Monday will be the anniversary of the day that Douglas County reported its first COVID-19 case.
It is now routine to see grocery shoppers wearing masks.
Restaurant dining has become a takeout affair.
Some county residents have transitioned to working from home. But essential workers have continued to go to work, day in and day out, bagging groceries, listening to heartbeats through a stethoscope, cleaning teeth.
2,603 of us have gotten sick over the past 12 months.
55 have died.
It’s been a hard year, but with vaccine supplies increasing, there may be light at the end of the tunnel.
Douglas County had been doing well throughout most of the pandemic compared to much of the state and the nation, with comparatively lower case rates.
But lately, even our case numbers have started to climb. A case of the Brazilian variant of COVID-19 was identified this week, and the county’s been placed back in the “extreme risk” category by the state.
“I think we are at a crossroads,” said Douglas County Public Health Officer Bob Dannenhoffer on Friday. “Cases have been decreasing nationwide, but we are still seeing a high number of cases and a high number of hospitalizations locally. We now have three effective vaccines, but we have also seen the emergence of dangerous COVID variants.”
Just days before the pandemic reached Douglas County, the Douglas County Board of Commissioners, which is the Local Public Health Authority for the county, delegated authority to Commissioner Tim Freeman to head up the response.
Within a very short time after that, Freeman had laid out a family tree of the organizations that would take up the challenge.
Freeman reached out to the health care community for help.
“I literally called the CEO or the executive director of each healthcare organization in this county on their cellphone one day and asked them, ‘Would you come help us,’ and every single one of them said ‘Yes, what do you need,’” he said in a press conference last year.
The Douglas County COVID-19 Response Team was established with five objectives: minimize loss of life, prevent the medical system from becoming overwhelmed by cases, ensure the safety of health care providers, ensure good communication and leverage available county resources.
“Although far too many Douglas County residents have been hospitalized, and far too many have died, our rates have been far less than the national average. Our health care system in Douglas County has responded brilliantly to the pandemic, and was never overwhelmed,” Dannenhoffer said.
Over the past year, the county has held 105 drive-thru clinics where it has administered COVID-19 tests to 2,325 people.
It has also operated a hotline with 136 volunteers and 45 staff members who have taken 7,000 calls.
Dannenhoffer has held 106 Facebook Live question and answer sessions in the past year.
Douglas Public Health Network, the private nonprofit that contracts with the county to manage public health, mushroomed from six employees to 30, with additional surge volunteers ready to step in if things got worse. Its case investigators and contact tracers worked to help curb the spread.
But many things about the pandemic remained outside county control. The state, for example, decided when some businesses must close and when they could reopen.
And those closures, along with other COVID-19 safety precautions, have sometimes sparked rebellions.
The state also determines when groups of people become eligible for vaccines.
So far, vaccinations have reached 14,818 county residents, among them health care workers, teachers and seniors. The first person in the county to receive a shot was CHI Mercy Medical Center Chief Medical Officer Jason Gray on Dec. 18.
Many are still not eligible and some may have months to wait.
The state also ruled that schools must close their doors to students in 2020. They quickly transitioned to virtual learning and many activities were canceled or altered.
By the start of the 2020-2021 school year some schools started on-site instructions, while others remained online. As of Feb. 1, all Douglas County schools were offering on-site learning, although some schools have had to close when large numbers of students or staff had to be quarantined due to COVID-19 outbreaks.
The pandemic turned the sporting world upside down, as the National Basketball Association shut down on March 11 and all other pro leagues followed.
On the local front, Douglas County athletes saw their high school spring seasons canceled and the Oregon School Activities Association was forced to move the 2020 fall sports season back to March 2021. The spring and winter sports seasons were also bumped back and are tentatively scheduled to begin in the next couple of months.
Umpqua Community College’s athletic teams were impacted as well. Cross country was able to start in February, but the volleyball and basketball teams won’t be tentatively starting until late this month.
For Dannenhoffer, whose life’s work has been in training for this kind of event, the COVID-19 pandemic has been challenging, sometimes overwhelming and exhausting.
“The cases, deaths and hospitalizations have been heartbreaking. The economic impacts to our local businesses have been enormous and devastating, but overall, I think Douglas County has done very well, with relatively low case counts and deaths,” he said.
Looking ahead, Dannenhoffer said everyone needs to remain vigilant about preventing the spread of the virus while the county and local healthcare providers work to vaccinate enough people to drive the case rate to near zero.
If all goes well, Douglas County should have enough people vaccinated by this summer to achieve herd immunity and start to get back to normal life again.
“I am cautiously optimistic but very aware of the possible potholes ahead,” Dannenhoffer said.
Getting the right puppy food, installing a thermostat, even finding a smaller birdcage.
Tracking the spread of COVID-19 throughout the community in hopes of slowing it down.
Helping people who are sick, and their families, live with COVID-19.
This is what the work of epidemiologists looks like during a pandemic, said Douglas Public Health Network Epidemiology Team Lead Vanessa Becker.
On March 12 of last year, just four days after Douglas County reported its first COVID-19 case, Becker attended a meeting where Douglas County Public Health Officer Bob Dannenhoffer spoke about the new virus.
That night, she emailed him to offer her assistance.
“He emailed me the next morning and said, ‘Can you come down to the building right now?’”
She did, and that day she started a new job at the Douglas Public Health Network, the private nonprofit that contracts with the county to provide public health services.
Becker was an obvious choice for the assignment.
She had served as executive director of Battered Persons’ Advocacy from 2000 to 2012, and was the chairperson of the Umpqua Community College Board of Trustees at the time of the 2015 Umpqua Community College shooting.
She also held a master’s degree in public health from the University of Michigan and had served for seven months in 2012 as interim deputy health administrator for the Douglas County Health Department.
Becker’s first task at Douglas Public Health Network was to serve as public information officer. Later, as the pandemic grew and cases climbed, Becker would receive her second title, epidemiology team lead.
Her team is one of three on a staff that has expanded from six to 30 this year.
Case investigators on each team reach out to patients who have tested positive for COVID-19, give them information and find out what they need and who they’ve been in close contact with while they’ve been contagious. These days, with rapid testing widely available, the people they’re calling often know they have the disease. But in the early days of the pandemic, case investigators usually had the tough job of breaking the news.
“Sometimes people would get upset and cry and some would be angry and frustrated and fearful, so it requires a lot of finesse and an ability to listen but also to be compassionate and provide information that the person needs at that time,” Becker said.
Case investigators also make initial calls to those close contacts, and then contact tracers step in 24 hours later to check in with contacts and see what they need.
Sometimes, case investigators and contact tracers encounter some pushback from people they call. Some are fearful that the county is going to force them to do something.
But that’s not what epi teams do.
“We’re not in a van outside making sure you’re doing everything,” Becker said.
Finally, support specialists figure out how to get people what they need during quarantine or isolation. Those terms mean essentially the same thing, except that quarantine is used when referring to contacts and isolation is used when referring to people who have been diagnosed with COVID-19.
Either way, it involves staying home for a period of time to avoid spreading the disease to others. And that means people sometimes need help to get their needs met during that time.
Some needs are obvious, food for the family for example.
Others have been a bit more unique. Epi teams have had to be adaptable and learn to solve new problems on the fly.
“One of my team members’ cases, the whole family were sick with COVID. All of them tested positive including a couple of little kids and they all had GI symptoms,” she said.
“So mom was at the end of her rope. She’s like, ‘Everybody’s sick in this house.’ She said, ‘I have a puppy that’s I think 4 months old, and this puppy gets GI problems as well if he doesn’t get his puppy food, and I can’t go out to get puppy food,’” she said.
“So we ended up going to Costco to get his special puppy food,” she said.
Another time, a little girl tested positive on her birthday and team members made sure she got a birthday cake.
One family’s thermostat broke the day they tested positive. Fortunately, one of their team members knew how to install a new one. He brought a new one and walked the family through the installation so they’d have heat again.
When the Archie Creek Fire displaced many county residents in September, people began calling the team’s COVID-19 hotline to seek or offer assistance. They adapted to serve that function as well.
One displaced woman in her 80s needed a smaller bird cage so she could transport her bird. The team posted that need.
“Within an hour somebody had found a birdcage and dropped it off, and we went and delivered that to her,” Becker said.
The toughest days for team members have been those days when they lost a patient.
“When we lose a patient to death that’s really rough,” she said.
The second toughest thing to handle has been people who don’t believe COVID-19 is real.
“That’s tough on people, to see the impact of COVID every day and then to read things or hear things from family or friends or community members doubting that it’s impactful,” she said.
Sometimes, those are the same people they later have to call.
“We have seen lots of cases where people said, ‘I don’t think this is a really big deal,’ and then they end up in the hospital and their family members are devastated,” she said.
“That adds an extra layer of grief and loss onto this that I think none of us really expected when we started going into this,” she said.
The people doing this kind of work have to learn some self care skills in order to keep going, she said.
“I personally have horses and that’s been my outlet for many, many years,” she said.
In all though, it’s the kind of work they’ll be able to tell their grandchildren about, she said. And they’ll be able to tell them they gave back to their community and made a difference.
“You’re in this fight in the pandemic on the right side of the fight,” Becker said.
It was almost a year ago that Holly Jimenez rushed her husband to the hospital.
Jose Jimenez had been ill since March 20, 2020. But on March 28, a pulse oximeter showed he was not getting enough oxygen into his blood.
Both are nurses. Jose Jimenez is a nurse at the Roseburg VA Medical Center and Holly Jimenez at McKenzie-Willamette Medical Center in Springfield.
It was to her Springfield workplace that she took Jose Jimenez for help.
He was later transferred to a Portland hospital and put on an extracorporeal membrane oxygenation, or ECMO, machine. That’s a mechanical life support machine that took blood out of him, added oxygen, removed carbon dioxide and then returned the blood back to him.
It would be months before Holly Jimenez would see him again.
“They finally allowed visitors in June and it was just one person per patient. I was the only one who was able to see him,” Holly Jimenez said.
Jose Jimenez stayed in the hospital for four months, and that was rough on the whole family.
“I’ve looked back and I’ve wondered, how did I survive that?” Holly Jimenez said.
She is glad she made the choice to approve doctors placing her husband on the ECMO machine.
“I just wanted to give my kids the chance for him to come back to life, because if we didn’t then I couldn’t honestly tell them that we tried everything,” she said.
The couple has six children, two grown and four at home ranging in age from 7 to 13.
“It was hard for them to really understand how sick he was. And we didn’t know if he would make it, so just living with the unknown for the two months that he was on ECMO was really hard,” she said.
Jose Jimenez returned home in late July, stopping for Red Lobster takeout in Eugene on the way. He received pulmonary rehabilitation therapy for a couple of months in autumn.
“2020 was pretty crazy,” Holly Jimenez said.
These days, Holly Jimenez does some support calls with Legacy Emanuel Medical Center for other families of patients that have been put on ECMO ventilators.
Jose Jimenez still needs oxygen with exercise, and he carries it around in a backpack.
He does have some scarring in his lungs. It could be permanent, but it might not be since it can take a year for the lungs to heal.
He plans to return to work at the Roseburg VA soon.
And he wants to get back to hiking up mountains.
Holly Jimenez said the lesson she takes away from the past year was that life can change in an instant, so be thankful for every day you have.
“I would say the past year or two changed me profoundly. My heart goes out to anyone dealing with it. We’re very fortunate that he made it and tell people that haven’t been affected by it or had a mild case of COVID to be thankful,” she said.