Oregon Gov. Kate Brown COVID-19 Press Conference Transcript August 19

Governor Kate Brown: (00:36) Good morning. I'm joined today by Patrick Allen, Director of the Oregon Health Authority, Dr. Dean Sidelinger, our state epidemiologist, Colt Gill, Director of the Oregon Department of Education, and Dr. Jeff Absalon, Chief Physician Executive for St. Charles. I'll start this morning by addressing Oregon's hospital crisis caused by the Delta surge. With over 845 Oregonians hospitalized for COVID-19 and 226 Oregonians in our ICU, our hospital and ICU beds are over 93% full. Some hospital regions are beginning the day with two ICU beds available or none at all. Overwhelmingly, the Oregonians who are being hospitalized or who are dying from COVID-19 are unvaccinated. This isn't just about beds, it's about having enough trained healthcare professionals to treat patients. Our nurses, doctors, and healthcare workers have been on the front lines of this pandemic in full PPE for over 17 months. They are being stretched to their absolute limits, providing life-saving treatment for the patients in their care. Governor Kate Brown: (05:07) We are all at risk right now when our hospitals are full. There may not be a staff bed for you if you have an unexpected medical emergency. When ambulances have nowhere to go, people die preventable deaths. I am devoting all available resources to help, including deploying the National Guard and nurse strike teams, establishing temporary decompression units to free up hospital bed space, and removing barriers to discharging patients who no longer require hospital-level care. I've also convened a hospital crisis prevention and response table to problem solve. Director Allen will go into more detail. Governor Kate Brown: (06:02) In addition, I've made requests to FEMA and the Biden-Harris administration for additional federal resources and support. I am working with Oregon's congressional delegation to secure FEMA assistance. Yesterday, I had the opportunity to speak directly to Administrator Criswell about Oregon's needs. I expect they will be able to respond to our near-term requests in the coming hours. However, we cannot wait for help to come. We must proactively implement solutions right now. We need every single frontline healthcare worker healthy and available to treat patients. Toward that end, Oregon's vaccination requirement for healthcare workers will no longer have a testing alternative. Healthcare workers will be required to be fully vaccinated by October 18th or six weeks after full FDA approval, whichever is later. Governor Kate Brown: (07:06) In the weeks since I announced Oregon's original test or vaccination policy, the Delta variant has put enormous pressure on our health systems. There are simply not enough resources to stand up weekly testing systems while also responding to the current crisis. I've also worked closely with healthcare stakeholders on this decision. I am calling on Oregon's hospital administrators to devote additional resources, including federal funds to support their staffs during current shortfalls. I will provide additional FEMA resources for small and rural hospitals. We cannot afford to lose a single healthcare worker. They certainly deserve our recognition and gratitude for their incredible hard work. As everyone knows, it's also the beginning of back-to-school season. Oregon schools are opening their doors for full-time in-person instruction over the next few weeks. I know many parents are anxious about sending their children back to school and back to the school buildings. We've seen school districts in the south being upended by COVID-19, with thousands of students quarantined because they opened without robust safety measures. Our kids need to be in the classroom full-time five days a week. We have to do everything we can to make that happen. As always in Oregon, we are following science and implementing health and safety protocols. And while we're still learning about the Delta variant, we know from previous experience that when schools open with safety measures in place, the risk of transmission is low. Governor Kate Brown: (09:08) From what we know today, there are two keys to keeping our students in classrooms with minimal disruptions. Because children under 12 still are not eligible for vaccination, masks are a critical tool to prevent our kids from getting sick at school. Just as important is ensuring all the adults around our students are fully vaccinated against COVID-19. That's why I've directed the Oregon Health Authority to issue a rule requiring all teachers, educators, support staff, and volunteers in K through 12 schools to be fully vaccinated against COVID-19, again, by October 18th or six weeks from FDA approval, whichever is later. There are those who will disagree with the actions I'm taking today, but school is starting across the state. COVID-19 poses a threat to our kids and our kids need to be protected and they need to be in school. And that's why I'm willing to take the heat for this decision. Governor Kate Brown: (10:25) I know we had all hoped for that by now, we could put the challenges of 2020 behind us, but after the last year and a half, I also know that we are absolutely capable when we are all working together of doing amazing things. Last year, we stood together for our nurses, doctors, and healthcare workers. We saved lives by following science and data. I'm asking you to do it again for our healthcare heroes, our vulnerable community members, and Oregon's kids. Our best tools to keep our schools, businesses, and communities open are wearing masks and getting vaccinated. And with that, I'll turn it over to Director Allen. Patrick Allen: (11:19) Thank you, Governor Brown. I'm Patrick Allen, director of the Oregon Health Authority. This morning, I want to give you an update on steps that the Oregon Health Authority and other state and federal partners are taking to help our hospitals to try to keep them from being overwhelmed by nearly a thousand COVID-19 patients infected with the Delta variant, nearly all of whom are unvaccinated. And we need to ask every Oregonian to help. We can blunt the surge and save our hospitals if unvaccinated adults get immunized and we all wear masks when we're in indoor public places. And if you remain unvaccinated, you need to avoid any non-essential activities where you're around others so you don't catch and spread the Delta variant. It's that simple. It's that urgent. Patrick Allen: (12:04) The numbers grow every day. I want to be honest, the situation in Oregon's hospitals is growing increasingly dire. Our health care system is on the verge of collapse in parts of the state. In coming weeks, every Oregon hospital could be overtopped. Right now, ambulances are transporting more people in respiratory distress, but they have to wait longer to get patients into emergency departments because those beds are full. Patients are spending days in emergency departments because critical care beds aren't available. Right now, more than 200 patients are boarding in Oregon hospitals' EDs waiting for a bed. Hospitals are converting outpatient rooms to medical-surgical rooms or ICU beds. Patients are parked in hallways. Staffing is critically short. Patrick Allen: (12:51) I need to be direct about what's causing this crisis. A growing wave of unvaccinated patients who have become so seriously sick with the Delta variant they need to be hospitalized. We've said it before, the COVID-19 pandemic is now a pandemic of the unvaccinated more than a quarter of the adult population still remains unprotected from COVID-19. Overwhelmed hospitals are what happens when such a large reservoir of vulnerable people offers itself as a target for a virus that has killed more than 600,000 Americans and almost 3000 Oregonians. State health officials are working desperately alongside hospital administrators and staff to keep Oregon hospitals staffed and beds open. Patrick Allen: (13:34) But here's what we all need to face. Oregon hospitals are not far from reaching the point where health systems may not be able to provide the highest level of care to everyone who needs it, whether they have COVID-19, or if they've been in an accident, or if they've had a heart attack or any other of many medical crises any of us could suddenly and unexpectedly experienced today or any day in our lives. We're not at that grim point yet, but if we don't act the crushing influx of unvaccinated COVID-19 patients means that doctors and nurses in some hospitals may soon face the terrible prospect of having to make heart-wrenching triage decisions about whom they can save and whom they cannot. Patrick Allen: (14:20) I know many people have struggled to acknowledge the threat COVID-19 poses to Oregon, but whether you view COVID-19 with concern or contrarianism, here are the stark facts we're facing. Today, we set another new record for ICU patients. As of this morning, 845 Oregonians are hospitalized with COVID-19, and 226 are in intensive care, two more than yesterday. We also had another record-setting week in hospitalizations. Over the past reporting week, which ended August 15th, a total of 546 Oregonians with COVID-19 were hospitalized. That figure is up from 322 COVID-19 hospitalizations just the week prior. That's a 42% increase in one week. That total represents the fifth consecutive week of increases. It's the highest weekly figure of the entire pandemic. The situation has changed dramatically in a month. On July 19th, there were 148 patients hospitalized with COVID-19 in Oregon, and 39 in intensive care. In the past month, we've seen more than a 500% increase in these numbers. Hospitals are approaching their maximum limits in beds and staffing. 93% of hospital beds in Oregon are occupied. 94% of adult ICU beds are full statewide. Patrick Allen: (15:44) Yesterday, our hospital region two, which includes Salem, had no adult ICU beds available. The Oregon Health Authority and our partners are working to shore up the two most important parts of a functioning hospital system, patient beds, and the people who staff them. Let's start with the beds. We're working with the Oregon Department of Human Services and long-term care facilities to create surge beds to ease overcrowding in hospitals. Skilled nursing facilities and rehabilitation centers will stand up surge and decompression beds in high-impact regions to help hospital patients who are waiting for discharge to other facilities where they can continue to safely recover. Speeding up these discharges frees more desperately needed hospital beds and staff to care for seriously ill patients with COVID-19, or other diseases, injuries, or trauma. State agencies are also working to cut red tape to remove prior authorization barriers and expedite appropriate patient discharges from hospitals to lower levels of care. Patrick Allen: (16:45) Oregon continues to pursue a fully staffed field hospital from the federal government. On August 10th, OHA submitted a request to the Federal Emergency Management Agency for a mobile hospital. We're keeping Oregon's congressional delegation informed while we continue discussions with our federal partners. We understand that many other states are facing even worse- Patrick Allen: (17:03) We understand that many other states are facing even worse challenges than Oregon, but we will continue to pursue federal help, despite the competing demands for these limited resources. Patrick Allen: (17:11) There is some late-breaking good news. Through Governor Brown's urgent advocacy and the responsiveness of our federal partners, Oregon will receive 24 EMT paramedics through FEMA national ambulance contracts to support six hospital emergency departments as emergency department extenders. In 96 hours, we will have 24 EMT paramedics at these six hospitals, five at Asante Rogue Valley Medical in Jackson County, five at Asante Three Rivers in Josephine County, three at St. Charles in Bend, three at St. Charles in Redmond, four at Providence in Medford, and four at Mercy Medical Center in Roseburg. Patrick Allen: (17:52) As in the case of the federal field hospital, we know more beds only help if we have enough healthcare workers to treat the patients in them. From day one of this pandemic, I have remained profoundly grateful to Oregon's committed, caring, and resilient healthcare workers. Here are the steps we're taking to support them. Oregon National Guard deployment. On August 13, Governor Brown announced the deployment of 1,500 Oregon National Guard members to support frontline healthcare workers at more than 20 hospitals statewide. Starting August 20, an initial 500 guard members will be sent to hospitals around the state to provide logistical support as well as assisting with COVID-19 testing and other services to support hospital operations. After consultation with hospitals we expect to call up 1,500 guard members, the maximum service numbers available at this time. Patrick Allen: (18:42) The first wave will be deployed in hospitals serving Deschutes, Douglas, Jackson, and Josephine Counties. Hospitals in Columbia, Curry, Marion, and the Tri-County Region will be prioritized for the second wave. Like healthcare workers, I am grateful to our guard members who have answered the call throughout this pandemic. We have asked for medical personnel from other states. Through OEM, Oregon has requested 35 physicians, 35 advanced practice providers, 300 registered nurses, 10 paramedics, and 100 respiratory therapists from other states. These staff would serve temporary assignments in Central and Southern Oregon. Patrick Allen: (19:24) We're contacting for eight nurse crisis teams to staff surge beds in longterm care facilities to free more hospital beds. Four of the teams will start in September, four more will start in October. The first team will start September 6 in Roseburg, the second will start September 9 in Medford, and we're working with licensing boards to set emergency rules that allow flexibility in healthcare staffing. The medical and nursing boards have issued temporary rules making it easier for out of state providers to work in Oregon during the crisis. Patrick Allen: (19:58) Let me end with some encouraging news. Oregon's vaccination rate continues to rebound. More and more Oregonians are choosing to get vaccinated every day. The seven day running average of vaccinations is now 6,037 shots administered per day. The seven day running average of first doses is 4,126. That's a 24% increase from just the end of July. The measures Governor Brown announced will drive these numbers up and help bring us closer to herd immunity, and they're just in time. If you're unvaccinated, the delta variant changes everything. You are more at risk, people in their twenties, thirties and forties have been hospitalized. Some have died. Older adults and children around you are more at risk if you get this highly contagious variant, and if you're still not ready to get vaccinated, please avoid all non-essential activities. Stay away from large groups of people. When you go out, wear a mask in public, even in outdoor spaces where you may be among crowds. The delta variant is relentless in its search for new people to infect. Don't let it find you. The consequences for you, your family, and our healthcare system could be catastrophic. With that, I'd like to hand off to Dr. Dean Sidelinger, Oregon's state health officer. Dr. Dean Sidelinger: (21:18) Thank you Director Allen. The grip of the delta variant is tightening, and without a concerted effort by all Oregonians over the next several weeks to wear masks and get vaccinated, we risk being swamped by the rapidly rising tide of infections in our community. Over the past week, daily cases and COVID-19 related hospitalizations have continued an alarming ascent, regularly setting new pandemic highs, far beyond what we experienced in previous surges. Dr. Dean Sidelinger: (21:51) The statistics are grim. Our most recent COVID-19 weekly report tallied 12,741 cases for the week of Monday, August 9 through Sunday, August 15, a 54% increase over the previous week, and a test positivity rate of 11.8%. Last week, OSA reported 8,304 cases, which was 40% higher than the week before. Today, we're reporting 2,971 daily COVID-19 cases, bringing our overall total to 250,835. Sadly, we're also reporting 19 new COVID-19 related deaths, raising the statewide total to 2,994. Our hearts go out to every person who has experienced a loss to COVID-19. Dr. Dean Sidelinger: (22:58) The 635 new hospitalizations reported August 10 set what was then a pandemic record. We have exceed that total every day since then. Today, OSA is reporting 845 COVID-19 related hospitalizations. As you have heard, this is putting an unprecedented strain on the ability of our hospitals to provide care to patients arriving at their doors. This avalanche of new cases and virus-related hospitalizations far outpace our recent modeling projections. But in a glimmer of hope, the most recent modeling being prepared by OHA and OHSU this week show modest slowing in the pace of increase in the coming weeks. This does not mean that we can let our guard down. For this to happen, we need all Oregonians to take steps to protect themselves and their loved ones right now. Get vaccinated if you're not already, wear masks in indoor public settings, and consider changing plans that put you at higher risk from getting COVID-19 if you're unvaccinated. Dr. Dean Sidelinger: (24:08) Throughout this recent surge, one pattern has starkly emerged. Oregonians sick with COVID-19, nearly all of them unvaccinated, are filling hospital beds in record numbers, and this poses a critical threat to all Oregonians in need of hospital care. If you are unvaccinated, you have never been more vulnerable to being sickened by the virus, passing the virus onto your loved ones, getting seriously ill, or even dying from COVID-19. If you are unvaccinated, you are risking the health of your family, your loved ones, and everyone you encounter while infected. Those are the facts, supported by our data and the science to date. I shudder to think about what the pandemic landscape might look like today without the availability of highly effective and safe vaccines. All three of the available vaccines serve as reliable shields against severe COVID-19 infections, which leads to hospitalizations. Dr. Dean Sidelinger: (25:11) The COVID-19 vaccine is saving lives every day here in Oregon. More than 2.5 million Oregonians have had at least a first dose of a COVID-19 vaccine. In early July, Oregon reached 70% of all adults vaccinated. In the meantime, we must do our part by following prevention measures, most notably the requirement to wear masks while in public indoor settings. The use of face coverings provides significant protection of people who are unvaccinated, as well as providing additional protection against the small risk of infection that exists for vaccinated people. They protect the person wearing the mask as well as those around them and the loved ones we return home to. Dr. Dean Sidelinger: (25:54) Let me address the scientific basis for requiring masks. The virus that causes COVID- 19 has mainly spread through respiratory droplets and aerosols that float in the air. These droplets are expelled when someone with COVID-19 speaks, coughs, or sneezes. Face coverings provide a barrier to these droplets, that when coupled with other intervention steps, reduce transmission. Data from numerous laboratory and community studies have demonstrated the effectiveness of masking to reduce risk. Masks are safe. Masks do not affect a person's ability to breathe. Dr. Dean Sidelinger: (26:32) This is the basis for requiring face coverings in K-12 schools across Oregon. The use of face coverings can keep students learning in-person by reducing infections and quarantines, especially when paired with other layered prevention efforts in our schools. Dr. Dean Sidelinger: (26:48) I'd now like to show you a slide that shows the increase in pediatric cases since July. Young people 18 and under are accounting for a larger share of COVID-19 cases. Our most recent pediatric data posted today shows that there have been 31,394 cases within the under 18 age group, representing 12.7% of all the COVID-19 cases here in Oregon. Pediatric case rates are highest among communities of color and specifically people who identify as Pacific Islander, American Indian, Alaska Native, Black or Hispanic. Dr. Dean Sidelinger: (27:28) I'd now like to show you another slide. This slide shows the highest case counts amongst children are in the 12-17 age range. Children are getting sick with COVID-19 in Oregon. Now the report also shows that while cases have increased, severe outcomes continue to be rare in children, but are still nonetheless devastating for the families facing these serious health crises. 0.9% of pediatric patients have been hospitalized at some point during their COVID-19 illness. There have been two reported deaths in Oregon with COVID-19 among people under 18 years. By wearing our masks and having our children wear theirs, we can ensure that those severe cases remain extremely low. We can bring the surge under control by getting vaccinated and by wearing a mask and by remaining faithful to the mitigation measures that have worked to reverse previous surges. Dr. Dean Sidelinger: (28:29) To everyone who has taken the time and effort to get the vaccine and now to wear masks, thank you. Once again, Oregonians are rising to the challenge. To people who have not been vaccinated, please make a plan and get vaccinated. It's the surest path back to normalcy that we all crave. With that, I'd like to turn things over to Dr. Absalon. Dr. Jeff Absalon: (28:57) Thank you Dr. Sidelinger. My name is Jeff Absalon. I am the chief physician executive for St. Charles Health System. We're located in Central Oregon. Our largest hospital in Bend serves as a regional resource hospital for the largest geographic area of the state. I also lead a group of physician leaders from hospitals and health systems throughout the state that have been engaging over the course of the last year and a half during the pandemic to learn from each other, to support each other in terms of how we can better care for our communities, for hospitalized patients and beyond. So I really appreciate the opportunity to talk to you all today. I'd like to share with you some of the perspectives from a hospital or health system and just appreciate your time. Dr. Jeff Absalon: (29:39) I can't overstate this, what we're going through right now is unimaginable. We are seeing an incredible surge of patients in our communities, as well as patients that are requiring hospitalizations. We are overwhelmed and this is really a dire situation. In our hospital in Bend, we have 62 COVID-19 patients this morning, the most we've had at any time during this pandemic. That approaches 30% of our acute care beds, and these are beds that are being utilized for these very important patients with a severe infection, but they're also taking the place of beds that are much needed for other care. So when you hear the numbers about capacity, what I'd like you all to know is that we are at capacity or over capacity in our hospitals throughout the state. We have had to delay care significantly during this pandemic in terms of scheduled surgeries. This is an impact that's been profound. So as I take the next couple minutes, I want to outline a couple things. One is I'd like to speak a little bit about this virus and why this is so different. I'd like to talk about the impact on our hospitals and what that really means is impact on patients in our community. I'd like to speak about our hospital and health system workforce and then finally what we need from you. Dr. Jeff Absalon: (30:57) You've heard a bit about this delta variant which is the variant in our state at this time. This particular variant carries 1,000 times the viral particles in the respiratory parts of the body, which makes it so transmittable and it is flourishing at this point in time. Patients are sicker and health systems are experiencing taking care of these patients as well as patients without COVID-19 who quite honestly are sicker than prior to the pandemic. Sometimes in many cases due to delay in care that as mentioned has been unavoidable in some cases. In our health system, we have had to postpone or cancel close to 3,000 scheduled surgeries. These are not cosmetic surgeries, these are very necessary, critical surgeries for the patients that we serve. These are patients that have cancer, heart disease, neurological disease, surgeries that are necessary to preserve life and function and they're being delayed right now. Dr. Jeff Absalon: (32:03) So quite simply put, and I don't want to mince my words, we're rationing care. Only patients that have the most severe needs for surgical care are getting that care in our hospitals today and many, many, many more are waiting. The hospital in the region that's suffering the most at this time is in Southern Oregon, so our partners in Roseburg and Medford have seen incredible surges. We're not far behind them here in Central Oregon as well as other parts of the state including Portland that have seen rises in cases. You've heard about the 845 cases of hospitalized patients, and there are predictive models estimating that we may see as many as 1,100 patients. That is if we continue to use the measures that are necessary to try to curb the spread of this disease. So if that happens, we will exceed the number of hospital beds in the state by a number of 400 or so, and again as you've heard, these are mostly unvaccinated folks. Dr. Jeff Absalon: (32:57) In some hospitals in our state, we're seeing nurses having to extend their care beyond their normal ratios and in some cases a single nurse taking care of as many as 10 patients. We would like to get back to normal care as much as possible. We really need to curb the spread of this disease. Dr. Jeff Absalon: (33:16) You know what scares me the most about this is what's already been alluded to which is if somebody gets in an accident or has a heart attack or need for acute care ... Excuse me, I'm going to get some water, they may not get the care in as timely of a fashion as normal. I really want you to think about this as you embark upon your activities. This is a time to be really cautious about your activities and keep yourself safe. This is really, really important. I mentioned to you what's happening in Southern Oregon. We have all been planning for a surge of patients, including resources. I know our health system as well as others have sent ventilators to Southern Oregon to help out at this point in time. That's exactly what - Dr. Jeff Absalon: (34:03) To Southern Oregon to help out at this point in time. And that's exactly what's happening at this point. The rate limiting step for us is our workforce. 18 months into this pandemic our frontline healthcare workers that have been caring for patients every day are exhausted, they're burned out. And we're in a pandemic that many of us regard at this time as largely preventable. And yet here we are with the highest number of hospitalizations that we've seen throughout the time of this pandemic. And so I just want to acknowledge our frontline healthcare workers, I want to acknowledge what they've been through, what they continued to do every day and ask for your support to prevent this from continuing and preventing us from being in a situation similar or worse in another 18 months or any other timeframe and so the time really to act is now. Our healthcare workers are experiencing what we call moral injury because they've not been able to care for patients in front of them the way that they need. Dr. Jeff Absalon: (34:59) Again, speaking to surgical patients that are not able to get in to get their care at this point in time. Inside of our healthcare system, we've experienced extreme challenges with regards to our clinical workforce in particular nursing care. We have 800 open positions in our healthcare organization, close to 200 of those are nurses. And we've been seeking nurses from outside of our area, outside of the state. We've got approximately 100 traveling nurses here at this time and we've requested additional assistance from outside of the state and appears we're going to be getting some here in the next several days, which will be much needed, but still won't be enough. We really appreciate the support of the national guard. We'll put those people to work and they will be helping us in terms of reducing barriers to flow of patients, improving the ability to get in for testing as well as triage and treatment of patients in our acute care settings, so we really appreciate that support. Dr. Jeff Absalon: (35:59) But I do want everybody to know that our hospitals and health systems are in crisis and we need everything possible to be done to help at this time. I want to share with you a little bit of my experience over the course of the last several days, just so that you can see what I see. Just a few days ago I had the honor of stepping into our intensive care unit and then... Unfortunately it was just a few minutes after we lost a young COVID-19 patient, someone 10 years younger than myself. Our nurses had tears in their eyes and yet they had to get right back to work to take care of the next patient that needed their services. And that's what they did and that's what they do. We also have been hearing about people, I'm sorry. Dr. Jeff Absalon: (36:50) We've also had family members that have had to say goodbye to their patients through a glass door or through an iPad. We've also had patients coming into our hospitals that don't believe in COVID-19 disease, that are diagnosed with the disease, but don't believe in it. And then there are those who didn't believe in COVID-19 or didn't believe in vaccinations until they were in our care gasping for their last breath of air and became believers and later encouraged their family members to get vaccinated and take measures to prevent the spread of this disease. That's what's happening in our hospitals and health systems. So here's my ask and it's consistent with everything that you've heard already so far today. If you're not vaccinated, get vaccinated, it's exactly what needs to happen. This is the way out of this pandemic. There is strong science behind these vaccines and they work. Dr. Jeff Absalon: (37:44) Although we've seen breakthrough cases in COVID-19 and fully vaccinated people, we know that the best way to prevent severe disease or hospitalization is to get vaccinated, just get vaccinated. Second of all, wear a mask. This is not political, okay? The mask can and will save lives and we need to prevent the spread of this virus, it's incredibly important. And I would urge people to avoid crowds, even in the outdoor environment. This virus is different than what we saw earlier in the pandemic. It's spreads readily, protect yourself, protect your family members, protect those that you don't know around you because that's what we need to do to curb this is pandemic. And I do want to point out that we're in the situation we're in right now with a much more transmissible form of this virus that's causing really severe disease because the virus has continued to survive and propagate and to evolve. Dr. Jeff Absalon: (38:46) And we need to stop this to prevent the next variant from coming along. So get a vaccine, wear your mask and then finally I want to remind everybody to make safe choices. Our hospitals are full. We want you to come and see us if you need our services, we do not want people to delay care, but please be careful, make good choices and keep yourself safe because the hospital environment is different now than what it was prior to this pandemic. So I thank you for your time and I will turn it back over to governor brown. Governor Kate Brown: (39:22) Thank you so much Dr. Absalon. We really appreciate you joining us today. And Charles we are ready for questions. Charles: (39:32) Thank you governor. We go first to Katie Streit with KOBI. Go ahead, Katie. Katie Streit: (39:38) Thank you so much. I can already see the comments coming in on our social media posts. I thought we were taking away our rights, how could you do this? What would be your response to Southern Oregonians who are still very hesitant to get the vaccine and still very hesitant on this mandate and then also, I guess a follow up question to that is would workplaces just refuse to enforce this new rule? Governor Kate Brown: (40:04) Dr. Sidelinger would you like to respond to that question please? Dr. Sidelinger: (40:09) Thank you, governor Brown. As you've heard, we have highly effective and safe vaccines that prevent the spread of COVID-19, keep people safe and save lives. Our health care providers are needed critically now on the front lines to combat this virus, to save the lives of patients, whether they have COVID-19 or something else. We also know that our schools are critically important place for students to be in front of talented teachers consistently and not impacted by going in and out with quarantines and cases. So having our teachers and staff in those settings vaccinated are key part to doing that. We need employers to work with their employees, to link them up to appropriate information so that they can learn the facts about this safe and effective vaccine and know that these vaccines are available throughout the state. So over the next several weeks and months, they can assist employees in getting vaccinated so they can continue to provide the vital services that they do to all Oregonians. Governor Kate Brown: (41:23) And Katie your second question was with regards to consequences. So first state executive branch employees that I oversee, there are two exemptions, both a religious exemption and a medical exemption. And that are frankly, those are the two choices that employees have. And the third option is if they are not willing to get vaccinated is unfortunately termination. In terms of other employers they'll have to speak to that directly. Katie Streit: (41:57) Perfect. Thank you so much. Charles: (42:00) Thank you Katie. We'll go next to Sarah Klein with the Associated Press. Go ahead Sarah. Sarah Klein: (42:05) Hi. Yes. So it seems Oregon's vaccine mandate will take some time for state employees and school staff and healthcare workers since they have until October 18th or later. With that said, it seems like we might not see the full impact that mandate will have on our case rate for some time. And based on current hospitalizations, it also seems that there's a need for immediate actions to slow the spread. So during previous searches, governor you've implemented capacity limits, indoor dining closures and county risk levels, is that something you're considering doing again and also director Allen are those additional health and safety measures, something that OHA has recommended that the governor do. Governor Kate Brown: (42:47) So just to be perfectly clear, all options are on the table. The reality is that vaccines are widely available and unfortunately the majority of the folks that are in the hospital with COVID are un-vaccinated. So while the deadline isn't for several weeks, we continue to encourage Oregonians to get vaccinated if they are able and they haven't gotten one to this date. In terms of other safety protocol, here's how I would respond to that question. Our businesses and our working families have shouldered the burden of the safety protocol over the last year and the best way to keep these businesses open and our families working is to get vaccinated and to wear your mask. With that I'll turn it over to director Allen. Director Allen: (43:51) Thanks. I would say first that after a long period of vaccinations declining day by day, we've seen pretty substantial increases in the daily numbers of people getting vaccinated over the last couple of weeks. And so as the governor indicated the deadline isn't until October, but we certainly hope that people who are covered by these requirements, who are going to get vaccinated, do it now and not wait until October. There's no benefit to waiting that long and in fact, there's a lot of benefit to getting vaccinated as quickly as you possibly can. I think the biggest thing that people can do right now that can have an immediate impact is in fact wearing masks. And I see a lot of commentary on social media and those kinds of things of, if you're afraid you wear a mask I'm not going to. And it misses the whole point which is the purpose of cloth face coverings is to protect people from you not to protect you from others. Director Allen: (44:43) When you have a communicable disease and someone else is sick there's not much that you can do to protect yourself. You need them to protect you, that's why it's a community effort and we all need to participate. If everybody in a community is wearing a mask that will have a profound impact on driving down the transmission of the disease. And that's the number one fastest acting thing people can do right now. Dr. Sidelinger: (45:06) Can I add to that for a second? Governor Kate Brown: (45:08) Sure. Go ahead Dr. Sidelinger. Dr. Sidelinger: (45:10) So you asked about restrictions on businesses. Right now as we've told you many times before we are living two different pandemics. If you're vaccinated you are very well protected, especially from serious disease and hospitalization. But as we stated, if you're un-vaccinated now is not the time to take risks. You are at grave danger of getting COVID-19. So if you are un-vaccinated consider changing your plans, limit your contact with others. Don't attend those events you are planning on doing because you are at risk and you will bring that virus home to your family and loved ones and potentially make them sick. So the restrictions on businesses would be a broad measure right now. And we know that it's that segment of Oregonians who are not vaccinated who need to take additional precautions, while they get their vaccines to be fully protected. Those precautions kick in right now so look at what you're doing, change your plans so you can protect yourself, your loved ones and really our broader community. Charles: (46:18) Thank you, Sarah. We'll go next to Julia Silverman with Portland Monthly. Go ahead Julia. Julia Silverman: (46:27) Well, actually I think my question has been answered. Sorry. I forgot to lower my hand. Charles: (46:33) Thanks Julia. Governor Kate Brown: (46:33) Thanks Julia. Charles: (46:35) We'll go next then to Rachel Alexander with Salem Reporter. Go ahead Rachel. Rachel Alexander: (46:42) Hi governor. I'm wondering what authority state has to enforce a vaccination mandate for K-12 educators if that's going to apply to both public and private schools. And then what you intend to do, if a district or a private school says that they're not going to enforce that for their own employees. Governor Kate Brown: (47:01) So great question which I'm going to turn that over to director Gil, but I just want to reiterate that in my conversations with educators, teachers, superintendents and school board members over the last couple of weeks, what we all agree is that vaccines are our best tool to keep children in the classroom full time during the school year. And with that I'll turn it over to director Gil. Director Gil: (47:32) Thanks, governor Brown. I couldn't agree more. What we are attempting to do in Oregon is to hold school reliably in person. That means we need to take every precaution possible. Face coverings and vaccinations for those who are eligible are a part of the picture. Vaccinated individuals are not required to quarantine when they're exposed unless they're showing symptoms. That means that we have more educators and support staff at school with students each day, that's the critical factor here. And this is all about being able to serve our students in person where we know they learn best and where we know that they have access to mental health and wellbeing supports, where that we know that they have access to good meals at school, that's the whole goal here. If we have a school district or individuals who would like to forego participation in this rule, we will first come at them with education. Director Gil: (48:32) We'll talk to them about why this is so critically important and how it can keep our kids at school which is a shared goal that we all have. Barring that the Oregon Health Authority has authority in state statute to levy civil penalties against the school district or an employer who fails to follow these requirements. These requirements are in place for our public school system, our public charter schools, our private and parochial schools as well. Rachel Alexander: (49:05) And just to quickly follow up is one of the enforcement measures you'd consider pulling state school funding for public schools that choose not to comply with this? Director Gil: (49:15) No. So the civil penalties will come along with the Oregon Health Authority statutory authorities and our goal is to have school held in person. So we're not attempting to withhold state school funds that would prevent the school from operating in person. We want our staff in front of our kids in a safe and healthy way so that they can provide that in-person instruction. And so that the students and the staff members and the families that they return to each day are kept safe. So that's the goal we have, we're not going to take action that would have any side effect of closing a school or getting us farther from our goal of in-person instruction. Rachel Alexander: (49:57) Thank you. Charles: (49:59) Thank you, Rachel. We will go next to Tim Gordon with KGW. Go ahead Tim. Tim Gordon: (50:06) Hi. For the governor, I think I'd like to ask you if I could, why not higher education staff for this vaccine mandate with the no lockout for testing and are K-12 substitute teachers included in this? Governor Kate Brown: (50:21) An answer to your last question, yes. Are substitute teachers included? Yes. In terms of higher education and childcare, as I said earlier, all the options are on the table and we will be having those conversations. Tim Gordon: (50:38) Why not yet though governor for them? Governor Kate Brown: (50:42) As I said, I certainly took the time to have conversations with the educator workforce, including our superintendents and school boards. We'd like to do the same thing with our higher education and childcare partners. Tim Gordon: (50:55) Thank you. I want to ask also, hostels the capacity like this, is there any talk of people with COVID who chose not to get... Tim: (51:03) Is there any talk of people with COVID who chose not to get vaccinated being deprioritized for beds or care for people with other urgent medical conditions? Governor Kate Brown: (51:11) Dr. Absalon, would you be willing to respond to that question, please? Dr. Jeff Absalon: (51:15) All right. That's a tough one, and I know that there's dialogue about that popping up in the physician ranks and other health care areas. So at this point in time, that's not happening here in the state. However, I have to say that we really are in a dire situation, and those kind of very difficult questions that are being raised are things that we may very well need to address or define how we're going to approach in the future. So very difficult question, and I can't predict where that would go, but I appreciate the question and the concern that people are raising around that topic. Dr. Sidelinger: (52:00) Can I add to that? Tim: (52:00) Thanks for answering. Governor Kate Brown: (52:02) Sure. Dr. Sidelinger, go ahead. Dr. Sidelinger: (52:05) Yeah. I would like to say, while that is a gut reaction to say that people made a choice not to be vaccinated and should pull lower on the list, we have a framework in place that we've worked on with our health care partners to prioritize care during these types of crises and emergencies that ensures that we won't discriminate against people because of the choices they've made, because of intellectual or developmental disabilities or other conditions. While we don't want to limit care to anybody, we know that during some of these critical times, we may have to do so. So we've set out some criteria, worked with hospitals so that they can do so in the fairest way possible, even though each of these decisions is difficult for our healthcare team, for the families, and the patients they're caring for, but it won't come down to making a decision based on the vaccine you chose to get or not get. That's an easy way out. Dr. Sidelinger: (52:59) But our healthcare workers, as you've heard, our professionals, they were mourning the loss of a young patient in the ICU in St. Charles, but turned right around to continue providing care to others. That's what they've done over the past 17 months. That's what our public health staff have done over the last 17 months to provide the best possible care to each and every Oregonian that we can to make sure that people had access to vaccines, to the services they need to recover, and to the treatment they needed. And we will continue to do so, but we need you on our side. Get vaccinated, but right now, take steps to protect yourself. If you're unvaccinated, consider staying home, and all of us need to be wearing masks in indoor settings right now, so that we can protect that vital resource, so that healthcare providers are not put in the point of making those difficult decisions. Thank you. Speaker 1: (53:56) Thanks, Tim. We have time for just about three more questions, so I'm going to go next to Eder Campuzano with The Oregonian. Go ahead, Eder. Eder Campuzano: (54:05) Hey, thanks. So the state previously stratified its reopening benchmarks for schools, one set of rules for middle and high schools, another for elementary students based on case rates and test positivity. Students in that former group, most sixth graders through high schoolers are eligible for vaccinations. And I know you said all options are on the table, so can you tell us why Oregon hasn't considered or yet enacted a vaccine mandate for students who are eligible, or when it might come if it is? Governor Kate Brown: (54:35) Director Gill, would you like to speak to that please? Director Gil: (54:39) Yeah. I will start, and also possibly pass this off to Director Allen as the student vaccination criteria are within the rules set at the Oregon Health Authority. But what I would start with, Eder, is that we're basing our system going forward into this school year off the success that we had last spring, when all of our schools were open to in-person instruction. Some schools did that with a portion of their students on a limited number of days per week. Many of our schools in Oregon served all of their students on a daily basis last spring. At that time, regardless of level, elementary, middle, and high school, and we were able to mitigate or stop the transmission of COVID-19 on those school campuses. Director Gil: (55:24) In controlled environments like schools, where folks are used to following a lot of rules, you all remember being in elementary school, and we all followed new rules that we didn't have at home. We took turns to go to the restroom. We walk in lines. Now you see our students using superhero arms to walk in line so that they're maintaining their physical distancing. There are all kinds of ways that our teachers do a fantastic job of teaching these new protocols. We did that last year. We saw very little transmission of COVID-19 on school sites, even though COVID-19 was frequently introduced to school settings. Director Gil: (56:03) So with face coverings, all of the practice protocols that our schools had in place last spring, and these added vaccination protections for the adults in the system, we believe we can do well. I would say we should do everything we can to encourage our students who are eligible for the vaccine to get the vaccine. I believe our rates right now are still under 50% for the youth that are eligible, and we need to move that number up as well. Director Gil: (56:34) The requirement for a youth vaccine or a childhood vaccine comes from rules at the Oregon Health Authority, and so I'll let Director Allen address that direct. Director Allen: (56:42) Thanks. The process for making a vaccine required for school is set out in state statute, and there are certain steps that we have to follow. In general, the vaccine needs to be approved, and there are recommendations for its use in school made by the Advisory Committee on Immunization Practices. And then we have a local advisory committee process that we go through. I would anticipate that that would be the way a vaccine would become a required vaccine for schools. Director Allen: (57:11) That said, everything director Gill said is exactly right about how these vaccines are safe and effective. The rate of uptake for kids 12 and older, it's now a little bit over 50%, but it's still in that 50% to 55% range, and we would really like to see that increase. And that is actually where the fastest growth in vaccinations is going on right now, are amongst kids in Oregon. Speaker 1: (57:37) Thank you, Eder. We have time for just two more quick questions, so I'll go next to Lisa Bailiff with [inaudible 00:57:43]. Lisa Bailiff: (57:44) Yeah. I just want to follow up on Eder's question. Are you looking at requiring all kids who can get the vaccine be required to do so, once there's full approval from the FDA? Governor Kate Brown: (57:56) Lisa, as I said earlier, frankly, all options are on the table to make sure that our kids are able to be in the classroom full-time, and to limit disruptions. Lisa Bailiff: (58:08) But will you go ahead once there's full federal approval and mandate that, like the teachers and the staff? Governor Kate Brown: (58:14) As I just said, all options are on the table. We're exploring every possibility at this point in time. Speaker 1: (58:21) Thanks, Lisa. We'll be going to the last question. It is from Gary Warner with EO Media. Go ahead, Gary. Gary Warner: (58:30) Hi, Governor. Thank you for the time today. Two questions. Within the next month, we've got the Oregon State Fair. We have a Oregon Duck football game against Fresno State, and then we have the Pendleton Round-up. So the first part of my question is, how can these events go on with this level of problems at the hospital? And secondly, there's a lot of the research that's coming out in Israel now that's showing a deterioration on the Pfizer vaccine. 39% efficacy after six months with some of the older patients. What are the discussions going on about that, and about boosters? Governor Kate Brown: (59:13) So Gary, I'll respond non-scientifically to your last question, and that is obviously that's why the federal government is recommending boosters after eight months. And I'll let Director Allen talk about that. Somehow, I knew you were going to get to the Pendleton Round-up when you got a question. So first of all, I think you're fully aware that Delta has changed everything, and I am strongly recommending that Oregonians be extremely cautious, that when you go out and are amongst people, that you be masked up, and of course that you get vaccinated, because that's the best tool that we have. I will say that I am really delighted to see venues and counties taking leadership. For example, Benton County took action, and our very own Timbers and Thorns are requiring either proof of vaccination or a test within 48 hours. So we encourage these events, these venues to work with their local public health authority, and we continue to encourage Oregonians to mask up and get vaccinated. And I'll let Dr. Sidelinger and Director Allen fill in with more detail. Director Allen: (01:00:36) Maybe I'll go ahead and jump in first and let Dr. Sidelinger clean up. We also have the news that the administration is preparing to authorize boosters, beginning late in September, September 20, I believe. And as you remember, vaccines that were available at the earliest stages of the vaccine rollout were limited to healthcare workers and people in long-term care. And so the boosters would follow the same pattern as the original, as the original rollout did, and start relatively small and build up over time. And so the really, really good news that we have right now is that unlike that initial rollout of vaccine, we have lots of vaccine in the state, and we have it in lots of places that we didn't have it back at the beginning of that process. We've got it in virtually every pharmacy in the state. Lots and lots of primary care providers now have it, and so it's much easier to get a shot, which is a good reminder for people who haven't gotten one yet, that you're actually still the number one priority, even before we get to boosters. Director Allen: (01:01:40) But the note of caution to sound is that hospitals, and health systems, and local public health have also been a big component of getting vaccine out, and they are completely swamped by cases right now. And so the best thing people can do to help ensure that we've got resources to roll out boosters is to wear masks, and if you're not vaccinated at all yet, get vaccinated so that we can take the heat off our public and medical health care systems, so that they can participate in that. Did you want to add anything? Dr. Sidelinger: (01:02:13) Sure. Thank you, Director Allen. You mentioned the Israeli data, so let me start with what we're seeing out of Israel, and out of the data from the US that was released just this week. What we're seeing is that the vaccines we're using, particularly the mRNA vaccines, remain highly effective against preventing serious disease, including hospitalization and death. That holds true in the Israeli data, and holds true in the US data. What we're seeing is that over time, particularly in individuals who were vaccinated early on in the pandemic, which included older folks, folks who were in congregate care settings, that their protection against mild and moderate disease does appear to be wearing off over time. They still have incredible protection, but they have the ability to get sick from this disease, and a small percentage may still get seriously ill. Dr. Sidelinger: (01:03:07) So that's why acting on data that was seen in Israel, but then data that was also collected here in the United States after vaccination, the federal government is rolling out a plan to begin booster doses with those highest risk populations who were vaccinated very early in the effort to receive booster doses near the end of September. Dr. Sidelinger: (01:03:28) Our federal partners at the FDA and CDC will work through to make that happen, and we will work through with our health care partners, public health partners, and community partners in Oregon to get those vaccines into arms. But as Director Allen said, the best thing we can do right now is if you're unvaccinated, right now, get a vaccine so that we can protect our healthcare capacity. Wear a mask. Consider changing your plans if you're unvaccinated. For that small segment of the population who's moderately or severely immunocompromised, get that additional dose to give you protection. By getting these doses out of the way now, we can be better prepared to start administering booster doses at the end of September to those who qualify and may need them. Dr. Sidelinger: (01:04:13) But let me make it very clear. These vaccines still remain incredibly effective. The booster will help increase that effectiveness even more for some of our most vulnerable patients, and ensure that they're more protected as we move into the fall and winter seasons, and that we don't see a huge resurgence in COVID-19 from waning immunity. Speaker 1: (01:04:36) Thank you, Gary. And that's all the time we have for questions today. Thank you, everyone.