SALEM — A recovery from the record-breaking spike in COVID-19 cases has been pushed from Halloween to Christmas, according to an Oregon Health & Science University forecast released last week.

Longer hospital stays for those with severe infections from the delta variant and signs of public weariness with pandemic safeguards have delayed the expected pace of a rebound.

The premature dropping of mask-wearing and limits on socializing, along with a return to tepid rates of vaccination, could slow the rebound further.

‘We’re in a moment right now where we’re going to see what happens as fatigue sets in,” said Peter Graven, Ph.D., lead data scientist on the OHSU forecast.

In mid-August, OHSU accurately predicted a sharply rising spike in cases from 200 hospitalizations per day in early July would top-out at nearly 1,200 by early September.

But the forecast that the numbers would drop at roughly the same rate as they rose proved overly optimistic.

The earlier forecast showed daily COVID-19 hospitalizations dipping below 200 by the end of October.

The data at the time showed the numbers falling under 100 by the time the holiday season kicked-off with Thanksgiving at the end of November.

In the forecast released Sept. 30, pre-spike hospitalization levels won’t be reached until the last half of December. Case levels will remain elevated throughout the holiday season, with 600 hospitalizations per day forecast on Nov. 1.

Rates below 50 cases per day wouldn’t be realized until mid-March 2022.

OHSU researchers underline that each forecast is just that — a model based on data. Each week’s forecast includes a graph overlaying prior forecasts.

Graven said the model was at a “tipping point” driven by both the resilience of the virus and weariness of the population. Oregon is wobbling in a “fright and fatigue” cycle in the pandemic.

When the delta variant skyrocketed in July, many parts of the state returned to masking and limiting contacts. The slow growth in immunization rates started to increase in July and August, even in counties where vaccine hesitancy or resistance was widespread.

OHSU said “breakthrough” cases of infection in people who had been vaccinated has risen to 20% of new cases. But the worst outcomes have remained steady, with stark differences for the vaccinated and those who are not. OHSU said unvaccinated people accounted for 95.5% of severe cases and more than 99% of deaths.

Those numbers hold up as September’s 498 COVID-19 deaths statewide make it the second most deadly month in the 19-month pandemic.

While hospitalizations have taken a steep dive, it is from the highest point in the COVID-19 crisis. If this forecast holds up, it will take over a month just to get below the peak of the 584 hospitalizations a day during last winter’s surge.

The OHSU forecast pointed to some troubling areas. Estimated mask usage dropped from 84% to 81%. Based on an analysis of social media traffic, people are becoming more active and getting together in larger groups. With the colder weather starting to take hold, researchers worry that will drive activity indoors, where the virus can spread more rapidly.

Vaccinations also slowed their pace of growth. A quarter of all adult Oregonians — just less than 1 million people — remain unvaccinated more than nine months after COVID-19 vaccines first became available.

The state is seeing a drop in infections and hospitalizations overall. But parts of Eastern Oregon are seeing an increase in infections, which some local health authorities have tied to outbreaks from the Pendleton Round-Up in mid-September.

An exception to the drop in hospitalizations is Region 7, which includes Deschutes, Crook, Jefferson, Grant, Harney, Klamath, Lake and Wheeler counties. After showing a decline along with the rest of the state, hospitalizations edged upward in Region 7 while declines continued in other regions.

Part of the region has some of the lowest rates of vaccination in the state. Lake has the second lowest percentage of eligible adults who have been vaccinated, 41.7% as of Thursday, according to Oregon Health Authority reports.

Grant is one of the four counties in the state where less than half of eligible adults have been vaccinated. It’s at 47.1%. Harney, at 50.3%, just crossed the threshold last week, nine months after vaccines first became publicly available.

After seeing two consecutive weeks of a decline in cases, Grant County quadrupled in cases from 30 to 116 between the weeks ending Sept. 15 and Sept. 22. The case rate per 100,000 people — a way to measure the level of infection between areas with different population sizes — was 1,596. The percentage of tests that were positive tripled from 5% to 14.6%

The highest infection rate in the state is in Harney County, where one out of every four tests was positive. Harney’s infection rates remained high for the month of September, the the survey at the end of the month showed it with a state-leading 1,675.8 cases per 100,000 people.

Deschutes County has the fifth highest vaccination rate in the state at 77% of eligible adults. Jefferson is at 62%, while Crook is 58%. The positive infection rates continue to be high in all three, according to a recent OHA County Covid-19 Community Transmission Report. Crook is at 15.1%, Jefferson at 12.1% Deschutes at 10.8%. The statewide average is 8.9% and OHA has said throughout the pandemic that any positive test rate above 5% allows for significant growth in cases.

The statewide impact of the Pendleton Round-Up outbreak that began last month still is not completely known, state officials said last week. While many of the Eastern Oregon counties have low populations, they can be a harbinger of new statewide spikes because of the large percentage of unvaccinated residents.

That’s what happened with the Pendleton Whisky Music Fest outbreak in July.

With infection rates at a low point in early summer and the statewide adult vaccination level near 70%, Gov. Kate Brown on June 30 lifted most restrictions on businesses and events across the state.

The move came despite wildly different levels of vaccination and infection among the 32 counties at a time when the highly contagious delta variant had swept across the country and into Oregon.

The Whisky Fest, an outdoor music event on July 16, attracted up to 12,000 people to Umatilla County. The county’s vaccination rate was under 50% at the time (it’s now 51.5%). An outbreak of cases after the event swamped hospitals in Eastern Oregon and spread to the rest of the state.

Each rise in infections targets the most vulnerable, those who have neither vaccination or exposure.

OSHU puts out an “Immunity Index,” which combines the number of people vaccinated, exposed to the virus, or both. Some level of immunity occurs when a person is infected with COVID-19 and is asymptomatic, has more mild symptoms or has severe illness but survives. Of the 4.24 million Oregonians of all ages, OHSU estimates 4% of the population is vaccinated, 23% have been infected at some point, and 11% have been vaccinated and infected. That leaves 23% of the population as unvaccinated and uninfected. These “susceptible” residents are the ones the delta variant will continue to hit the hardest.

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