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By Dr. Peter J. Plantes

September 21, 2020

Oregon’s Multnomah County is somewhat lower on the list this week but represents the largest population area in terms of population size impacted by a rapidly growing “outbreak” of COVID-19. This is a county that borders along the southern shore of the Columbia River and includes the metropolitan area of Portland. The presence of both nightly street protests for the past 4 months and the severe air pollution caused by numerous regional forest fires have created a perfect petri dish for accelerating COVID-19.

The Local Risk Index (LRI) has risen from 2 to as high as 13.5 in the past 10 days and the average 7vs7 acceleration factor that was as low as 0.25 has rapidly escalated to 2.9 over the same period.  This will be an area of the country to watch closely over the next several weeks as there is no indication that the local precipitating factors are expected to change in terms of the fires or the protests. 

Multhnomah County

Centre County, PA is a rural region in the middle of Pennsylvania. This is another demonstration of the impact of the local main campus of Penn State University and its 40 thousand undergraduate students arriving for classes and dormitories on August 26th (⇧). Within 10 days the wonderfully low baseline LRI rate of approximately 1.0  started to rapidly rise ( ⇗ ) to a high of 20.15. The 7vs7 rate of acceleration of 23 indicates that the current 7-day average of LRI readings vs. the previous 7-day average has increased by 23 times! We have not seen a story that the campus has gone into lockdown mode yet. In fact, it is reported by the Center Daily* that there is “No move to remote learning, as Penn State adds 226 cases of COVID-19 since [the] last update.” 


LRI and 7vs7 Trends – Centre County, PA

Centre County


Spokane County, WA sits on the border of Idaho in the far eastern high country of Washington State and includes the metropolitan area of Spokane with just over one-half million population.  This is another west coast area inundated by the thick smoke air pollution resulting from the numerous forest fires. In the last 2-weeks the LRI has been steadily rising there as well from a lower baseline of 5 and now at 15. The 7vs7 ratio is a concerning 3.1 meaning the LRI rate of positivity in Viral SARS-CoV-19 testing has tripled in the past week.  If the trend continues into the next week, LRI rates could climb into the 30 or 40 % positivity rate.

 LRI and 7vs7 Trends – Spokane County, WA

Spokane County

And finally, we are again watching Kent County, Michigan home of Grand Rapids.  This manufacturing and healthcare system center has had its second rapid acceleration of COVID-19 testing positivity over thepast month.  In the earlier case of late August and now in mid-September, the LRI has peaked at a moderate level.  What is concerning is the more recent 7vs7 rates of 2.4 to 3.0 over the past week.  If the current surge rate is not reduced, then we would expect this region to enter October in a much higher LRI range of 25 to 30.  This high baseline rate existing with the onset of flu season would be like dry tinder leading to a Michigan “firestorm” of COVID-19.  

Kent County

About the Author

Peter J. Plantes, M.D. has three decades of experience creating service and delivery solutions that enhance marketplace success and clinical performance for clinical practice groups, academic faculty group practices, hospitals, health systems, and health care organizations. His success stems from his ability to blend and synergize clinical knowledge, operational expertise, financial performance, and collaborative methodology with his deep commitment to serve patients and improve the health of the community. Dr. Plantes has served in CEO & Physician Executive roles for a number of large healthcare clinical delivery networks including regional community networks, academic practices, national hospital networks, international health systems (Chile, Colombia),  and corporate managed care/HMO networks.

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