middle
age adult population (28-65 year olds). While young adults are an important driver in the
increase in cases, they are not the only population driving the increase. There is clearly
community spread.

Given the communitywide spread of COVID in Lane County (and in Oregon and the nation), the
community will need a multi-pronged approach to regain a foothold on the disease and
successfully bend the curve. The overall prevention tools remain the same until an effective
vaccine is widely available—masking, physical distancing, handwashing, and limiting the size
of gatherings. For those who do contract the disease, the community needs sufficient testing
availability, rapid investigation and contact tracing, and adequate quarantine and isolation.

Through disease investigation and contact tracing, Lane County has identified outbreaks of
disease in the following areas (as of week of 9/27/20):

While the indicators for severe illness in Lane County are still relatively stable, the increase in
new cases is significant, and demands consideration of what additional actions could be
deployed to contain the spread of disease and effectively bend the curve. In addition to
flattening the curve to preserve critical hospital and other healthcare resources, this is a critical
time to contain the spread before the weather becomes challenging for outdoor activities and
more people shift to staying indoors where transmission is more likely.

F. Alternatives/Options

The growth in new cases in Lane County is happening while cases are increasing overall for
the state and in many parts of the nation. Many communities with colleges and universities are
seeing increases in cases, along with communities where schools are returning to in-person
instruction. In addition to the core elements that are part of the County’s COVID Plan, the
following are options for consideration by the Board:
1. Continue to monitor and intensify messaging efforts regarding masks, gatherings,
distancing, and hygiene.
2. Sector-specific work (i.e., work with higher education, businesses, faith communities, etc.)
3. Direct staff to prepare an ordinance to require mask wearing
4. Request to be placed on the Governor’s Watch List
5. Request to return to return to Phase 1

1. Continue Monitoring and Intensify Messaging

This strategy would continue to intensify the messaging to the community regarding masks,
gatherings, distancing, and hygiene and closely monitor for changes over the next two
weeks. This includes a significant focus through both earned and paid media, enhanced
messaging with the University of Oregon, and strong partnership with the new business
alliance.

Given the incubation period of the virus, we know that even if behavior change started last
week, the change in numbers won’t be noted for at least that two week period. This would
both allow time to assess any change in behaviors as a result of the messaging changes,
and will allow for the results of the communication survey that was put in the field last week
and might inform next steps for effective communication and behavior change.

2. Increased Sector-specific Work

This strategy would focus additional outreach and attention on sectors where new cases
seem to be the highest, currently including higher education, farmworker communities,
specific neighborhoods or geographic areas. Currently staff are working closely with the
University of Oregon to coordinate and amplify effective messaging targeted at students on
and off campus; partner for testing, tracing, quarantine, isolation, and case management;
identify promising approaches from other universities related to incentives and conduct code
enforcement; and other strategies to support containing the spread of disease. Staff are also
engaged with community members and CBOs to address farmworker communities with
bilingual and bicultural strategies to support containing the spread of disease. We have
convened a business partners group to help support different business sectors with their
own supportive strategies—it has lots of potential and needs to grow. With additional
resources and community partnerships, efforts might be built on the ground with city
partners, neighborhood associations or neighborhood watch, faith leaders. This is much
larger than just governmental public health, and we need a variety of champions to help
engage the larger community in the effort.

3. Direct Staff to Prepare an Ordinance to Require Masks

The Board has had some discussion about potential local ordinances that could be adopted,
with the most recent suggestion an ordinance requiring that masks be worn. Currently, there
 is a statewide mask requirement from the Governor, and the concern seems to be about a
lack of enforcement, rather than the text of the requirement itself. If the County were to
adopt a local ordinance, the same question of enforcement would need to be resolved. If
the Board chooses to direct staff to prepare this or other COVID-related ordinances, the
recommendation is that they be adopted by the Board of Health in order to have countywide
applicability. County Counsel confirmed this would go through the normal ordinance
adoption process, including at least two readings two weeks apart, and a public hearing.

4. Governor’s Watch List

Counties are placed on the watch list when there is a sporadic case rate of ≥ 50 per 100,000
in the last two weeks and the county has >5 sporadic cases in the last two weeks. Sporadic
cases are those cases that cannot be traced to a source, which indicates community spread.

Counties remain on the watch list for a minimum of three weeks and until their sporadic case
count drops below 50 per 100,000 or ≤5 cases in the previous two weeks. The watch list
helps policymakers and the COVID-19 response team to prioritize resources and assistance
to the counties that are seeing the broadest spread of COVID-19. The assistance offered to
a particular county depends on the assessment of its needs. Often it includes
epidemiological assistance and staffing support. Presence on the watch list does not
indicate that a county is being moved back a phase in reopening, nor is it punitive.

Below is the most recent report from OHA on data for the watch list, and you can see Lane
County’s sporadic case rate does not currently meet the threshold for the watch list, although
it does exceed the state average. The watch list does not change any of the policies or
sector guidance for the community, but does signal a level of state concern. In many ways,
this is similar to the ALERT system that Lane County has put in place, but is based just on
sporadic case spread.

5. Request to Return to Phase 1

As the Board knows, the Governor’s Office re-opened counties in Oregon based on
performance on a number of metrics, allowing greater degrees of opening at Phase 2 than
at Phase 1. There are a number of sectors where there is now statewide guidance in effect
regardless of specific phase of reopening. There are currently four counties still in Phase 1
of reopening: Clackamas, Malheur, Multnomah, and Washington. Based on conversations
with the Governor’s office there is not a clear process for a county to request returning to
Phase 1, and staff are awaiting more information from the state. A concern about this option
is its failure to specifically target areas of concern—the whole County would roll-back, and
this would not change the guidance for some particular areas of concern in Lane County
 such as private parties, smaller social gatherings, and many workplaces.

Below is information about the different phases.

 Phase 1: Includes limited reopening of personal services like salons and barbers,
gyms, and malls, and restaurants and bars open for in-person service until 10pm.
Indoor social get-togethers are capped at 10 people with physical distancing.
Cultural, civic, and faith gatherings are capped at 50 people with physical distancing
for indoors or outdoors.

 Phase 2: After 21 days in Phase 1, counties that meet specific prerequisites may be
able to enter Phase 2. Counties with more than 100 cases must have their case
counts reduced to 100 cases or less per 100,000 people per week. Wider reopening
includes recreational sports, venues like movie theaters, bowling alleys, and arcades,
and increased in-office work. Indoor social get-togethers are capped at 10 people
with physical distancing.

Key areas with specific Phase 1 guidance:

 Personal services
 Fitness-related organizations
 Restaurant/Winery/Bar
 Indoor mall

Key areas where there is no Phase 1 guidance:

 Indoor entertainment
 Outdoor entertainment
 Sports
 Venues
 Youth Clubs

A summary of the phases and Governor’s reopening guidance can be found at:
https://sharedsystems.dhsoha.state.or.us/DHSForms/Served/le2689.pdf

IV. Recommendation
Staff recommends continuing to monitor and intensify messaging regarding masks,
gatherings, distancing, and hygiene; and providing additional outreach and attention on
sectors where new cases seem to be the highest, currently including higher education,
farmworker communities, specific neighborhoods or geographic areas.

IV. ATTACHMENTS
None