by Anne Scheck

COUNTY COVID CASES RISE, LEGISLATORS MULL ACTION
COVID-19’s tally in Polk County reached 11 cases this week, with two hospitalizations – a jump that health authorities say reflects the results of increased testing. “It’s expected,” said Dawn Mautner MD, senior health advisor to the Oregon Health Authority (OHA). 
 
In an OHA video update yesterday, Dr. Mautner explained that the numbers will keep rising “because we are expanding the testing as we can” to reach more broadly into the population. For example, Salem Health -- with three locations in Polk County -- was forced to suspend coronavirus testing at some sites after reportedly running out of detection kits. 
 
Meanwhile, a legislative committee on the coronavirus crisis is mulling measures for stay-at-home life as efforts to identify viral outbreaks continue. Guidelines for distance-learning in the event that that more tools for online public education are needed and a temporary rule that would allow medical professionals such as physician assistants and dentists to have enhanced roles for meeting emergency conditions are under review by the legislative Joint Special Committee on Coronavirus Response. 
 
A special legislative session is predicted soon, though it hasn’t been scheduled yet. “We are currently working to figure out the best way to bring legislators back to the Capitol to convene in a safe way,” said Rep. Paul Evans, in a statement sent this week in his newsletter. Rep. Evans, who represents Independence in the Oregon House of Representatives, is a member of the Joint Special Committee on Coronavirus Response.   
 
Polk County Fire District No. 1, along with the City of Independence and other agencies, is distributing signs that state “Stay Home, Save Lives,” to support this safety measure amid the threat of COVID-19 to the community, according to Fire Chief Ben Stange. Fire District No. 1 is expected to bear the brunt of local pressure from the pandemic—firefighters and paramedics all across the state have faced a surge in 911 calls over the past week.

GAME CHANGER: EASIER RULES ON CURB PICK-UP  
As Independence downtown favorites like Arena Sports Bar & Grill go on hiatus during the coronavirus crisis, some establishments – those that sell alcohol and marijuana as “take-out” – are showing a sharp increase in sales, according to state figures. 

There’s been a 25% increase in transactions for curbside marijuana and about the same rise for purchases of beer and wine-to-go deliveries – both now permitted under temporary rule changes by the Oregon Liquor Control Commission (OLCC). The OLCC has charted the rising sales of marijuana since the March 8 emergency declaration by Gov. Kate Brown; Alcoholic beverages by home delivery, which were extended from a 9 pm curfew to 2:30 am, have accounted for much of the revenue boost in liquor, according to data-tracking by Nielsen Corp. The robust sales have prompted some reports that over-use may be on the rise. 

“Every single decision that this agency (OLCC) is making, both for the liquor and marijuana industries, are for the consideration of helping people make a living and to continue to make a living,” said Paul Rosenbaum, OLLC’s commission chair, at its meeting last week.
 
However, the growth of wine, beer and marijuana businesses has been a topic of discussion by the Polk County Board of Commissioners, who in the past have noted there are increasing opportunities for impaired driving. At the last meeting of the board, Commissioner Craig Pope reiterated this point. Mr. Pope voted, along with the other two commissioners, to modify restrictions on county definitions of farm sites and vineyards that could offer craft-beer and wine-tasting. However, “it does trouble me that we are continuing to (promote) alcohol for major tourism without consideration” of the needs for added oversight, such as law enforcement, he said. 

CITY BOND REFINANCE
At the last meeting of the Independence City Council, councilors approved the city’s recommendation to seek re-financing for both bond debt and a previous loan for repairs to Hoffman Road. The refinancing, which will need to be voted on by the city council once it is structured, is likely to be undertaken when the city can get the best deal possible, according to city manager Tom Pessemier. 

by Anne Scheck

COUNTY SHUTDOWN CURTAILS SERVICES
Polk County offices in Dallas were formally closed today in a virtual lock-down that means that citizen access to services, ranging from public works to the county assessor, will be available only by appointment, according to Matt Hawkins, county administrative services director. Public meetings, such as those routinely held by the county’s Board of Commissioners, are open to the public – but a special attendant at the main entrance admits those seeking entrance to the courthouse building. The Academy Building, where social and veterans services are offered, can be entered by a door at the east wing. An employee is stationed there to monitor visits. 
 
Amid these measures is a bright spot: Fewer people have been housed in the county jail, thanks in part to actions taken earlier this year that diverted some occupants there to other programs. And no cases of COVID-19 have been detected. “Everyone’s healthy,” said County Sheriff Mark Garton. 
 
For employees staying on county premises, “everyone has a bottle of hand sanitizer,” noted Todd Whitaker PE, director of public works for the county. A declaration of emergency issued recently by the commissioners was designed “to give us flexibility in addressing this” in the weeks ahead, said Polk County administrator Greg Hansen, referring to the coronavirus crisis.  

LOCAL INTERNET AFFIRMS VITAL HEALTH NETWORK
Health clinics across Polk County are depending more heavily on internet technology for communicating with patients, to help reduce the risk to them and their healthcare providers from coronavirus. To lower the need for the kind of face-to-face contact of traditional medical care, Salem Health Hospitals & Clinics, which has a hospital in Dallas and a clinic in Independence, has a smart-phone app called “MyChart” available for this purpose. In West Salem, SwiftCare is offering telemedicine consultations. 
 
Telemedicine has proven effective at Central Health and Wellness Center in Independence and for a group of Polk County 2nd-graders in a pilot program a few years ago; The children were screened for dental needs by a team from Oregon Health and Sciences University (OHSU) and Capitol Dental. Of the 349 children evaluated in the OHSU study, 48% were found to have healthy teeth and 52% were referred for further dental care. The investigation confirmed such a plan is potentially feasible for other areas of the state, according to the findings published by OHSU. 
 
Regional experts in information technology who were interviewed this week said the threat of COVID-19 has shown the importance of reliable internet usage in the area. Though surges have caused some interruptions, the sudden, heavy use of online connections is to blame, one expert noted. “It’s like a source of water. When everyone wants to take some at the same time from the same drinking supply, it means there’s less to go around at that time,” he said. 
 
Pressures on internet providers are likely to worsen: The peak of infection predicted by the state for COVID-19 occurs next month. A substantial portion of county residents could be considered in a risk group for the coronavirus – about 15% are classified as having a disability or underlying condition, according to the county’s 2019 public health report.

GO ONLINE OR CALL TO ANSWER CENSUS
The use of the Independence Library as the county’s “help-hub” for the US Census has been scrapped, and “we are going big-time into audible mode,” said Ramon Martinez, who directs community engagement for the City of Independence. The US Census questionnaire, which has been arriving in local mailboxes, has “10 straightforward questions,” he said. The state is believed to have grown by 450,000 people since the last census was taken, and accurate growth counts mean more money – $3,200 in federal dollars for every citizen, he pointed. “So, it is really important we count everyone,” he stressed. 
 
“From our end, we’re advising a digital push,” Mr. Martinez said, noting that if anyone is uncomfortable using the internet, they can call the 800-phone number provided on the forms. The Census Assistance Center will be available to help residents of the county, but it won’t be at an on-site location because the Independence Library has been closed due to the coronavirus concern. The new plan for census assistance is expected to be announced by April 1, which is official "Census Day," he said. Mr. Martinez reported the development at a recent meeting of the county’s Board of Commissioners. 
 
COMMENTARY
If economic indicators from the past are a reliable guide, some will soon suffer a bumpy financial ride. Possibly none more so than our local businesses, which have been hoping for a tourism boost – a business increase that now seems dimmed by the threatened spread and subsequent closure of so many places. For quite a while, I’ve doubted my determination to track tax money spent by our city. There are times that the quest to find where those dollars are headed hasn’t been easy – the city budget and audit seem about as easy for someone like me to interpret as Sanskrit. The last audit presentation for the city council was so brief that I followed the auditor into the city parking lot where her car was parked. I kept asking her if the growing city debt – by my calculation, $40-million-plus – was of concern to her? “It’s all relative,” she kept repeating, excusing herself because one of her children needed retrieving from a sports event. But, in my opinion, it isn’t “all relative.” Relative to what? I don’t live elsewhere, and nothing that happens here is “relative” to me. Instead, it’s “relevant.” So I am committed, in the months ahead, to translating what, to me, looks like Sanskrit.

A Personal Note: As most of you probably know by now, COVID-19 is the name of a disease caused by a newly identified coronavirus, which arose in China last year. But coronaviruses in general have been with us for quite some time – they’re a common cause of colds, along with rhinoviruses. In fact, COVID-19 seems to be behaving a lot like a condition most of us are all-too-familiar with: the flu. COVID-19 is estimated to be about as contagious as the flu and, like that seasonal illness, is most worrisome in older people and others who have weakened immune systems. This may be why, so far, children seem pretty resilient to COVID-19, often experiencing only mild symptoms. 
 
Who’s at greatest risk? Probably someone like me who passed my 60th birthday several years ago, and who has an underlying infection – if you count a root canal gone bad and in need of yanking out. So, I decided to take a look at COVID-19, vowing that no sub-microscopic intruder is going to get me down for long, if it invades my system. 
 
What follows is a question-and-answer with public health officials and the result of a medical literature search conducted this past week, which I thought might be helpful reading for others, too. The sources of the information are in boldface and links are provided. Call your healthcare provider if you suspect you may have COVID-19; You don’t want to rely on information from a writer in the higher-risk-group category who's currently suffering a toothache. However, here are some answers I found: 
 
-- What is this thing called coronavirus, anyway? Under high-powered microscopes, it looks like a soccer ball with spikes. On some birds-eye views, the sphere is encircled by a crown – like the corona of the sun. That’s how it got its name. It isn’t named for a beer!  (The National Institutes of Health has released photos at https://www.niaid.nih.gov/news-events/novel-coronavirus-sarscov2-images). 
 
-- What has the local response been so far? According to clerks at stores that serve Independence, residents have been stocking up on hand sanitizer – clearing the shelves of one brand. But thorough hand-washing with soap and water is the recommended protective strategy, according Jonathan Modie, lead communications officer in public health at the Oregon Health Authority (OHA).  For utilizing hand-sanitizer, use one with 60% alcohol content, he advised. (My own favorite hand-washing instruction so far is the one that went viral with a song by Mexican nurses. These nurses really nail it. Here's the link: https://www.pri.org/stories/2020-03-06/die-bacteria-die-mexican-nurses-croon-hand-washing-psa-video).
 
-- What will happen if a case is detected in Polk County? Polk County Public Health will conduct an investigation on any confirmed case that’s reported, following the protocol in place by the OHA -- and follow-up will include informing those who may have been in contact with the case, according to Kristty Polanco MPH, the director of public health for Polk County. Confidentiality is provided to those infected with COVID-19, but if the index case comes from a facility, that facility will be made public, she said. 
 
-- How are schools in Central District 13J handling this? With vigilance, according to information imparted at the last school board meeting. Custodians are working intensively, making sure surfaces are wiped with effective reagents – even though that source of contamination is considered a far lower risk than person-to-person transmission, according to the OHA. It’s unlikely to stay viable on surfaces very long, said OHA’s Mr. Modie. How long? “You can count on two hours,” he said. Lysol and diluted Clorox are two solutions that seem to work well for disinfection, he said. 
 
-- Is there a special treatment for COVID-19? Not yet, at least not for widespread use. A large majority of cases are expected to be fairly mild. However, for severe infections, treatment with certain anti-virals has been used in what is called “compassionate” circumstances in other countries. This is a situation in which a really sick individual is given a therapy that is not yet proven but, based on previous scientific study, is thought to be possibly helpful. One antiviral used this way, called Remdesivir, shows promise -- and now an American clinical trial on it is starting at the University of Nebraska Medical Center (https://www.nih.gov/news-events/news-releases/nih-clinical-trial-remdesivir-treat-covid-19-begins).
 
-- But isn’t likening COVID-19 to the flu comparing apples and oranges? It may seem that way, perhaps due to the fact that this coronavirus is new and will take more investigation and understanding, while influenza is anticipated every year -- with its very own name for winter, “Flu Season.” Transmission from both often comes from exposure to droplets carried in sneezes and coughs – but COVID-19 may be able to stay airborne even after the ill person is no longer nearby, according to Johns Hopkins University (https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-disease-2019-vs-the-flu)
 
-- What else is like COVID-19? A month ago, a team from the University of Texas, Galveston, and the University of North Carolina, Chapel Hill, published a commentary on the new coronavirus, concluding that it had “awakened the echoes” from an earlier era of the epidemic called Severe Acute Respiratory Syndrome (SARS) of nearly two decades ago. Like SARS, COVID-19 can cause severe respiratory symptoms. However, as the researchers observe in their recent publication, “with technological advances and important lessons gained from previous outbreaks, perhaps the world is better equipped to deal with the most recent emergent group 2B coronaviruses.” They note that most deaths from COVID-19 have occurred in people who have other chronic illnesses, and that’s one reason why elderly people are at greater risk. (Return of the Coronavirus: 2019-nCoV, published January 2020).  
 
-- What about a vaccine? It’s at least a year away, but yes, testing a vaccine for COVID-19 appears to be on the horizon, according to Dr. Todd Ellerin, an infectious disease specialist who was the expert on a recent Harvard Health podcast on the emerging coronavirus (See Coronavirus Resource Center at https://www.health.harvard.edu). 
 
-- What is this “social distancing” that’s suddenly being recommended? Well, we in the Willamette Valley can be a mighty friendly group. Watch people in downtown Independence greet each other along Main Street and you’re likely to see hugs, handshakes, arm grabs and high-fives. Try replacing this casual contact with just “hello” and a wave in the air. And keep in mind that certain people are more susceptible to complications; Pregnant women and the elderly, for example. You can read about why both groups need to exercise caution at: https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/index.html
 
-- Is there a method to predict how much transmission will occur? The way this is done is to find the average number of infections one case can generate – and that’s variable because containment and control can have a powerful effect. When Canadian and Chinese researchers worked together to determine this, they found that the outcome could be heavily influenced by responsiveness with appropriate resources, like diagnostic testing, and with interventions, such as the ability to quarantine, (Infectious Disease Modeling 2020 5:248-255). For example, some companies have the ability to send staff home to telecommute – Amazon did this after one employee tested positive for the virus (https://www.cnn.com/2020/03/05/tech/amazon-seattle-coronavirus/index.html) 
 
-- Does caring for a sick loved one mean COVID-19 will spread to the caretaker? This is where using sanitary precautions, like hand-washing around infected family members, may be paying off. Among early cases in the United States, the numbers of close contacts who seem to have been infected under these conditions hasn’t been as high as expected.  “And I do think that’s good news.”  said Nancy Messonnier MD, director of the National Center for Immunization and Respiratory Diseases. But the finding comes from a relatively small number of cases, compared with the global figures, she cautioned. “So we take that as optimistic but we still need to be cautious with these early cases and do complete investigations, which our state and local health departments are doing.” Dr. Messonnier made the statements last week, in a briefing at the Centers for Disease Control and Prevention (CDC). 
 
-- Where can I get good up-to-date information? The OHA has a terrific Question-and-Answer page, which can be found at:https://www.oregon.gov/oha/PH/DISEASESCONDITIONS/DISEASESAZ/Pages/COVID19-FAQ.aspx
 
-- What's next?  “Like everywhere in the country, we are recommending that people think through what they might do if there is a risk in their community,” the CDC’s Dr. Messonnier advised in her March 3 CDC briefing. General preparedness plans should be taking place, she said. “It is good to have those conversations in advance so that if you do need to act you are ready to do it,” she added.  -end-