Former Gov. John Kitzhaber says the state needs to move beyond a public health response to the Covid-19 pandemic to an emergency response, vastly stepping up its efforts to expand heath care capacity and appointing a coronavirus leader for the state.

In a Sunday blog post, Kitzhaber, an emergency room physician, said the on-the-ground, day-to-day response to this challenge will fall to state and local jurisdictions and that the state needs an emergency response team, an emergency response leader and an emergency response plan.

“Every day that goes by without an aggressive, coordinated Emergency Response Plan, undermines the likelihood that we will be able to successfully respond and manage the potential of a dramatic increase in hospital admissions,” he wrote. “Therefore, it is urgent that we move beyond a public health response (as important as that is) to an Emergency Response.”

Kitzhaber said Oregon’s health care system is not prepared to deal with the potential magnitude of the crisis. Oregon has 6,729 staffed hospital beds and 776 ICU beds, he said, which could quickly be overwhelmed by the volume of admissions even if only a small percentage of Oregonians contract the virus, he said.

That likely surge is coming in an environment of deepening scarcity caused by increased demand and the disruption of global supply chains, which could lead to a shortage of key supplies such as pharmaceuticals, saline, oxygen, ventilators, and protective gear.

He called for a variety of emergency actions, including:

1. Immediate appointment of an Emergency Response Team with the authority to develop an Emergency Response Plan and to manage and coordinate all resource allocation decisions related to the pandemic. State agencies would be partners in the execution of this plan. The plan must include, among other things:

· Bed management and coordination, allocation of limited resources and patient triage, if necessary. The latter should be planned for in advance with the deep involvement of the OHSU Center of Ethics in Health Care and other like resources.

· Immediate development of statewide inventories of key supplies and resources. This needs to go beyond just counting masks. We need to be proactive and creative—for example, how many people in Oregon who have been diagnosed with sleep apnea have a CPAP (continuous positive airway pressure) machine sitting unused in their home?

· First responders and front-line workers should be given initial priority on protective gear to ensure an adequate health workforce.

· Immediate steps to expand “quarantine” hospital bed capacity.

· The identification of facilities/beds that could be ready in the shortest period of time to be used for the COVID 19 admissions (e.g. Peace Health facility in Eugene—104 beds; Tuality Hospital in Hillsboro—215 beds).

· The identification of facilities/beds that will take longer to bring online, such as the Wapato jail.

Read his blog post here.

-- Ted Sickinger; tsickinger@oregonian.com; 503-221-8505; @tedsickinger

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