UPDATE (11:17 a.m. PT) – Oregon's COVID-19 diagnoses crossed the thousand-case mark recently and kept climbing. Cases have been confirmed in at least 28 of Oregon's 36 counties, but the most positive tests by far are in the more densely populated Willamette Valley.
Marion, Multnomah and Washington counties together account for nearly two-thirds of the state’s total confirmed cases.
Confirmed cases only tell part of the story, as a recently published study suggests Oregon has had approximately 7,000 infections — five times as many as measured by tests. State health officials have said more testing and analysis of confirmed cases will be key to identifying the best approaches to limit the spread of the virus.
Nationally, people suffering from the illness are more likely to be people of color than white. According to the Centers for Disease Control and Prevention, one-third of people hospitalized by the virus nationwide are African American. That's two and a half times greater than the proportion of Black people in the overall U.S. population.
Oregon is not seeing the same disproportionality. African Americans' share of Oregon's COVID-19 cases is 2.1% — very similar to the proportion of the state population.
There is some evidence that Oregon's outbreak has disproportionately sickened people who identify as ethnically Hispanic, however. Oregon Health Authority data show that Hispanics represent nearly 30% of positive COVID-19 cases for people whose ethnicity was identified by county health officials. Oregon's Latino/Hispanic population is 13.3% according to the most recent figures from the U.S. Census Bureau.
But a lack of firm numbers make it hard to draw specific conclusions on the racial impact of COVID-19 in Oregon. In more than 37% of confirmed cases, whether or not a person is Hispanic or not wasn't recorded. Hispanics would still represent 18.4% of known cases if all of the unidentified cases turn out to be non-Hispanic Oregonians.
State officials said problems with the data start with how it's gathered. In an email to OPB, the Oregon Health Authoirty said its figures come from “local public health authorities based on their interviews and data-gathering related to COVID-19-positive patients.” OHA said some patients “have not been fully interviewed and some data are incomplete.”
The health authority said that gathering better information on COVID-19 cases by race and ethnicity is "of public interest" and would help the agency track the virus, but said health officials often don't ask or patients don't answer.
State officials are shying away from big takeaways based on the demographic data collected to date — in part because the numbers are still relatively small and there are inconsistencies. Also, privacy protections under the Health Insurance Portability and Accountability Act, or HIPAA, limit what can be shared.
The trouble with testing
Further complicating any effort to draw big conclusions is that testing has been slow and uneven in Oregon. Doctors often encourage symptomatic patients who may have contracted COVID-19 to stay home and rest up, rather than seek out a test. Oregonians who have gotten tested routinely report waiting more than a week for results, slowing down any analysis of the test results. Health officials in Oregon and the rest of the country also are grappling with a spate of false negative test results.
OHA is pressing for more testing in order to better understand how the virus is behaving.
“To determine the spread of the disease, we need to expand testing,” Oregon Health Authority spokesman Jonathan Modie wrote to OPB. OHA said there are now nine labs running tests for Oregon patients: OHSU, Providence, Kaiser, Legacy, Asante, Oregon State Public Health Laboratory, LabCorp, Quest and the University of Washington.
For more insights into how the virus is spreading in Oregon, the public can look at indicators beyond raw testing numbers, such as cases of serious illness.
The most recent weekly report from OHA counted 338 patients in Oregon who have tested positive for COVID-19 and required hospitalization — about one-quarter of all positive cases in the state. OHA reported that at last count, 353 patients in hospitals were “suspected or confirmed COVID-19” cases, including 56 people on ventilators.
OHA shares daily information about COVID-19 cases and whether the patients are in hospitals or not. Those numbers are ticking upward. Over the first two weeks of March, OHA was reporting roughly 6.4 new COVID-19 cases in hospitals each day. Over the last two weeks of March, that had more than doubled to 13.8 per day. That’s accelerating at roughly the same rate as confirmed positive cases outside of hospitals. Numbers for April are incomplete because, according to OHA, “Illnesses that began during this time period may not be reported.”
The death toll in Oregon
Ultimately, the biggest question is how many people will die of COVID-19 in the state. The metric national health experts are watching is the number of deaths per million people. Oregon’s 51 deaths as of Saturday, in a population of 4.2 million, put the state at 12.1 deaths per million. That’s significantly lower than the national average of 39.4 deaths per million, which is driven by hard-hit states such as New York.
The death toll in Oregon is concentrated in the state’s most populous counties. About one-third of coronavirus deaths occurred in Multnomah County, significantly higher than the county’s 19% share of Oregon’s population.
And like overall diagnosis counts, coronavirus fatalities are concentrated in three counties. Nearly two-thirds of Oregonians who’ve died from COVID-19 lived in Marion, Washington or Multnomah counties. The disease has been fatal for at least one person each in nine Oregon counties, all west of the Cascades.
The average age of Oregonians who’ve died from coronavirus is 77.6 years. Slightly more men (27) than women (24) have died, based on state numbers released Saturday. All but one of the fatalities had an underlying medical condition according to health officials — the one exception listed “unknown” on whether there was any underlying condition.
And similar to hospitalizations and case numbers overall, the number of daily deaths from COVID-19 appears to be rising.
From the day the first Oregonian died of coronavirus on March 14 to the end of last month — two and a half weeks — OHA counted 19 coronavirus-related deaths in the state. Through just over one week in April, COVID-19 had claimed the lives of 32 Oregonians.