This is the first article in a three-part series on Oregon’s COVID-19 response, as we enter the second year of the pandemic.
A year after the coronavirus pandemic began, it became clear that Oregon was able to contain the spread of COVID-19 in a way that was practically unprecedented in most other states in the country.
By mid-March, 3.8% of Oregon’s population had tested positive for COVID-19. Only Vermont, Maine and Hawaii had a lower percentage. Washington came in fifth, just behind Oregon.
This is an achievement that can be attributed in part to the willingness of Oregon residents to be vigilant in social detachment and wearing masks, but also to the government and health officials who impose often unpopular social restrictions to protect public health.
Although, in a way, comparing Oregon to other states is like saying that he is one of the best players in the worst team in the league. The response of coronavirus in the United States was practically the worst in the world.
“What I have been doing … during the pandemic is not only to see how we are doing compared to other states, but also to look at other countries,” said Oregon Health Authority Director Patrick Allen. “As things unfold, decrease and flow, we actually compare quite favorably to most European countries.”
Among countries with more than one million inhabitants, the US case rate is in third place in number of cases per population.
On that scale, Oregon would be rated the 45th worst – faring better with case rates than countries like Ireland, Lebanon and Spain, but worse than Germany, Canada and Mexico.
Oregon against the world
What percentage of the population in a country or state has been infected with COVID-19?
Although the United States had one of the worst responses to COVID-19 in the world (ranked third in the case rate among countries with more than a million people behind the Czech Republic and Slovenia), Oregon and Washington fared much better . If states were similarly ranked on the world stage, they would be ranked 36th and 46th worst, respectively. Graphic: Jes Burns / OPB Data source: Our World in Data / University of Oxford, CDC 3-15-21
Double-edged sword
The low case count is commendable, but the success has put Oregon and Washington in an unusual position: we may have a harder time obtaining collective immunity from COVID-19.
Herd immunity is the gold standard for disease control; that’s why we don’t have massive measles outbreaks every year. We obtain collective immunity when a sufficient number of people in a population become immune to an infectious disease that is unlikely to continue to spread.
To become immune to COVID-19, you can be infected and survive. A recent analysis suggests that this “natural” immunity increases in the first three months after the recovery of COVID-19 and is likely to last many months afterwards.
The other option is to develop immunity in response to a vaccine.
For COVID-19, probably more than 70% of people will need to be vaccinated or previously infected to achieve collective immunity.
Due to our relatively low case rate, the population of Oregon has a lower rate of immunity from infection compared to people living in other states. And that means that we don’t have the natural immunity buffer that so many other states have. Consequently, Oregon (and Washington) will depend much more on vaccines to make up for the difference and lead us to collective immunity.
“I think that this is definitely playing a role. How much of our role, I think, will likely be revealed in the coming months – it’s difficult (to know) now, ”said Oregon state epidemiologist Dr. Dean Sidelinger.
Related: Returning to ‘normal’ in Oregon means obtaining collective immunity COVID-19
Because there are so many asymptomatic cases of COVID-19, the Centers for Disease Control and Prevention estimates that there are actually 4.6 times more coronavirus infections than reported across the country. Using this to calculate a number closer to the realist of people with natural immunity shows some striking differences between states and regions.
“The Midwest is really building collective immunity,” said Oregon Health & Science University professor Mark Slifka.
States like North Dakota and South Dakota, which have had massive and uncontrolled outbreaks, already have about 60% of their populations naturally immune.
The number of cases in Oregon has been low, so our naturally immune population is only about 17%. Washington’s is just over 21%.
This is unlikely to affect early vaccination strategies. Without testing across the population, people who did not experience symptoms and unreported cases of COVID-19 cannot be segregated from the vaccine pool. Even so, health officials know that a certain percentage of the unvaccinated population is already protected from the virus to some degree. And the higher that number, the greater the chances of ending the pandemic.
The double-edged sword of COVID-19 case fees
States that have failed to keep the number of cases low are naturally closer to reaching the herd’s immunity limit of 70% -75%
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Populations in states that have failed to keep the case count low have suffered more illnesses and deaths from COVID-19, but the number of people with natural immunity is greater. States that have been successful in keeping the case count low will consequently rely more on vaccines to achieve collective immunity. Oregon and Washington are two of the country’s most vaccine-dependent states. Here, the official case count has been multiplied by 4.6 to estimate natural immunity rates. The CDC estimates that there are 4.6 times more cases of COVID-19 than confirmed across the country. Graphic: Jes Burns / OPB Data source: CDC 3-15-21
Deaths
On March 15, 2,324 Oregon residents died of COVID-19. Each of these deaths is a tragedy. And the state’s response was not without stumbles.
But Oregon as a whole has done better than everyone, except four other states – Hawaii, Vermont, Alaska and Maine – when it comes to deaths from the disease. The state lost 5.5 people for every 10,000 residents. Across the country, 16 out of 10,000 died of COVID-19.
“If we had people dying in Oregon on the national average, we would have 4,000 more deaths in the state than we have today. Every time I think about it and think about how horrible they are … the deaths we’ve had so far [are], imagine triple that number, ”said Allen.
The low mortality rate is closely linked to the state’s low case count. However, Oregon is also in the top third of states in deaths from COVID-19 by number of cases. About 1.5% of Oregon residents who tested positive for the disease died. Washington is also there.
Allen said that when you look at COVID-19 case rates, mortality rates and test positivity rates, Oregon’s response to the pandemic has averted a lot of suffering.
“What that tells me is that the sacrifices (made by the inhabitants of Oregon) worked,” he said.
Oregon against the states
COVID-19 deaths per 10,000 inhabitants