Multnomah County submitted its Reopening Framework to the state of Oregon on Friday to reopen much of public life and many businesses. If approved by the state — and if Chair Deborah Kafoury and the Health Officer continue to see positive trends reflected in key metrics — the County will move to Phase 1 on Friday, June 12.
Phase 1 permits seated service in restaurants and bars, personal services by appointment, the use of gyms and fitness centers, and gatherings up to 25 people. Retail businesses reopened May 15.
“We have moved thoughtfully and deliberately to this day so that the sacrifices our communities have made since March will not be lost,” said Chair Deborah Kafoury. “We must also acknowledge that this reopening is taking place at a historic moment, when millions of people nationally, and tens of thousands of people here in Multnomah County, are crying out for justice, demanding we collectively confront the profound harms and injustices of systemic racism. The County’s response to COVID-19, and the work we’re putting into reopening, hasn’t taken place in a vacuum.
"Addressing the inequitable disease burden on communities of color is a critical part of our response and our path forward.’’
Multnomah County has gone further in its reopening framework than any other county, applying several equity standards that will help ensure that reopening occurs in a way that advances every corner of our community. The framework prioritizes the needs of Black, indigenous and other communities of color; people over age 65; people who live in congregate settings; and those with underlying health conditions.
“We have led with our values,” said Commissioner Jessica Vega Pederson. “There is a lot of concern in the community around risk of reopening, and it’s critical that we’re paying attention and providing the resources and information needed for our most impacted communities.”
The plan directly addresses Multnomah County’s unique circumstances as Oregon’s most densely populated county. It is also one of the most diverse, with nearly 31 percent of residents identifying as Black, indigenous, or people of color (BIPOC). In addition, 14 percent of residents are foreign-born, and 20 percent of residents speak a language other than English at home. Thirteen percent of residents are over age 65.
The County also has the largest houseless population in the state. About 2,000 people are unsheltered on any given night, and another 2,000 stay in emergency shelters or transitional housing. These and other congregate facilities, like nursing homes and jails, have elevated risks. The County also has a disproportionate share of Oregon’s health care capacity, with more hospitals and hospital beds than any other county.
“Multnomah County will continue to work with community partners and state and local governments to address systemic racism and the broad and deep underlying social conditions that the COVID-19 pandemic has brought into sharp relief: racism, lack of housing, gaps in behavioral health services, and inequities in employment, education, income, and access to health care,” said Public Health Director Rachael Banks.
COVID-19 affects people of all ages and walks of life, However the plan calls out that people over 65 and those with underlying medical conditions have a greater risk of hospitalization and death from COVID-19. Additionally, people who live in congregate settings are at greater risk of contracting the illness because of the challenges of controlling infection.
Black, indigenous and other people of color are disproportionately impacted both nationwide and in Multnomah County, where they make up 30 percent of the residents but 40 percent of the cases. Latinx and Asian American residents appear more likely to be hospitalized from the virus, and many of those residents reported underlying health conditions.
The County, working with community members, has paired its overall framework for reopening with an additional detailed and specific framework on BIPOC priorities and strategies. The County also worked with community partners on a data review committee to advise regional health department leaders and epidemiologists on how to interpret and release data on race and ethnicity. The County publishes race and ethnicity data on its daily dashboard.
“We have been clear, from the beginning, that Multnomah County’s COVID response, reopening, and recovery must center the needs of Black, indigenous, and people of color communities — those most vulnerable to the burden of the disease, and those most affected by its economic consequences,” said Commissioner Susheela Jayapal. “Our reopening plan, created in concert with our most impacted communities, does just that. And we’ll continue to be disciplined, watchful and responsive as we move forward.”
Commissioner Lori Stegmann said, “I am incredibly proud of the tremendous dedication of our employees and the commitment our communities have demonstrated throughout this crisis. So many have been on the frontlines ensuring the health and safety of our most vulnerable communities while putting their own lives at risk. They have not only slowed the spread of COVID-19, but undoubtedly they also have saved countless lives.
"Because of their dedication we are able to now apply for Phase 1.”
“Multnomah County is uniquely complex in terms of the considerations we have had to take into account and the risks we face,” said Commissioner Sharon Meieran. “We have a lot to lose from opening up too much, too soon, yet we also have a lot to lose from unnecessary delay. It’s been a delicate balance, and I am proud that our plan has proceeded thoughtfully and intentionally, with a basis in data and science, and with a focus on those most vulnerable in our community.”
The County plans to employ a total of 133 employees to work on cases of COVID-19. As of June 3, the team investigating cases and tracing contacts of those cases had expanded from seven in February to 63. To round out its team, the County plans to hire 30 additional staffers at the Public Health Division while also contracting with culturally specific community organizations.
Communicable Disease Director Kim Toevs told the Board that once the full team is in place, 78 percent of employees should have specific language or cultural skills. That hiring, however, won’t be complete by the time Multnomah County submits its proposal to reopen on June 5, she said.
Multnomah County Public Health has also teamed up with the County’s primary care clinics to launch drive-through testing in mid- and east County, starting Monday at the East County Health Center in Gresham. That site will be open 9 a.m. to 4 p.m. Mondays and Tuesdays.
The sites are reserved for symptomatic people who lack health insurance, who are residents of color, or who do not have a regular healthcare provider. The County asks people who can access testing through their own health care provider to do so instead if they can.
A second site is not yet final, but is likely to be hosted by a community organization with a spacious parking area.
Multnomah County Reopening Framework can be downloaded here.