More than 250 days after Klamath County’s first COVID-19 infection and several weeks into a third nationwide acceleration in cases, here’s how to understand the virus’s spread in the local community.

Klamath County Public Health spokesperson Valeree Lane said earlier this week that most of the new local cases can be attributed to gatherings held around Halloween rather than community spread, though that has now expanded to workplace, social event and household spread. That means holiday gatherings over the coming weeks could make or break the county’s response to the pandemic.

“We are now seeing the second-wave of COVID-19,” said KCPH Director Jennifer Little. “When an individual is exposed to the virus and proceeds to go out into the community, whether to work or social events, the spread becomes exponential. Next week is Thanksgiving. We can all make proactive choices to reduce the spread, protecting ourselves and others.”

First, let’s look at the cases themselves. Daily new cases remained below 15 for much of the spring, summer and early fall. The anomaly was an isolated outbreak among more than 50 strawberry farmworkers at the beginning of October. New cases increased during the first few weeks in November, and Thursday’s addition was the largest since the October cluster. Then came Friday’s 75 new cases.

covid klamath

New COVID-19 cases in Klamath County since the start of the pandemic. This week’s increase has been the largest since the strawberry farmworker outbreak in October (data from Klamath County Public Health).

| Klamath Falls Herald and News

The large increase in cases this week has caused the county’s 7-day average to spike. On Sunday, that number was seven — by Thursday, it had increased to 9.5, approaching the county’s record weekly average of 10.1 cases caused by the October cluster. As of Friday, Klamath County has 658 cases and 279 recoveries, and the graph of the county’s 7-day average shows that they’ve been increasing for the past several weeks.

7-day average

The 7-day average of new cases recorded in Klamath County since the start of the pandemic. The current average of 9.5 is approaching the county’s record of 10.1 (data from Klamath County Public Health).

| Klamath Falls Herald and News

Lane said the county has been fairly steady up to this point, but that could change if cases continue to rise as a result of holiday-related gatherings. At this point, more cases have been connected to private groups of people than public places like the grocery store.

Demographic data on the cases show a clear discrepancy between who spreads COVID-19 and who it impacts most seriously. People between the ages of 20 and 29 hold the largest share of cases (128), but the lowest number of hospitalizations for the virus (one). As shown by the red dots (hospitalizations) versus the black dots (cases), the share of hospitalizations increases with each older age group. The most equitable bloc is 40-49 year-olds, who make up 16.3% of cases and 16.7% of hospitalizations. But 70-79 year-olds, who comprise less than 5% of cases, are hospitalized at a rate six times greater than 20-29s.

covid demographics

The age distribution of COVID-19 cases and hospitalizations. The difference in size between the red dots and gray dots show the disproportionate number of older people hospitalized for the virus, despite having a smaller share of the county's cases (data from Klamath County Public Health).

| Klamath Falls Herald and News

“It’s young people getting together,” Lane said. KCPH staff originally thought children and teenagers would be superspreaders because of their higher viral loads, but both those age groups make up less than 13% of the county’s COVID-19 cases combined.

The county’s four deaths have also skewed older, with the youngest person falling within the 40-49 range.

“It’s our older citizens who are by far the ones having a lethal experience with this,” Lane said.

Klamath County’s testing rate falls around the middle range compared to all other Oregon counties, but Lane said it’s slightly more superior compared to counties with similar demographics. She said she focuses on Douglas, Coos and Union counties, all of whom saw their timber industries decline at similar times, deal with similar health disparities and have similar rural-urban layouts to Klamath County.

Klamath County

Klamath County’s testing data, as of November 19 (data from the Oregon Health Authority).

| Klamath Falls Herald and News

Klamath County has tested 13,540 people as of November 19, or about 19.9% of its population. A little over 4% of those tests have been positive so far, amounting to about 840 cases per 100,000 people. Adjusting for population, the county has conducted 19,856.9 tests per 100,000 people.

Douglas County

Douglas County’s testing data, as of November 19 (data from the Oregon Health Authority).

| Klamath Falls Herald and News

Douglas County, which has a higher population, has fewer cases per 100,000 than Klamath County but has tested a smaller share of its population.

Union county

Union County’s testing data, as of November 19 (data from the Oregon Health Authority).

| Klamath Falls Herald and News

Union County, which is dealing with significant outbreaks at long-term care facilities, has ramped up its testing to have one of the highest rates in the state. It’s tested 24.2% of its population for a rate of 24,205.5 tests per 100,000 people. Nearly 10% of those tests have been positive.

Coos County

Coos County’s testing data, as of November 19 (data from the Oregon Health Authority).

| Klamath Falls Herald and News

Coos County, whose population is comparable to Klamath County’s, has 200 fewer cases than Klamath but has tested only 17% of its population for a rate of 17,026.9 tests per 100,000. A little over 3% of those tests have been positive.

“Our ability to test has been superior to other counties,” Lane said, adding that a recent delivery of 1,000 rapid tests to KCPH will help people who are reporting symptoms or contact with a confirmed positive case get test results within hours instead of days.

Tom Hottman, spokesman for Sky Lakes Medical Center, said last week that the hospital’s COVID-19 isolation unit has 6 rooms but that clinicians have some flexibility for scaling up treatment in the event of an influx of hospitalizations. Five people are currently hospitalized for the virus there, and Hottman said it’s possible to move patients around and make more room in other areas to accommodate COVID-19 patients.

Hospital beds

More than 81% of South-Central Oregon’s hospital beds are occupied — that includes nearly 90% of its ICU beds (data from the Oregon Health Authority).

| Klamath Falls Herald and News

In OHA Region 7, which includes Klamath County, 18.6% of 553 total hospital beds are unoccupied. Only 4.9% of ICU beds are available. Lane said that makes her less concerned about the number of cases and more concerned about the availability of resources to treat COVID-19 patients who fall seriously ill.

Hottman also said Sky Lakes hasn’t run into shortages of personal protective equipment yet, but more hospitalizations will cause them to burn through things like masks, gloves and gowns more quickly.

Sky Lakes PPE

The status of Sky Lakes Medical Center’s personal protective equipment (data from Oregon Health Authority). “Days on hand” refers to the number of days that category of PPE will last if the hospital doesn’t receive any new shipments of it.

| Klamath Falls Herald and News

Scientists at the Georgia Institute of Technology have developed a risk assessment tool for COVID-19, which tracks the likelihood of encountering a positive case in each county of the U.S. based on different event sizes. While Klamath County’s risk factor is lower compared to other Oregon counties, it increases sharply along with event sizes. If someone were to attend a 10-person Thanksgiving dinner, for example, their likelihood of encountering a positive COVID-19 case would be 6%. Add 15 people, and the risk more than quadruples.

COVID Risk Curve

The risk of encountering someone with COVID-19 at an event increases as more people attend, according to the Georgia Institute of Technology’s risk assessment tool.

| Klamath Falls Herald and News

Alex Schwartz is the environmental reporter for the Herald & News and a member of the Report for America service journalism corps. He can be contacted at aschwartz@heraldandnews.com or at 541-885-4477.