33 Fall/Winter 2021-22 person, all those issues are public health issues that are not going to be solved by the public health department, they need to be solved at a bigger level. The attention that’s come to that, hopefully the resources that are coming to address those issues, will help us address those inequities and come out of this pandemic stronger so that the next time we have to face a crisis we don’t see those inequities where those communities of color are devastated by a viral illness that comes in and other communities are spared. We want everyone to have the same opportunities at protection and being able to weather the pandemic. That’s where my hope lies, with what weren’t we ready for to where we’ll be stronger the next time. But give us some rest and hope the next time doesn’t come anytime soon. Some things that Oregon does relatively well as a health care system, focusing on prevention and having an efficient hospital capacity system, have been under strain during the pandemic. What do we need to focus on moving forward? The focus on keeping all people healthy is still the way to go, and that healthy piece is broad. It’s not just keeping people out of the hospital, but healthy means they have access to a job, where they can support their family, where they can have adequate housing, access to healthy food, educational opportunities are there for kids, that childcare opportunities are there for working parents, not just those who can afford it, but quality childcare is there for all. I think that broad definition is still the way to help us in the next pandemic. We can’t staff an empty ICU 365 days a year if we’re going to use those beds 20 days a year. So how do we keep people as healthy as we can and we have that strong health care delivery system with tertiary and quaternary hospitals and surge capacity with the ability to surge for those shorter periods like we do every year during flu season, but not to design a system that’s designed to care chronically for this level of patients. It wasn’t just Oregon or our west coast neighbors that have comparatively low hospital beds to population ratios. Even in states with much higher hospital bed to population ratios, they faced even higher peaks than we did. They had capacity issues and crises even more so than we did. I think in that sense we can be proud, having that same sense of coming together, having a system that keeps people healthy that allows us to decrease hospital beds has also allowed us to weather this pandemic better than most. That’s hard to keep in mind now as we come down from our worst surge of the pandemic with hospital and public health employees exhausted because we have a high level of cases. But as we look cumulatively, Oregon has one of the lowest case rates compared to other states and our death rate is near the bottom as well. That was due to multiple efforts, that was due to acting early, acting together, that was our public health system along with our community partners, it was our public health and partners stepping up to vaccinate folks, it was people keeping the public health guidance on staying home and wearing masks, getting our vaccine rates up, all those things together helped us to weather this better, and that comes from that same ethos with where we are with the Oregon Health Plan and CCOs, that idea that it’s better to keep people healthy, that it’s better to provide services to people where they are than to build a sick care system. How can we use the resources we have to focus on wellness as we have here in Oregon? “We still want to look at case rates, we still want to look at percent positivity, but they mean different things now. With higher case rates in a highly vaccinated population, many of those folks aren’t going to go on to need a hospital bed.” Dr. Dean Sidelinger, State Health Office & Epidemiologist continues
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