‘Everybody you know is getting infected’: Why Oregon is awash in unreported COVID-19 infections

Todd Ouzts let his guard down this week for perhaps the first time in two years and quickly regretted it.

After spending most of the pandemic isolated at home with his wife, Ouzts went to a Home Depot on Monday, maskless, to buy a garage door opener. The 60-year-old semi-retired stop-motion animator had already received four doses of the COVID-19 vaccine and figured he was as prepared as he could be to transition back to a more normal life.

But in a variation of what is now a familiar story, Ouzts had a sore throat and was coughing and sneezing the next day. He originally thought the cause was dust he breathed in his garage while installing the opener. But by the following day, his body hurt and he had a headache. He took an at-home COVID-19 test and found out he was positive for the coronavirus.

While he made the choice to go to the store maskless, Ouzts is now frustrated about what he sees as mixed messages coming from the government about what precautions to take.

“I’m angry that we haven’t solved this yet as a society,” Ouzts said. “No one wants to be inconvenienced with rules anymore.”

The Washington County man’s experience is becoming increasingly common, as thousands of Oregonians continue to get infected with the virus daily, even as the state and nation appear to be moving on.

COVID-19 infections have increasingly become part of the new normal. Few businesses still require masks or proof of vaccination, and the state’s messaging around precautions has been muted when compared to the frequency and volume of warnings during past surges.

Infections appear to be so widespread, even Dr. Anthony Fauci, the country’s top infectious disease expert, recently tested positive for COVID-19.

“I think it’s a confusing time for people,” said Dr. Marcel Curlin, an infectious disease expert with Oregon Health & Science University. On the one hand, he said, there are clearly a lot of infections. On the other, the state long ago lifted most restrictions meant to curb spread of disease.

“What the heck is going on? Which is it?” Curlin said many people are likely asking themselves.

The answer appears to be somewhere down the middle.

The country is in the transition phase before the coronavirus becomes endemic, or a regular and constant presence in society, Curlin said. That evolution is to be expected, given that evolution favors viruses that spread easily and keep hosts alive so they can pass the virus to others.

But because “we’re not there yet,” Curlin said, the virus can still cause severe illness, meaning it is worthwhile to take precautions to prevent infection.

As if to underscore the confusion, official reported infection numbers are widely considered to be a profound undercount of the true number of infections. COVID-19 cases are undercounted primarily because of the wide availability of at-home tests that don’t have to be reported to the state and because some people with no or mild symptoms might not get tested at all.

Indeed, according to a University of Washington model, the current infection surge in Oregon has driven the second-most cases of any wave during the pandemic, behind only the first omicron surge this winter. One wouldn’t know that looking at state data, which shows the delta wave peak exceeding the peak of the current surge.

Figuring out the true scope of infections would require surveys that could show approximately what percentage of cases aren’t reported, and to then use those results to extrapolate how many cases aren’t being reported statewide, experts say.

In the absence of such data, state officials estimate that the true number of infections could be 20 to 30 times higher than the roughly 1,450 cases a day being publicly reported in Oregon.

“We assume these numbers are a dramatic undercount of actual cases,” state epidemiologist Dr. Dean Sidelinger said at a media briefing Friday.

According to a more modest University of Washington analysis, Oregon’s reported count is about 17% of the true case count, said Ali Mokdad, who has been tracking and modeling pandemic trends for two years.

According to Mokdad’s estimates, the infection peak of the current surge, at about 10,160 active infections in Oregon, was higher than during any surge besides for the first omicron wave, including the delta wave.

A precipitous drop in masking rates is the greatest driver behind case growth, he said. Only about one in six surveyed Oregonians reported they regularly wore a mask in public, the lowest rate on record, he said.

“That’s why everybody you know is getting infected,” Mokdad said.

Douglas, Lane and Jackson counties spent one week in the federally designated “high” risk category for spread of COVID-19, meaning the Oregon Health Authority and the Centers for Disease Control and Prevention recommended everyone in those areas wear masks when in indoor public places.

Curry, Coos and Hood River counties are now at high risk of spread of disease, according to the CDC. Another 22 Oregon counties are at “medium” risk, including Multnomah, Washington and Clackamas counties. Federal health officials urge people in those counties who are at risk of severe disease to consider wearing masks.

Experts say people concerned about getting infected now should follow known methods to prevent infection, including wearing a well-fitting mask when in public indoor spaces, avoiding crowded social settings and regularly washing hands.

State officials have also cautioned the public to remember the pandemic “is not over,” and have urged people to consider wearing masks in indoor public places. But they have also repeatedly pointed to a critical difference between the current wave and past waves: severity of disease.

Despite the volume of COVID-19 cases during the current wave, hospitalizations appear to have peaked June 5 at 327 occupied beds — several times less than the hospitalization peaks during the delta wave and the first omicron wave. Reported monthly deaths have also returned to lower levels not seen since July 2021.

But for Oregonians who recently got sick after taking precautions and getting vaccinated and boosted, the low hospitalization numbers offer little consolation.

Terry Marchyok, 49, had recently decided she was ready to “move on with her life” and spend more time with people, when her husband brought COVID-19 home around June 7 and got her sick, too.

The Portland couple thinks he may have caught COVID-19 while on a shopping trip. Marchyok, who was vaccinated and boosted, said she got so sick she went to a Zoom care to get an electrocardiogram.

“It sort of shakes your confidence in, ‘Do I know what is risky and what’s not risky?’” Marchyok said.