Dr. Jennifer Vines doesn't have a crystal ball. But what the health officer for the Portland metro region does have is a critical understanding of viral diseases. Vines is responsible for leading communicable disease prevention across Multnomah, Clackamas, and Washington counties, making her a crucial decision-maker in the regional COVID-19 response. On Thursday morning, she joined Governor Kate Brown in announcing a new, sweeping ban on large gatherings across Oregon in hopes of stalling the coronavirus' spread. That afternoon, Vines explained to the Mercury why this announcement was so critical (and helped us answer a lot of other important questions).
MERCURY: At this morning's press conference you said the virus has moved at "warp speed," changing the priorities of public health systems. Can you explain what that means?
VINES: The governor's announcement marked a significant shift in our response to COVID-19. Up until now, we've been focusing on individual cases and monitoring the people close to them. Now, we're balancing keeping society running while trying to spread people apart.
You're talking about "social distancing."
Yes. It's unpleasant, I know. But we know that extreme and early social distancing helps slow the spread of influenza. [COVID-19] isn't the flu, but that's all we can use to base our decisions on at this point. We don't know a lot about this virus. We're looking at all the tools in our public health toolkit—but there's only so much.
At the press conference, you mentioned that once we're seeing crowded emergency rooms and hospitals, it's "too late" for social distancing measures to have an impact. What did you mean by that?
I meant that if you are going to wait until things get really bad—when the public health system is overloaded—to start practicing social distancing, it's not going to make a difference. It's already too widespread.
What would it take to really slow the coronavirus down? Can you learn anything from how Washington has handled the spread?
Honestly, I don't think we know. I don't think my public health colleagues in Washington did anything wrong, they were just the unlucky ones. I know they're doing their best.
There's a lot of information (some of it correct, a lot of it not) floating around about coronavirus. It's hard to know what to prioritize. What's the top thing you want public to understand right now?
For now, what I would like the to know is that we don't have testing for COVID-19 widely available. For a number of complicated reasons, we have limited capacity at the state public health labs. We can handle 80 tests each day, that's not enough. Our goal is to get the broad message out to the public, "Don't seek health care if you wouldn't otherwise."
Okay, but what if you WOULD seek healthcare? What if you're showing signs of COVID-19, like a fever, cough, or shortness of breath?
Call ahead to your doctor's office and make a plan to be seen. Get a mask as soon as you enter the facility... you're going to be seen by a doctor wearing goggles and a mask. If a doctor believes you may have the virus, they can either decide to send it to commercial lab testing [which is currently limited] or public health testing.
And what determines if the state public health lab will run a test on that patient?
Right now, we're recommending our labs only test people when it's going to make a difference in that person's life. So, maybe they're high risk due to other existing health conditions, or they work in a long term care facility or a shelter.
So if someone is healthy and doesn't work with vulnerable populations shows signs of COVID-19, they probably won't get tested?
That's right. Right now, our capacity is so limited that the state lab is reserved for people sick enough that are showing symptoms of viral pneumonia but they don't have influenza. The challenge right now is shifting gears and being clear with the public around testing. People are scared, they want to be tested to protect people around them and I completely understand that. Completely. But right now, we have to prioritize.
What's the mood like in your office today?
It's a big transition day. We've all talked about this moment coming... getting to this point in an outbreak. I think now we're all taking a big breath and letting it sink in that, "Okay, we're here. This is it."
Any final thoughts?
Just to remind people to not overburden our public health system, our hospital systems. Think about your entire community. And the same stuff you've heard before: Wash your hands, stay home if you're sick, wear a mask if you have a cough. Things are uncertain. This is unprecedented. But we're back to basics with this. And if we all do those basic things, it'll work.