Oregon has reimposed restrictions on public gatherings as Covid-19 cases rise again, a reminder that even as 100 millions Americans are now fully vaccinated, states are still seeing localized outbreaks.

Fifteen of Oregon’s 36 counties are now considered at “extreme risk” for coronavirus spread. This designation bans indoor dining and significantly reduces capacity at gyms and entertainment venues.

“I was presented with data showing two paths Oregon could take,” Governor Kate Brown said on Friday, adding that tightening restrictions would save “hundreds of lives” and prevent as many as 450 hospitalizations in the next three weeks.

“As your governor, I chose to save lives,” said Brown, a Democrat.

Cases in Oregon have risen 21% in the last week, a fifth week in a row of increases greater than 20%.

Importantly, the spread of Covid-19 in Oregon is still not as severe as in other parts of the country. Oregon has half the per-capita rate of cases of Michigan, which remains the worst-affected US state.

New Jersey, Delaware, Puerto Rico, Pennsylvania, Minnesota, Maine and Colorado follow behind Michigan. Nationally, the seven-day average of new cases has fallen from a peak of 254,000 in mid-January to just over 50,000.

Brown’s decision places more pressure on the hospitality industry in particular, which has only recently begun to move toward recovery as people feel comfortable leaving home. However, a sense of relief washing across the US may also play a role in Oregon’s rising cases.

“We are looking at multiple factors contributing to this surge,” Chunhuei Chi, director of Oregon State University Center for Global Health, told the Los Angeles Times, “including variants and people relaxing their guard because of pandemic fatigue and a sense of security or hope from vaccinations.”

Officials warned the increase may be partly attributable to variants. According to the federal Centers for Disease Control and Prevention (CDC), the more contagious B117 variant first identified in the UK is responsible for about 40% of cases in the region. That is lower than in other regions such as the midwest and parts of the south.

At the same time, Oregon has seen a major slowdown in daily vaccinations. The state distributed more than 52,000 vaccines in one day in mid-April, but daily inoculations fell to about 34,000 on Friday.

The increase in Oregon is driven by working-aged adults, who have proven among the most important and most difficult sections of the population to vaccinate. Nationally, working-aged adults are vaccinated at about half the rate of people older than 50.

Unlike the elderly, this group is less susceptible to life-threatening Covid-19, may face difficulties getting time off of work or feel they can afford to wait to get a vaccine. About 40% of adults in Oregon have received at least one shot.

The worst per-capita spread in the state is in rural Grant county, where a low vaccination rate has translated to “room to roam” for the virus, a local pharmacist said. Grant county experienced an early slowdown in demand and by the second week in April public health officials there had difficulty distributing doses.

Today, just 31% of Grant county has received at least one shot, Oregon Health Authority data shows. Nationally, 42.6% of Americans have received at least one shot, according to the CDC.

Also like much of the country, the worst vaccination rates in Oregon tend to correspond with the most Republican counties. In 2020, Grant county voted for Donald Trump by a 57-point margin. Polls have shown Republicans are the most likely group to report they will “definitely not” get a vaccine.

“I think the issue is that we have this very fragmented response system to Covid,” Dr Javier Nieto, an epidemiologist at Oregon State University in Corvallis told Bloomberg News. “You have a fragmented response where one county is doing one thing, another county – something else.”



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