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Oregon governor extends emergency order as respiratory viruses rise among children and adults

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Marcelo Leal
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Oregon Gov. Kate Brown is extending last month’s state of emergency as a surge of respiratory illnesses strains the state’s hospital systems.

The executive order calls on the Oregon Health Authority and other state agencies to deploy emergency volunteer health care workers and designate emergency health centers. It also allows state agencies to develop new procedures or waive existing ones in order to alleviate the public health threat.

OHA is pursuing supplemental nurse staffing contracts of up to $25 million to help address critical workforce shortages, according to Brown’s statement. That’s in addition to the $21.8 million for nurse staffing the Oregon Legislative Emergency Board approved in September.

Hospitals have begun treating some infants at neonatal ICUs, which are typically reserved for premature newborns. As a result, NICUs have seen a dwindling supply of available beds. At a briefing Wednesday, OHA Director Patrick Allen told legislators that an Oregon infant born prematurely was recently treated in an adult intensive care unit because no neonatal ICU or pediatric ICU beds were available in Oregon, Washington or Idaho.

Statewide, fewer than 5% of hospital beds are currently vacant.

“It’s far and away the most critical lack of capacity we’ve had to this point,” Allen said.

Dana Braner, the chair of pediatrics at Oregon Health & Science University’s Doernbecher Children’s Hospital, said the state is running out of pediatric ICU beds on a daily basis, and that in addition to setting up beds in surge spaces, at one point, OHSU’s pediatric unit had two children occupying a single PICU bed.

OHSU and other hospitals are taking measures similar to steps they took during the delta wave of the COVID-19 pandemic. They’re also cancelling surgeries except for the most urgent ones, like those for cancer or “life and limb.”

“It literally constitutes the greatest threat to children’s health in our state that we have seen in the last 30 years,” Braner said.

The acute capacity crisis is being driven by an unusually early and severe RSV — respiratory syncytial virus — season that has hospitalized more than 150 kids since October, as well as an early flu season and a small increase in COVID-19 hospitalizations.

But hospitals have struggled with too many patients — and too few staff to treat them — for much of 2022, as nurses frustrated with their working conditions have left bedside and acute care jobs, and patients have shown up on average sicker due to delayed care during the pandemic.

Allen said the state is working as quickly as possible to line up contracts with temporary employment agencies that provide travel nurses, and said that some had arrived at OHSU this week.

In response to questions, Allen acknowledged those travel nursing contracts are an expensive and short-term solution to the problem. OHA estimates it will cost about $25 million for contracts to cover 10 weeks of temporary staffing support for the state’s hospitals.

“Travelers are faster than a long-term strategy,” Allen said.

Meanwhile, Brown’s new executive order today extends one issued on Nov. 14, which was a response to the rising number of children and infants falling critically ill with respiratory viruses. Brown’s order says hospitals are now being further strained by adult cases of influenza and COVID-19.

In the order, Brown says hospital conditions “have continued to deteriorate due to ongoing surges in respiratory infections, including but not limited to RSV, Influenza, and COVID-19 in Oregon, and now, adult hospital capacity, in addition to pediatric hospital capacity, are both critically strained.”

The declaration says COVID hospitalizations have skyrocketed, returning to levels last seen in July. Rates are expected to continue rising through mid-December.

The Oregon Association of Hospitals and Health Systems released a statement expressing appreciation for the “staffing flexibility” the governor’s order allows. But it goes on to say that hospitals need such flexibility “all of the time” and that the situation shouldn’t have been allowed to get so critical.

“We have critically ill children in adult units and boarding in Emergency Departments who should be in pediatric intensive care units in Portland, but there are few available beds,” said Lisa Goodman, the association’s vice president of communications. “We’ve been saying it for more than two years: Our system is failing. The unfortunate position we find ourselves in today could have been prevented, and it wasn’t.”

In a statement, Brown called on Oregonians to take extra precautions this holiday season.

“Stay home if you are sick, stay up to date on your vaccinations, and consider wearing a mask in crowded indoor situations –– especially if you are at higher risk for severe illness from RSV, the flu, or COVID-19,” she said.

Most RSV infections go away on their own in a week or two and can be managed with proper nutrition, hydration, sleep and use of over-the-counter medication. Oregon hospitals are discouraging people from visiting emergency rooms for illnesses that can be treated at home.

Copyright 2022 Oregon Public Broadcasting. To see more, visit Oregon Public Broadcasting.

April Ehrlich, Amelia Templeton