Clatsop County has reported five positive cases of the coronavirus, but the spread of the disease locally is clouded by a lack of testing.

The Oregon Health Authority tracked the results of 221 tests in the county as of Wednesday morning, or about 0.5% of the population. Columbia Memorial Hospital in Astoria and Providence Seaside Hospital, the dominant health care providers on the North Coast, are still mostly only testing people with severe symptoms or who are at greater risk from COVID-19.

Quest Diagnostics

A Quest Diagnostics vehicle parked outside Columbia Memorial Hospital. Quest Diagnostics is a lab that tests for the coronavirus.

The county has not publicly provided an assessment of how many cases of the virus to expect locally, but has pointed to statewide modeling by the Institute for Health Metrics and Evaluation at the University of Washington. The modeling predicts a peak in daily deaths in Oregon on April 24 and that 172 people will die from the disease statewide by early August.

A study by the University of Texas at Austin examined the potential for outbreaks in counties across the United States. A county with no reported cases has a 9% probability of a growing outbreak. Counties with five reported cases — like Clatsop County — have an 85% probability.

The modelers assumed just 1 in 10 cases are tested and reported given the low testing rates for the virus throughout the nation.

Michael McNickle, Clatsop County’s public health director, believes social distancing has helped keep the local case count low. However, he said the lack of testing is also a contributing factor.

“And unfortunately, we still don’t have testing as advertised at certain levels of governments. It’s just not available yet,” he said.

“I think that we’re looking at it across the board from the 10,000-foot level from all of Oregon. So, Clatsop County in particular, it’s really hard to say. That’s why the lack of testing is difficult for us. If we had the ability to test communitywide we would have a great idea of where we’re at.”

National shortage

There is a national shortage of COVID-19 tests, and to preserve tests and personal protective equipment, the federal Centers for Disease Control and Prevention has created guidelines to help hospitals and public health departments decide who to test.

CMH Urgent Care

Columbia Memorial Hospital Urgent Care in Warrenton.

The guidelines list the top three priorities. The first two prioritize people who are hospitalized with severe symptoms, people showing symptoms who are at higher risk for the disease and health care workers and emergency responders with symptoms.

The third priority depends on available resources. It covers anyone showing symptoms in places with a high volume of cases and health care workers and emergency responders regardless if they are showing symptoms.

Columbia Memorial Hospital reported 88 tests for the virus as of Wednesday morning. None of the test results so far have been positive, according to the hospital.

The hospital said in mid-March that it had about 350 testing kits. Nancee Long, the hospital’s director of communications, said they have enough to test people under CDC priorities one and two.

Providence Seaside has been processing tests through a regional laboratory in Portland that is running about 600 tests per day with results in 24 hours. The hospital is also following the CDC’s guidelines when deciding who to test, Mike Antrim, a hospital spokesman, said.

The county’s Public Health Department received an allotment of about 15 tests from the state, which are only being used to test health care workers and emergency responders on a limited basis. The Oregon State Public Health Laboratory sends the county a new test after the county submits one to the lab.

Unable to get tested

Several people have told The Astorian they believe they have been sick with COVID-19 but were unable to get tested locally.

“There are many, many people who have had COVID-19-like symptoms who have been told just to stay home and go through your normal recovery and only if it gets to the point where you have serious complications do they administer the test,” Astoria Mayor Bruce Jones said.

“So I have no doubt that there are many more people that have already had the COVID-19 and are recovered or have it now and haven’t been tested, and they aren’t being tested because there aren’t enough tests.

“But I don’t think this is a problem where Clatsop County needs to stomp its feet and demand more tests. This is a national problem. They just simply aren’t putting out the tests, developing and producing and distributing them quickly enough at the national level.”

Jones said he believes local and state elected officials have done their best and that the county has coordinated well with the state and local hospitals.

“Individual states and individual counties within states should not have to be fighting to get more tests,” he said. “That’s got to be managed centrally at the federal level. The federal government has to procure enough tests and get them distributed to all the states.”

Kathleen Sullivan, the chairwoman of the Clatsop County Board of Commissioners, said she believes the county has done everything it can to get more testing.

“But we’re not there yet,” she said. “But I do think social distancing is helping — I really do — and I think we need to keep it up. I think that’s our main weapon against this.”

As of right now, the county does not know when and if more tests will arrive. So the Public Health Department is focusing on the importance of social distancing.

McNickle agreed that it is difficult to determine if the curve is flattening because of the lack of testing. He said it is difficult to say anything with certainty because there are wild cards, including the number of people locally who show no symptoms and may be spreading the virus.

About 25% of people infected in the U.S. may show no symptoms, according to the CDC.

McNickle said the county is afraid of a potential undetected outbreak, but believes social distancing will still prove effective.

He pointed to South Korea as an example, saying the country took somewhat of a draconian approach with social distancing, but it was effective.

“I think even the amount of social distancing we’ve done, hopefully if we can continue for the next few weeks and get through two or three or four more incubation periods — that’s what our model is showing is, it will flatten the curve,” McNickle said.

Reporter

Nicole Bales is a reporter for The Astorian. Contact her at 971-704-1723 or nbales@dailyastorian.com.