Ask a Black Doctor on The Numberz

Additional resources OHA COVID-19 vaccine website: covidvaccine.oregon.gov OHA Facebook  Safe+Strong website Ask a Black Doctor on The Numberz REACH webpage and REACH Facebook Cornell University Infographic on Spotting Fake News Fighting COVID-19 Vaccine Misinformation and Heart Awareness:  Q1: Some social media posts I've read suggest COVID-19 vaccines lead to football player Damar Hamlin collapsing in the middle of an NFL game on Monday. Should I believe them? It's best to be cautious about other users' online posts around the COVID-19 vaccine, especially if they are vague, and trigger emotional responses like fear and anxiety. In this case, many of these posts imply a connection between Hamlin's collapse, and the COVID-19 vaccine without citing any sources. Some even say he passed away from the incident using the hashtag #diedsuddenly, when he's actually in a hospital as of the publishing of this episode. It's also important to note that Hamlin's vaccination status is unknown, and his full medical history isn't publicly accessible information.  For now, Hamlin's team the Buffalo Bills say he experienced a cardiac arrest shortly after a tackle. While there's no confirmed reason as to why, doctors following the situation say it was possibly due to something called commotio cordis. Q2: What is commotio cordis? Is it the same as a heart attack? Commotio cordis happens whenever someone experiences enough blunt force or trauma to the chest during a specific timing of their heartbeat, when the heart is most vulnerable to such impacts. Their heart can stop beating unexpectedly as a result, otherwise known as cardiac arrest.  In this situation, calling 9-1-1 and giving CPR as soon as possible can save that person's life until emergency response teams (EMTs) arrive.   By comparison, heart attacks can happen when the heart doesn't get enough blood, usually due to something blocking the bloodflow. Since someone experiencing a heart attack can still talk and breathe, they don't need CPR, but they do need to get to a hospital right away. Q3: Does getting the COVID-19 vaccine have any side effects that may affect my heart? There have been rare reports of Myocarditis and Pericarditis, inflammation of the heart muscle and inflammation of the heart's outer lining respectively. While few, these cases tend to happen in teen boys and young men within a week of getting their second COVID-19 shot. With that said, they felt better quickly after getting some care and medicine.  Those aside, there's a remote chance of a severe allergic reaction within minutes to an hour of getting your COVID-19 vaccine. A fast heartbeat and dizziness are some possible signs of this.   Q4: Are COVID-19 vaccines safe? Should I still get myself or my child vaccinated? Yes. Vaccines go through constant testing for quality and safety, even after they're licensed and approved by the Food & Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC). Getting vaccinated and boosted against COVID-19 helps prevent possibly severe complications like getting seriously ill, being hospitalized and dying. Additionally, the vaccine helps reliably create an immune response against the virus without the potential illness or post-COVID conditions that can come with an infection. As the virus evolves over time and mutates into different variants like Omicron, keeping up to date on booster shots you're eligible for can offer protection against those new variants. Q5: I heard about a new variant type called XBB.1.5 in the news. What is the latest we know about it? At this time, we know that XBB.1.5 is a subvariant of Omicron that's steadily grown across December 2022. By the end of that month, it made up 18.2% of cases across Oregon, Washington and Idaho, and 40% of cases nationally, according to the CDC. There's currently no evidence of it causing more severe illness from catching the virus, though its mutations allow it to spread more quickly than other subvariants. While there's still a lot to learn, I think we should be hearing more about it in the coming weeks as new information becomes available.  Document accessibility: For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print, or braille. Contact the Health Information Center at 1-971-673-2411, 711 TTY or COVID19.LanguageAccess@dhsoha.state.or.us. QUESTIONS FROM THE COMMUNITY: "Why are we getting an influx of super sicknesses? Respiratory systems seem to be under attack (RSV, colds, Covid) what factors are contributing to this?" - Janita Jones "Might be good to address the concerns of myocarditis and vaccines." - Holly Hinson "Ideas & Community Care practices inclusive of immunocompromised people - how can we move forward without leaving a group of people behind?" - Emma Holland

Additional resources  OHA COVID-19 vaccine website: covidvaccine.oregon.gov  OHA Facebook  Safe+Strong website  Ask a Black Doctor on The Numberz  REACH webpage and REACH Facebook [Insert FAQ Topic] Q1: As we wrap up the holiday season, are there still concerns about respiratory viruses, including influenza, RSV and COVID-19? Yes, all three continue to circulate in our communities, but at different levels. The percentage of positive influenza tests and resulting hospitalizations rapidly increased in the last several weeks, but, fortunately, percent positivity and hospitalizations for RSV have declined since peaking in early December. Similar to flu, we have seen a rise in COVID-19 cases, which pushed hospitalizations well above 300 per day and kept bed capacity at or near 100%. Those hospitalization include patients waiting in emergency departments because no bed is available. Q2: Why is the high number of hospitalizations such a problem? Don't hospitals typically operate at or near capacity? They do, but during this respiratory season the problems are caused both by a lack of beds and a shortage of nurses to staff those beds. Many of these health care workers are out with the same viral infections as everyone else, making the problem more acute. What we've been reminding people is that if you go to the hospital, you may have to wait half a day in the emergency department to be seen, and if you have to be admitted you may not be in a regular room. OHA 3900 (9/28/2021) Q3: Are there things people can do to reduce their risk of needing hospitalization due to a respiratory virus? Yes. The best way to protect loved ones and friends who are most at risk of severe illness from influenza, RSV or COVID-19 is to take steps that increase your chances of not getting the virus in the first place. And they're the same things we've been talking about during the last nearly three years of the COVID-19 pandemic:  Wear a mask in all indoor public places.  Limit the size of holiday gatherings, especially if they will include young children, older adults or individuals with underlying medical conditions.  Stay home and limit contact with others if you are sick.  Cover coughs and sneezes.  Clean all high-touch surfaces.  Regularly wash hands with soap and water or use hand sanitizer.  Get a flu shot and stay up to date on COVID-19 vaccinations, including boosters. For most people, respiratory viruses will only mild illness. But those with symptoms and in a high-risk group, or very sick and worried about their illness, should seek care right away. For children, warning signs needing medical attention include:  Fast breathing or trouble breathing – flaring nostrils, wheezing or grunting.  Bluish lips or face.  Ribs pulling in with each breath.  Chest pain.  Severe muscle pain (child refuses to walk).  Dehydration (no urine for eight hours, dry mouth, no tears when crying).  Not alert or interacting when awake.  Seizures.  Fever above 104°F.  Any fever in children younger than 12 weeks old.  Fever or cough that improve but then return or worsen.  Worsening of chronic medical conditions.  In infants and toddlers, very ill or drowsy, poor feeding or high-pitched cry. For adults, warning signs needing medical attention include:  Difficulty breathing or shortness of breath.  Persistent pain or pressure in the chest or abdomen.  Persistent dizziness, confusion, inability to arouse.  Seizures.  Not urinating.  Severe muscle pain.  Severe weakness or unsteadiness. OHA 3900 (9/28/2021)  Fever or cough that improve but then return or worsen.  Worsening of chronic medical conditions. Q4: Is there anything OHA is doing in response to the staffing problems at hospitals in Oregon? Yes. OHA is working closely with Gov. Brown to bring staffing relief to Oregon's strained hospitals.  Earlier this month, Gov. Brown issued a new executive order that continues and expands her Nov. 13 emergency declaration to provide additional flexibility to Oregon hospitals so there are enough health care workers to meet current needs, hospitals can draw on a pool of medical volunteer nurses and physicians, and other critical steps can be taken to care for patients.  OHA has helped hospitals bring additional health care providers from out of state to help ease Oregon's hospital capacity issues. We have already brought in more than [NUMBER] contract nurses and respiratory therapists to support our hospital partners, and we are pursuing up to $25 million in additional state funding for supplemental nurse staffing contracts to help address the critical workforce shortages.  OHA also has communicated regularly with the health care, public health, laboratory and emergency preparedness communities through the Health Alert Network, or HAN, to provide updates on the surge response; medical, treatment, vaccination and testing supplies; investigative guidelines and clinical recommendations; and prevention and health promotion messages. Document accessibility: For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print, or braille. Contact the Health Information Center at 1-971-673- 2411, 711 TTY or COVID19.LanguageAccess@dhsoha.state.or.us.

Additional resources OHA COVID-19 vaccine website: covidvaccine.oregon.gov OHA Facebook  Safe+Strong website Ask a Black Doctor on The Numberz REACH webpage and REACH Facebook Q1: What is RSV? Respiratory syncytial virus, also known as RSV, is a common respiratory virus that spreads through virus-containing repiratory droplets produced from coughing and sneezing For most children, RSV produces mild illness. However, young children are especially susceptible to RSV.  Those at higher risk of severe illness are: Children under the age of 2 Premature infants Infants with congenital or chornic cardiopulmonary disease  Older adults 65+ Children and adults with weakend immune systems When children are first infected with RSV, between 25-40% will have symptoms of bronchiolitis or penumonia Yet, it's important to keep in mind that only about 2% of children will require hospitalization Q2: What are signs and symtpoms of RSV? Symptoms will show within 4 to 6 days after getting infected.  Runny nose Decrease in appeitite Sneezing Fever Wheezing Symptoms in infants with RSV may be Irritability Decrease activity  Breathing difficulties These symptoms usually appear in stages and not all at once. Q3: What is the impact of RSV in the Black and African American community? Research has show that due to racism-related stress Black and African American women are more likely to deliver a premature baby.  The risk of contracting RSV is even higher for premature babies. Making this of particular concern for Black and African American community.  Being aware of the impact of RSV on the community and the preventive steps that can be taken, is critical to protect the health and well-being of children.   Q4: What are some safety measure one should take? Stay home when sick to help protect other others in the community from catching the illness, if possible Avoid close contact with sick people Wash your hands often with soap and water for at least 20 seconds  Disinfect high touched surfaces such as doorknobs and mobile devices  Consider a mask in crowded indoor settings During this time of year, it's recommend to stay up to date on flu and COVID vaccinations to help prevent other repiratory illness.  If you have questions about your child's care, call your health care provider or visit an urgent care center.  Document accessibility: For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print, or braille. Contact the Health Information Center at 1-971-673-2411, 711 TTY or COVID19.LanguageAccess@dhsoha.state.or.us.

Additional resources OHA COVID-19 vaccine website: covidvaccine.oregon.gov OHA Facebook  Safe+Strong website Ask a Black Doctor on The Numberz REACH webpage and REACH Facebook Q1: What is RSV? Respiratory syncytial virus, also known as RSV, is a common respiratory virus that spreads through virus-containing repiratory droplets produced from coughing and sneezing For most children, RSV produces mild illness. However, young children are especially susceptible to RSV.  Those at higher risk of severe illness are: Children under the age of 2 Premature infants Infants with congenital or chornic cardiopulmonary disease  Older adults 65+ Children and adults with weakend immune systems When children are first infected with RSV, between 25-40% will have symptoms of bronchiolitis or penumonia Yet, it's important to keep in mind that only about 2% of children will require hospitalization Q2: What are signs and symtpoms of RSV? Symptoms will show within 4 to 6 days after getting infected.  Runny nose Decrease in appeitite Sneezing Fever Wheezing Symptoms in infants with RSV may be Irritability Decrease activity  Breathing difficulties These symptoms usually appear in stages and not all at once. Q3: What is the impact of RSV in the Black and African American community? Research has show that due to racism-related stress Black and African American women are more likely to deliver a premature baby.  The risk of contracting RSV is even higher for premature babies. Making this of particular concern for Black and African American community.  Being aware of the impact of RSV on the community and the preventive steps that can be taken, is critical to protect the health and well-being of children.   Q4: What are some safety measure one should take? Stay home when sick to help protect other others in the community from catching the illness, if possible Avoid close contact with sick people Wash your hands often with soap and water for at least 20 seconds  Disinfect high touched surfaces such as doorknobs and mobile devices  Consider a mask in crowded indoor settings During this time of year, it's recommend to stay up to date on flu and COVID vaccinations to help prevent other repiratory illness.  If you have questions about your child's care, call your health care provider or visit an urgent care center.  Document accessibility: For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print, or braille. Contact the Health Information Center at 1-971-673-2411, 711 TTY or COVID19.LanguageAccess@dhsoha.state.or.us.

(Part 1) Bivalent Vaccine Key Facts: The Moderna and Pfizer updated boosters each contain an mRNA component that targets the currently circulating subvariants (BA.4 and BA.5) and an mRNA component that targets the original COVID-19 virus strain. The FDA concluded the vaccines are safe and effective based on the totality of available evidence. The Pfizer/Moderna mRNA vaccines went through extensive clinical trials before they updated their formulas for the bivalent booster, similar to the way the flu vaccine gets updated every year. You do not need to have had previous boosters to receive the new updated booster. The updated booster, like all COVID-19 vaccines, is free, and no insurance or proof of residency is required. Common side effects are similar to those felt after more than 7 million monovalent mRNA COVID-19 vaccine doses were administered in Oregon. Pfizer's updated bivalent booster is a single booster dose for people age 12 and older available at least two months after completing an initial vaccine series or at least two months after their most recent booster dose. Moderna's updated bivalent booster is a single booster dose for people age 18 and older available at least two months after completing a primary vaccine series or at least two months after their most recent booster dose. (Part 2) Addressing Behavioral & Mental Health during COVID-19: The 988 Suicide and Crisis Lifeline (formerly known as the National Suicide Prevention Lifeline) is available 24 hours per day, 7 days per week, offering people compassionate care and support from trained crisis counselors. 988 is available to help people who are having a range of behavioral health crises, including: thoughts of suicide, self-harm, substance use or any other kind of behavioral health crisis. People can also contact 988 if they are worried about a loved one. Some people may have heard that 988 is like 911 – there's some misinformation out there There is a vision that 988 will become as well-known as 911, and make it easier for anyone to access behavioral health services While 911's focus is on dispatching in-person responders, 988 provides emotional support over call, text or chat in the moments people most need it, in a compassionate, one-on-one conversation 988's vision to provide a behavioral health response to behavioral health crises. It's understandable that some people may be hesitant to call an emergency or crisis number, especially if they have experienced an emotional or mental health crisis in the past, have been adversely impacted by systemic and historical social injustice, or have experienced harm or mistreatment by police or healthcare systems.  For serious and life-threatening situations, 988 call centers will work with local mental health providers to support appropriate interventions. https://988lifeline.org/

featuring Dr. Roberta Hunte, Dr. Mariotta Gary-Smith & Sherly Paul.

featuring Dr. Roberta Hunte & Sherly Paul. As mentioned in the episode Trust Black Women Loretta Ross Undivided Rights

Additional resources  OHA COVID-19 vaccine website: covidvaccine.oregon.gov  OHA Facebook  Safe+Strong website  Ask a Black Doctor on The Numberz  REACH webpage and REACH Facebook  ODE: Planning for the 2022-23 School Year COVID-19 & Back to school Q1: What can students and families expect for the 2022-23 school year? Oregon schools have taken strong steps to limit the spread of the virus in schools. School districts will continue making health and safety decisions for their schools to best meet the needs of local communities. Learning from last year, and what we know now about COVID-19, there are health and safety recommendations and requirements that all K-12 public, charter, and private schools must follow. For example, the Oregon Department of Education (ODE) has advised schools to use these tools for protecting students and staff against COVID-19:  Vaccination for those eligible,  Face coverings,  Physical distancing,  Ventilation and airflow,  Handwashing, and  Staying home if ill OHA 3900 (9/28/2021) Q2: How can families help everyone stay safe as kids head back to the classroom? For parents, getting your children vaccinated against COVID-19 is an easy and safe way to help protect your whole family. COVID-19 vaccines are safe and effective for children 6 months and older. The vaccines were tested over several months and with thousands of children from several races and ethnicities. All of us can still take simple steps to look after our fellow Oregonians, especially as school starts. Along with being up to date with vaccinations, each of us still can wear well-fitting masks in indoor settings. For those at high risk, or those who care for or live with someone at high risk, wearing a mask in indoor public places offers extra protection. Wearing a mask in areas of the state seeing higher COVID-19 transmission also provides protections to others around you. Q3: Should families be worried about hMPXV spreading at school? School settings present low risk for transmission of monkeypox. As we continue to face this outbreak, there will be students, staff or teachers who are diagnosed with monkeypox. The Oregon Department of Education (ODE) encourages them to stay home if they are sick or develop a new rash. Seek care for testing and treatment. This will help minimize potential exposures – even exposures that present low risks for transmission – in schools. ODE is asking schools to plan for how they will support staff and students who may have prolonged times isolating at home while they recover. Anyone with prolonged skin-to-skin contact with an individual with monkeypox can get monkeypox. Right now, the disease is spreading primarily in gay, bisexual or queer men who report recent sexual activity with other men. But anyone can get Monkeypox. Document accessibility: For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print, or braille. Contact the Health Information Center at 1-971-673- 2411, 711 TTY or COVID19.LanguageAccess@dhsoha.state.or.us.

Additional resources  OHA COVID-19 vaccine website: covidvaccine.oregon.gov  OHA Facebook  Safe+Strong website  Ask a Black Doctor on The Numberz  REACH webpage and REACH Facebook  50 th Anniversary Celebration of Juneteenth COVID-19 Variants (BA.4 + BA.5) and hMPXV Update Q1: I'm hoping you can give us an update on hMPXV, which is an abbreviation for human monkeypox virus As of July 27, 53 cases of hMPXV have been reported in Oregon since June 16, 2022. They are among more than 1,000 cases in 43 U.S. states and 11,000 cases in 65 countries that are considered to be part of the current global outbreak. The CDC is urging health care providers in the U.S. to be alert for patients who have rash illnesses consistent with hMPXV, regardless of whether they have travel or specific risk factors for the virus, and regardless of gender or sexual orientation. The CDC also is working with state and local health officials to identify people who may have been in contact with people who have tested positive for hMPXV so they can monitor their health Q2: Who is most at risk of infection? While anyone can be affected by hMPXV, the current global outbreak of the virus happens to largely affect gay, bisexual and other men who have sex with men. As such, OHA is prioritizing the empowerment of men who have sex with men and the larger LGBTQIA+ and queer community with information, testing, prevention and treatment strategies so they can take steps to protect themselves from the virus. OHA 3900 (9/28/2021) Q3: How is it spread? hMPXV is transmitted person to person. This can happen through prolonged, close contact, either skin to skin, contact with fluid from hMPXV lesions, or less commonly from large respiratory droplets. Most infections in the current outbreak appear to be due to skin-to-skin contact. Q4: What are the symptoms? Illness typically starts with fever, headache and muscle aches. This is followed in one to three days by a rash, often on the face, spreading to the limbs. The rash starts with flat patches that then form large, firm bumps, which then fill with fluid or pus. These then scab and fall off, usually over two to four weeks. Q5: How long after exposure do symptoms start? Usually within seven to 14 days, with a range of five to 21 days. Q6: When can a person ill with hMPXV spread it to others? Ill people can potentially transmit the infection from when symptoms start until the rash has resolved. However, this is not an easy infection to catch. It typically requires prolonged, close, skin-to-skin contact. People at increased risk include sexual partners of an ill person, or family members and health care workers caring for someone ill with hMPXV. Q7. What should I do if I think I have hMPXV? Call your health care provider to let them know. If you don't have a health care provider, reach out to your local public health authority, which can see you in one of its clinics or help you find a health care provider. If you plan to go to the emergency room or an urgent care, let the check-in staff know that you are concerned about hMPXV. They will ask you to wear a mask and help you cover rashes that may not be covered by your clothing while you wait to be seen. Document accessibility: For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print, or braille. Contact the Health Information Center at 1-971-673- 2411, 711 TTY or COVID19.LanguageAccess@dhsoha.state.or.us. Resources on staying cool this summer!!

Additional resources  OHA COVID-19 vaccine website: covidvaccine.oregon.gov  OHA Facebook  Safe+Strong website  Ask a Black Doctor on The Numberz  REACH webpage and REACH Facebook  50 th Anniversary Celebration of Juneteenth COVID-19 Variants (BA.4 + BA.5) and hMPXV Update Q1: I'm hoping you can give us an update on hMPXV, which is an abbreviation for human monkeypox virus As of July 13, 11 cases of hMPXV have been reported in Oregon since June 16, 2022. They are among more than 1,000 cases in 43 U.S. states and 11,000 cases in 65 countries that are considered to be part of the current global outbreak. The CDC is urging health care providers in the U.S. to be alert for patients who have rash illnesses consistent with hMPXV, regardless of whether they have travel or specific risk factors for the virus, and regardless of gender or sexual orientation. The CDC also is working with state and local health officials to identify people who may have been in contact with people who have tested positive for hMPXV so they can monitor their health Q2: Who is most at risk of infection? While anyone can be affected by hMPXV, the current global outbreak of the virus happens to largely affect gay, bisexual and other men who have sex with men. As such, OHA is prioritizing the empowerment of men who have sex with men and the larger LGBTQIA+ and queer community with information, testing, prevention and treatment strategies so they can take steps to protect themselves from the virus. OHA 3900 (9/28/2021) Q3: How is it spread? hMPXV is transmitted person to person. This can happen through prolonged, close contact, either skin to skin, contact with fluid from hMPXV lesions, or less commonly from large respiratory droplets. Most infections in the current outbreak appear to be due to skin-to-skin contact. Q4: What are the symptoms? Illness typically starts with fever, headache and muscle aches. This is followed in one to three days by a rash, often on the face, spreading to the limbs. The rash starts with flat patches that then form large, firm bumps, which then fill with fluid or pus. These then scab and fall off, usually over two to four weeks. Q5: How long after exposure do symptoms start? Usually within seven to 14 days, with a range of five to 21 days. Q6: When can a person ill with hMPXV spread it to others? Ill people can potentially transmit the infection from when symptoms start until the rash has resolved. However, this is not an easy infection to catch. It typically requires prolonged, close, skin-to-skin contact. People at increased risk include sexual partners of an ill person, or family members and health care workers caring for someone ill with hMPXV. Q7. What should I do if I think I have hMPXV? Call your health care provider to let them know. If you don't have a health care provider, reach out to your local public health authority, which can see you in one of its clinics or help you find a health care provider. If you plan to go to the emergency room or an urgent care, let the check-in staff know that you are concerned about hMPXV. They will ask you to wear a mask and help you cover rashes that may not be covered by your clothing while you wait to be seen. Document accessibility: For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print, or braille. Contact the Health Information Center at 1-971-673- 2411, 711 TTY or COVID19.LanguageAccess@dhsoha.state.or.us.

featuring Dr. Roberta Hunte, PhD, Dr. Kim Heller, Dr. Mariotta Gary-Smith and Ngozi Olemgbe

6/24/2022 Additional resources OHA COVID-19 vaccine website: covidvaccine.oregon.gov OHA Facebook  Safe+Strong website Ask a Black Doctor on The Numberz REACH webpage and REACH Facebook Vaccinating children under 5 Q1: Now that vaccines have been authorized for children under 5, what should parents know? First of all, it might be helpful for folks to remember the decision was made this past weekend and Monday was the Juneteenth holiday. So the vaccine may be in some clinics today, but it may take a few days for the vaccine to make it to all pediatricians and clinics. The safest thing for parents to do is call their pediatrician, or call the local county health clinic, first and ask them if they have the vaccine yet. Secondly, there are two vaccines available for children under 5. Both went through clinical trials that lasted several months and involved thousands of children. Both vaccines were proven to be safe and effective. The two vaccines are the Pfizer-BioNTech and the Moderna. The Pfizer vaccine is for children 6 months old to under 5 years. It is three doses.  The Moderna vaccine is for children 6 months old to under 6 years. It is two doses.  Q2: What else do we know about the safety and effectiveness of vaccines for children under 5?  In addition to the clinical trials, the FDA, the CDC and the Western States Scientific Safety Review Workgroup, along wth two independent advisory committess, reviewed the vaccine trials data. They all agreed that the vaccines are safe and effective. Q3: Why is it important to vaccinate children under 5? Parents and caregivers should be aware that while rates of severe COVID-19 are lower in children, children can still get infected and become very sick. The rate of hospitalization for COVID-19 for children under five soared during the Omicron peak earlier this year. It was five times higher than during the Delta wave of 2021, according to the CDC.  The vaccine can help protect children from getting infected, becoming sick, and potentially ending up with long Covid. Q4: How can I tell if my child is experiencing a side effect from a vaccination they received?  Common side effects include redness or pain at the site of vaccination. Some people might also experience tiredness or fever. These are often signs that the immune system is responding to the vaccine.  Sometimes people might have other symptoms following vaccination. These might or might not be related to receiving the vaccine. If your child has symptoms following vaccination, discuss with your healthcare provider.  Q5: Is it safe to vaccinate my child under 5 if they already had COVID-19?  Yes. Vaccination can increase protection from COVID-19 infection, even in someone who has already been infected. Evidence shows that vaccines are safe in this setting, and the benefits outweigh any risks. Talk to your healthcare provider if you have any questions or concerns about COVID-19 vaccines. Q6: Can you share some tips for helping keep young children calm during vaccination? Sure!  If your child is age 2 or younger, ask your child's health care provider to give them a sweet solution – usually glucose or sucrose – a minute or two before the shot. Something sweet can help reduce the pain response. Breast feeding can calm or relax the child and has some sweetness to reduce pain. Ask for a pain-relieving ointment. The ointment can block pain signals, but it takes a little time to work, so ask in advance. The cooling spray can be given right before. Be honest and calm. We know kids are smart so take the time to explain what is happening and what to expect. For example, they will feel a pinch, but it will go away fast. Use helpful words like pressure or poke rather than pain or shot. A calm voice can be reassuring even for babies. Bring something that a child finds comforting – a favorite toy or book to help them focus on something pleasant. That can be a helpful way to soothe.  Right before the shot, consider ways to distract the child. Tell a story, sing a song, act silly. Pull the child's attention away from the person giving the shot. Bigger kids need support, too. Take deep breaths with them and have them imagine the pain is leaving their mouth as they breathe out. You can have them do it while they're getting the shot. After the shot, be calm and comfort them. You can hug older kids, and swaddle older babies. Hold your child close, soothe them so they know they are safe and loved. Document accessibility: For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print, or braille. Contact the Health Information Center at 1-971-673-2411, 711 TTY or COVID19.LanguageAccess@dhsoha.state.or.us. 6/24/2022 Additional resources OHA COVID-19 vaccine website: covidvaccine.oregon.gov OHA Facebook  Safe+Strong website Ask a Black Doctor on The Numberz REACH webpage and REACH Facebook Vaccinating children under 5 Q1: Now that vaccines have been authorized for children under 5, what should parents know? First of all, it might be helpful for folks to remember the decision was made this past weekend and Monday was the Juneteenth holiday. So the vaccine may be in some clinics today, but it may take a few days for the vaccine to make it to all pediatricians and clinics. The safest thing for parents to do is call their pediatrician, or call the local county health clinic, first and ask them if they have the vaccine yet. Secondly, there are two vaccines available for children under 5. Both went through clinical trials that lasted several months and involved thousands of children. Both vaccines were proven to be safe and effective. The two vaccines are the Pfizer-BioNTech and the Moderna. The Pfizer vaccine is for children 6 months old to under 5 years. It is three doses.  The Moderna vaccine is for children 6 months old to under 6 years. It is two doses.  Q2: What else do we know about the safety and effectiveness of vaccines for children under 5?  In addition to the clinical trials, the FDA, the CDC and the Western States Scientific Safety Review Workgroup, along wth two independent advisory committess, reviewed the vaccine trials data. They all agreed that the vaccines are safe and effective. Q3: Why is it important to vaccinate children under 5? Parents and caregivers should be aware that while rates of severe COVID-19 are lower in children, children can still get infected and become very sick. The rate of hospitalization for COVID-19 for children under five soared during the Omicron peak earlier this year. It was five times higher than during the Delta wave of 2021, according to the CDC.  The vaccine can help protect children from getting infected, becoming sick, and potentially ending up with long Covid. Q4: How can I tell if my child is experiencing a side effect from a vaccination they received?  Common side effects include redness or pain at the site of vaccination. Some people might also experience tiredness or fever. These are often signs that the immune system is responding to the vaccine.  Sometimes people might have other symptoms following vaccination. These might or might not be related to receiving the vaccine. If your child has symptoms following vaccination, discuss with your healthcare provider.  Q5: Is it safe to vaccinate my child under 5 if they already had COVID-19?  Yes. Vaccination can increase protection from COVID-19 infection, even in someone who has already been infected. Evidence shows that vaccines are safe in this setting, and the benefits outweigh any risks. Talk to your healthcare provider if you have any questions or concerns about COVID-19 vaccines. Q6: Can you share some tips for helping keep young children calm during vaccination? Sure!  If your child is age 2 or younger, ask your child's health care provider to give them a sweet solution – usually glucose or sucrose – a minute or two before the shot. Something sweet can help reduce the pain response. Breast feeding can calm or relax the child and has some sweetness to reduce pain. Ask for a pain-relieving ointment. The ointment can block pain signals, but it takes a little time to work, so ask in advance. The cooling spray can be given right before. Be honest and calm. We know kids are smart so take the time to explain what is happening and what to expect. For example, they will feel a pinch, but it will go away fast. Use helpful words like pressure or poke rather than pain or shot. A calm voice can be reassuring even for babies. Bring something that a child finds comforting – a favorite toy or book to help them focus on something pleasant. That can be a helpful way to soothe.  Right before the shot, consider ways to distract the child. Tell a story, sing a song, act silly. Pull the child's attention away from the person giving the shot. Bigger kids need support, too. Take deep breaths with them and have them imagine the pain is leaving their mouth as they breathe out. You can have them do it while they're getting the shot. After the shot, be calm and comfort them. You can hug older kids, and swaddle older babies. Hold your child close, soothe them so they know they are safe and loved. Document accessibility: For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print, or braille. Contact the Health Information Center at 1-971-673-2411, 711 TTY or COVID19.LanguageAccess@dhsoha.state.or.us.

Additional resources OHA COVID-19 vaccine website: covidvaccine.oregon.gov OHA Facebook  Safe+Strong website Ask a Black Doctor on The Numberz REACH webpage and REACH Facebook 50th Anniversary Celebration of Juneteenth  Celebrating Juneteenth and Holiday Safety  Q1: What is June 19th or “Juneteenth” and why is it so important nationally this year? Juneteenth, or “Freedom Day” is the oldest nationally celebrated commemoration of the ending of slavery in the United States. It was on June 19, 1865 that Union soldiers, led by Maj. Gen. Gordon Granger, landed in Galveston, Texas with news that the war had ended and that all slaves were free.  This holiday is considered the “longest running African-American holiday” and has been called “America's second Independence Day.” Q2: What is the significance of this year's Juneteenth celebration in Oregon? Oregon Senate Approves Juneteenth as Official State Holiday 50th anniversary celebration of Juneteenth will be in person this year, after having to go virtual during pandemic. After so much grief and hardship, it is time to provide some healing and celebration, and take this as an opportunity to celebrate all the amazing work done by the REACH program: Over 150 partners have collaborated in this work.  The REACH program was pivotal in the establishment of the first drive-thru vaccine clinic in Multnomah County. Vaccinated more than 22,309 people. (Not including data from January and February - where they held multiple clinics vaccination of 500+ people) Q3: What are the key events happening this weekend to celebrate Juneteenth in Oregon? Wattles Boys and Girls Club Health FairThey will be providing plant starters from Black farmers, vaccines, food, and games. 50th anniversary celebration of Juneteenth in North PortlandTalk about the displacement in Vanport and Albina and the importance of taking up space there. Gresham celebrationsBecause of the displacement due to redlining, gentrification, etc., a lot of the Black community is now in Gresham. The celebration in Vance Park in Gresham is hoping for a huge turnout and is put on by  Play Grow Learn, a fantastic organization that “is dedicated to healthy opportunities for sheltered and underserved youth in the community to play, grow, and learn. Initially aimed to support homeless youth, with the extended mission to serve all disenfranchised youth and families.” There will also be an afterparty in Downtown Rockwood  Q4: During our Juneteenth events, we will be asking questions from the REACH team and some of the long-standing partners in the African American and African Immigrant and refugee communities of Multnomah County the following questions and we thought it would be great to ask these of all of you! What does Black Joy, Liberation and Healing look like to you? What's your special message to anyone about the Juneteenth celebration? Name the challenges you encountered during COVID and how did you get through those?   Share your responses with REACH Facebook or Ask a Black Doctor on The Numberz. Q5: Is it safe to gather in large groups for holiday events this weekend? What are COVID cases looking like? With summer arriving, school out, and many of us enjoying the warmer weather, events like Juneteenth will bring people, families and communities together. Statewide, COVID-19 cases appear to be leveling. Test positivity has not changed much lately and was 11.7% on June 13. During the last month, daily reported case counts also have leveled, from a rolling seven-day average of 1,401 cases a day on May 17, to 1,487 reported on June 13. However, these numbers are likely an undercount because many people are using at-home tests and not reporting the results. We also know many others are not getting tested.  So if you are out and about, you will be exposed to COVID-19. If you are planning to celebrate Juneteenth, celebrating outdoors is safer than celebrating indoors. And we encourage folks who are older or at high risk to wear a mask in indoor public spaces.  The Number One thing you can do to protect yourself, your family and your community, is to get vaccinated and boosted. Q6: If I am in a large group outside, should I wear a mask? This depends on personal factors, your risk level and your comfort level.  For folks who are at high risk, or for folks who care for someone at higher risk, or who live with someone at high risk, wearing a mask in indoor public places offers extra protection. However, the evidence we have seen suggests the virus in its current form can spread much more easily indoors. And like we said earlier, most outdoor settings are safer.  Q7: What is the latest news on vaccinations and boosters for children under 5? We know that many families with children under 5 have been eager to vaccinate their youngest children.  The FDA and the CDC and their advisory committees are meeting this week and this Saturday to consider two vaccines for young children: Pfizer-BioNTech's, for children 6 months old to under 5 years; and Moderna's, for children 6 months old to under 6 years. If the Western States Scientific Study Review Pact and Governor Kate Brown approve of the FDA and CDC review this weekend, the vaccine for children under 5 could be available as early as next week in Oregon. We encourage parents who want to vaccinate their children under 5 to check with their pediatricians, local public health authority, or a trusted health care provider first, to see if they have the vaccine. If you don't have a health care provider or pediatrician, call 211 and they can help you find the vaccine.   Document accessibility: For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print, or braille. Contact the Health Information Center at 1-971-673-2411, 711 TTY or COVID19.LanguageAccess@dhsoha.state.or.us.

Additional resources OHA COVID-19 vaccine website: covidvaccine.oregon.gov OHA Facebook  Safe+Strong website Ask a Black Doctor on The Numberz REACH webpage and REACH Facebook 50th Episode Milestone Q1: What are the best practices for living with COVID-19?  Getting vaccinated and boosted is the best way to protect ourselves from the risk of severe disease, hospitalization and death.  Monitor the spread of the virus in your community. Follow local public health partners who inform residents about COVID-19 trends in their areas.  If you have underlying medical conditions, are immunocompromised, or live with someone who is, consider minimizing time in indoor gatherings and wearing a highest quality mask in indoor public settings. And if you are at high risk, consider making a plan now for how you will get tested and receive treatment in case you get COVID.  Q2: What is the latest information on booster eligibility for children 5-11?  The Federal Drug Administration, Centers for Disease Control and Prevention, and the Western States Scientific Safety Review Workgroup recently authorized a single booster dose of the pediatric Pfizer COVID-19 vaccine for children ages 5 through 11. That means: Children ages 5 through 11 who are not immunocompromised should get a booster dose at least five months after receiving the second dose in their primary vaccine series. Children ages 5 through 11 who are immunocompromised (and who have received a third primary series dose) should get a booster dose at least three months after receiving the third dose in their primary vaccine series. Boosters have been shown to increase antibodies against Omicron in children 5–11 to 36 times the level they had after the second dose.  But you can't get a booster until you've gotten a vaccination so it's really important is to get that primary vaccine series to kids who haven't had it yet. Q3: What is the latest information on when vaccines may become available for children for under 5? We don't have a date just yet but we do know that the FDA's vaccine advisory committee is scheduled to meet June 15 to consider requests for an Emergency Use Authorization, or EUA, for children under 5. So we expect to learn more sometime later this month. Document accessibility: For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print, or braille. Contact the Health Information Center at 1-971-673-2411, 711 TTY or COVID19.LanguageAccess@dhsoha.state.or.us.

Additional resources OHA COVID-19 vaccine website: covidvaccine.oregon.gov OHA Facebook  Safe+Strong website Ask a Black Doctor on The Numberz REACH webpage and REACH Facebook Rising Case Rates and Masking Recommendations Q1: I hear COVID cases and hospitalizations are rising. What's the latest? Test positivity has risen from 7% on April 20 to 12.3% on May 23. Daily reported case counts have more than doubled as well, from a rolling seven-day average of 600 cases a day on April 20, to 1,692.4 reported on May 23.  And, we also know that most cases are not being reported to public health — both because testing is occurring at home and because some individuals do not get tested. So, our state and national trends all tell us significant disease transmission is occurring.  As for hospitalizations, they have increased recently, but OHA is optimistic the overall number of Oregon's hospitalized patients with COVID-19 will not exceed our hospital system's ability to care for them.  Modeling from Oregon Health & Science University projects that the number of COVID-19-positive patients in Oregon's hospitals will peak at 321 around June 10. This is less than a third of the number we saw during the Delta and Omicron waves We will continue to watch COVID-19 hospitalizations closely and we are ready to respond to any future surges.  Q2: With cases rising, what can I do to protect myself and those around me? Being vaccinated and boosted is the best way to protect ourselves from severe disease.  One way to assess your risk is to monitor the spread of the virus in your community. Our local public health partners continue to inform their residents about COVID-19 trends in their areas. Multnomah County, for example, recently recommended its residents consider wearing masks for the next few weeks in school, work and other indoor settings. Finally, folks at high risk of severe illness from COVID-19 will face greater challenges, even if they have been vaccinated and boosted.  Those with underlying medical conditions, or who are immunocompromised, should consider contacting their health care providers now to make a plan to get tested and receive treatment — should they become ill. People who don't have a health care provider can contact their local community health center or call 211.  OHA strongly encourages people with these risk factors minimize indoor social gatherings. We recommend wearing masks in these social settings, and choose the highest quality mask that fits them well. Q3: When do you anticipate cases will stop rising? Recent data show a slowing of the increase in reported cases, indicating we may be nearing the top of this current peak.  Q4: Now that my children go to school in-person, they seem to be getting sick more often. Why is this and how can we take care of ourselves at home? Oregon did see a late-season rise in flu cases – flu season generally peaks around late January or February – as people began removing their masks after mask requirements were lifted for indoor public places and schools on March 19, and as people resumed indoor activities. This made it easier to spread the influenza, and potentially other respiratory viruses such as the common cold, from person to person. Q5: What is the latest news on vaccinations and boosters for children? We do not know yet when vaccinations may become available for children from 6 months to five years of age.  However, the FDA, the CDC and the Western States Scientific Safety Review Workgroup authorized a single booster dose for children ages 5-11 last week, so that means parents of children in that age group can now better protect their children ages 5-11 from serious illness from COVID by getting their childrn a booster. Document accessibility: For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print, or braille. Contact the Health Information Center at 1-971-673-2411, 711 TTY or COVID19.LanguageAccess@dhsoha.state.or.us.

Additional resources OHA COVID-19 vaccine website: covidvaccine.oregon.gov OHA Facebook  Safe+Strong website Ask a Black Doctor on The Numberz REACH webpage and REACH Facebook COVID and Cardiovascular Health Q1: What is the cardiovascular system? The cardiovascular system consists of your heart and blood vessels. It supplies your body's organs with oxygen and nutrients so your organs can do their jobs. It makes sure that your body gets what it needs during exercise and during rest as well as keeping your temperature at a normal level. Blood vessels called veins carry carbon dioxide and other waste to organs that can get rid of it. Q2: What risks does COVID-19 pose on the cardiovascular system? A recent study shows that even a mild case of COVID-19 can increase a person's risk of cardiovascular problems for at least a year after diagnosis. Researchers found the risk of heart failure increased by 72% in people who had recovered from COVID-19. The risk was elevated even for those under age 65, nonsmokers, and for those who didn't have other risk factors such as obesity or diabetes. COVID may also cause myocarditis, which is inflammation of the heart muscle, and stress cardiomyopathy, which is a heart muscle disorder that affects the heart's ability to pump blood effectively.  Most serious of all is the possibility of the immune system releasing proteins called cytokines that attack the invading virus but also can damage healthy tissues. Such a “cytokine storm” can be difficult to survive. Other COVID-19 related heart problems include coronary artery disease a (buildup in arteries that limits blood flow) and heart attacks. A diagnosis of heart failure after COVID-19 is rare.  But if you have shortness of breath, palpitations, chest pain or leg swelling after COVID-19, you should contact a health care provider. People who had recovered from COVID-19 were also 52% more likely to have had a stroke. Q3: How does COVID-19 affect my cardiovascular system once I am infected? When COVID first began, we thought of it as a lung disease. But, what we found is that the virus gets into the cells of the body by binding to a receptor called ACE2. ACE2 is a protein found throughout the body, including in cells in the lungs. When we breathe the virus in, it attaches to ACE2 and is able to enter our bodies. ACE 2 is also present in nerve cells, the stomach, the intestines, the heart, and the lining of blood vessels throughout the body.  When the virus binds to the ACE2 in a blood vessel it can trigger blood clotting. That's why COVID-19 can cause clotting throughout the body.  Q4: How does forming blood clots from COVID harm my health? Blood clots that form in veins is a condition called venous thromboembolism or VTE. Clots can form in a leg or elsewhere, then may break free and move to the lungs, blocking their blood supply, or what is known as a pulmonary embolism, which is a serious and often fatal condition. Older stroke patients who have a history of COVID-19 are more likely to develop dangerous blood clots in the veins than those who did not.   Research suggests there is a 64% higher risk of VTE among stroke patients with a history of COVID-19 hospitalization, and a 21% higher risk among those who had COVID-19 but weren't hospitalized. Black stroke patients had the highest rate of VTE compared to other racial and ethnic groups.  Q5: I have high blood pressure; how can I stay healthy if I get COVID-19? Nearly half of U.S. adults have high blood pressure, or hypertension, which means the measurement of the pressure of blood pushing against blood vessel walls is consistently too high. Patients taking common types of blood pressure medicines who contract COVID-19 should continue treatment unless otherwise advised by their health care provider.  People taking corticosteroids, oral birth control, immunosuppressants, mental health medications and some cancer medications should monitor their blood pressure with their health care provider. Decongestants and painkillers called NSAIDs, such as naproxen and ibuprofen, can increase blood pressure.  If you are taking medications for high blood pressure and you get COVID, talk to a health care provider. If other symptoms occur — such as chest or back pain, numbness or weakness, loss of vision, or difficulty breathing or speaking—call 911. Q6: I have a congenital heart condition. What are my risks if infected with COVID-19? Congenital heart defects occur when the heart, or the blood vessels near it, fail to develop properly before birth. Research finds that people born with heart defects were up to twice as likely to die or be critically sick if they were hospitalized due to COVID. Having another underlying health condition in addition to a heart defect placed people at highest risk for the most severe illness from COVID-19. They also had a higher risk of needing a ventilator or being treated in the intensive care unit than people without heart defects. The increased risks held true regardless of age or having other health conditions. Document accessibility: For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print, or braille. Contact the Health Information Center at 1-971-673-2411, 711 TTY or COVID19.LanguageAccess@dhsoha.state.or.us.

Additional resources  OHA COVID-19 vaccine website: covidvaccine.oregon.gov  OHA Facebook  Safe+Strong website  Ask a Black Doctor on The Numberz  REACH webpage and REACH Facebook Diet and Nutrition Q1: Why does nutrition matter during the COVID-19 pandemic? People who don't eat a healthy diet are at a greater risk of various bacterial, viral, and other infections. And, chronic or severe infections can lead to nutritional disorders. Therefore, it is important for all of us to pay attention to what we eat during the pandemic. In a recent large study, researchers asked 593,000 adults (mostly middle-aged and older) what they ate in February 2020, and then followed their health for the next six months. Scientists found that people who reported eating more fruits, vegetables, and legumes had a 9% lower risk of getting COVID and a 41% lower risk of developing severe COVID during the study period, compared with people who reported eating fewer fruits and vegetables. Q2: Is there a recommended diet for people with COVID-19? The best way to prevent COVID-19 is to get vaccinated and wear a mask in higher- risk situations. There isn't any particular diet or food that can prevent COVID-19 or decrease the severity of symptoms. But all the basics of eating healthy are still important. OHA 3900 (9/28/2021) Eat fruits, vegetables, legumes (lentils and beans), nuts and whole grains (such as oats, wheat and brown rice), and potatoes and yams. Eating several servings of fruit and vegetables a day is important. Foods from animal sources (such as meat, fish, eggs, and milk) are good sources of protein, vitamins, and minerals. Chicken and fish are better choices than red meat because they are generally lower in fat. Water is the best choice for drinking fluids. But you can have other drinks that contain water, such as unsweetened tea or coffee.  Keep processed foods to a minimum because they are typically high in sugar, fat, and/or salt. Q3: Cases have been increasing lately. Is it safe to eat out in restaurants? If you are vaccinated and boosted then you have already taken the most significant step to reduce your risk of serious illness from COVID-19. Although cases are currently relatively low in Oregon, the pandemic is not over, so it's still important to keep an eye on trends. You can check case counts and hospitalizations in your county on OHA's data dashboards and CDC's community levels. What is safe is an individual decision, so it's important to understand your level of risk and make decisions that you feel are in the best interest of your health and the health of your loved ones. For example, if you or someone you live with are at high risk due to medical conditions or age, consider ordering take-out or cooking at home. If you decide you want to eat out, you can still consider how to minimize your risk of exposure to COVID-19. Many restaurants offer outdoor seating, which generally provides better ventilation. You can also plan your visit to find a restaurant that is not typically crowded or go at a less busy time. Q4: Any advice for breastfeeding mothers during COVID ? Being vaccinated and boosted is the best thing you can do to protect your health and the health of your baby. The COVID-19 vaccines are safe and effective during pregnancy and breastfeeding. If you are in isolation for COVID-19 and have a newborn, there are a few things you can do to reduce the chance of spreading the virus to your baby:  Wash your hands with soap and water for at least 20 seconds before holding or caring for your newborn. If soap and water are not available, use a hand sanitizer with at least 60% alcohol.  Wear a well-fitting mask whenever you are within 6 feet of your newborn.  Keep your newborn more than 6 feet away from you as much as possible.  Consider using a breast milk pump and having a healthy caregiver feed the baby. The caregiver should wear a mask when caring for the baby. OHA 3900 (9/28/2021) Q5: Are there any nutritional supplements I could take to strengthen my immune response to COVID-19? Existing research hasn't conclusively shown that any nutritional supplement can prevent COVID-19 or decrease the severity of symptoms. Few randomized clinical trials of supplements for COVID-19 have been completed to date. Eating a healthy diet is key to prevent nutritional deficiencies. Nutritional supplements are not substitutes for a good diet because supplements cannot provide all the benefits that healthy foods do. Some supplements are promoted with exaggerated or unsupported claims. The immune system relies on various nutrients, including vitamin C, vitamin D, and zinc. Vitamin D is produced when our skin is exposed to sunlight, but in the winter, the sun's intensity is generally inadequate to produce enough vitamin D. Low levels of vitamin D may increase the risk of some respiratory infections. Talk to your healthcare provider if you have any questions about nutrient levels or supplements. Q6: How important is it to stay hydrated if I've tested positive for COVID-19? Hydration and nutrition play an important role in your body's response to and recovery from a COVID-19 infection. With an infection, the body must work intensely to mount an immune response. High fever is the immune system's way of revving up metabolism to "battle the bug." Even though you may not be thirsty or hungry, it is important that you continue to eat and drink fluids to support your body's ability to fight the virus and support your body's immune function. When you are dehydrated, your respiratory secretions may thicken and are hard to clear from your lungs, which may increase your risk of pneumonia.  Increase your fluid intake by drinking small amounts every half hour.  Water and unsweetened beverages are best. Avoid sugary drinks, including soda, energy drinks, and even fruit juice. Most fruit juices have high sugar content, even if they have no added sugar.  Avoid beverages with alcohol and caffeine, which can dehydrate the body and interfere with sleep. Document accessibility: For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as OHA 3900 (9/28/2021) translations, large print, or braille. Contact the Health Information Center at 1-971-673- 2411, 711 TTY or COVID19.LanguageAccess@dhsoha.state.or.us.

Additional resources OHA COVID-19 vaccine website: covidvaccine.oregon.gov OHA Facebook  Safe+Strong website Ask a Black Doctor on The Numberz REACH webpage and REACH Facebook Long COVID and Emerging Variants Q1: I have heard people talking about long-term COVID. What is that? Long-term COVID goes by many names. Some people call it post-COVID syndrome, long COVID or long-haul COVID. It is formally known as PASC, or post-acute sequelae of SARS-CoV-2. It is a post-viral syndrome and refers to conditions that people experience 28 days or more after first being infected with COVID-19.  Post-viral syndromes occur from a range of infections, and long-term COVID can be different types and combinations of health problems for different lengths of time. Symptoms persist in an estimated 10% to 30% of COVID-19 patients and can happen to anyone who has had COVID-19, even if the illness was mild, they had no initial symptoms or they no longer test positive for the virus or antibodies.  Long COVID has potentially affected up to 23 million Americans. The Centers for Disease Control and Prevention and experts around the world are working to learn more about short- and long-term health effects of COVID-19, who gets them, and why.  Q2: How can I prevent having long-term COVID? The best way to prevent post-COVID conditions is to prevent COVID-19 illness. Get vaccinated and boosted. If you are high risk, consider wearing a well-fitted mask – preferably an N95 mask – to help protect yourself and others. Q3: When should I see a doctor about post-COVID symptoms? Long-term COVID doesn't usually come with one symptom—there's often a cluster of symptoms. There are many symptoms and they affect many organ systems. Don't ignore loss of smell, depression, anxiety or insomnia. Any symptom that interferes with your daily life is worth a call to your doctor. If you experience new chest pain, difficulty breathing, bluish lips or any other sign of a life-threatening problem, seek emergency medical care. It is also important to talk to a health care provider because another condition could be masquerading as long COVID. In spring 2021, Oregon Health & Science University launched a Long COVID Program designed to coordinate care and learn about the long-term effects of coronavirus. OHSU's criteria for Long COVID referrals is 28 days from hospital discharge, or three months when not hospitalized. If you have questions or want to learn more, please call the program at 833-647-8222 weekdays, 8 a.m. to 5 p.m.  Q4: Is long COVID considered a disability? As of July 2021, “long COVID” can be considered a disability under the Americans with Disabilities Act (ADA), Section 504, and Section 1557, if it substantially limits one or more major life activities. “Major life activities” include activites such as caring for oneself, eating, sleeping, breathing, concentrating, thinking, interacting with others and working. “Major life activities” also refers to the operation of a major bodily function, such as the immune system, cardiovascular system, neurological system or circulatory system, or the operation of an organ. Q5: How do I know if I have long COVID or not? Because data on COVID-19 and its long term effects only date back to the past two years, experts are still learning what long COVID is and how it affects people. There is no one way to test for long COVID. It is possible to have many of the symptoms of long COVID, but they could be caused by something else.  To be sure, talk to a health care provider. Health care providers may use COVID-19 antibody tests to confirm previous infection, then rule out other conditions. Treatment is based on a patient's specific symptoms and may include therapeutics, such as steroids or anti-inflammatory medication. Trials are underway to test new therapeutics for long COVID patients. According to the CDC, the most common lasting symptoms are fatigue, shortness of breath, cough, joint pain and chest pain. Other issues include cognitive problems, difficulty concentrating, depression, muscle pain, headache, rapid heartbeat and recurrent fever. Additional effects of Long COVID could be loss of appetite and diarrhea, acute kidney injury, blood clots, hair loss and rashes. For some, COVID-19 may cause the immune system to attack its own antibodies. For others, it may disrupt the immune system and reactivate old viruses like Epstein-Barr.  No organ system is spared from long COVID. Q6: My neighbor has long term COVID. How can I help her? A good place to start is to listen with compassion. Taking steps to understand the person's experiences might make them feel less isolated. Directly ask what they need or what you can do to help. There will be times where you may not be able to support a person exactly as they need, and it's OK to acknowledge that. Just be direct in saying what you can and can't do.  School administrators, school counselors and school nurses can work with families and health care professionals to provide learning accommodations for children with post-COVID conditions, particularly those experiencing thinking, concentrating or physical difficulties. Q7: What's the latest information on COVID variants? The emerging variant of interest in the United States is still Omicron. The most important thing to understand is the infectiousness of these variants—they move very quickly, and vaccination and boosting is key to preventing severe disease.  Omicron infection generally causes less severe disease than infection with prior variants. Some people, however, may still have severe disease, need hospitalization and could die from the infection with this variant. The Omicron variant, like other variants, is comprised of a number of lineages and sublineages. The three most common lineages of Omicron are BA.1, BA.1.1 and BA.2. Document accessibility: For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print, or braille. Contact the Health Information Center at 1-971-673-2411, 711 TTY or COVID19.LanguageAccess@dhsoha.state.or.us.

Additional resources OHA COVID-19 vaccine website: covidvaccine.oregon.gov OHA Facebook  Safe+Strong website Ask a Black Doctor on The Numberz REACH webpage and REACH Facebook Mental Wellness and Behavioral Health Q1: Throughout the pandemic, I have sometimes found it hard to cope. What are some of the ways COVID-19 has affected our mental health? Many people have experienced anxiety, stress or depression during the pandemic. This has come from several factors, such as social isolation, economic stress or the loss of loved ones. Or even contracting COVID-19.  For example, a recent study of 154,000 COVID-19 patients in the Veterans Affairs health care system found that people who had COVID-19 were 39% more likely to be diagnosed with depression and 35% more likely to be diagnosed with anxiety than people who did not have COVID-19.  So, you are not alone. Many of us have experienced the effects of COVID on our mental health. Q2: What can I do to protect or improve my mental health during this pandemic? Great question! The good news is there are several things you can do to stay mentally fit during the pandemic, some of which are fun. For starters, find an exercise you enjoy. Try going for a walk, jogging or doing yoga. You can also prepare and eat healthy and well-balanced meals with lots of fresh fruits and veggies. Try to limit junk foods, caffeine and alcohol. Sleep is also important and staying connected to loved ones is critical. Finally, be sure to monitor how much news and social media you consume. Watching and hearing constant updates can worsen feelings of anxiety. Q3: I hear people talking about “mental health,” but I also hear them say “behavioral health.” What is the difference? Let me explain. Behavioral health is a term used to encompass mental health conditions, substance use disorders, problem gambling and other addictions. Behavioral health is a broader term than mental health. Mental health conditions, substance use disorders and problem gambling are more narrow classifications. The National Alliance on Mental Illness intentionally uses the terms “mental health conditions” and “mental illness/es” interchangeably. A mental illness is a condition that affects a person's thinking, feeling, behavior or mood. These conditions deeply impact day-to-day living and may also affect the ability to relate to others and live the life you want to live. It is not the result of one event. Genetics, environment, relationships during early life, life experiences such as traumatic events, and lifestyle influence whether someone develops a mental health condition. A stressful job or home life may make some people more susceptible. Biochemical processes and basic brain structure may play a role, too. Mental illness is no one's fault. And for many people, recovery is possible, especially when you start treatment early and play a strong role in your own recovery process. Q4: What resources are available in the community to cover mental health issues and what type of services are offered? Your mental health is a priority. To find psychiatrists, counselors, therapists and nurses who specialize in behavioral and mental health services, contact the Mental Health Call Center at 503-988-4888. If you are on the Oregon Health Plan or Medicaid you can visit the Mental Health & Substance Abuse provider directory or call 503-988-5887. If you have no insurance you can contact agencies on the  County Contracted Addiction Services Provider Agency List. You can also call 211 for help. Another option is to visit your primary care provider. Finally, there are community-based organizations like Center for African Immigrants and Refugees Organization (CAIRO), African Family Holistic Health Organization and the Catholic Charities where support is also available.  Q5: How has COVID affected suicide rates in Oregon, especially the Black community?  This is a difficult topic, but I think it is important.  One suicide is too many. When looking at 2020, available data did not show a suicide rate increase in the U.S. In fact, Oregon was one of seven states that showed a decrease in suicide rates between 2019 and 2020. Due to the low number of suicides by individuals identified as Black Non-Hispanic and data system limitations, it is challenging to determine which communities were disproportionally affected by suicide related to the COVID pandemic in Oregon.  However, when looking at suicide rates over the past decade, all races have seen an increase in Oregon. Of specific concern is the increase in the Non-Hispanic Black population with a rate of 3.5 in 2000 to a rate of 10.9 in 2019. Oregon also reports to national suicide data. National data has shown increased rates of suicide among Black adults and children over the past decade.    What are some resources for support for those struggling with thoughts of suicide? Health inequities exist due to historic and systematic policies, rooted in white supremacy, that continue to have harmful effects today. In communities of color, addressing racism and its effects is a form of suicide prevention. The Racial Equity Support Line, 503-575-3764 (available weekdays from 10 a.m. – 7 p.m. PST), is a service led and staffed by people with lived experience of racism. It offers support to those who are feeling the emotional impacts of racist violence and microaggressions, as well as the emotional impacts of immigration struggles and other cross-cultural issues. Also, Oregon launched the Safe + Strong Helpline and website, recognizing that COVID-19 has changed our lives in many ways. Call the Safe + Strong Helpline at 1-800-923- HELP (4357) and visit the Safe + Strong website to help make sense of what you're going through and to learn more about what resources and support can help you, your loved ones and the communities you live and work in. Additional Resources • 24/7 Suicide Prevention National Lifeline number: 1-800-273-8255 • 24/7 Crisis Text Line: Text “OREGON” to 741741 • Senior Loneliness Line: 503-200-1633  What should we do if someone tells us they are having thoughts of suicide? If you think someone is thinking about suicide, take the following steps: • Talk to them in private: Listen to their story, and let them know you care. • Ask directly about suicide, calmy and without judgment: “Are you thinking about killing yourself?” • Take the person seriously. • Encourage them to reach out to the National Suicide Prevention Lifeline, 1-800-273-8255 or the Crisis Text Line, text OREGON to 741741.  • Stay with them while they contact one of these services. . Q6: Ever since the pandemic started, I have noticed that my son is struggling to stay happy. How can I help him? Being a young person during this time can be especially difficult. Kids and teens have had to cope with isolation, missing school and milestones, and uncertainty about the future. Unlike adults, they are still developing skills to navigate these challenges.  Our young people also face issues like racial injustice and bullying. This can lead to low self-esteem and several kinds of behavioral problems, like substance abuse.  It is important for family and friends to reach out to youth and let them know they are not alone, and let them know you are there to help. When young people have caring family members or friends who support them, they can better manage times like these. There are lots of places you can go for help. YouthLine for teen-to-teen crisis help is a phone line and a texting support line are offered through Lines for Life. Trained teens respond from 4 p.m. to 10 p.m. Monday through Friday, PDT. Adults are also available 24/7. Call 1-877-968-8491; text teen2teen to 839863. You can also Google:  Therapy for Black Girls or email info@therapyforblackgirls.com National Alliance on Mental Illness or call 703-524-7600 Q7: Sometimes I feel like I can't deal with one more thing. First we shut down due to this pandemic, then George Floyd, then there's confusion about when to wear masks, or don't wear masks. Now, there's inflation and a war in Ukraine. How can I cope with all of these changes? It is exhausting isn't it? We are ALL tired. It has been a long and difficult two years. What you are feeling is called change fatigue. As people, we like routine, and we get fatigued when our routines are disrupted. One thing that helps is to find a new rhythm. If keeping a mask on is helpful for you, then keep it on. If you want to continue to follow physical distance guidelines, do that. You can also try things like eating at the same time every day, or going to bed and getting out of bed at the same time every day. These are little things that can provide predictability and routine in our unpredictable world.  Q8: April is National Minority Health Month. How does this support the Black, African American and African Immigrant community? National Minority Health Month highlights the ways in which the FDA's Office of Minority Health and Health Equity is working to improve minority health and health equity. This year's theme is “Give Your Community a Boost” and focuses on the fight against COVID-19. One goal is to address misinformation. So there are videos that show people from diverse backgrounds working on the COVID-19 vaccines, and the importance of diverse communities getting vaccinated and boosted. Getting vaccinated and boosted is the best thing we can do to protect ourselves and protect our community, so I hope you'll check out the videos on the FDA's Minority Health and Health Equity website.  Document accessibility: For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print, or braille. Contact the Health Information Center at 1-971-673-2411, 711 TTY or COVID19.LanguageAccess@dhsoha.state.or.us.

Additional resources OHA COVID-19 vaccine website: covidvaccine.oregon.gov OHA Facebook  Safe+Strong website Ask a Black Doctor on The Numberz REACH webpage and REACH Facebook Treatments for COVID-19 Q1: I have heard that some people can get treated for COVID-19. What treatments are available and how are they different from vaccines? Yes – treatments for COVID-19 are available for some people. Some treatments are given in the hospital, some are infusions and some are pills you can take at home. They are all in short supply and currently available to people who are high risk of severe disease.  Vaccines introduce your immune system to a protein from the virus, allowing you to build up antibodies without being infected. Vaccination can also boost any natural immunity a person may have from being previously infected.  When somebody with sufficient antibodies is exposed to COVID-19, they immediately fend off the virus, which prevents infection. As antibody levels drop, the virus may be able to infect the person but the immune system still has a decent chance to fight COVID-19 and prevent severe infection.  Booster shots rebuild antibodies quickly, within a few days, even quicker than the original vaccination. This rapid rebuild also happens when an unvaccinated person previously infected with the COVID-19 virus gets their first vaccination. So be sure to get vaccinated and boosted, even if you have previously been infected with COVID-19. Treatments do not replace vaccination, which remains the most important step we can take to protect ourselves and our loved ones.  If someone can't get vaccinated, there is a treatment available that helps the body fight the virus that causes COVID-19.  Treatment for COVID-19 must take place shortly after someone has tested positive. If you've tested positive for COVID or have symptoms, contact your doctor right away. Q2: Someone was telling me about the federal Test to Treat program. Is this a program for everyone? The Test to Treat program connects people that are at high risk of severe illness from COVID-19 with the right treatment. It provides people a place to go to get tested, receive a prescription for a treatment, and fill that prescription all at one location. The program is intended for people that do not have a doctor or who cannot easily get in to see their doctor. However, anyone can receive treatment at a Test to Treat site. To participate, a person can use the Test to Treat Locator to find a site, or call 1-800-232-0233. These sites receive their therapeutics from the federal government. OHA is working on adding additional sites that fit federal criteria to be a Test to Treat site.   Q3: If treatments support defense against COVID-19, why aren't they available to everyone? There a few reasons why treatments are not available to everyone. First, vaccines have proven to be the best defense against COVID-19. Get vaccinated and then boosted. Also, don't forget your flu shot. Secondly, because of nationwide shortages, treatments are not widely available. Finally, it is all based on eligibility. A healthcare provider determines eligibility based on your medical profile. They will consider things like if you cannot get vaccinated due to health conditions or if you had a bad reaction to the vaccine or if you need additional treatment due to a weakened immune system. Only a healthcare provider can assess if you are eligible. Q3: Are treatments safe?  Depending on your medical history, certain treatments are not recommended. To determine which treatment is right for you, consult your doctor. You should also always check that your information is from a trusted source. If you have questions about any medication, contact the FDA's Division of Drug Information at 301-796-3400 or druginfo@fda.hhs.gov. Q5: What are the names of the FDA approved or authorized treatments and once I take them, how do they work in my body to fight COVID-19? The FDA has authorized two oral antiviral medications, one from Pfizer named Paxlovid. The other from Merck named Molnupiravir. With either one, they must be taken as soon as possible after a positive COVID-19 test and within the first five days of symptoms to be effective.  Paxlovid works by stoping the replication of the COVID-19 virus in the body by binding to an enzyme that disrupts the virus' ability to mutate and keeps certain viral proteins from forming correctly.   Molnupiravir interrupts replication of the virus' genetic material by introducing mutations. As the virus copies itself, it gets so mutated that it can no longer function.   The same thing happens with the FDA approved antiviral drug Remdesivir, known as Veklury, it also acts on the virus' genetic material, blocking its ability to mutate. It is administered by injection into the vein through an IV. Monoclonal antibodies (mAbs) are authorized for use to treat COVID-19. They work by mimicking the antibodies your body produces in response to a virus. These molecules are produced in a laboratory and they work to block the COVID-19 virus from entering your cells. Monoclonal antibody treatment is a fluid given using a needle either into a vein (infusion) or under the skin (subcutaneously). Your healthcare provider or the site where you will be getting treatment will explain which treatment you will get. For both procedures, needles are used by a trained medical professional. If you are unvaccinated, you should wait 90 days after your treatment to get the vaccine. Regen-Cov, Sotrovimab, Bebtelovimab and Evusheld are all monoclonal antibodies. Sotrovimab is effective against infection by the  Omicron variant.  Q6: Finally, April is National Minority Health Month how can I get involved? This year the U.S. Department of Health and Human Services (HHS) Office of Minority Health (OMH) and its partners are highlighting the important role community plays in helping to reduce health disparities in racial and ethnic minority and American Indian/Alaska Native groups. The theme for this year is Give Your Community a Boost!  To support COVID-19 vaccination and boosting, OMH invites you to #BoostYourCommunity by using, sharing, and attending National Minority Health Month (NMHM) resources and events with your organization, communities, and network!  If you are not insured, you might qualify for the Oregon Health Plan, which covers COVID-19 vaccines, boosters, treatment and home tests. It also covers regular check-ups, prescriptions, mental health care, addiction treatment, dental care and more. To see if you qualify and to learn more go to OHP.Oregon.gov and click Apply for OHP. You can also call 800-699-9075 or find a local community partner at bit.ly/ohplocalhelp for help.Document accessibility: For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print, or braille. Contact the Health Information Center at 1-971-673-2411, 711 TTY or COVID19.LanguageAccess@dhsoha.state.or.us.

Additional resources OHA COVID-19 vaccine website: covidvaccine.oregon.gov OHA Facebook  Safe+Strong website Ask a Black Doctor on The Numberz REACH webpage and REACH Facebook COVID-19 and other Chronic Disease+ Emerging Variants & New Booster Q1: The first week of April is Public Health Week and April is also National Minority Health Month. What's that mean to us? These types of observances help us focus on important issues – in these cases public health in general and the health of communities of color, specifically. The theme of National Minority Health Month is “Give your community a boost!” which is a great reminder for people to protect themselves against COVID-19 by getting vaccinated and boosted. And also don't forget to get your flu shot. Q2: I've heard that a second COVID-19 booster is approved. How is this different from the first booster? Yes. On March 29th, the Centers for Disease Control and Prevention updated its COVID-19 vaccination guidelines to include a second booster dose for some adults, and for immunocompromised people age 12 and older. Eligible people can get a Second booster dose four months or more after getting their first booster dose. Q3: I've also heard federal funding for COVID-19 treatment, testing and vaccination for uninsured people is going away? What's happening? Congress did not pass the funding needed to continue to pay for COVID-19 testing, treatment or vaccinations for uninsured people. They are still discussing the funding package and we hope they will pass one soon.  If you are not insured, you might qualify for the Oregon Health Plan, which covers COVID-19 vaccines, boosters and additional doses. It also covers treatment and home tests. You can apply any time of the year. The best way to find out if you qualify is to apply. You can apply online, in person or through the mail. You can also get help applying for free. To learn more go to OHP.Oregon.gov and click Apply for OHP. You can also call 800-699-9075 or find a local community partner at bit.ly/ohplocalhelp for help. Q4: How would you define health equity? How does this affect the Black community? I would say health equity is when all members of society enjoy a fair and just opportunity to be as healthy as possible. The pandemic has highlighted that health equity is still not a reality. COVID-19 has disproportionately affected Black people, putting us more at risk of getting sick and dying from COVID-19. While the mask mandate has been lifted and hospitalizations have dropped in the state of Oregon, the Black community is still very much struggling with the effects of COVID-19. Overall, Blacks and other ethnic minorities do not have equal access to health care. Issues such as lack of insurance, transportation, child care, or ability to take time off of work can make it hard to go to the doctor. It makes it hard to prevent and manage issues like chronic illness.  As I mentioned before, Oregon Health Plan can help bridge the gap for health care coverage. Besides COVID-19 related care, it covers regular check-ups, prescriptions, mental health care, addiction treatment, dental care and more. Q5: Speaking of chronic illness, my mother has high blood pressure and diabetes.  What are her risks if she catches COVID-19? People who are over 65 or who have chronic diseases like diabetes, cancer, or heart disease are more likely to get very sick with COVID-19. If you or a loved one have one of these conditions, talk with your doctor about how to protect against severe disease from COVID-19. Again, if you are able to get vaccinated then do so. Also, get all available boosters that you qualify for. You can visit multco.us/reach for information on upcoming vaccination sites.   I don't have a chronic disease, but I am overweight.  Will this make me more sick if I get COVID-19? Obesity, smoking and even pregnancy are all conditions that increase the risk for severe illness from COVID-19. Vaccination and boosting is safe and effective for protection against COVID-19. Q6: Besides my fears about COVID-19, I am worried about how chronic disease affects my health overall. Are there any other tips for managing chronic disease better? Creating an action plan for proactively managing your chronic illness is the first step in practicing good self care as it relates to your personal health. Talk to your doctor or a community health worker to learn tips on how to manage your medicaton, become more active, manage stress and eat healthy foods. Q7: I keep hearing that there is another new variant out, can you please explain what it is?  Should I be worried? Sure, glad you asked! BA.2 is a subvariant of Omicron.  It spreads 80% faster than the earlier Omicron and was first identified in the United States in December. It accounted for about 55 percent of new U.S. cases in the week ending March 26, according to C.D.C. estimates on Tuesday, March 29. To be safe from BA.2 and all variants, get vaccinated and boosted. And if you had a booster more than 4 months ago, you may qualify for another if you're over 50 or are over 12 and have a compromised immune system. Document accessibility: For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print, or braille. Contact the Health Information Center at 1-971-673-2411, 711 TTY or COVID19.LanguageAccess@dhsoha.state.or.us.

Additional resources OHA COVID-19 vaccine website: covidvaccine.oregon.gov OHA Facebook  Safe+Strong website Ask a Black Doctor on The Numberz REACH webpage and REACH Facebook Spring Gatherings and Holiday Safety Q1: After two long years of being in the pandemic, I want to gather with family and friends, is it safe now? Nowadays many people are vaccinated or have recently recovered from COVID-19, so have a degree of immunity. COVID-19 cases are also fairly low, so we can get together. But we should still do so in ways that reduce our risk. If you are getting together indoors with a lot of people – and especially if you are doing so without a mask, you must accept that there's a good likelihood of being exposed to COVID-19. If you're in a room with 100 people, we assume that 2 will have COVID-19, but cases are creeping up a bit. So, keep that in mind. COVID-19 spreads through airborne particles. So if you are gathering indoors, good ventilation can help create a safer environment. Maybe consider keeping gatherings a little smaller so that people can spread out if they need to. As always, the best protection for everyone ages 5 and up is to get vaccinated and boosted and to also get your flu shot. Make an appointment or walk in to get that first shot, that second shot, and that booster shot. Vaccines still offer us our best protection and having all your recommended vaccine doses is the best way to protect yourself and the loved ones that you want to gather with this spring. Something else you can do to stay safe is move your gathering outdoors to celebrate those good times. If everyone is vaccinated and boosted, you can enjoy looking at people's smiles in the sunlight. You can also use CDC's COVID Data Tracker to learn if your community or the community where you are gathering has a high number of COVID-19 cases. That should help you decide what kind of safety measures to take. Q2: During some religious practices we eat and drink from the same utensils, should I be worried about getting COVID-19? Getting COVID from the surface of a glass or a fork isn't the easiest way of transmission. It's more being near someone who has COVID and breathing the same air. Using individual utensils could provide more safety. Wiping utensils in between use can also offer a layer protection.  Q3: You say to assess my own risk when gathering. How do I do that? To assess your risk, ask yourself if you are 65 or older, do you have other medical conditions or chronic disease like diabetes, lung disease or heart disease. Are you taking medications that reduce your immune system like high doses of steroids or chemotherapy to treat cancer? Do you have HIV that is not well controlled or an autoimmune disease?  If the answer is yes for you, someone in your household, or someone that you are visiting with then consider wearing a mask. If your health condition allows you to be vaccinated, make sure you are vaccinated and boosted and that you have your flu shot.   Q4: I really like to hug people when I have not seen them in a long time. Are we safe to hug again now? Many of us have missed hugging our loved ones. I think it is really important. So again, think about your own risks and the risks of the person you're hugging. Are you both vaccinated? Are you at risk for severe disease? Are they? We know COVID spreads through the air, so if you are going to hug you might think about turning your head or wearing a mask. Q5: During the holidays, I like to travel to gather with family and friends. How can I stay safe? Getting vaccinated and boosted and your flu shot before you travel is a great start.  After that, I'd recommend you bring a high-quality, well-fitting mask, like an N95 or KN95, and plan on wearing that mask. The federal government still requires masks on public transportation, and in airports and on airplanes, through April 18. So, you should expect to wear your mask. I would also encourage using the community-level map again for travel. That way you can check the COVID-19 spread in the area you are going to. If you are traveling by car and you do not know the status of those you are traveling with, you can wear a mask and keep the windows open. Another option is to fly direct and limit the number of layovers you have in different places. Q6: I heard about the second booster, but if hospitalizations are down and masks are coming off, why not wait to get it later, like in the fall when things might get bad again? If I get my second booster now, won't it be worn off by the fall? I understand the reasoning, but if you only had two doses you probably have very little protection left from Omicron right now. COVID is still circulating in our communities. Boosters will bring your protection level up. We don't know what will happen in the fall. We're making our recommendations based on what we know today. Q7: Finally, I heard that April is National Minority Health Month, tell me more about it. How can I participate? I would love to. National Minority Health Month is celebrated every year in April. Its origin is in the 1915 establishment of National Negro Health Week by Booker T. Washington. The focus is to establish “appropriate programs and activities to promote healthfulness in minority and other health disparity communities” (H. Con. Res. 388). This year's theme is “Give Your Community a Boost.” If you want to get involved, on April 20, 2022 from 11 a.m.-12 p.m., you can join the Twitter chat “COVID-19 Gamechangers: Trusted Messengers Giving Communities A Boost!” held by the National Institute on Minority Health and Health Disparities @NIMHD and the Office of Minority Health @minorityhealth. It will be hosted in English and Spanish @OMH_Espanol.  Document accessibility: For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print, or braille. Contact the Health Information Center at 1-971-673-2411, 711 TTY or COVID19.LanguageAccess@dhsoha.state.or.us.

Additional resources OHA COVID-19 vaccine website: covidvaccine.oregon.gov OHA Facebook  Safe+Strong website Ask a Black Doctor on The Numberz REACH webpage and REACH Facebook Living with COVID-19 Q1: I have heard people talk about COVID-19 being “endemic.” Does that mean COVID is over?  No, COVID is definitely not over. The term “endemic” means the disease is still with us, but it doesn't cause widespread death and disruption. The seasonal flu is an example of an endemic disease. Public health officials can predict the flu's behavior; this is why we can say we have a “flu season”. And  with an endemic, the disease doesn't overwhelm our healthcare system or interrupt the way society functions much.   With COVID-19, we have not yet reached the point of being endemic like the flu. The virus is still circulating, and public health officials can't predict its patterns. We have had seen surges (like Delta) during warm weather months when people spend more time outdoors, and we've seen surges (like Omicron) during cold weather months when people spend more time indoors.  We are hopeful that enough people will gain immune protection from vaccination and from natural infection that there will be less transmission and much less COVID-19-related hospitalization and death, even as the virus continues to circulate. Q2: How long will it take for COVID-19 to become endemic? Unfortunately, we don't know the answer to that question yet. It depends on several factors, like how long people are able to maintain immune protection from vaccination and natural infection. The answer is also effected by the lack of COVID-19 mitigation policies in some countries and the lack of vaccines. These factors affect how well we are able to control the spread of COVID-19.   In Oregon, we monitor positive COVID-19 test samples, as well as wastewater samples from around the state. If a new variant emerges or a new surge is coming, this monitoring system will help us know and help us respond quickly. Q3: Will we continue to see some folks wearing masks?  Yes, I think so, for the time being. Even though most indoor masks requirements were lifted March 11, OHA continues to recommend that folks who are at high risk of getting COVID-19, or work or live with someone at high risk, continue to wear masks. You'll also continue to see requirements to wear masks in health care settings, such as hospitals, doctor offices, dentist offices and places like that. And the federal government still requires people to wear masks on public transit and in airports and on airplanes through April 18. Q4: How can we help protect people who are immunocompromised now that the mask requirement has been lifted? The best thing we can all do to protect ourselves and our communinties is to get vaccinated and boosted. You can also help slow the spread of COVID-19 by wearing a mask in crowded indoor settings where you don't know everyone's vaccination status, and wearing a mask around people who are at high risk, and washing your hands frequently.  Q5: When will kids under 5 be eligible for the vaccine? As you may have seen in the news, vaccination makers have indicated they will seek emergency authorization to use their vaccines for children under six. That request is undergoing scientific review and will have to go through the Centers of Disease Control and Prevention, or CDC, for approval, and then through the Western States Workgroup here in Oregon, before approved. So far, what we've seen is that kids infected with COVID-19 have had very mild symptoms compared to adults. However with Omicron, we saw a lot more children ending up in the hospital and unfortunately, more kids dying. What the vaccines have shown repeatedly is that they are very, very safe and they're very effective. Especially at preventing severe illness and hospitalization. This is why it's highly recommended for children to get vaccinated. Hopefully vaccines will be rolled out for the five and under in the next few months. And hopefully, the parents will line up to get their kids vaccinated. So what would the dosing be? Is it the same for a 1-year-old versus a 3-year-old to a 5-year-old?  That is what they're working on right now. They are trying to figure out what dosage to give those age groups. What early reports are showing is that the 6-month-old and 4-year-old require the same dose, which is three doses of these vaccines. As of right now, the best thing you can do to protect kids under 5 is to get vaccinated and boosted, and that includes everyone in the child's circle-family members, caregivers, parents and grandparents. Q6: We are all experiencing COVID fatigue.  The thought of going back into quarantine is not favorable.  We are ready to move on with our lives.  We hear a lot about booster shots, even a FOURTH booster.  Do they really work? Do we still need them? Yes boosters are very important and effective!   So there's been a lot of talk about whether or not we should get a fourth dose. And part of it is because there are some countries like Israel that rolled out four doses. They've been doing this for about two months now. This is because we know that our immune system begins to wane after a while. The analogy that I like to use is our cell phones. When you get your phone, it has the latest software. After six months or so, you get a notification to update your software operating system so that your phone continues to run smoothly. The same thing is true with vaccines. After a while, your immune system forgets how to mount a response. Boosters upgrade the cellular infrastructure in your body to say, “Hey, this is what this virus looks like and this is how you find it.” And then there are some people who have immune systems that are not as robust. For instance, people who are older than 65 get double the dosage of flu shot every year. So if you're immunocompromised, meaning if you have cancer, if you have to take medications that weaken your immune system, or if you're over 65 then it's a good idea to get an extra shot. The CDC hasn't come out and said this, but that's where we're headed. What we saw with the Omicron surge was that people who got boosted ended up with significantly less hospitalizations and significantly less serious illness. Document accessibility: For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print, or braille. Contact the Health Information Center at 1-971-673-2411, 711 TTY or COVID19.LanguageAccess@dhsoha.state.or.us.

Additional resources OHA COVID-19 vaccine website: covidvaccine.oregon.gov OHA Facebook  Safe+Strong website Ask a Black Doctor on The Numberz REACH webpage and REACH Facebook COVID-19 and Pregnancy Q1: What are the risks for a pregnant person if they get COVID-19? Glad you asked!  If a pregnant person gets COVID-19, they are more likely to get severely ill compared to non-pregnant people. Risks to pregnant people can include hospitalization, intensive care, the use of special equipment for breathing, or in the worst cases, death.  Pregnant people who have COVID-19 also have a higher risk of stillbirth, pre-eclampsia and preterm birth. COVID-19 has also been associated with newborns being admitted into intensive care units. Some reasons for this may be: In unvaccinated people, COVID-19 can invade and destroy the placenta. This can lead to a lack of oxygen to the fetus. COVID-19 has led to increased stress, mental health problems and substance use, which can affect maternal health. Q2: How likely is stillbirth in people with COVID-19? Stillbirths due to COVID-19 are uncommon, but they do happen. Overall, there are about 24,000 stillbirths in the United States each year. But a recent study by the Centers for Disease Control and Prevention (CDC) found that: Pregnant people who had COVID-19 when they delivered their babies were almost twice as likely to have a stillbirth as someone who did not have COVID-19. The severity of COVID-19 symptoms was the key factor in their heightened risk of stillbirth. Unvaccinated pregnant people were the most severely ill.  The Oregon Center for Health Statistics (CHS) does not have stillbirth rates due to COVID-19 because this information is not collected on the stillbirth certificate in any way that could indicate that COVID-19 was the cause of a stillbirth.  Q3: In the United States, the number of people who died during pregnancy or shortly after giving birth increased during the pandemic. Why? At the beginning of the pandemic, the number of people who died with pregnancy related issues increased sharply. This was partly due to pandemic-related disruptions. For example: Hospitals hadn't figured out how to deliver obstetric care safely.  Health systems were not set up yet to manage telehealth, and many doctors stopped seeing patients in person.  Hospitals were crowded and emergency rooms were filled with COVID-19 patients. There were also barriers like having kids home from school that didn't allow for parents to get away for medical appointments. Q4: The CDC recently reported that Black people are dying from childbirth at greater rates than white people. Why is this happening? Vaccination rates among pregnant people are lower in general. Fewer than one-third of pregnant people were vaccinated before or during their pregnancy. But the lowest rates have been among pregnant Black people, at 15 percent.  In Oregon, Black people have suffered disproportionately from the pandemic.  While the percentage of people who tested positive with COVID-19 who died is higher among the White community, the percentage of people with COVID-19 who were hospitalized is higher in the Black community. And the overall case rate per 100,000 among the Black community is nearly double that of the white community. But, Black people experienced higher rates of maternal mortality long before COVID-19. Reasons for this include: Structural health inequities that have complex root causes:   Multiple factors contribute to these disparities, such as variation in quality healthcare, underlying chronic conditions, structural racism, and implicit bias. Social determinants of health have historically prevented many people from racial and ethnic minority groups from having fair opportunities for economic, physical, and emotional health. The leading causes of pregnancy-related deaths are cardiovascular conditions, and infections. Research has found that cardiomyopathy, a disease of the heart muscle; blood clots to the lung; and hypertensive disorders of pregnancy contribute to a higher proportion of pregnancy-related deaths among Black people than among white people. Some experts find that pregnant people's complaints are often dismissed, and that is probably much more significant for Black and brown people. In the United States, one-third of the pregnant people and new mothers who died in 2020 were Black, though Black people only make up 13% of the total population.  In Oregon, Black people make up only 2.2% of the total population of the state.  According to the Oregon Center for Health Statistics (CHS), there were 19 maternal deaths in 2020, two (10.5%)  of those were of Black birthing parents. Q5: Is it true that if you get vaccinated during pregnancy, this can protect your child during pregnancy and after the baby is born? In general, mothers pass antibodies to their babies during pregnancy. This protects them against diseases in the early months of life when they have no antibodies of their own. Recent reports from the CDC have shown that people who received the COVID-19 mRNA vaccines during pregnancy similarly can transmit antibodies to their fetuses, which may help protect them from COVID-19 after they are born. The antibodies have been found in umbilical cord blood. At 6 months old, 57% of infants born to vaccinated people had detectable antibodies against COVID-19. mRNA COVID-19 vaccination during pregnancy can help protect babies younger than 6 months old from hospitalization due to COVID-19. The CDC's report noted 84% of babies hospitalized with COVID-19 were born to people who were not vaccinated during pregnancy.  The CDC also reports that women who breastfeed and have been vaccinated with an mRNA vaccine have antibodies in their breast milk, which can help to protect their babies. The COVID-19 vaccines are not considered a risk for people who are breastfeeding, nor for their nursing babies because the vaccines do not contain a live virus or alter people's DNA. Q6: What are the long-term effects on the baby when a person gets a COVID-19 vaccine during pregnancy? Scientific studies to date have shown no safety concerns for babies born to people who were vaccinated against COVID-19 during pregnancy. Based on how these vaccines work in the body, experts believe they are unlikely to pose a risk for long-term health effects.  Q7: Is there a risk for miscarriage or infertility from the COVID-19 vaccine? NO! The COVID-19 vaccines have undergone rigorous safety testing. Researchers have found both the Pfizer and Moderna vaccines produced robust immune responses in pregnant people and did not damage the placenta.  There is currently no evidence that any vaccines, including COVID-19 vaccines, cause fertility problems in people.  None of the three FDA-approved vaccines change people's DNA or interact with the organs necessary for reproduction.  People who are thinking about having children can get the vaccine as an effective way to prevent infection and complications caused by COVID-19 during pregnancy.  It is not necessary to avoid getting pregnant after getting vaccinated against COVID-19. Q8: How can pregnant people protect themselves and their fetus from COVID-19? While being fully vaccinated and boosted is the safest and best way to protect yourself from COVID-19, we recommend that people who are pregnant or nursing talk with their doctor about any doubts or worries they might have about the vaccines. Every person is different, with different needs to consider about their health care decisions.  Whatever people decide, we recommend that people continue to take precautions to prevent infection during pregnancy, such as wearing a mask in crowded indoor settings and distancing from others, especially when transmission levels are high.  Q9: Which COVID-19 vaccine should pregnant people receive?  In most situations, including for people who are pregnant or breastfeeding, the mRNA (Pfizer and Moderna) vaccines are preferred over the Johnson & Johnson vaccine for primary and booster vaccination.  The J&J COVID-19 vaccine can cause low platelets and blood clots in large blood vessels. The J&J/Janssen COVID-19 vaccine may be considered in some situations, including for persons who Had a severe reaction after an mRNA vaccine dose or who have a severe allergy to an ingredient of mRNA COVID-19 vaccines Would otherwise remain unvaccinated for COVID-19 due to limited access to mRNA COVID-19 vaccines Document accessibility: For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print, or braille. Contact the Health Information Center at 1-971-673-2411, 711 TTY or COVID19.LanguageAccess@dhsoha.state.or.us.

Additional resources OHA COVID-19 vaccine website: covidvaccine.oregon.gov CDC: Travel Updates CDC: Small and Large Gatherings CDC: Know your COVID-19 Community Level Oregon State University: COVID-19 Updates for Spring Break OHA Facebook  Safe+Strong website Ask a Black Doctor on The Numberz REACH webpage and REACH Facebook Spring Break Safety Q1: I am going to a place with large crowds during Spring Break. What are some ways I can protect myself against COVID-19? The No. 1 thing you can do to protect yourself from COVID-19 is to get vaccinated. And after you get vaccinated, get boosted.  If you are gathering with a lot of people and you don't know their vaccination status, you can wear a mask for an extra layer of protection. Even though Oregon has lifted most indoor masking, we still recommend that people who are at high risk, or people who live or work with someone who is at high risk, continue to wear a mask. And try to keep your distance from others, and wash your hands or use hand sanitizer after touching surfaces like doorknobs.  Another layer of protection is to move your gathering outdoors  If you're indoors, good ventilation can also help provide another layer of protection. Q2: If I choose to travel during Spring Break, any travel tips to avoid getting COVID-19?  Getting vaccinated and boosted before you travel is a great start.  After that, I'd recommend you bring a high-quality, well-fitting mask, like an N95 or KN95, and plan on wearing that mask. The federal government still requires masks on public transportation, and in airports and on airplanes, through April 18. So you should expect to wear your mask. Another thing I would suggest is that you check the COVID-19 spread wherever you're going so you can prepare for what you're getting into. The Centers for Disease Control and Prevention, the CDC, has a community-level map on its website, and that's a good place to start your research.  That will also help you understand the rules where you're going, so you can follow all state, tribal, local and territorial travel restrictions, including proper mask wearing, proof of vaccination, testing, or quarantine requirements. Q3: If I am not feeling well, but I have been fully vaccinated, can I still travel for Spring Break? You should NOT travel if you are sick, even if you recovered from COVID-19 within the past 90 days or are up to date with your COVID-19 vaccines. You also shouldn't travel if you tested positive for COVID-19. Don't travel if you are waiting for results of a COVID-19 test, and if you had close contact with a person with COVID-19 and are recommended to quarantine. Finally, don't travel until a full 5 days after your last close contact with the person with COVID-19. It is best to avoid travel for a full 10 days after your last exposure. Q4: Should I get tested for COVID-19 after traveling during Spring Break? Yes, you should get tested for COVID-19 if you are experiencing symptoms like fever or chills, coughing, difficulty breathing, fatigue, and muscle or body aches. But you don't need to get a COVID-19 test just because you traveled. Document accessibility: For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print, or braille. Contact the Health Information Center at 1-971-673-2411, 711 TTY or COVID19.LanguageAccess@dhsoha.state.or.us.

Additional resources OHA COVID-19 vaccine website: covidvaccine.oregon.gov Governor Kate Brown Press Release OHA Mask Recommendations and Requirements OHA Announcements on Mask Requirements FAQ Health Care Settings Mask Requirements FAQ OHA Press Conference: https://www.youtube.com/watch?v=69qoY5AEK1c https://www.youtube.com/watch?v=rx5KNhW6WxA OHA Facebook  Ask a Black Doctor on The Numberz REACH webpage and REACH Facebook Q1: I've heard there are big changes in the COVID-19 pandemic in Oregon happening March 12. What's changing? Two big changes are coming tomorrow, March 12. OHA is pausing quarantining, including in schools and childcare settings. And OHA is lifting most mask requirements in most indoor settings except in healthcare settings. Q2: What is quarantining and why is OHA pausing it? Quarantine means to stay away from other people after you have been exposed to someone who has COVID-19. Starting tomorrow, OHA will no longer require you to quarantine. So if you or your kid is exposed to someone and is asymptomatic, you do not have to stay home or keep your child home from school. So why is OHA pausing quarantining? For a couple of reasons: A significant proportion of our state's population has been vaccinated or has developed immunity following a COVID infection. At the same time, the tools we previously used, such as contact tracing, are no longer as effective because transmission occurs quickly, many infected people have no symptoms, or mild symptoms and many infections are not reported to public health.    But it's important to remember that: Schools will continue to exclude individuals who have symptoms or known COVID-19 infection, and  Isolation will remain at 5 days after a positive test result + additional 5 days of masking. Q3: How is isolation different than quarantine? I know, it's confusing. Isolation means staying away from other people after you have tested positive. So, if you test positive for COVID, you still need to stay away from people for five days and then wear a mask for five days. Q4: You said indoor masks are being lifted. Is that everywhere? No. Masks are still going to be required in health care settings, such as hospitals, doctor and dentist offices, and in places like long-term care facilities, jails and shelters. And you will still need to wear a mask on public transportation, and in airports and on airplanes. And people may continue to wear masks in public settings. We strongly recommend that people who are high risk for severe disease continue to wear masks in public places. Q5: Does OHA's announcement to end some mask requirements mean the pandemic is over? No. While we would all like the pandemic to be over, it is still with us.  Q6: If a new variant comes along that is more transmissible than Omicron, will OHA reinstate the mask requirement? OHA is monitoring the Omicron variant and an Omicron subvariant known as BA.2 We will notify the people of Oregon as we learn more. State officials will continue to review the impact COVID is having on communities and consider options for masking recommendations. Q7: When mask requirements are lifted, what about people in Black communities and others who are disproportionately impacted by COVID – can we still access and wear masks?  Yes. Anyone who wants to continue to wear a mask can do so, and some places may still have their own mask requirements.  OHA is facilitating the distribution of high-quality masks to community-based organizations, such as Tribal Nations, local public health, K-12 schools, hospitals, shelters serving people experiencing houselessness, early learning facilities, hospitals and migrant seasonal farmworkers. Q8: What can I do if someone harasses me for continuing to wear a mask after the requirements are lifted?  People should respect the choices of others to wear masks. There are different reasons why someone may wear a face covering. Some reasons include that a person may have a disability or medical condition that puts them at high risk for severe COVID-19 illness.  People of color may experience harassment, bias, exclusion or other negative reactions when wearing masks or face coverings. This may be because of racial bias, stereotyping or discrimination.  But Oregon law does not allow discrimination or hate or bias crimes. A hate or bias crime is a criminal act, including offensive physical contact, assault, property damage or threats, that may be motivated by another person's perceived:  Race,  Color,  Disability,  Religion,  National origin,  Sexual orientation, or  Gender identity. Bias incidents are any hostile expression toward another person, including hate language, mocking, mimicking, exclusion, or discriminatory refusal of service, relating to the other person's perceived protected class, which I mentioned.  If you believe you have experienced a hate or bias crime or incident because of wearing of a mask, face covering or face shield,  there are resources to help you. To report a bias crime, call law enforcement at 911. To report a bias incident, call the Oregon Department of Justice at 1-844-924-BIAS (2427). Dial 711 for Oregon Relay. For more information, go to StandAgainstHate.Oregon.gov. To file a civil rights complaint, visit Bureau of Labor and Industries (BOLI) website or call 971-673-0764. Q9: After March 12, can businesses or workplaces continue to require masks?  Yes. Organizations may have policies to protect workers, customers, visitors and clients, including requiring masks and proof of vaccination, in compliance with Americans with Disability Act guidelines and Title VII of the Civil Rights Act.  Q10: My community-based organization provides services that some individuals need. Can I still require masks for all individuals when the requirement is lifted?  While you can require your staff to wear a mask and require masks for those coming into your facility for services, if you are going out into the community to provide services, you may not be able to require individuals you serve to wear a mask, unless you have a service agreement with them that states they have to wear a mask when receiving services. You may want to have staff wear highly protective masks such as KN95 or N95, if individuals you serve are not going to be wearing a mask.  Q11: What general resources can I access as a worker to understand my rights?  Workers have rights under a number of different laws enforced by several different state and federal agencies.  The Occupational Safety and Health Administration accepts complaints related to health and safety violations in the workplace.  For questions about civil rights protections based on protected classes like disability, race and religion among others, call the Bureau of Labor and Industries at 971-673-0761 or email help@boli.state.or.us. Q12: Besides washing hands and wearing a mask, what else can immunocompromised people do to stay safe if they are unable to get vaccinated? There are some therapies available to immunocompromised people if they are not able to get vaccinated. They can use the oral medications that Pfizer and Merck have come out with. They can also get monoclonal antibody infusions to prevent progression of disease. Document accessibility: For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print, or braille. Contact the Health Information Center at 1-971-673-2411, 711 TTY or COVID19.LanguageAccess@dhsoha.state.or.us.

OHA: Find a COVID-19 vaccine OHA: COVID-19 vaccine information for parents, guardians and people under 18 OHA: COVID-19 vaccine boosters and third doses OHA: Press release about lifting mask requirements: Statement by Governor Kate Brown  OHA: Mask recommendations and requirements   OHA Facebook  Safe+Strong website Ask a Black Doctor on The Numberz REACH web page and REACH Facebook Current Masking Mandates and What This Means for Us Q1: What is the latest about mask requirements for indoor settings? OHA announced yesterday that it will lift indoor mask requirements in schools and for the general public on March 12, 2022 because hospitalizations and cases are rapidly declining.  Earlier this month, OHA had announced that the indoor mask requirement would be lifted by March 31, with the option of lifting it sooner if conditions improved enough. Conditions have improved. A recent modeling report by Oregon Health & Science University (OHSU) predicted Oregon will have 400 or fewer people in the hospital with COVID-19 by March 20. Daily COVID-19 hospitalizations have declined 48% since peaking in January. Over the past two weeks, hospitalizations have fallen by an average of more than 30 a day. Reported COVID-19 infections also have dropped in recent weeks. Over the past month, new infections have declined by more than 80%. The seven-day moving average for new cases is 84% lower than at the peak of the Omicron surge. We hope the March 12 date gives communities and schools time to prepare for the transition.  Q2: I'm a business owner. Am I allowed to require employees or patrons to wear face masks after the general public indoor mask requirements are lifted? Once requirements are lifted, employers and businesses may establish their own mask requirements to protect employees and customers. Each business owner is allowed to enforce restrictions in their own business.  Q3:  Will masks be required in spectator sports and indoor concerts?  It depends. Practice and play for indoor competitive sports don't require masks or face coverings. However, venues may continue to require masks or face coverings for spectators as part of their business policy. Q4: Since the indoor mask requirements will be lifted on March 12, does that mean face masks no longer help prevent COVID-19 transmission? No. Health experts still strongly recommend high-risk individuals, and the people who live with them continue wearing masks.  People at high risk of COVID-19 infection include people who are: Unvaccinated Immunocompromised At high risk of COVID-19 hospitalizations, including those with underlying health conditions 65 and older Those who live with someone in any of these conditions Q5: Does lifting the mask requirement in public settings also apply to non-public settings, such as businesses?  The answer depends on the business. Masks will still be required in some places, such as health care settings. Health care settings include places like hospitals, doctor offices, dentist offices, urgent care and dialysis centers. You will also still have to wear a mask on public transportation, and in airports and on airplanes.  Q6: Is there anyone who should not wear a mask, face covering or face shield? Yes. The following individuals should not wear a mask, face covering or face shield: Children under the age of two (2). Anyone who cannot safely wear a mask, face covering or face shield because of a disability or medical condition, in which case an accommodation should be requested. Anyone who is having trouble breathing, is unconscious, or unable to put on the face covering, take it off or remove it without help.  Anyone who is sleeping. In addition to wearing a mask, there are other things you can do to protect yourself from COVID. Getting vaccinated and getting a booster can help keep you safe. Source: https://sharedsystems.dhsoha.state.or.us/DHSForms/Served/le3818.pdf Q7:  Is OHA pausing quarantining? Yes. Starting on March 12, OHA will no longer require you to quarantine if you have been exposed to someone who has COVID. This applies to the general public, K-12 schools and childcare settings. Why is OHA pausing quarantining? For a couple of reasons: A significant proportion of our state's population has been vaccinated or has developed immunity following a COVID infection. At the same time, the tools we previously used, such as contact tracing, are no longer as effective because transmission occurs quickly, many infected people have no symptoms, or mild symptoms and many infections are not reported to public health.   It's important to know that: Schools will continue to exclude individuals who have symptoms or a known COVID-19 infection, and  Isolation will remain at 5 days after a positive test result + additional 5 days of masking. Document accessibility: For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print, or braille. Contact the Health Information Center at 1-971-673-2411, 711 TTY or COVID19.LanguageAccess@dhsoha.state.or.us.

Additional resources OHA: Find a COVID-19 vaccine OHA: COVID-19 vaccine information for parents, guardians and people under 18 OHA: COVID-19 vaccine boosters and third doses OHA: COVID-19 case rate and vaccination stories CDC: COVID-19 Timeline OHA Facebook  Safe+Strong website Ask a Black Doctor on The Numberz REACH web page and REACH Facebook What we knew then and what we know now about COVID-19 Q1: When this started in March 2020, we heard a lot about “flattening the curve.” What does that mean? “Flattening the curve” means slowing the spread of a virus so that fewer people need to seek treatment at any given time. We do this by doing things like hand washing, wearing masks and physically distancing, including staying at home. These types of measures are needed when a new virus emerges and we have no immunity from it. The Centers for Disease Control and Prevention (CDC) first recommended these types of measures in 2007 to protect ourselves during future pandemics. In 2017, the CDC updated their recommendations to include other measures like masking and handwashing, and lessons learned from the 2009 H1N1 or “swine flu” pandemic. So this is not a new idea. Q2: But COVID-19 is still here. Does that mean we didn't flatten the curve? No; in fact, these types of measures did flatten the curve and slow the spread of COVID-19.  In Oregon, we started by staying at home. If you look at Oregon's COVID-19 data for the first year of the pandemic, you can see Oregon's curve is pretty flat. It doesn't have the sharp rises that would cause strain on the health care system. You can also look at “zero COVID” countries, like China and New Zealand. They put measures in place very early: In January 2020 for China, and March 2020 for New Zealand. Their measures included staying at home, mass testing and contact tracing. China first declared they were COVID-free in March 2020. New Zealand did the same in June 2020. Studies have shown that what we went through in that first year, across the U.S., helped us avoid millions of COVID-19 cases, the United States and globally.  Q3: So, what happened? In April and May 2020, states began reopening. Oregon didn't reopen as early or as fully as other states. So while there were states seeing big increases in COVID-19 cases as early as July, Oregon wasn't among them. So staying at home, avoiding crowds, and the other precautions were still helping us.  As we got into the fall and winter, we did experience another surge of COVID-19 as more activities had to be indoors, not outdoors, due to the weather. But also, these measures could not protect everyone. Not everyone was able to work from home. Essential workers could not stay at home. If people could not afford the time, money, or other supports that could help them stay at home and avoid infection, they went to work. They were still at risk.  Q4: Then the vaccines became available. How did that change things? Supplies were limited in December. This meant that Oregon had to decide where these limited supplies would have the most benefit. So the vaccines first went to health care workers and patients in residential care. By April 2021, everyone over age 16 could get the vaccine. By May, everyone over age 12 could get the vaccine. That spring, Oregon did have another COVID-19 surge. Most of the United States experienced a spring surge, for many reasons: Reopening, loosened COVID-19 restrictions, and there was more travel. Pandemic fatigue was setting in. The B.1.1.7 (or Alpha) variant also emerged, which was more transmittable than the original virus.  But with the rising vaccination rates, Oregon still saw a decline in COVID-19 cases, hospitalizations and deaths when compared to the previous surge in November. Case rates decreased as vaccination rates increased, until Delta. So we learned two things during this time: that vaccines worked. And how variants could drive up case rates. We were also reminded that the precautions we took at the beginning of the pandemic still work.  Q5: Oregon reopened on June 30, and the Delta surge followed. What can we learn from this? Oregon reopened because almost 70 percent of adults in Oregon had been vaccinated. The effectiveness of the COVID-19 vaccines was evident. Oregon turned to what worked in the past. That's why masks were recommended in public indoor settings in response to the Delta surge and continued to promote vaccines. The Delta variant is more than twice as transmissible than the original COVID-19 strain, and 50% more transmissible than Alpha. It is also associated with more severe cases of COVID-19, including hospitalizations and deaths. This, and low vaccination rates in many areas and groups, caused the surge we had in the summer of 2021. But at the height of the surge, Oregon's rate of COVID-19 cases among the unvaccinated was six times as high as the rate of COVID-19 cases among fully vaccinated people.  It wasn't until after the Delta surge that research suggested that Delta could evade vaccine immunity. COVID-19 is a novel coronavirus. It means it's new, and our understanding changes as we learn more. Our understanding is changing as the virus changes. We need time to see how the virus, and the vaccines, affect the pandemic. We need to make decisions that are based in science and what the data tells us. Since the virus is new, it takes time to collect and understand the data. Q6: Would COVID-19 boosters be an example of how health recommendations change over time, in response to what we learn about the virus and the vaccines? Yes. We couldn't see that we needed a booster dose of COVID-19 vaccine until there was enough data showing us that the vaccines became less effective over time. When that happened, booster doses were recommended. Even so, researchers will continue to study the effectiveness of the vaccines and collect more data that may change those recommendations in the future. We have been using booster doses for a short time. But already Oregon's report on COVID-19 breakthrough cases shows that booster doses do better protect us against COVID-19. The latest report shows that the rate of COVID-19 cases among unvaccinated individuals was almost twice the rate of COVID-19 cases among those who are fully vaccinated and 3.4 times the rate of COVID-19 cases among those who are fully vaccinated and boosted.  Q7: What about Omicron and the plan to lift masking requirements by March 31? Are we still following what the science tells us? Yes. Cases have been declining since Omicron's peak in January. This is because we have continued to take the steps to protect each other such as wearing masks, getting a booster shot or vaccinating our children. This is why Oregon has the third lowest cumulative COVID-19 case rate in the nation and the eighth lowest COVID-19 death rate since the start of the pandemic.  March 31 just means the statewide requirement is lifted. Counties and schools will decide whether to continue masking for their communities. Masking is still recommended for people who are: Unvaccinated, Immunocompromised, At high risk of COVID-19 hospitalizations. This includes people with underlying health conditions and people who are 65 and older. Or Living with people at high risk. Q8: Looking back at the changes we've experienced throughout the past two years, and entering our third year, what does the science tell us now about COVID-19? It tells us that the precautions we have taken throughout the pandemic work. It confirms that getting vaccinated is the best protection against COVID-19. Getting fully vaccinated, and getting a booster dose if you are eligible, provides the best protection. Everyone 5 and older should get vaccinated. No health insurance is required. Free vaccines are available regardless of immigration status. Everyone 12 and older should get a booster dose if it has been more than 5 months since their second Pfizer or Moderna vaccine, or for adults who got the Johnson & Johnson vaccine, if it has been more than two months since getting the vaccine. For people who are immunocompromised, the CDC now recommends a booster (fourth) dose of an mRNA vaccine (Moderna or Pfizer) three months after the third dose. For people who received the Johnson & Johnson vaccine, the CDC recommends an additional dose of an mRNA vaccine at least 28 days after the initial dose, then a booster dose two months later.  If you have concerns about which vaccine you should get, ask your health care provider. 

Additional resources OHA: Find a COVID-19 vaccine OHA: COVID-19 vaccine information for parents, guardians and people under 18 OHA: COVID-19 vaccine boosters and third doses OHA: COVID-19 testing CDC: Protect yourself from COVID-19 ODE: Ready Schools, Safe Learners ODE: How to Talk with Children About the Coronavirus OHA and ODE Guidance for Caregivers, Parents and Families OHA Facebook  Safe+Strong website Ask a Black Doctor on The Numberz REACH web page and REACH Facebook Reminders about keep in-person learning safe during COVID-19 Q1: Is it safe to return to in-person learning during Omicron? In Oregon and elsewhere, we have seen that in group settings we can reduce and nearly eliminate the spread – but only if health and safety recommendations, like using face coverings, are followed. We also have seen high rates of spread in places where face coverings were not required.  Face coverings, keeping physical distance, and regular hand washing are tools we have been using to control the spread of the virus. Each tool on their own can't control the spread of the virus. But when you use all the tools combined, they are highly effective at minimizing the spread of the virus. Q2: How do schools decide whether to close or stay open when there is an outbreak?  School districts and school boards decide when or how schools respond to an outbreak of COVID-19. The Oregon Department of Education (ODE) offers districts and school leaders resources to consider when making those decisions, such as the Oregon Data for Decisions Dashboard. Factors schools must consider include: COVID-19 case rates, vaccination rates, school safety measures Student health and safety Staffing availability In January, case rates were at record levels. Many Portland-area schools closed at the time because of related absences.  Q3: What if I don't feel it's safe for my child to be in school?  If you have concerns, contact your schools and school boards. The ODE website has information about each district's COVID-19 safety plans at Oregon.gov/readyschools. Because schools are managed settings, with layered health and safety measures in place, the risk of COVID-19 transmission can be lower than in general community settings without such protocols in place.   Most student-age COVID-19 transmission happens outside of school. Then students bring the virus into school. So, the more we can keep safety measures in place in school, the more we can reduce the spread of the virus and ensure more kids stay in school.   Q4: How can we keep safe during extracurricular activities, such as youth sports?  ODE has also recommended that schools and other organizations pause extracurricular activities or make sure they follow the same safety protocols practiced during the school day (use of face coverings, screening and diagnostic testing, encourage vaccination, frequent handwashing, etc.).  But if you have students participating in extracurricular activities, open communication is best. If any household member, gets sick from COVID-19, let the coach and team know so that fellow team members can take the necessary precautions.  The coach can then make decisions that can help stop the potential spread of the disease, such as rescheduling practices, or practicing outdoors.  The Omicron variant is highly transmissible and it's important to know where and how it's spreading. Schools, coaches and families all want to know this information to better protect their community. Make sure you know what your school district is doing and let them know if you have concerns with COVID-19 safety at any school events. You can find COVID-19 information for your school district on the Oregon Department of Education website. Q5: What if we have concerns about COVID-19 safety in our schools? All Oregon school districts have posted their current COVID-19 safety protocols, which explain how they are following Oregon's Ready Schools, Safe Learners guidance. You can find links to information for your school district on Oregon's Ready Schools, Safe Learners website at Oregon.gov/readyschools.  If you believe a school is not in compliance with Oregon's Ready Schools, Safe Learners guidance, you can file a complaint with Oregon OSHA. Your complaint can be confidential. You can also email COVID-19 school related questions to the Oregon Department of Education at ODECOVID19@ode.state.or.us. Q6: How can families help everyone stay safe as kids head back to the classroom? OHA and ODE have shared a 5-step checklist for families that includes: Make a plan to vaccinate all eligible household members. Wear face coverings or masks in public and in carpools. Limit gatherings with other households — including big events for kids, like birthday parties. Move social activities outdoors. Make a plan in case your child needs to miss school. Q7: Getting vaccinated is first on this list. Why? Getting vaccinated is one of the best tools we have to protect students during COVID-19. Everyone 5 and older should get vaccinated. No health insurance is required. Free vaccines are available regardless of immigration status. Everyone 12 and older should get a booster dose if it has been more than 5 months since their second Pfizer or Moderna vaccine, or for adults who got the Johnson & Johnson vaccine, if it has been more than two months since getting the vaccine. Getting vaccinated is a way to keep ourselves, our families, and our communities safe from the virus. Over 2 million Oregon adults, teens and kids have been vaccinated against COVID-19.  Clinical studies show that the COVID-19 vaccine is more than 90% effective at preventing serious illness for kids 5 and older. More than 40,000 people participated in the clinical trials for the Pfizer vaccine to measure safety and effectiveness. More than 3,000 children ages 5 through 11 participated in the pediatric trials. Vaccinated students do not quarantine or get excluded from school when they have been exposed to COVID-19 unless they are showing symptoms. Once your students are vaccinated, they can safely return to more of their normal life — school, sports, social time, and other activities that are so important to a child's health and well-being. When enough people get a vaccine, we will all be able to get back to the people and activities we miss the most. It's normal to have questions about COVID-19 vaccines. It's important to get your questions answered. If you have questions about the vaccines and their safety, please consult your doctor or pediatrician. Local vaccine events Date Time Location AddressSaturday, Feb. 12 | 11 a.m. to 4 p.m. | Rosewood Initiative | 16126 SE Stark StPortland, OR Tuesday, Feb. 15 | 2 to 8 p.m. | Lloyd Center | 1260 Lloyd CenterPortland, OR Thursday, Feb. 17 | 8 a.m. to 2 p.m. | Lloyd Center | 1260 Lloyd CenterPortland, OR You can find more vaccine events at multco.us/vaccineclinics. Document accessibility: For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print, or braille. Contact the Health Information Center at 1-971-673-2411, 711 TTY or COVID19.LanguageAccess@dhsoha.state.or.us.

2/11/2022 Additional resources OHA: Find a COVID-19 vaccine OHA: COVID-19 vaccine information for parents, guardians and people under 18 OHA: COVID-19 vaccine boosters and third doses OHA: COVID-19 testing CDC: COVID-19 Testing: What You Need to Know CDC: COVID-19 Self-Testing Medline.gov – What are PCR tests? Federal Trade Commission: Don't assume every COVID-19 testing site is legit Oregon Department of Justice: COVID-19 Sales, Scams and Fraud U.S. Department of Health and Human Services: COVID-19 Scams OHA Facebook  Safe+Strong website Ask a Black Doctor on The Numberz REACH web page and REACH Facebook Reminders about health, safety and cleaning guidance Q1: What kind of COVID-19 tests are out there at the moment? COVID-19 tests can detect either SARS-CoV-2, the virus that causes COVID-19, or antibodies that your body makes after getting COVID-19 or after getting vaccinated. Tests for SARS-CoV-2 tell you if you have an infection at the time of the test. This type of test is called a “viral” test because it looks for viral infection. Antigen or Nucleic Acid Amplification Tests (NAATs) are viral tests.  Tests for antibodies may tell you if you have had a past infection with the virus that causes COVID-19. Your body creates antibodies after getting infected with SARS-CoV-2 or after getting vaccinated against COVID-19. These tests are called “antibody” or “serology” tests.  The CDC does not currently recommend antibody testing to find out if you have COVID-19. Only viral tests are recommended to detect current COVID-19 infection. Q2: Is it possible to get a false positive on a viral test? NAATs, or molecular tests, are considered the most accurate form of COVID-19 testing because they detect genetic material from the virus that causes COVID-19. Polymerase chain reaction (PCR) tests are a type of NAAT. These tests are processed by certified laboratories, with most results available in 2 to 5 business days. Unlike many other tests, PCR tests can detect the virus in the earliest stages of infection. Other tests may miss early signs of disease because there aren't enough viruses in the sample, or your body hasn't had enough time to develop an antibody response. This means the test can detect the virus even before you show symptoms of COVID-19. Antigen testing is faster, but not as accurate. It detects proteins from the virus that causes COVID-19. This means the test is best done when you are showing symptoms of COVID-19 or have a lot of virus in your system. False negatives can happen if your body doesn't have enough of the virus for an antigen test to detect.  This is why the Centers for Disease Control and Prevention (CDC) considers NAATs, such as PCR tests, the gold standard for COVID-19 testing.  The CDC also recommends getting a NAAT if an antigen test provides negative results, but you have symptoms of COVID-19. But overall, positive viral tests are right more than 95% of the time. Q3: What are some of the aspects to consider in self testing for COVID-19? COVID-19 self-tests at home are one of many risk-reduction measures, along with vaccination, masking, and physical distancing, that protect you and others by reducing the chances of spreading SARS-CoV-2, the virus that causes COVID-19.  A positive self-test result means that the test detected the virus, and you must isolate so as to reduce the risk of spreading disease to someone else.  A negative self-test result means that the test did not detect the virus and you may not have an infection, but it does not entirely rule out infection. Repeating the test within a few days, with at least 24 hours between tests, will increase the confidence that you are not infected. The best time to test is 3 to 8 following an exposure and/or when you have symptoms. Q4: What are some things to look out for if I think I may be giving my information to a fake COVID testing site? Some warning signs that you can look out for are things such as: A provider asking about your nationality or immigration status. A site asking for your Social Security number. No notice of privacy practices provided, or no explanation for how your personal data will be used. A provider demanding to see your passport or driver's license when you have other documents that show your insurance status. Employees at the site who are not wearing full protective gear. Misspellings or unusual names in the URL for the website where the testing provider required you to sign up online. An unsolicited call or text from the testing site. If you receive one, do not provide any personal information until you have confirmed that source of the call or text is legitimate. Q5: Where can I go to find legitimate COVID testing sites in my local area? If you are looking for information on where to get tested for COVID-19, you can contact your primary health care provider or visit Oregon Health Authority's COVID testing web page at healthoregon.org/covid19testing. Q6: At what point should I take an at-home COVID test? People with symptoms can take a rapid antigen test immediately, experts said, but those who have had a known exposure to the virus should wait three to five days before doing so. Testing too soon, before the virus has had a chance to replicate, increases the odds of a false negative. Q7: What has happened if self-tested results show “Invalid” or “Error”? This means your specimen may not have been collected correctly, or the test may have malfunctioned. Invalid test results are rare but can occur. If the self-test shows an invalid result or a test error, the test did not work properly. If this happens, refer to the instructions for use in the package insert and contact the manufacturer for assistance. When in doubt about the whole process then seek professional help. Local vaccine events Date Time Location AddressSaturday, Feb. 12 | 11 a.m. to 4 p.m. | Rosewood Initiative | 16126 SE Stark StPortland, OR Tuesday, Feb. 15 | 2 to 8 p.m. | Lloyd Center | 1260 Lloyd CenterPortland, OR Thursday, Feb. 17 | 8 a.m. to 2 p.m. | Lloyd Center | 1260 Lloyd CenterPortland, OR You can find more vaccine events at multco.us/vaccineclinics. Document accessibility: For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print, or braille. Contact the Health Information Center at 1-971-673-2411, 711 TTY or COVID19.LanguageAccess@dhsoha.state.or.us.

Additional resources OHA: Find a COVID-19 vaccine OHA: COVID-19 vaccine information for parents, guardians and people under 18 OHA: COVID-19 vaccine boosters and third doses OHA: COVID-19 testing CDC: Protect yourself from COVID-19 ODE: Ready Schools, Safe Learners Oregon BOLI: COVID-19 Resources Oregon OSHA: COVID-19 General Guidance OHA Facebook  Safe+Strong website Ask a Black Doctor on The Numberz REACH webpage and REACH Facebook Reminders about health, safety and cleaning guidance Q1 COVID-19 cases are at record levels worldwide, and in Oregon. Why is this happening? We're seeing a sharp increase in breakthrough cases among the vaccinated – That's when a person becomes infected despite having been vaccinated. Previously infected unvaccinated people are also being infected for a second time. This is for two reasons: COVID-19 immunity fades over time, whether from a vaccine or from previous infection.  The Omicron variant evades immunity more than previous COVID-19 variants. This is why getting fully vaccinated and boosted is important. But the virus is still spreading widely, so you still might become infected. Q2: For those who are worried that they will get COVID-19 even if they're vaccinated, what are other ways we can protect ourselves? It's still important to do the things we have done throughout the pandemic to help prevent the spread of COVID-19: Wear a mask that covers your nose and mouth to help protect yourself and others. Stay 6 feet apart from others who don't live with you. Avoid crowds and poorly ventilated indoor spaces. Wash your hands often with soap and water. Use hand sanitizer if soap and water aren't available. If you think you were exposed to someone who has COVID-19, or that you may have COVID-19 symptoms, test to prevent spread to others. You can now order four free COVID-19 tests at COVIDtests.gov. To find local testing locations, visit GetVaccinated.Oregon.gov or call 2-1-1. Q3: Is it safe to go out in public and interact socially? If you are taking the precautions we've talked about and aren't feeling sick, it can be safe. If you want to spend time with people who don't live with you, outdoors is the safer choice. You are less likely to be exposed to COVID-19 during outdoor activities, even without the use of masks. In general, you do not need to wear a mask in outdoor settings. But since Omicron is so contagious, consider wearing a mask in crowded outdoor settings and for activities with close contact with others who are not fully vaccinated. it's smart to also mask up whenever you're with people from different households. And, if you participate in carpools with others, it's safest for everyone to wear face coverings and roll the windows down for good air circulation. Q4: What about staying safe at school? The best tools to protect students, families and staff are vaccination for those eligible, face coverings, physical distancing, staying home if ill or exposed to someone with COVID-19, ventilation and airflow, and hand hygiene. This is part of Oregon's Ready Schools, Safe Learners guidance to help continue in-person learning throughout the school year. Because schools are managed settings, with layered health and safety measures in place, the risk of COVID-19 transmission can be lower than in general community settings without such protocols in place.   It's important to know that most student-age COVID-19 transmission happens outside of school – Carpools, sports, community gatherings, parties, sleepovers, etc. Then students bring the virus into school. So, the more we can keep safety measures in place in school, the more we can reduce the spread of the virus and ensure more kids stay in school.   Think of COVID-19 protection measures like layering up with extra coats, gloves and hats for winter weather. The more you layer up, the more protected you are. Q5: At schools, cleaning and disinfecting is part of that layering. Is that something we should also do at home? In most situations, cleaning with soap or detergent removes most virus particles on surfaces. So, you probably wouldn't need to disinfect at home, except when someone in your home is sick or if someone who has COVID-19 has been in your home. Clean high-touch surfaces regularly, such as doorknobs, tables, handles, light switches, and countertops. People with certain medical conditions are more likely to get very sick from COVID-19. To better protect them, you could clean surfaces more frequently, or also disinfect. You can also prevent contaminating high-touch surfaces by: Asking visitors to wear masks. Isolating people who are sick with COVID-19. Have everyone in your household wash hands often, especially when returning from activities outside the home, including work and school. Q6: Another layer is good air circulation. How can we put that in place? If a visitor needs to be in your home, improving ventilation (air flow) can help prevent COVID-19 virus particles from building up in the air in your home. Like we mentioned before, this can be opening the windows of your car when you are driving with people who don't live with you.  It can be opening a window while people visit, using fans, using HEPA filters. The CDC now has an online tool to help people understand what kind of ventilation their home might need during or after such a visit. Q7: The CDC updated their mask guidance. Should we be upping our mask game? The CDC has updated their mask guidance to include respirators such as N95s and KN95s. Respirators fit closely on the face to filter out particles, including the virus that causes COVID-19. They can also contain droplets and particles you breathe, cough, or sneeze out so you do not spread them to others.  The CDC recommends wearing the most protective mask you can that fits well and that you will wear consistently. Some masks and respirators offer higher levels of protection, and some may be harder to tolerate or wear consistently. It is most important to wear a well-fitted mask or respirator correctly that is comfortable for you and that provides good protection. Q8: What if we have concerns about whether our schools or local businesses are doing what they can to keep us safe? All Oregon school districts have posted their current COVID-19 safety protocols, which explain how they are following Oregon's Ready Schools, Safe Learners guidance. You can find links to information for your school district on Oregon's Ready Schools, Safe Learners website at Oregon.gov/readyschools.  If you believe a school is not in compliance with Oregon's Ready Schools, Safe Learners guidance, you can file a complaint with Oregon OSHA. Your complaint can be confidential. You can also email COVID-19 school related questions to the Oregon Department of Education at ODECOVID19@ode.state.or.us.  If you have concerns about safety in your workplace, you can find resources on the Oregon Bureau of Labor and Industries website. Consumers and employees can also report concerns on the Oregon OSHA website.  Another way to alleviate concern about your safety during COVID-19 is to get vaccinated and get a booster dose if you are eligible. Everyone 5 and older should get vaccinated. Everyone 12 and older should get a booster dose if it has been more than 5 months since their second Pfizer or Moderna vaccine, or for adults who got the Johnson & Johnson vaccine, if it has been more than two months since getting the vaccine. Local vaccine events Date Time Location AddressSaturday, Jan. 29 | 11 a.m. to 4 p.m. | Rosewood Initiative | 16126 SE Stark StPortland, OR Tuesday, Feb. 8 | 9 a.m. to 3 p.m. | Highland Haven | 7600 NE Glisan St Portland, OR Tuesday, Feb. 22 | 9 a.m. to 3 p.m. | Highland Haven | 7600 NE Glisan St Portland, OR You can find more vaccine events at multco.us/vaccineclinics. Document accessibility: For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print, or braille. Contact the Health Information Center at 1-971-673-2411, 711 TTY or COVID19.LanguageAccess@dhsoha.state.or.us.

Additional resources OHA: COVID-19 vaccine information for parents, guardians and people under 18 OHA: COVID-19 vaccine boosters and third doses OHA: COVID-19 testing OHA: COVID-19 mask requirements CDC: Quarantine and isolation guidance CDC: What we know about quarantine and isolation OHA Facebook  Safe+Strong website Ask a Black Doctor on The Numberz REACH webpage and REACH Facebook Frequently asked questions about testing, masking and critical care Q1 If I'm feeling unwell, at what point should I go get tested for COVID? If you are experiencing COVID-19 symptoms you should get tested regardless of your vaccination status. To protect the health of others, the best thing to do is stay home and away from others while you wait for the results of your COVID-19 test.  Many COVID-19 symptoms are like the flu and the common cold, so please contact your primary care provider if you aren't sure whether to get tested. If you are fully vaccinated and boosted, you do not need to quarantine, but should wear a well-fitting mask around others for 10 days. Q2: What is the difference between at-home antigen COVID tests versus getting a PCR test at a facility? Is one more accurate than the other? PCR testing is much more accurate at identifying COVID-19 infection because it can amplify traces of the virus. This means even if you have a small amount of virus, it can detect it – This can be as early as a day after you develop COVID-19 symptoms, or a few days after you are exposed to someone with COVID-19.  Antigen tests don't do this. This means you need a high viral load to test positive. Q3: Does a patient develop immunity after having COVID? If you test positive for COVID, you will likely develop some degree of immunity, unless you are immunocompromised. However, we don't know how long that immunity lasts which is why it is still important to get vaccinated and boosted when eligible. At the same time continued masking should be a priority even after being vaccinated. People with COVID-19 who have symptoms should wait to be vaccinated until they have recovered from their illness and have met the criteria for discontinuing isolation; those without symptoms should also wait until they meet the criteria before getting vaccinated. This guidance also applies to people who get COVID-19 before getting their second dose of vaccine.  Q4: How long after exposure should you get tested for COVID?  According to the CDC, the incubation period for COVID is between two and 14 days, though the newest guidance from the agency suggests a quarantine of five days for those who are not boosted, but eligible or unvaccinated. Those looking to get tested after exposure should do so five days after the exposure or if they begin experiencing symptoms, the CDC recommends Q5: I got vaccinated. Should I still get tested? You can still get tested even after getting vaccinated for the sake of protecting those around you. So if you feel any symptoms, you should get tested. By getting tested you stay safe and aware.  Q6: I've tested positive for covid, how soon should I get tested again? Once you've tested positive for the virus, you do not need to be tested again for 90 days from symptom onset, if you became ill, or from the date of your positive test, if you remained asymptomatic. However, if you develop symptoms of COVID-19 during that three-month period, and if clinicians cannot identify another cause for these symptoms, you may need to be re-tested at that time. Q7: Do I still need to wear a mask when I go out? I thought my vaccine would protect me. Regardless of vaccination status, it is a requirement that you wear a face mask, face shield or face covering in all public indoor settings. COVID-19 spreads when an infected person breathes out droplets and tiny particles that contain the virus. Other people can then inhale these droplets and particles.  Given the fact that the Omicron variant spreads more easily than previous COVID variants, wearing a face covering is more important than ever to slow the spread of COVID-19. In certain cases, there are exceptions to this mandate, such as when you're at a restaurant and are actively eating or drinking.  While it is not currently a requirement to wear face coverings in outdoor settings, please still be mindful of maintaining a safe physical distance of at least 6 feet when traveling outdoors and you're around people whom you do not live with. Q8: What are critical care guidelines, and what does that mean during Omicron? The federal COVID-19 treatment guidelines for critical care provide recommendations for how to provide care for patients with severe COVID-19. SARS-CoV-2 infection control for health care workers. Treating COVID-19 patients who are in shock. Respiratory support for adults with severe COVID-19. Options for COVID-19 patients with acute kidney injury. In Oregon, there are concerns about how hospitals will be able to provide critical care if the Omicron surge leads to a workforce shortage.  If a hospital does not have enough staff or equipment to provide treatment, OHA has provided a tool to help hospitals fairly decide who receives care. For example: Decisions cannot withhold care solely based on a patient's race, sexual orientation, national origin, immigration status, faith, ability to pay, insurance coverage, disability, age, or any other non-medical status.  Instead, decisions are based on medical evidence, such as the nature and severity of the patient's condition. Q9: How can we help make sure hospitals don't need to make these types of decisions?  Hospitals will only make these types of decisions after exhausting all other resources, including reaching out to OHA and other partners about their situation. This is why Oregon is working on building up resources in case of a staffing shortage. There will be 500 National Guard members are on call to support frontline medical workers. OHA has created a team of up to 1,000 additional clinicians to support nurse crisis response teams and extended clinical staffing for hospitals, long-term care facilities and other congregate care settings. We can do our part of staying out of hospitals by continuing to protect each other from COVID-19. Get vaccinated and boosted if you're eligible.  Everyone 5 and older should get vaccinated. And everyone 12 and older should get a booster as soon as they are eligible. Studies show that over time, vaccinated people may be only 35% protected against Omicron. But a booster dose of Pfizer or Moderna boosts that protection to 75%. Other ways to stay safe: Stay home if you're sick. Keep your family members at home if they get sick. Keep your distance from others and wear a mask when indoors with others who don't live with you. Wash your hands, especially where you are more likely to touch shared surfaces with people who may be sick or carrying the virus. If you're at home with sick people, clean and disinfect shared surfaces. Another way we can protect our hospitals is by only using them for emergencies.  Do not go to the emergency room for COVID-19 testing.  For testing, call 2-1-1 or visit GetVaccinated.Oregon.gov. You can find both vaccine and testing locations using the Vaccine Locator there. You can also call 2-1-1 or visit 211info.org to get help finding clinics, urgent care, immunizations and other health care resources. Local vaccine events Date Time Location AddressSaturday, Jan. 22 | 11 a.m. to 4 p.m. | Rosewood Initiative | 16126 SE Stark StPortland, OR Tuesday, Jan. 25 | 9 a.m. to 3 p.m. | Highland Haven | 7600 NE Glisan St Portland, OR Tuesday, Jan. 25 | 2 to 8 p.m. | Lloyd Center | 1260 Lloyd CenterPortland, OR Thursday, Jan. 27 | 8 a.m. to 2 p.m. | Lloyd Center | 1260 Lloyd CenterPortland, OR You can find more vaccine events at multco.us/vaccineclinics. Document accessibility: For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print, or braille. Contact the Health Information Center at 1-971-673-2411, 711 TTY or COVID19.LanguageAccess@dhsoha.state.or.us.

Additional resources OHA: COVID-19 vaccine information for parents, guardians and people under 18 OHA: COVID-19 vaccine boosters and third doses OHA: Did you test positive for COVID-19? OHA: Find a COVID-19 test OHA: Isolation and quarantine guidance CDC: Quarantine and isolation guidance CDC: What we know about quarantine and isolation OHA Facebook  Safe+Strong website Ask a Black Doctor on The Numberz REACH webpage and REACH Facebook Updated isolation and quarantine guidance Q1: People now only have to isolate or quarantine for 5 days, not 10 days. What does this mean? People who are exposed to COVID-19, but not up to date on their COVID-19 vaccines, need to: Stay home and at least six feet away from everyone, including household members, for five days from the time they were first exposed to COVID-19; then wear a mask around others for an additional five days. Stay home for 10 days if they are unable to wear a mask. Wear a mask for 10 days around others if they are unable to stay  home. People who are up to date on their vaccines do not need to isolate, but must wear a mask around others for the 10 days following exposure.  Everyone exposed to COVID-19 should get tested five days after their exposure..  People who test positive for COVID-19, but are not fully vaccinated and boosted, need to isolate for 5 days from the time of their positive test.  If you continue to have fever or other symptoms after 5 days, you continue to isolate until you are fever-free for 24 hours without the use of medication and your other symptoms have improved  If you develop symptoms soon after you test positive, the day you started having symptoms becomes your new first day of the 5-day isolation.  In both cases, you would need to wear a well-fitting mask for during isolation or quarantine, and for 5 days after isolation or quarantine ends. This is to limit spread of COVID-19 to others. If you are fully vaccinated and boosted, you do not need to quarantine, but should wear a well-fitting mask around others for 10 days. Q2: So recommendations seem to have changed if you have few or no symptoms of COVID-19. What about if you're sick and showing symptoms? There are groups that should still isolate and quarantine for at least 10 days: People who cannot wear a mask, including children less than 2 years of age. People who have moderate or severe COVID-19 illness. People with severe COVID-19 illness (e.g., requiring hospitalization, intensive care or ventilation support) and people who are immunocompromised might need to isolate longer than 10 days. People in these groups should ask their health care provider how long to isolate. Q3: It seems like early in the pandemic, people were concerned about how the virus spread in people who were infected, but weren't showing symptoms of COVID-19. Has that changed? The Centers for Disease Control and Prevention found that the average period of infectiousness was between 2-3 days before and up to 8 days after symptom onset. So the 5-day isolation and quarantine period focuses on making sure people stay away from others during this period when the risk of transmission is highest. Study of the Omicron variant is ongoing, but some reports suggest that compared with previous variants, symptom onset for Omicron is 2-4 days after infection. So that would make the period of infectiousness even shorter. Q4: How does testing fit in with the new guidance?  Although it's not required, anyone who has been exposed to the virus should get tested five days after exposure. People showing symptoms should limit contact with others until a negative test confirms no infection. Trusting Science During COVID-19 Q5: Do the changes follow the science and what we know about COVID-19? The changes do follow what we know now. But what we know about COVID-19 has been changing throughout the pandemic, and we are still learning about the Omicron variant, so recommendations may also change over time. COVID-19 is also known as “novel coronavirus.” That means it's new. We don't have all the information about how it works, and the information keeps growing. As our understanding grows, recommendations have changed. This is also true for other diseases that aren't so new, such as cancer and heart disease. For example, at one time drinking coffee was thought to cause heart disease, but now studies show it's not as harmful, if at all, as previously suspected. Q6: Is it fair to say that when it looks as if decisions or recommendations are changing, it's because our understanding of the science is changing? Our understanding is changing as the virus changes. We have seen this with the Delta and Omicron variants. But it is also due to society changing. We are feeling pandemic fatigue. We have seen people become less strict about their mask wearing and holding indoor gatherings, even with Omicron. So in a way the guidelines, which are very clear about the importance of strict mask wearing and distancing, might be the reminder we need right now. Schools, businesses, public health departments and hospitals are also strained due to staffing shortages related to COVID-19 illness, isolation and quarantine. The new isolation and quarantine guidance will shorten the period that people are asked to stay home with minimal increased risk in spreading the virus. The CDC has continued to review isolation and quarantine recommendations for various populations throughout the pandemic and will continue to evaluate these recommendations as more data become available. Q7: What are some ways we can address doubts or concerns when changes like this happen? It's still important to encourage prevention – Getting vaccinated against COVID-19. Even with the changes we have seen, the vaccines still protect against illness and hospitalization.  If you aren't vaccinated yet, you are in greater danger of getting the virus and of passing it along to others than ever before. Everyone age 12 and older should get fully vaccinated if they haven't already.  If they are fully vaccinated, they should get a booster dose once they're eligible: five months after the second dose of Pfizer, five months after the second dose of Moderna, or two months after a dose of Johnson & Johnson.  Right now, people 12-17 years of age are only eligible to receive the Pfizer vaccine.  Also share resources: OHA's COVID-19 testing website has information about where to get tested for COVID-19, and what to do after you get tested. OHA is setting up a COVID-19 Case Support Hotline for people who test positive or are exposed to someone with COVID-19. Callers can get information on isolation and quarantine and learn about resources that will help them stay isolated. 2-1-1 remains the best resource for general COVID-19 questions, information about testing and access to vaccination appointments. Local vaccine events Date Time Location AddressSaturday, Jan. 15 | 11 a.m. to 4 p.m. | Rosewood Initiative | 16126 SE Stark StPortland, OR Tuesday, Jan. 18 | 2 to 8 p.m. | Lloyd Center | 1260 Lloyd CenterPortland, OR Thursday, Jan. 20 | 8 a.m. to 2 p.m. | Lloyd Center | 1260 Lloyd CenterPortland, OR You can find more vaccine events at multco.us/vaccineclinics. Document accessibility: For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print, or braille. Contact the Health Information Center at 1-971-673-2411, 711 TTY or COVID19.LanguageAccess@dhsoha.state.or.us.

Additional resources OHA: COVID-19 vaccine information for parents, guardians and people under 18 OHA: COVID-19 vaccine boosters and third doses OHA: FAQ about CDC Johnson & Johnson Recommendations OHA COVID Vaccine News: FDA authorizes new guidance on Pfizer vaccines and boosters for children and adults OHA: Omicron fast facts CDC: Omicron variant – What you need to know CDC Breakthrough Infections page CDC: COVID-19 Booster Dose Recommendations CDC: Johnson & Johnson COVID-19 Vaccine Overview and Safety OHA Facebook  Safe+Strong website Ask a Black Doctor on The Numberz REACH webpage and REACH Facebook COVID-19 Omicron Variant, Booster Doses and Breakthrough Cases Q1: We've been hearing that getting a booster dose of COVID-19 vaccine will help protect against the Omicron variant. Why is that? Omicron has a number of mutations (approximately 50) that raise concern that it will spread more easily, may affect vaccine effectiveness and immunity. Because of these mutations, we think vaccines will be less effective against preventing infection with COVID-19.  Early laboratory data seems to support this. However, we believe that vaccines will remain effective against preventing severe infection (i.e., hospitalization and death). Early information out of South Africa and Europe seem to support this as well. With time, we will learn more. And, laboratory studies indicate that people who get a booster dose of COVID-19 vaccine may be better protected. Q2: When should people get a booster dose? The Centers for Disease Control and Prevention (CDC) recommends that everyone age 16 and older receive a booster dose once they're eligible: six months after the second dose of Pfizer or Moderna, or two months after a dose of Johnson & Johnson. Right now, people 16-17 years of age are only eligible to receive the Pfizer vaccine. This week, the U.S. Food and Drug Administration (FDA) amended the Emergency Use Authorization for the Pfizer vaccine in three ways:  Expand booster doses to children 12-15 years of age.  Shorten the time between completion of the primary vaccine series and a booster dose from six months to five months.   Allow for a third primary series dose for certain immunocompromised children ages 5 through 11.  The CDC now recommends two of these changes: the shortened booster timeline and the third dose for immunocompromised children. However, several steps must be taken over the next few days before any of these changes are implemented in Oregon.   Q3: Are there certain things we need to consider when getting a booster dose?  The CDC supports the recommendation that people 18 and older get an mRNA (Pfizer or Moderna) COVID-19 vaccine over Johnson & Johnson's COVID-19 vaccine. This is because the mRNA vaccines have proven to be more effective and safer. The new guidance also recommends that anyone who had a Johnson & Johnson vaccine as their first dose should get an mRNA vaccine as the booster dose.  But people can still request a Johnson & Johnson vaccine if they want one and have been informed about the vaccine's risks. The benefits of receiving the vaccine still outweigh the risks of not getting a COVID-19 vaccine.  You can learn more about the who should and should not get the Johnson & Johnson vaccine on the CDC website. Q4: What are the risks associated with Johnson & Johnson vaccines? The CDC has found that the Johnson & Johnson COVID-19 vaccine continues to be associated with an elevated risk of two specific conditions: Thrombosis with Thrombocytopenia Syndrome (TTS) and Guillain-Barré syndrome (GBS). Although both conditions are still rare, the occurrence is higher than originally thought. TTS occurs when someone experiences a blood clot and low platelet count at the same time. This condition can be deadly. Blood clots that form in a blood vessel can cause serious effects like a heart attack or stroke. If someone has a low platelet count, they can bleed more easily for longer than normal.  GBS is a rare condition in which a person's own immune system damages their nerves, causing muscle weakness or sometimes paralysis. Symptoms can last for a few weeks or several years. Most people recover fully.  Q5: Can you give an example of when someone might still prefer to get a booster dose of Johnson & Johnson instead of Pfizer or Moderna? Someone might prefer to get Johnson & Johnson instead of Pfizer or Moderna if they: Developed myocarditis or pericarditis from a prior mRNA vaccine. These conditions have been reported in a very small number of cases after receiving a Pfizer or Moderna COVID-19 vaccine, and more often occur in males ages 12-25 than in females or older age groups. Medical researchers at the CDC have studied these cases and determined the risk of severe illness from COVID-19 is much greater and more severe than the risk of developing one of these heart conditions after vaccination. It is important to note the risk of myocarditis or pericarditis is much greater from getting COVID-19 than from getting a COVID-19 mRNA vaccine. Had an allergic reaction to a prior mRNA vaccine. This is a rare side effect that has been reported, and usually occurs within 15 minutes of vaccination. If you have concerns about which vaccine you should get, ask your health care provider.  Q6: With the Omicron variant, are we more likely to see more COVID-19 infections in vaccinated people? If so, what does that look like? Omicron is highly transmissible, which makes it more likely that we will see more infections, even in vaccinated people. The CDC expects that anyone with Omicron infection can spread the virus to others, even if they are vaccinated or don't have symptoms. The symptoms for breakthrough COVID-19 cases are similar to COVID-19 symptoms in unvaccinated people, but typically are milder as far as severity. You may not notice any symptoms at all. If you are fully vaccinated and develop a fever, feel ill, or experience any symptom that is not typical for you, taking a COVID-19 test may be a good idea. If you test positive, please contact your primary care provider. Q7: How can we protect each other from breakthrough infections and help stop the spread of Omicron? The best way to protect yourself against Omicron, or any variant of COVID-19 that is circulating, is to be vaccinated. Vaccination remains the best protection against COVID-19.  Those who are not yet vaccinated should get their first COVID-19 vaccine as soon as possible. Those due for a booster should get it as soon as possible. Other ways to protect yourself and your loved ones are by doing things such as: Getting a COVID-19 vaccine as soon as you are able. Find a vaccine. Wear a mask that covers your nose and mouth to help protect yourself and others from possible infection. Stay six feet apart from others who don't live with you. Avoid crowds and poorly ventilated indoor spaces. Breakthrough cases as of Dec. 30, 2021 During the week of December 19–December 25, there were 6,993 cases of COVID-19. 4,426 (63.3%) were unvaccinated and 2,567 (36.7%) were vaccine breakthrough cases. The median age of breakthrough cases was 36 years. 15 (0.6%) breakthrough cases were residents of care facilities, senior living communities or other congregate living settings. 274 (10.7%) cases were 65 or older. There were 137 (5.3%) cases aged 12-17. To learn more, read OHA's Breakthrough Report. Local vaccine events Date | Time | Location | Address Saturday, Jan. 8 | 9:30 a.m. to 4:30 p.m. | Latino Network  | 312 SE 165th Portland, OR Tuesday, Jan. 25 | 9 a.m. to 3 p.m. | Highland Haven | 7600 NE Glisan StPortland, OR Tuesday, Feb. 8 | 9 a.m. to 3 p.m. | Highland Haven | 7600 NE Glisan StPortland, OR Tuesday, Feb. 22 | 9 a.m. to 3 p.m. | Highland Haven | 7600 NE Glisan StPortland, OR You can find more vaccine events at multco.us/vaccineclinics. Document accessibility: For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print, or braille. Contact the Health Information Center at 1-971-673-2411, 711 TTY or COVID19.LanguageAccess@dhsoha.state.or.us.

Additional resources OHA: COVID-19 vaccine information for parents, guardians and people under 18 OHA: COVID-19 vaccine boosters and third doses OHA: Omicron fast facts CDC: Omicron variant – What you need to know OHA Facebook  Safe+Strong website Ask a Black Doctor on The Numberz REACH webpage and REACH Facebook COVID-19 Pediatrics Vaccines & Holiday Safety Q1: Can you please explain what the Omicron variant is all about? Over time, the SARS-CoV-2 virus that causes COVID-19 mutates to produce new variants. On November 26, 2021, the World Health Organization named the B.1.1.529 variant Omicron and classified it as a variant of concern (VOC) because of suspected increased transmissibility for coronavirus. On December 1, 2021 the first confirmed U.S. case of Omicron was identified. The Omicron variant likely will spread more easily than the original strain of coronavirus that has impacted so many. Current vaccines are expected to protect against severe illness, hospitalizations, and deaths due to infection with the Omicron variant. However with that being said, the recent emergence of Omicron further emphasizes the importance of vaccination and face mask usage. Source: https://www.cdc.gov/coronavirus/2019-ncov/variants/omicron-variant.html Q2: How is it different from the other variants that we have seen before? We know both Omicron and Delta are variants of the original SARS-CoV-2, the virus that causes COVID-19.The Delta variant is more than twice as contagious as previous COVID-19 variants, according to the CDC, and it may cause more severe illness than previous variants in unvaccinated people. Now we have the Omicron variant that the World Health Organization mentions has a “large number of mutations,” and it seems to be more likely to reinfect people who have previously had COVID-19. What's unclear right now, though, is whether Omicron is as contagious as Delta or even more infectious than Delta. Source: https://www.prevention.com/health/a38400888/omicron-vs-delta-covid-19-variant-comparison/ Q3: There are also concerns that Omicron may be able to evade the vaccine on some level. Can you speak to that? We don't know how Omicron affects vaccine effectiveness against severe infection (hospitalization and death). We should have early answers in the coming weeks. New studies indicate that people who get a booster dose of COVID-19 vaccine may be better protected. The best way to protect yourself against Omicron, or any variant of COVID-19 that is circulating, is to be vaccinated. Vaccination remains the best protection against COVID-19. Those who are not yet vaccinated should get their first COVID-19 vaccine as soon as possible. Those due for a booster – all adults either two months after a Johnson & Johnson vaccination or six months after a Moderna or Pfizer vaccination – should get it as soon as possible.  Source: https://directorsblog.nih.gov/2021/12/14/the-latest-on-the-omicron-variant-and-vaccine-protection/  Q4: Does Omicron pose higher risks for infants than other variants? It's not confirmed as yet but the research shows that among those age 4 or younger, 1% of admissions resulted in death, according to the data. However, the total number of admissions in that group was 70, making it unclear what the 1% figure represents. Source: https://www.reuters.com/business/healthcare-pharmaceuticals/does-omicron-pose-higher-risks-infants-than-other-variants-2021-12-01/ Q5: The already vaccinated are being encouraged to get a booster. With the Omicron variant being here, what's the next step? And what should pediatrics do in this case? To keep children safe and calm, make sure that they adhere to the COVID-19 protocols of masking, social distancing, and hand sanitizing. Avoiding crowds and eating healthy would help. Also staying up to date with the children's shots is a plus. There is still more research to be done to define the specific solutions for children in this Omicron challenge.  Source: https://kalingatv.com/nation/how-to-keep-children-safe-from-covid-19-omicron-variant-know-tips/ Q6: We just came out of the Delta variant, what are you hearing about children being hospitalized and the impact of Omicron? The World Health Organization is expected to have data on Omicron's transmissibility within days, but scientists said it could take two to four weeks to learn more about the variant. All they know for now is that it has similar attributes to COVID-19 but the specifics are still to be formally determined. Source: https://www.ctvnews.ca/health/coronavirus/does-omicron-pose-higher-risks-for-infants-than-other-variants-1.5689299 Q7: What's the guidance for the holidays? Holiday traditions are important for families and children. There are several ways that you can enjoy holiday traditions while still protecting your health. Because many generations tend to gather to celebrate holidays, the best way to minimize COVID-19 risk and keep your family and friends safer is to get vaccinated if you're eligible. Ways to protect yourself and your family are by doing things such as: Getting a COVID-19 vaccine as soon as you are able. Find a vaccine. Wear a mask that covers your nose and mouth to help protect yourself and others from possible infection. Stay 6 feet apart from others who don't live with you. Avoid crowds and poorly ventilated indoor spaces. Source: https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/holidays/celebrations.html Q8: Is the Omicron easily contagious? What's the way forward now? How do people stay safe? The new Omicron variant of the coronavirus is substantially more contagious and reduces the effectiveness of COVID-19 vaccines, a study from South Africa released Tuesday found. Even though the variant so far seems to produce mostly mild disease, world health leaders warned it could bring a wave of illness that crushes health systems. But, “people who are fully vaccinated are still largely protected against severe disease, according to early data released.” Source: https://www.usatoday.com/story/news/health/2021/12/14/covid-omicron-south-africa-study/6502201001/ Local vaccine events Date  | Time | Location | Address Tuesday, Dec. 21 | 2 to 8 p.m. | Lloyd Center | 1260 Lloyd CenterPortland, OR 97232 Tuesday, Dec. 28 | 9 a.m. to 3:30 p.m. | Highland Haven | 7600 NE Glisan StPortland, OR Tuesday, Dec. 28 | 2 to 8 p.m. | Lloyd Center | 1260 Lloyd CenterPortland, OR 97232 Thursday, Dec. 30 | 8 a.m. to 2 p.m. | Lloyd Center | 1260 Lloyd CenterPortland, OR 97232 You can find more vaccine events at multco.us/vaccineclinics. Document accessibility: For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print, or braille. Contact the Health Information Center at 1-971-673-2411, 711 TTY or COVID19.LanguageAccess@dhsoha.state.or.us.

Additional resources: OHA: Fast facts about the omicron variant CDC: Omicron variant World Health Organization: Tracking variants Ask a Black Doctor on The Numberz REACH webpage and REACH Facebook OHA Facebook Omicron variant and COVID-19 Q1: We've been hearing about the Omicron variant a lot since Thanksgiving weekend. Why? On Nov. 26, 2021, the World Health Organization identified the Omicron variant as a variant of concern. This variant appears to be more transmissible than the Delta variant and contains many mutations that may affect vaccine effectiveness and immunity.  Q2: Why are they more concerned about this variant than others? The concern about Omicron is due to how quickly it is spreading in South Africa as well as the specific mutations in the variant: Omicron appears to be more transmissible than the Delta variant, which until now has been considered the most transmissible Coronavirus variant. Many of Omicron's mutations occur in the spike protein — a part of the virus that affects infection and immunity and a part of the virus that our current COVID-19 vaccines are based on. So, there is a concern about how effective vaccines will be against infection caused by Omicron. This is actively being investigated by scientists worldwide. Q3: What causes variants? The novel coronavirus mutates over time in order to infect more and more people. Variants emerge in areas with low COVID-19 vaccination rates. Places with low vaccination rates suffer vaccine inequity for various reasons: They do not have access to the COVID-19 vaccines,  They do not have the systems or resources in place to support widespread vaccination (for example, they may not afford to purchase the vaccines or related resources needed to put the vaccines into people's arms), and They may distrust the health care system because of historical injustices. This map shows the association between income and vaccination rates — countries with the lowest incomes have the lowest vaccination rates. This is also true within the United States. Q4: How does vaccine inequity in other countries affect us in the United States? As long as any part of the world remains unvaccinated, variants will continue to emerge. Again, it is still too soon to know whether Omicron poses a serious threat.  But only half the world has been vaccinated against COVID-19.  Until we achieve global vaccination against COVID-19 — where all nations have achieved a significant vaccination rate —new, more serious variants will continue to emerge.  This is why the World Health Organization and other organizations are urging wealthier nations to support vaccine equity by taking actions such as sharing their stockpiled vaccines with lower-income nations. Q5: What can we do to protect ourselves against the Omicron variant? Please do the same things we have been doing to protect ourselves from COVID-19. Get vaccinated if you're not. Vaccination remains the best protection against COVID-19.  Get a booster if you are 18 years or older and it has been more than 6 months since you completed your primary COVID-19 vaccine series. Wear a mask in indoor public settings or outdoor crowded settings. Maintain six feet of physical distance from people outside your home if you don't know their vaccination status. Wash hands frequently. Avoid large crowds. Local vaccine events Date of Event | Time of event | Event Name or Location | Address Saturday, Dec. 11 | 9 a.m. to 4:30 p.m. | Latino Network | 312 SE 165th, Portland Tuesday, Dec. 14 | 9 a.m. to 3:30 p.m. | Highland Haven | 7600 NE Glisan Street, Portland Tuesday, Dec. 14 | 2 to 8 p.m. | Lloyd Center | 1260 Lloyd Center, Portland

Additional resources OHA COVID-19 Vaccine Boosters and Third Dose website CDC: COVID-19 and HIV Basics HIV.gov – Symptoms of HIV, HIV Treatment as Prevention and HIV and COVID-19 National Institutes of Health – HIV Information Page Ask a Black Doctor on The Numberz REACH webpage and REACH Facebook OHA Facebook HIV/AIDS and COVID-19 vaccines Q1: This Wednesday was World AIDS Day. Why do we celebrate World AIDS Day? World AIDS Day takes place on December 1 each year. It's an opportunity for people worldwide to unite in the fight against HIV, to show support for people living with HIV, and to commemorate those who have died from an AIDS-related illness. Founded in 1988, World AIDS Day was the first ever global health day. Q2: How can you tell if you have HIV? The starting point is to get tested. If you test positive, you can take antiretroviral medications to manage HIV. By taking HIV medicine daily as prescribed, you can make the amount of HIV in your blood (your viral load) very low—so low that a test can't detect it (called an undetectable viral load).  Getting and keeping an undetectable viral load is the best thing you can do to stay healthy. If your viral load stays undetectable, you have effectively no risk of transmitting HIV to an HIV-negative partner through sex. Getting tested for HIV is the key for early awareness and treatment. Q3: What are the common symptoms of HIV? A few weeks after getting HIV, many people have flu-like symptoms, which may last days or weeks. These symptoms can include fever, headache, tiredness, and enlarged lymph glands in the neck and groin area. Some people may have no symptoms. Q4: What is AIDS? AIDS is the most advanced stage of HIV, when a person's immune system is severely weakened and has difficulty fighting infections and certain cancers. At this stage, serious symptoms develop, such as: Rapid weight loss Serious infections Pneumonia Recurrent fevers Prolonged swelling of the lymph glands Skin blotches Prolonged diarrhea Sores of the mouth, anus, or genitals Memory loss Depression Other neurologic disorders Q5: Are people who have tested positive for HIV/AIDS at greater risk from the impacts of COVID-19? There is still much we are learning about how COVID-19 affects people with HIV. Based on what we know at this time, people with HIV are at greater risk for becoming severely ill from COVID-19. Various factors can contribute to this as well, such as age and other underlying medical conditions. We recommend folks with HIV take preventive actions (including getting vaccinated, wearing a mask, avoiding large gatherings, good hand hygiene, and practicing physical distancing) to protect themselves from getting COVID-19. Q6: Are COVID-19 vaccines safe for people who are HIV/AIDS positive? YES! These vaccines are safe and effective in people with HIV. The COVID-19 vaccines have gone through testing to meet safety requirements set by the U.S. Food and Drug Administration (FDA) to support Emergency Use Authorization. People with HIV were included in vaccine clinical trials, though safety data for this group are not yet available. According to the CDC, “If you have HIV and are at least 12 years old, you can get vaccinated if you have not had a severe or immediate allergic reaction to any of the vaccine ingredients.” Read CDC's FAQs about the safety of vaccines for people with HIV and when to get vaccinated, and see detailed COVID-19 vaccine information for people with underlying medical conditions. 7. How does COVID-19 affect people with HIV? People who have advanced or untreated HIV may benefit from an additional dose of the COVID-19 vaccine to make sure they have enough protection against COVID-19.  CDC does not recommend an additional dose of the COVID-19 vaccine for people with HIV who are virally suppressed or who do not have advanced HIV.  Talk to your health care provider to determine if getting an additional dose is right for you. You should also talk to your health care provider about the benefits of HIV treatment. People with HIV who take HIV medicine daily as prescribed can live long, healthy lives and protect their partners. In fact, people with HIV who get and keep an undetectable viral load (or stay virally suppressed) have effectively no risk of transmitting HIV to their sexual partners.

Additional resources OHA COVID-19 Vaccine Boosters and Third Dose website OHA Weekly Breakthrough Case Report – Nov. 12, 2021 CDC Breakthrough Infections page Ask a Black Doctor on The Numberz REACH webpage and REACH Facebook OHA Facebook COVID-19 and Breakthrough Cases Q1: We heard from community members who are fully vaccinated, but later needed to be hospitalized due to COVID-19. Why is this? Although COVID-19 vaccines currently appear very effective against severe disease and death, no vaccine is perfect. Because vaccines are not 100% effective, as the number of people who are fully vaccinated goes up, the number of COVID-19 infections among fully vaccinated people will also go up. These infections are called vaccine breakthrough cases. In Oregon, there have been 39,686 breakthrough cases. This is a very small proportion (4%) of the more than 2.6 million people who have been fully vaccinated. Q2: Does a breakthrough case mean the vaccines aren't working? No. In fact, it still means the vaccines are working. We know this because most cases of COVID-19 are in people who are not fully vaccinated.  The risk of infection is still much higher for unvaccinated than vaccinated people. According to the Centers for Disease Control and Prevention (CDC), studies show that vaccinated people are 5 times less likely to be infected and 10 times less likely to experience hospitalization or death. Some evidence shows that vaccination may also make illness less severe for people with breakthrough infections. This includes people aged 65 years and older, who are at higher risk of severe COVID-19 illness. Q3: Are there certain groups or individuals who are more likely to get COVID-19 even after they're vaccinated? In Oregon, more than 80% of vaccine breakthrough deaths have occurred in people 70 years and older. This may be due to increased disease severity caused by the Delta variant and waning vaccine immunity over time in elderly populations, since they were among the first groups to get the vaccine. Living in an area with high COVID-19 transmission may be another reason.  If you live in an area with low vaccination rates, or even live with unvaccinated people, you are going to be exposed to more virus than you would in a fully vaccinated household or area with higher vaccination rates. The CDC recommends wearing a mask and being more cautious if you live in an area with high COVID-19 transmission, even if you are vaccinated; and Oregon requires masks in most public indoor and outdoor settings. You can check transmission levels by state and county on the CDC website.  Vaccine effectiveness also depends on how well our immune systems respond to vaccines. This varies among individuals. The CDC also reviewed recent studies in several countries about vaccine effectiveness and found that: Vaccine effectiveness was lower among immunocompromised adults compared to those without immunocompromising conditions.  In some studies, immunocompromised persons accounted for over 40% of infections among fully vaccinated hospitalized persons. Q4: So, we know that older adults and immunocompromised people are at greater risk of hospitalization, even if they have been fully vaccinated. How can we protect them? For these groups, the best protection is to get an additional COVID-19 dose if you are eligible. Older adults age 65 and older who were fully vaccinated using the Pfizer or Moderna vaccine can get a booster shot. Many other groups can get a booster, such as frontline workers, health care workers, teachers, and more. Immunocompromised people who were fully vaccinated using Pfizer or Moderna can get a third dose 28 days after their second dose of Pfizer or Moderna. You can get these doses in the same places you got your original vaccine doses, such as your doctor, clinic, or pharmacy. You can learn more by visiting OHA's Vaccine Boosters and Third Dose website.  Q5: And if we live in an area with high COVID-19 transmission levels, or spend a lot of time among unvaccinated people, we could also get COVID-19, even if we're fully vaccinated. What else can we do? We can keep taking the other precautions that have protected us during the pandemic. For example: Wear a mask. Use good hand hygiene: Wash your hands regularly, and avoid touching your eyes, nose or mouth if you can't wash your hands or don't have hand sanitizer you can use. Avoid crowds. If you're meeting people from other households, remember outdoor gatherings are safer than indoor gatherings. If you have to be indoors, increase air circulation by opening windows and doors. Use an air purifier. Stay home if you feel sick.  Q6: What will symptoms look like for those who are infected by COVID and have been vaccinated? The symptoms for breakthrough COVID cases are similar to COVID-19 symptoms in unvaccinated people, but typically are milder as far as severity. You may not notice any symptoms at all. If you are fully vaccinated and develop a fever, feel ill, or experience any symptom that is not typical for you, taking a COVID-19 test may be a good idea. If you test positive, please contact your primary care provider.  Local vaccine events for Nov. 19 through Dec. 3, 2021 You can find more vaccine events at multco.us/vaccineclinics. Oregon breakthrough cases as of Nov. 12, 2021 Between Oct. 31 and Nov. 6, there were 6,776 reported cases of COVID-19. 71 percent of those cases occurred in unvaccinated people. 1,962 (29%) were vaccine breakthrough cases. The median age of breakthrough cases was 45 years. Forty breakthrough cases were residents of care facilities, senior living communities or other congregate living settings. There were 76 cases in people ages 12-17. Document accessibility: For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print, or braille. Contact the Health Information Center at 1-971-673-2411, 711 TTY or COVID19.LanguageAccess@dhsoha.state.or.us.

Additional resources OHA COVID-19 vaccine website OHA COVID-19 resources for parents and guardians OHA FAQ: COVID-19 Vaccines for 5 through 11-year-olds CDC: COVID-19 Vaccines for Children and Teens CDC: Multisystem Inflammatory Syndrome in Children (MIS-C) associated with COVID-19 Ask a Black Doctor on The Numberz REACH webpage and REACH Facebook OHA Facebook Pediatric vaccinations and COVID-19 symptoms in children Q1: Children ages 5 through 11 can now get the Pfizer COVID-19 vaccine. Is it the same as the Pfizer vaccine for ages 12 and older? No. The vaccine authorized for children ages 5 through 11 is a new formulation for younger children. It's a smaller dose: The pediatric vaccine is 10 micrograms, while the vaccine for ages 12 and older is 30 micrograms. Q2: Where can we take our children to get this vaccine? Can we get them in same places we get the other vaccines? States are getting shipments of the vaccine in batches. But many, if not most, pediatric clinics will have the vaccine by the end of this week. You can visit GetVaccinated.Oregon.gov to find locations that carry the pediatric Pfizer vaccine. You can also call 211, or ask your child's doctor if they can provide the vaccine. Pharmacies can also provide the vaccine, but it may take time for pharmacies to be ready to vaccinate younger children. If you plan to get the vaccines at a pharmacy, you will need to call ahead and ask if the pharmacy has the pediatric Pfizer vaccine; and if they are ready to vaccinate younger children. Q3: What are the recorded side effects? For the COVID-19 vaccines, side effects do not appear to last longer than 48 hours. They include pain at the injection site; body aches; headaches or fever. These are signs that the vaccine is working to stimulate your immune system.  Allergic reaction (anaphalaxis) is a rare side effect that has also been reported. So if you care for children who have had severe allergic reactions in the past, especially to vaccines, you should consult with their doctor. Q4: Are there long-term impacts of kids getting the vaccine? Will vaccines alter DNA or affect reproductive organs? Data from vaccination of adolescents have not demonstrated a significant risk of long-term side effects. Virtually all side effects from vaccines occur within a few days and at most six weeks following vaccination. The vaccines do not affect DNA. Data on COVID-19 vaccination of many women, including pregnant women, have not shown an effect on fertility or on the likelihood of miscarriage. Q5: What about myocarditis? Rare side effects such as myocarditis were not seen in the trials leading to authorization of the pediatric vaccine. The risk of vaccine associated myocarditis in this age group is thought to be lower than the risk noted in the older age groups.  The group at highest risk of vaccine-associated myocarditis has been from the 2nd dose in males 16-17 years old, where it has been about 1 case out of every 14,500 people. The risk has been lower in males of other ages, and much lower in females. The risk of getting myocarditis from COVID-19 infection has been much higher. Q6: Why is it important to get children vaccinated? Aren't children less affected by COVID-19 than adults? Although children are at a lower risk of becoming severely ill with COVID-19 compared with adults, children can: Be infected with the virus that causes COVID-19, Get very sick from COVID-19, Have both short and long-term health complications from COVID-19, and Spread COVID-19 to others. Children with underlying medical conditions are also more at risk for severe illness from COVID-19 compared with other children. Children who get infected with the virus that causes COVID-19 can also develop serious complications like multisystem inflammatory syndrome (MIS-C). Q7. Can you tell us more about MIS-C? This condition causes different body parts become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs. We know that many children with MIS-C had the virus that causes COVID-19 or had been around someone with COVID-19. This suggests that MIS-C may be a delayed immune response to COVID-19.  MIS-C can be serious, even deadly, but most children who were diagnosed with this condition have gotten better with medical care. Q8. What about “COVID toes”? The American Academy of Dermatology has noted that COVID toes and rashes may also be signs of past or present COVID-19 in children. These types of rashes can also occur with other infections, like the measles. While COVID toes can appear at any age, children, teenagers, and young adults seem most likely to develop this condition. Many never develop other symptoms of COVID-19; and if they do, the symptoms tend to be mild. A recent study suggests that “COVID toes” are caused by having a powerful immune response to the COVID-19 virus. While COVID toes aren't harmful, other rashes may indicate MIS-C, which can be very serious. A skin rash is one of the symptoms the CDC advises parents to look for, in addition to: Stomach pain Bloodshot eyes Diarrhea Dizziness or lightheadedness (signs of low blood pressure) Vomiting Q7: What about children who have already had COVID-19? Should they get vaccinated? Yes. Natural immunity provides some but not complete protection, and there continues to be continued spread of COVID-19 in this age group despite the larger number of children with prior infection; a COVID-19 vaccination provides additional proven protection. Local vaccine events, Nov. 12 through 19, 2021 Date | Time | Location | Address Friday, Nov. 12 | 11 a.m. to 6 p.m. | IRCO-MId County | 10301 NE Glisan St Saturday, Nov. 13 | 11 a.m. to 5 p.m. | Rosewood Initiative  | 16126 SE Stark St Saturday, Nov. 13 | 12:30 to 5 p.m. | Latino Network -Rockwood | 454 SE 165th Ave Saturday, Nov. 13 | 1 to 5 p.m. | Painted Horse/4th Dimension | 10209 SE Division, Bldg D Saturday, Nov. 13 | 12 to 4 p.m. | Compassion SE Portland  | 9715 SE Powell Blvd Saturday, Nov. 13 | 8:30 a.m. to 5:30 p.m. | Fabric Depot | 700 SE 122nd Ave Tuesday, Nov. 16 | 2 to 8 p.m. | Lloyd Center | 1260 Lloyd Center Blvd Thursday, Nov. 18 | 8 a.m. to 2 p.m. | Lloyd Center | 1260 Lloyd Center Blvd Thursday, Nov. 18 | 7:30 a.m. to 2 p.m. | Walt Morey Middle School | 2801 SW Lucas AveTroutdale, OR 97060 Thursday, Nov. 18 | 10:30 a.m. to 2 p.m. | Reynolds High School | 1698 SW Cherry Park RdTroutdale, OR 97060 Find more local vaccine clinics at multco.us/vaccineclinics. Document accessibility: For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print, or braille. Contact the Health Information Center at 1-971-673-2411, 711 TTY or COVID19.LanguageAccess@dhsoha.state.or.us.

Additional resources OHA COVID-19 vaccine website Flu.Oregon.gov CDC: Flu Disparities Among Racial and Ethnic Minority Groups CDC: Similarities and Differences between Flu and COVID-19 CDC: Healthy Habits to Help Protect Against Flu CDC: Frequently Asked Questions – 2021-2022 Flu Season CDC: The Flu and Chronic Health Conditions HHS Office of Minority Health – Black/African-Americans Ask a Black Doctor on The Numberz REACH webpage and REACH Facebook OHA Facebook COVID-19, the flu, and vaccines Q1: Flu season is here. Should we be concerned? Last year's flu season was very unusual. Throughout the United States, there was very low flu transmission. In Oregon, we had a record low for flu cases with only a handful of positive tests for flu out of thousands that were given. This was because we were staying physically distant, wearing masks and staying home when we could. But this year, people are starting to change these habits. Some are wearing masks less often, eating in restaurants, going to movies and concerts, playing sports and gathering at each other's homes. Most kids are back at school in person. All these activities can increase the risk of flu transmission. In fact, the biggest driver of flu transmission is school-age children. Q2: Oregon schools are supposed to still practice many precautions to protect children and staff from COVID-19. If they protect against COVID-19, won't they also protect against the flu? According to the CDC, COVID-19 is still more transmissible than the flu. But as our school-age children interact with people outside our household, the risks increase. We still need to protect each other outside of school.  In October, the CDC published a study that reviewed children's flu hospitalizations in the United States, from 2009 through 2019. It found that: Black people had the highest rates of hospitalization and Intensive Care Unit (ICU) admission. Black children under 5 were also more than twice as likely to be hospitalized than white children.  So, we need to be vigilant about protecting our younger children who are still at home and not in school. We need to protect the adults in the household, too.  Q3: Why are these disparities happening? According to the CDC, part of the reason is the difference in rates of flu vaccination. During the 2018-2019 season, for example, about 75 percent of white children between 6 months and 4 years old received flu vaccines compared to 67 percent of Black children. Black people of most age groups also had lower rates of flu vaccination compared with white people. But most important are the social determinants such as good food, adequate housing, education, safe neighborhoods, freedom from racism and other forms of discrimination, that support health and make it easier to access health care. For example, if you live an area where public transportation is difficult; you don't have a car; you have no health insurance; you don't know where to get a vaccine; or your work doesn't give you time off to get a vaccine; then how can you get a flu vaccine, for yourself or the children you care about? When people don't have the same access to these things, their health suffers. This results in higher rates of chronic disease among people of color. For example, in looking at the federal Office of Minority Health's data for 2018, non-Hispanic African American adults: Were 40 percent more likely to have asthma than non-Hispanic whites. Were 30 percent more likely to die from heart disease than non-Hispanic whites. Are 40 percent more likely to have high blood pressure, but less likely than non-Hispanic whites to have their blood pressure under control. Are 60 percent more likely than non-Hispanic white adults to be diagnosed with diabetes by a physician. And chronic disease can increase the risk of a case of the flu turning severe. During recent flu seasons, the CDC says that 9 out of 10 people hospitalized with flu had at least one underlying health condition. This is why getting an annual flu vaccine is especially important for people with certain chronic health conditions. Q4: What can we do to close the health gaps in our community? Could REACH fill this in? Could speak to local partners/events/strategies, etc. to promote health equity and community health. Q5: Some people think flu and COVID-19 are the same, and that's why there were so few flu cases last year—Because they were reported as COVID cases. Is that possible? No. Both are contagious, and have some symptoms in common, but they are caused by different viruses. If your health care provider diagnosed you with flu, they would report a flu case for you. If they diagnosed you with COVID-19, they would report a COVID-19 case. COVID-19 cases are reported separately from all other disease reports. Q6: What can we do to protect our community against the flu and COVID-19? The good news is that there is a safe, effective vaccine to protect against flu, and it can be given to children as young as six months old.  The Oregon Health Authority recommends everyone six months and older get an annual flu shot to keep you and your loved ones healthy. Getting a flu shot is especially important for health care workers, people with chronic health conditions and those who care for them, older adults, pregnant women and children. While getting a flu shot won't protect you from COVID-19, it's a safe and effective way to prevent the flu. It also helps essential workers stay healthy and it preserves medical resources for patients with COVID-19. You can learn more about getting a flu vaccine at Flu.Oregon.gov. To protect against COVID-19, be sure you are fully vaccinated against COVID-19. If you have gotten a first dose of the Pfizer or Moderna vaccine, but not the second dose, make a plan to get your second dose today. If you are fully vaccinated but immunocompromised, be sure to get your third dose of the Pfizer or Moderna vaccine at least 28 days after your last COVID-19 vaccination. If you are fully vaccinated and it has been more than 6 months since your last COVID-19 vaccination, find out if you need a booster dose of the COVID-19 vaccine. Many different groups can get a booster dose if they are at high risk due to where they live, where they work, their age, or underlying medical conditions.  You can get the flu vaccine at the same time as the COVID vaccine. Talk to your health care provider or pharmacist about scheduling your flu vaccine at the same time as you get the COVID-19 vaccine.  You can learn more about COVID-19 vaccines and where to get the vaccine at GetVaccinated.Oregon.gov. Also, keep practicing these good habits to help prevent the spread of both flu and COVID-19: Wear a mask to prevent spreading germs to others. Stay home when sick. Wash hands often with soap and water or use an alcohol-based hand sanitizer. Cover coughs and sneezes. Avoid touching your eyes, nose and mouth. Clean and disinfect frequently touched surfaces often.  Local vaccine events, DATE through DATE Find more local vaccine clinics at multco.us/vaccineclinics. Source: https://www.cdc.gov/flu/highrisk/disparities-racial-ethnic-minority-groups.html, accessed 10/15/2021 Document accessibility: For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print, or braille. Contact the Health Information Center at 1-971-673-2411, 711 TTY or COVID19.LanguageAccess@dhsoha.state.or.us.

Halloween Safety During COVID-19 10/29/2021 Additional resources OHA COVID-19 vaccine website OHA COVID-19 third dose and booster dose website OHA COVID-19 vaccination rates by race and ethnicity CDC COVID-19 recommendations for older adults CDC COVID-19 recommendations for people with certain medical conditions CDC Halloween checklist for parents Ask a Black Doctor on The Numberz REACH webpage and REACH Facebook OHA Facebook COVID-19 and tips for having a safe Halloween Q1: What is different about this Halloween compared to last year? Now that vaccines are available, more of us are protected against COVID-19. Everyone 12 and older can be vaccinated. Right now, 53 percent of adults age 18 or older in Oregon's Black community are fully vaccinated. That's over 59,000 people vaccinated, which is encouraging. But to really protect our community, we still need to get those numbers higher. So be sure to talk to your family members, friends and coworkers about getting vaccinated if they can. Another difference is the Delta variant. It's highly transmissible and is currently the cause of 99 percent of all COVID-19 cases. Unlike previous variants, the Delta variant has been sending more children and younger adults to the hospital. Most people who are hospitalized for COVID-19 are unvaccinated. We are also almost two years into the pandemic, and people are feeling COVID fatigue—They want to get back to normal. In some ways, we are getting there. This year, we're out of lockdown and can go back to things like the pumpkin patch, corn mazes, harvest festivals, and haunted houses—All the activities that weren't open last Halloween. Q2: How can we keep children safe while they trick or treat? When giving treats, wear a mask and do it outside, if possible. Also reduce contact: For example, you can hand out candy instead of letting kids reach into the bowl to choose themselves. If you choose to do that, be sure to wash your hands or use hand sanitizer before you open the door each time. Also disinfect that doorknob before the trick or treating begins, since you'll be using it often!  Instead of handing out candy, you could do something more contact-free, like individual bags kids can pick up from a table, or the candy chutes some people made last Halloween.  When kids are trick-or-treating: Bring hand sanitizer and use it between house visits. Go out in small groups that allow physical distancing. Even if they are wearing a costume that has a Halloween mask, everyone should wear a COVID-safe mask. This is especially true if there is a chance that they will get close to people from other households, whether it's fellow trick-or-treaters on the sidewalk or people handing out candy at their front door. Make sure children know to avoid large groups—If people are crowding a doorstep or doorway, your trick-or-treaters can stand back and wait for the crowd to leave. This is a good idea no matter where treats are handed out. Also keep six feet of space when you're sharing the sidewalk with people from other households. Have everyone wash hands before handling treats when you get home.  Q3: What about indoor activities like Halloween parties, harvest festivals, haunted houses? It's best to avoid indoor activities with people from other households unless everyone in your family is vaccinated. If you do choose to participate, make sure the activity or event is taking appropriate COVID-19 safety measures: Are masks required? All public indoor and outdoor settings require masks.  Who can attend? For example, do you need to be vaccinated? Do they have a plan for physical distancing? For example, is there enough space to allow physical distancing between different household groups? You should still avoid crowds and close interaction with other households, unless you know they have been vaccinated. If you are hosting a party in your home, it's good to take more precautions, such as wearing masks and distancing, if you have unvaccinated guests or guests who have health conditions that put them at higher risk of developing severe COVID-19. If you have to celebrate indoors, you can open windows to increase air circulation and use an air purifier.  Q4: What about the outdoor activities that are coming back, like the pumpkin patch or corn maze? Take the same precautions that you would with indoor events. Masks, the number of people in attendance, and physical distancing are still all important for reducing the spread of COVID-19, even if you're vaccinated. Q5: What about our multigenerational households? How do we protect our grandparents and older household members while we celebrate? The risk of severe illness from COVID-19 increases with age. The CDC reports that people aged 85 and older face the greatest risk of severe illness from COVID-19 and that 8 in 10 COVID-19-related deaths in the U.S. have been among adults aged 65 and older.  Older household members may be at even higher risk of severe illness due to COVID-19 if they have underlying medical conditions. So, it's important to limit their exposure to COVID-19, even if they are vaccinated. If you are hosting a party at home, the safest choice would be something small and outdoors for better physical distancing and air circulation. Indoor activities are still a risk. But if you are indoors, increase the layers of protection: Make sure that unvaccinated guests and family members physically distance from elders and high-risk household members.  Increase air ventilation by opening windows. Use an air purifier. Have everyone wear masks. Choose one or two household members who are not high-risk to answer the door and directly engage with guests.  Q6: What would you say is the most important thing we can do protect each other, given all the different levels of risk we need to consider? There are two main things we need to do, and they are important throughout the year, not just as we enter the holiday season. First, consider the risks of any activities you plan to attend or host.  Protect against those risks with protections appropriate to the vaccination status, age and health of the people you are celebrating with.  For younger children who can't get vaccinated yet, and for people at higher risk of developing severe COVID-19, take more precautions. We have some links to information about how to protect these groups. Second, if you can, get vaccinated.  If you haven't gotten vaccinated yet, make a plan to get vaccinated today.  If you have loved ones who are age 65 or older or are at higher risk of developing severe COVID-19 who got their second Pfizer vaccine, they can get a booster shot. If it has been at least 6 months since they got their second Pfizer vaccine, encourage them to get their booster shot as soon as they can. Many different groups have been approved to get a booster if they need it. You can learn more by visiting OHA's third dose and booster dose website.  If someone you know is immunocompromised and got their second Pfizer or Moderna vaccine at least 28 days ago, encourage them to get their third dose.  You can learn where to get a vaccine by visiting GetVaccinated.Oregon.gov.  Q7: What are some low risk activities that youth can participate in to celebrate Halloween? Recommendations: There are different ways kids can still celebrate Halloween while protecting themselves from possible COVID exposure. Some low-risk activities that we suggest for youth are things such as holding an online costume contest, watching Halloween themed movies at home, pumpkin carving with people in your household, decorating your house or apartment, or touring the neighborhood to look at decorated houses with members of your household.  Source: https://www.oregon.gov/oha/ERD/Pages/OHA-provides-tips-for-a-safe-(but-still-spooky-and-fun)-Halloween.aspx Q8: Do kids still need to wear a face mask if they have a Halloween costume that will cover their face? Traditional commercial Halloween masks that are part of a costume do not protect you or others against the COVID-19 virus. Parents/guardians should do their best to try and provide a costume that allows a trick-or-treater to wear a COVID-safe face covering. Q9: With so much candy sharing and random home visits, how can the community members ensure youth safety during the celebration? Recommendations: The starting point could be to make sure the parents remind the kids that COVID is still out there. Even with vaccines, there is still some risk in catching the disease. Every step should be taken to ensure that the kids use hand sanitizer, maintain social distancing and they stay masked throughout the event. Per CDC Guidelines as quoted in the USA Today, “while the general tradition is deemed safe, it's important for costume-wearers to travel in small groups to go house to house and to avoid boxed-in candy counting/trading scenarios or trunk-or-treat gatherings in a central location.” Q10: How can we reduce COVID spreading, given the store-purchased costumes, candy containers and the candy itself? Recommendations: If there are some costumes at home, those could help to lower the risk that comes with store purchased items. If the store purchases can be washable, that could possibly help too. Candy containers will need thorough cleaning and the candy should stay wrapped and safe. “Masks are an easy way to protect others this fall, but experts caution not to “double mask” by wearing a costume mask over a cloth or surgical mask because it can make breathing more difficult. A fun substitute can be a Halloween-themed mask made of two or more layers of breathable fabric or making cloth or surgical masks part of Halloween costumes.” Source: https://www.uab.edu/news/youcanuse/item/12376-trick-or-treat-stay-safe-this-halloween-by-following-these-simple-steps  Q11: Is it safe to throw a Halloween party at my house and invite guests? It is best to avoid indoor gatherings with those from other households. If you do throw a party indoors, try to gather with vaccinated people and make sure to wear a face covering, keep your distance and open your windows for ventilation. An alternative option is to also use online platforms such as Zoom to connect with one another and have a virtual party.  Q12: Are there any safety precautions someone should take if they plan on handing out candy? We recommend wearing a facemask to protect yourself and others from possible COVID exposure. You might also consider putting treats in individual baggies and handing them out to trick or treaters individually to help them avoid contact exposure from other youth. Please keep hand sanitizer readily available as well. Q13: So, what's the CDC advice about Halloween safety on COVID? Recommendations: The Centers for Disease Control and Prevention (CDC) has shared tips on how to safely participate in Halloween activities like treat-or-treating. Those tips include: Avoid direct contact with trick-or-treaters. Give out treats outdoors, if possible. Set up a station with individually bagged treats for kids to take. Wash hands before handling treats. Wear a mask

In this episode Dr. Dube and DJ Ambush are joined by Lafonda Grant, Charles Lott and Lionel Coleman as they discuss their pandemic experiences and the steps they've taken to remain safe and healthy. 

Additional resources OHA COVID-19 vaccine website OHA COVID-19 vaccination rates by race and ethnicity OHA and Oregon Department of Education Guidance for Caregivers, Parents and Families CDC Youth Sports Communication Toolkit OSAA communication to superintendents, principals and athletic directors: “OHA Mask, Indoor/Outdoor Space, and Game Officials Clarifications” OSAA communication to superintendents, principals, athletic directors, and fall commissioners: “Officials Communication and the October 18 Vaccination Mandate” AAU Basketball COVID-19 event procedures Ask a Black Doctor on The Numberz REACH webpage and REACH Facebook OHA Facebook COVID-19 and youth sports Q1: Are youth who participate in sports at higher risk than other children? It depends. Where athletes train, practice and compete matters. COVID-19 is more likely to spread in closed indoor spaces with poor ventilation. Since masks aren't required during competition, training or practice, close contact sports are riskier than more distanced sports.  For example, golf is outdoors and easily distanced, so it's lower risk. Wrestling is indoors and very close contact, so it's higher risk. Football is outdoors, but there is frequent close contact. Basketball is both indoors and close contact. Swimming is typically indoors, and while there is no physical contact, swimmers are only a few feet apart during a swimming match. Every activity has some level of risk. . Q2: What about sharing equipment?  If youth are training on shared equipment, such as for weight training, it's best to follow the CDC's recommendations for gyms—Wipe the equipment down after using it. If they don't know if a piece has been cleaned, wipe it down before using it. Schools should be making sure facilities and equipment are cleaned and disinfected regularly. Coaches and staff should also remind players about the importance of cleaning shared equipment. During practice or competition, it's unlikely that there is time to frequently disinfect equipment like a basketball or football. So that's when players need to be reminded to keep their hands away from their mouth, nose and eyes. Use the back of your arm to wipe away sweat, for example. Q3: You mentioned masks aren't required during competition. That just applies while youth are actively playing, right? And it also applies during practice. That's right. According to the Oregon School Athletics Association (OSAA), students are not required to wear a mask when practicing or playing a competitive sport at any level. That's indoors and outdoors. It also includes cheerleading and dance/drill teams.  Students do have to wear a mask when they are on the sidelines. They also have to wear masks when they are in the weight room. At any school sporting event, all spectators have to wear a face covering. So do sports officials, when they aren't actively officiating. Q4: What about officials and referees at youth sporting events? Do they need to be vaccinated? How does their presence impact youth exposure to COVID-19? Sports officials are considered contractors/service providers to OSAA member schools, so they are also required to be fully vaccinated or provide their school documentation of a medical or religious exception. If they don't this by October 18, 2021, they cannot officiate school events, regardless of where the event is held.  Q5: What will youth participation look like for Athletic Amateur Union (AAU) activities, specifically for basketball?  AAU has published guidelines for participation in AAU-sanctioned basketball games. They include: Players and coaches should use hand sanitizer upon entering the court for warm up or games. The AAU program will provide hand sanitizer for each scorer's table. Teams cannot bring in their own basketballs. AAU programs will provide basketballs. The AAU program will disinfect basketballs, scorer's table and team benches. The AAU program will spot clean team benches and scorer's tables in between each game. Each athlete must bring their own water bottle. After the game, teams cannot do the traditional handshake; but can do a modified greeting that accounts for social distancing. Athletes will be required to wear a mask while on the bench. Coaches must wear a mask to coach, and while on the bench. Q6. How can parents help to keep the COVID-19 pandemic in check among our young athletes? Open communication is best. If their child, or any other household member, gets sick from COVID-19, parents should let the coach and team know so that fellow team members can exercise caution.  The coach can then make decisions that can help stop the potential spread of the disease, such as rescheduling practices, or practicing outdoors.  Open communication about COVID-19 infection also helps our public health departments if they have to do contact tracing in the event of an outbreak.  It's not something to be ashamed of. The Delta variant is highly transmissible and it's important to know where and how it's spreading. Schools, coaches and families all want to know this information to better protect their community. Make sure you know what your school district is doing and let them know if you have concerns with COVID-19 safety at any school events. You can find COVID-19 information for your school district on the Oregon Department of Education website. Outside of school, there are probably too many programs to mention them all here. But you know which ones your kids participate in. You can contact them, visit their website, and learn about their COVID-19 safety procedures. For example, Portland Parks and Recreation has a page about their COVID-19 procedures. It's also important to stay home if you're sick and showing symptoms of COVID-19. Stay home from school. Don't go to practice. You may have to miss a game. But missing one game to quarantine is better than passing the virus to your fellow players and canceling future games. This has already happened in some parts of Oregon. The best protection for everyone is to get vaccinated if they can.  Everyone 12 and older can be vaccinated. So be sure to talk to your family members, friends and teammates about getting vaccinated if they can.  You can learn where to get a vaccine by visiting GetVaccinated.Oregon.gov. Document accessibility: For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print, or braille. Contact the Health Information Center at 1-971-673-2411, 711 TTY or COVID19.LanguageAccess@dhsoha.state.or.us.

Additional resources OHA COVID-19 behavioral health resources Multnomah County Health: Culturally specific behavioral health resources Centers for Disease Control and Prevention: Coping with stress OHA Public Health Division: Mental health, social well-being and resiliency resources for families OHA Public Health Division: Substance Use Prevention website Safe+Strong: Black/African American resources for mental and emotional health SELF Magazine: 44 mental health resources for Black people Swell Collective: Resources for processing racial trauma Ask a Black Doctor on The Numberz REACH webpage and REACH Facebook OHA Facebook COVID-19, Increased Drug Use and Overdoses Q1: We've heard that during the pandemic, substance use has increased. In the news, we're hearing that overdoses have gone up, too. Yes. This month, the Kaiser Family Foundation reported that white individuals had higher rates of drug overdose deaths than Black individuals through 2013. But Black overdose deaths increased by 45 percent during 2020, nearly double the growth for white overdose deaths. Oregon also had a spike in opioid overdose deaths in early 2020, with higher rates for Black people, American Indian/Alaska Natives, and males. Overdose-related hospitalizations in 2020 also showed higher hospitalization rates for Blacks. Q2: Methamphetamine use is also going up, which might be surprising to some people. Yes. For a long time, methamphetamine use has been higher among white people, and low among Black people. But a new study in the Journal of the American Medical Association reviewed national drug use survey data from 2015 through 2019 and saw a 10-fold increase in methamphetamine use among Black people. This isn't new to the pandemic. This increase has been going on for some time, but it does mean many overdose deaths are due to methamphetamine use. Q3: Why are these disparities happening? While Black and white people have similar rates of drug use for most substances, these groups do not have the same experiences or access to health care. The American Academy of Pediatrics has found that racial trauma is consistently associated with worse health, including substance use outcomes and preventing recovery.  Black people are also more likely to experience severe consequences for substance use, such as arrest, conviction, sentencing, and incarceration. These experiences can lead to perceiving substance use disorder as a stigma, discouraging treatment.  Black people are less likely to receive specialty treatment for substance use disorder, even though Black patients seek treatment at higher rates than white patients. These      higher rates are also observed in the initiation and engagement with specialty addiction treatment as compared to white patients. Black people are also more likely to drop out of treatment if they believe their provider is being discriminatory or showing racial bias. They experience a system where racial trauma and socioeconomic circumstances may invite substance use. It also provides harsher punishment for drug use, and fewer effective resources to address the drug use. Q4: What can we do to end this cycle? The American Academy of Pediatrics study recommends that to address the role of racial trauma, substance use disorder treatment must address racism at multiple levels (systemic, organizational, and individual). This includes asking people about their experiences with racial discrimination or structural racism when evaluating them for treatment.  The system itself needs to be diverse and reflect the people it serves—Black providers treating Black people, at every level, including primary care. OHA's goal is to eliminate health inequities by 2030. Cultivating a diverse health care workforce is part of that goal. Q5: That seems like a pretty long-term goal. What we can we as individuals, family members, health care providers, community members, do now?  We can all listen to, learn about and affirm experiences of racial trauma. We can acknowledge the harm that such experiences cause. We can research, seek out and refer people to culturally specific health care providers and resources that understand and reflect our experiences and values.  It's also important to take care of our mental health and find healthy ways to cope with stress, and help our loved ones manage stress. We need to take the time for self-care, reaching out and making social connections—And if we can, help our friends and family make healthier choices for dealing with stress. For example: Guided relaxation, meditation, or mindfulness exercises.  Physical exercise.  Writing in a journal Creative expression like singing or making music, creative writing, or creating artwork.  Taking a break from news and reducing the amount of time you spend on social media We've included many resources related to coping with stress and building resilience in the “Additional Resources” this week. Source: Monthly Opioid Overdose Report, 9/15/2021 Unintentional drug overdose deaths and rates by sex, race and ethnicity, Oregon, 2020 Sex/Race/Ethnicity* | Deaths | Crude Rate | 95% CI Male | 486 | 23.2 | 21.1-25.3 Female | 210 | 9.9 | 8.5-11.2 Non-Hispanic White | 568 | 17.5 | 16.1-18.9 Non-Hispanic Black | 37 | 34.4 | 24.2-47.4 Non-Hispanic Am. Indian/Native Alaskan | 27 | 46.3 | 30.5-67.3 Non-Hispanic Asian/Pacific Islander | 11 | 4.6 | 2.3-8.2 Hispanic | 63 | 11.1 | 8.5-14.2 * Race includes any mention (one or multirace). Hispanic includes all races.  Rates are deaths per 100,000. Source: State Unintentional Drug Overdose Reporting System (SUDORS) and CDC National Center for Health Statistics (NCHS) Unintentional drug overdose deaths and rates by age group, Oregon, 2020 Age Group (years) | Total deaths | Rate, deaths per 100,000 Males | Females | All 0-9 | 0 | 0.0 | 0.0 | 0.0 10-17 | 4 | 1.5 | 0.5 | 1.0 18-24 | 67 | 28.6 | 7.9 | 18.5 25-34 | 155 | 38.7 | 12.1 | 25.7 35-44 | 158 | 35.2 | 20.2 | 27.8 45-54 | 151 | 37.0 | 22.1 | 29.6 55-64 | 107 | 28.9 | 11.4 | 19.9 >=65 | 54 | 11.4 | 3.4 | 7.0 Source: SUDORS and NCHS |  Document accessibility: For individuals with disabilities or individuals who speak a language other than English, OHA can provide information in alternate formats such as translations, large print, or braille. Contact the Health Information Center at 1-971-673-2411, 711 TTY or COVID19.LanguageAccess@dhsoha.state.or.us.

Additional Resources  OHA COVID-19 vaccine website: covidvaccine.oregon.gov  OHSU News article  Ask a Black Doctor on The Numberz Q1: OHSU will be studying data related to COVID-19 and menstruation. Why? A1: Since the vaccines became available, people have been reporting changes to their menstrual cycles— For example, getting their period earlier or later than usual, or even missing a cycle. These types of changes could cause concerns. A missed period could cause a pregnancy scare for some, or false hope about a potential pregnancy for others. For people who have heard about these reports, not knowing how or why their period may change may be why they haven't gotten vaccinated yet. To date there have been no causal link between menstrual changes and COVID-19 vaccines. This study is designed to provide clarity on this issue. Q2: How will the study work? A2: Data will be collected from two apps that track menstrual cycles, Clue and Natural Cycles. Study questions include:  How long does the period typically last?  How often does it happen and is it regular?  Was it heavier or lighter bleeding?  What changed after getting vaccinated? This data will then be compared to the control group, that is, unvaccinated women. Q3: Is this study going to include females of all ages? A3: Given the consent parameters of the data OHSU is getting – no one under the age of 18 is included. The primary analysis will be 18-45 as that is the norm for looking at menstrual cyclicity. As women age, menstrual cycle variance becomes a confounder which is why we aren't just including everyone until menopause. Another researcher funded by the NIH monies is looking at adolescents. Q4: How do race and ethnicity fit into the study? A4: Individuals of all race/ethnicities are included in this study. Q5: This study is being done in part to allay concerns about the vaccines, but the vaccines are still considered safe. A5: That's right! We know COVID-19 vaccines are safe and effective. But we also know that many people want to learn more about the vaccines before deciding to get vaccinated. There is plenty of anecdotal evidence indicating that menstrual changes, if any, after vaccination are minimal and self-limited. We also know that Covid-19 illness will lead to significantly more menstrual disruptions. Q6: There are also lots of different reasons a period could change, right? A6: Yes, there are many factors, because the reproductive health system is incredibly complex. Some of these factors include increased stress, lifestyle changes, dietary changes, amount of physical activity. Symptomatic infection with the novel coronavirus is significantly more disruptive to menstruation than the vaccines. It is, however, theoretically possible that COVID-19 vaccines may cause menstrual changes due to the immune response. Q7: Just last week, it was reported that in the U.K., there were over 30,000 reports of menstrual changes related to COVID-19 vaccines. So this topic is gaining attention. It is true that this issue has gained a lot of attention. It is also important to note that 30,000 out of hundreds of millions of vaccinated women is still a tiny fraction. This highlights how safe and effective these vaccines are even for females who are still menstruating. These types of reports might lead to decreased vaccine confidence hence the need to conduct studies such as these. Q8: Are these types of changes normally studied as a side effect? A8: No. In general, menstrual changes aren't really studied in vaccine clinical trials, or in many areas outside women's (reproductive) health. The Vaccine Adverse Event Reporting System (VAERS) has not shown this to be a Covid-19 vaccine side effect. When experiencing menstrual changes, women often pause and think about their health.  Am I feeling stressed?  Am I getting enough to eat?  Am I getting enough sleep  Is this something I need to ask my doctor about? References: https://covid19.nih.gov/news-and-stories/covid-19-vaccines-and-menstrual-cycle https://grants.nih.gov/grants/guide/notice-files/NOT-HD-21-035.html https://www.npr.org/sections/health-shots/2021/08/09/1024190379/covid-vaccine- period-menstrual-cycle-research https://vaers.hhs.gov/

Additional Resources COVID-19 Case Rates by Race Q1: We've been talking a lot about children's health and safety now that the school year has started. Can you tell us about how COVID-19 cases are increasing among children? A1: COVID-19 case counts among children aged have increased dramatically since July 2021.  The case rate for Black children is three times the rate of white or Asian children. The case rate for Pacific Islander and American Indian/Alaska Native children is even higher. These counts are for children who have tested positive for COVID-19, or are presumed to have COVID-19 because they had COVID-like symptoms and had close contact with someone who tested positive for COVID-19.  Statewide, there have been 36,080 pediatric cases of COVID-19. 1,104 of those cases have been among Black children. Of the total cases statewide: Over half reported symptomatic COVID-19. One percent (349) required hospitalization. Over a third were due to close contact with other household members who had COVID-19. Q2: How does that compare to the case rates among individuals overallBlack adults? A2: We don't have a report that shows the case rates for just adults, but if we look at the statewide data across age groups, we find that statewide: There have been over 290,000 cases of COVID-19. The case rate for Black adults and children is twice the case rate for white adults and children. The case rates for Pacific Islander and American Indian/Alaska Native adults and children are close to three times the case rate for white adults and children. Of the total cases for Black adults and children (7,012), 8% (536) have been hospitalized. Meanwhile, 7% of the cases for white adults and children were hospitalized. Q3: What is being done to address the disparities you talked about? A3: OHA is partnering with community-based organizations, local public health authorities, coordinated care organizations, and community health clinics to promote vaccination in communities experiencing health disparities. Some of the community based organizations already involved in Oregon's COVID-19 response received funding to support vaccination. OHA's vaccine planning unit addresses vaccine equity including partnership with pre-existing Community Partner Outreach Program (CPOP) Supporting outreach to farmworkers as described in the Protecting our Farmworkers Resource Guide. OHA is also collaborating with federal partners who are coordinating regional interstate efforts to support migrant seasonal farmworkers with H-2A visas. FEMA Mobile Vaccine Unit State planning and resources Oregon vaccine advisory committee Public posting of vaccination data Vaccine web page Vaccine info and resources for communities  Communications campaign Radio If people are having problems with vaccine access or have other vaccine complaints, they can also call 211. Monoclonal Antibody Therapy Q4: Are there treatments that can reduce the risk of being hospitalized for COVID-19? A4: Yes. Monoclonal antibody therapies can help prevent severe illness and save lives.  Monoclonal antibodies are antibodies developed in a lab. The antibodies work by attaching to the COVID-19 virus. This prevents the virus from entering your cells. It helps in two ways: This is an effective treatment for people ages 12 and older at high risk of developing severe COVID-19.  This is also an effective form of prevention for high-risk individuals who have been exposed to cannot gain immunity from the COVID-19 vaccines. Monoclonal antibody therapy can help mitigate the disproportionate rates of hospitalization seen within Oregon's Black, Latina/o/x, and Tribal communities.  Can reduce the risk of hospitalization when used in those with mild to moderate disease by 70%. When used as post exposure prophylaxis can reduce the risk of symptomatic disease by 81%. Studies also show that it is most effective within 10 days of testing positive for COVID-19. Q5: Are these communities accessing this treatment now? A5: OHA is now working on making sure monoclonal antibody therapy is provided equitably throughout the state. Right now, that isn't the case. For example, OHSU treated 90 patients since May 2021. Of those patients: 64 were white. 3 were Black/African American (currently experiencing highest rates of hospitalization) 2 were American Indian/Alaskan Native 1 was Asian 20 were other/not specified. Q6: How does it work? A6: You can get monoclonal antibody treatment two ways:  Intravenous infusion puts the antibodies into your vein. Subcutaneous injection puts the antibodies into the fatty layer of your skin. Monoclonal antibodies are antibodies developed in a lab. The antibodies work by attaching to the COVID-19 virus. This prevents the virus from entering your cells. Q7: Who qualifies for this treatment? A7: This treatment is recommended for people who have an increased risk of developing severe COVID-19. Factors that contribute to developing severe COVID-19 include but are not limited to: Age Obesity Diabetes Chronic lung disease Chronic kidney disease Cardiovascular disease  Pregnancy  Sickle cell disease  Neurodevelopmental disease  Dependence on medical-related technologies, such as tracheostomy  Race and ethnicity can also be associated with increased risk for progression to severe COVID-19. For example, data show that patients of color or from Tribal communities are most harmed by health inequities, and the risks of hospitalization and death for these groups are greater than those of white patients.  These patients may face higher risk than white patients due to longstanding societal injustices such as racism, discrimination and colonization, which have and continue to negatively impact health outcomes.  Q8: How can we make sure everyone, including the Black community, is aware of this treatment? Q8: It used to be that this treatment could only be provided at infusion centers. But now that there is a product that providers can deliver by injection, the product should become more widely available. For example: Pharmacists can now complete education and training to provide a specific monoclonal antibody product at the pharmacy or any other location that is appropriate.  More traditional hHealth care providers can provide this treatment in the office setting. But the most urgent need is sharing this information with the communities who need this information, including the Black community.  Q9: Would it also help to share this information with our providers? A9: Definitely. The injectable form is new, and nNot all providers may know they can order and use this treatment. If you think you may qualify, Aask your provider if they offer this treatment, or if they plan to order it for use in their clinic. 

Q1: What can students and families expect for the 2021-22 school year?  A1: Oregon schools have taken strong steps to limit the spread of the virus in schools. Last year, there were more than 120 state requirements to follow. Now school districts are back to making health and safety decisions for their schools to best meet the needs local communities. Learning from last year and what we know now about COVID-19, there are health and safety recommendations and requirements that all K-12 public, charter, and private schools must follow. For example, the Oregon Department of Education (ODE) has advised schools to use these best tools for protecting students against COVID-19: Vaccination for those eligible,  Face coverings,  Physical distancing,  Ventilation and airflow, Handwashing, and  Staying home if ill or exposed to someone with COVID-19. Q2: How are things different now from what they were last year at the start of school?  A2: We know a lot more about the virus now than this time last year. We know much more about how it spreads and how to keep students and teachers safe.  This year, all schools will operate full-time, in-person instruction every day. School districts are only required to offer remote learning for students who have to stay at home for isolation or quarantine. There are also two testing programs for K-12 schools to identify COVID-19 infections early and often: Diagnostic testing to quickly confirm COVID-19 in staff and students showing signs of COVID-19 infection; and A screening program to identify COVID-19 in staff and students who aren't showing signs of infection.  This year, we have three vaccines available to protect ourselves from COVID-19; and all school staff and volunteers are also required to be fully vaccinated by October 18, 2021. All staff and students ages 5 and older are also required to wear masks indoors.  Q3: What about the Delta variant? A3: Oregon has seen a steep increase in COVID-19 rates and hospitalizations in recent weeks. This is driven by the Delta variant of the virus, which is much more easily transmitted and now makes up over 95% of cases in Oregon. There have been more “breakthrough cases” among vaccinated people due to the Delta variant, though the number of breakthrough cases remains exceedingly low.  The Delta variant doesn't appear to cause more severe illness among children, but among adults (including younger adults) there is an increase in hospitalizations— So much that hospital bed capacity across the state is highly stressed.  The vaccine and mask requirements will help make it less likely that: Students and staff become exposed to COVID-19;  COVID-19 related isolations and quarantines occur; or COVID-19 related hospitalizations occur. By reducing these risks, we are making it more likely that students can keep learning in person. Q4: If COVID-19 cases are going up again, is it safe to return to in-person school at all?  A4: Cases are up, but we know from last year that we can greatly limit the spread of COVID-19 in schools. In Oregon and elsewhere, we have seen that in group settings we can reduce and nearly eliminate the spread – but only if health and safety recommendations, like using face coverings, are followed. We also have seen high rates of spread in places where face coverings were not required.  Face coverings, keeping physical distance, and regular hand washing are tools we have been using to control the spread of the virus. Each tool on their own can't control the spread of the virus. But when you use all the tools combined, they are highly effective at minimizing the spread of the virus. Q5: Are schools a place where the virus is commonly spread? Have there been outbreaks in schools?  A5: The spread of COVID-19 was not common in Oregon schools last year, but there were some outbreaks. Because children under age 12 are not yet eligible for a vaccine, and a significant number of people age 12 and older are not yet vaccinated, schools are settings with a large number of unvaccinated individuals. This gives schools high potential to spread COVID-19 if safety precautions are not taken. In other states that have started in-person school without masks and other protective measures in place, there are already many reports of outbreaks and schools needing to close again.  Q6: What happens if a school or school district does not implement or enforce the rules?  A6: Any person who has a concern that a school is not in compliance with the ODE guidance can file a complaint with Oregon OSHA at 1-833-604-0884 or online. If OHA or ODE receive complaints, they will refer them to Oregon OSHA.  Q7: What steps have schools taken to improve ventilation and air circulation?  A7: Schools have been advised to improve the indoor air quality in schools by:  Increasing the amount of fresh outside air that is introduced into the system;  Making sure air moves from indoors to the outdoors; and  Cleaning indoor air with effective filtration methods (e.g., HEPA filters).  Your school district's website should provide information about improvements schools have made with indoor ventilation. What families can do: Q8. How can families help everyone stay safe as kids head back to the classroom?  Q8: OHA and ODE have shared a 5-step checklist for families that includes: Make a plan to vaccinate all eligible household members. Wear face coverings or masks in public and in carpools. Limit gatherings with other households— including big events for kids, like birthday parties. Move social activities outdoors. Make a plan in case your child needs to miss school. Resources for Students and Parents! Additional Covid-19 Resources

ACOG COVID-19 in Pregnancy and Breastfeeding Patient Page: https://www.acog.org/womens-health/faqs/coronavirus-covid-19-pregnancy-and-breastfeeding SMFM COVID-19 Patient Page: https://www.highriskpregnancyinfo.org/covid-19 CDC Website on COVID-19 Vaccine in Pregnancy and Breastfeeding: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/pregnancy.html CDC Website on Vaccines in Pregnancy: https://www.cdc.gov/vaccines/pregnancy/vacc-during-after.html Q1: How do we know the COVID-19 vaccines are safe? A1:  The COVID-19 vaccines have undergone rigorous safety testing. The vaccines were authorized for emergency use by the FDA after clinical trials from around the world revealed the vaccines to be safe and effective in preventing infections, hospitalizations, and deaths from COVID-19. Q2: Is it safe to get vaccinated if you want to have children now or in the future? A2: Yes, there is no evidence that indicates the vaccines cause infertility in men or women. None of the three vaccines authorized for emergency use in the U.S. change people's DNA or interact with the organs necessary for reproduction, like the brain and the reproductive system, so they will not cause infertility in anyone. People who are thinking about having children can get the vaccine as an effective way to prevent infection and complications caused by COVID-19 during pregnancy. It is not necessary to avoid getting pregnant after getting vaccinated against COVID-19. Q3: Is it true that the fetus can develop COVID-19 antibodies if you get vaccinated during your pregnancy? A3: In general, mothers pass antibodies to their babies during pregnancy, which protect them against diseases in the early months of life when they have no antibodies of their own. Recent reports from the CDC have shown that people who have received one of the mRNA vaccines during pregnancy (especially during the third trimester) similarly can transmit antibodies to their fetuses, which may help protect them after they are born. Q4: How dangerous is it for a pregnant woman to contract COVID-19? A4: People who are currently pregnant or who were recently pregnant are more likely to get severely ill with COVID-19 compared to non-pregnant people. Severe illness during pregnancy can be avoided by getting fully vaccinated.  In recent weeks, infections among pregnant people have been increasing, and in combination with the low rates of vaccinations in pregnant people, the highly transmissible Delta variant, and complications from COVID-19 during pregnancy the call for pregnant people to protect themselves and their pregnancies could not be more urgent.  Risks to pregnant people who become infected with COVID-19 can include hospitalization, intensive care, the use of respirators or special equipment for breathing, or in the worst cases, death. Furthermore, pregnant people who have COVID-19 also have a higher risk of preterm birth. Q5: Is there any risk for breastfeeding women who would like to get the COVID-19 vaccine? A5: No. Current data from the CDC demonstrate that breastfeeding people who have been vaccinated with an mRNA vaccine have antibodies in their breast milk, which can help to protect their babies.  Although the information about the COVID-19 vaccine's interaction in people who are breastfeeding is still limited, the COVID-19 vaccines are not considered a risk for people who are breastfeeding, nor for their nursing babies because the vaccines do not contain a live virus or alter people's DNA. Q6: If pregnant people or nursing mothers decide not to get the vaccine right now, what can they do to keep themselves and their babies safe? A6: We recommend that pregnant people and nursing mothers talk with their doctor and clear any doubts or worries they might have about the vaccines. Every person is different and there are different considerations when making a decision.  If you are pregnant and have decided not to receive or complete the COVID-19 vaccine series, we recommend that you continue abiding by preventive measures to prevent infection: Wear a mask in public places. Consider double-masking in indoor public places. Don't gather in large groups. Maintain physical distance from people you do not live with. Wash your hands. Use disinfectants. Q7: In recent weeks, infections among pregnant people have been increasing. Why is this? A7:  With the combination of low rates of vaccinations in pregnant people, the spread of the highly transmissible Delta variant and the higher risk of complications from COVID-19 during pregnancy — the call for pregnant people to protect themselves and their pregnancies is urgent. Q8: What did the new data reveal? A8: In a new analysis of the latest data from the V-safe pregnancy registry — which collects health information from people who received COVID-19 vaccination in the periconception period or during pregnancy — scientists did not find an increased risk for miscarriage among people who received an mRNA COVID-19 vaccine before 20 weeks of pregnancy. Previously, preliminary safety data from three safety monitoring systems on vaccinations late in pregnancy were reassuring, but data from people  vaccinated during early pregnancy were lacking. These new findings, which showed no increased risk of miscarriage after receiving an mRNA vaccine before 20 weeks of pregnancy, helped to fill that gap in knowledge. Growing evidence about the safety and effectiveness of COVID-19 vaccination during pregnancy demonstrates that the benefits of receiving a COVID-19 vaccine outweigh any known or potential risks. Q9: Is the rate of miscarriage concerning? A9: No. The miscarriage rates after receiving an mRNA COVID-19 vaccine are within the range seen in previous studies of pregnant women who never received a COVID-19 vaccine (11–16%). The latest data do not suggest an increased risk of miscarriage after receiving an mRNA COVID-19 vaccine. Q10: So, the vaccines are working as expected? A10: That's right! The most recent report we have from the CDC that followed people 65 and older hospitalized for COVID-19 in Oregon showed that: The Pfizer and Moderna vaccines were 91-96% effective in reducing the risk of hospitalization. And, the Johnson and Johnson vaccine was 84-85% effective in reducing the risk of hospitalization. In other words, vaccines save lives. 

Covid-19 Information & Vaccination Series