Oregon hospitals are seeing a surge in COVID-19 cases even as reported new infections start to drop, public health agencies reported Thursday.

The Oregon Health Authority reported Thursday that 1,130 people in state hospitals have tested positive for COVID-19, a jump of 69 cases in one day.  

The record of 1,178 people in Oregon hospitals was set Sept. 1, when the delta wave that began in late June peaked.

The Oregon Health & Science University forecast last week that the number of hospitalizations would peak at 1,553 next Tuesday. A new forecast due Thursday won’t come out until Friday.

There were 169 COVID-19 positive patients in intensive care unit beds, up from 155 the day before.

OHA reported 19 new deaths on Thursday, bringing the state total since the beginning of the pandemic two years ago to 6,067. OHA noted the fatality milestone on Wednesday.

“We’ve lost mothers and fathers, sisters and brothers. Coworkers and neighbors. These losses pain all of us,” said Dr. Dean Sidelinger, state health officer and state epidemiologist. “What makes these losses more painful is that nearly all our most recent deaths could have been prevented by COVID-19 vaccines, which remain the best protection against serious illness and death.”

Unvaccinated Oregonians make up the overwhelming majority of severe cases and deaths.

The Centers for Disease Control and Prevention reported earlier this week that Americans 65 and older who are not vaccinated are 49 times more likely to be infected and require hospitalization than those vaccinated and had a booster shot. 

Oregon is showing signs of following the nationwide trend of hitting a peak in omicron-driven infections followed by a steep drop-off.  

Oregon’s hospitalization spiral comes as reported new infections dropped to 7,781, down from 8,207 in Wednesday’s report. A week ago, the state tallied 10,034 new infections in its Thursday report.

The percentage of tests that were positive dropped to 23.6%, down from the previous day’s average of 24.9%

Multnomah County, the state’s most populous, had 1,101 new cases. Marion (989), Washington (936), Lane (869), Clackamas (522) and Deschutes (454) followed.

The counties with the highest number of cases over the previous week, adjusted for population, were Sherman, Jefferson, Wheeler, Crook and Wasco.

Morrow County had the highest positive test rate at 52.3%, followed by Wheeler (50%), Malheur (44.1%), Curry (42.2%), Douglas (38.1%) and Wallowa (37.2%).

Oregon is hoping to soon join the parts of the country where the wave hit and peaked earlier and is now receding.

New infections are down 21% nationwide compared to two weeks ago, according to an ongoing survey by The New York Times. Data shows 31 of 50 states reported falling case rates. Hospitals reported the number of COVID-19 patients had slowed to a 5% increase compared to 14 days ago.

Deaths, which have been a lagging indicator throughout the pandemic, are up 34% over the same period.

A total of 878,220 people in the United States have died from COVID-19, the most of any country, according to the Johns Hopkins Coronavirus Resource Center. More than 5.63 million have died from COVID-19 worldwide.

Dr. Anthony Fauci, the nation’s top infectious disease expert, said Sunday that enough data had come in to be able to show a definite decline in COVID-19 cases nationwide.

“Things are looking good,” Fauci said. “We don’t want to get overconfident, but they look like they’re going in the right direction right now.”

Health officials have increasingly shifted to the idea that COVID-19 surges are less likely in the future as vaccination and exposure to the virus leave few Americans with no defenses.

COVID-19 could become endemic — a permanent but cyclical part of life that can be managed but not eradicated.

But the primary pair of vaccines — Moderna and Pfizer — have been in use for 14 months and show evidence of waning effectiveness. The CDC has recommended one booster shot to increase immunity. A fourth booster shot is under consideration and already suggested in other nations, such as Israel.

The omicron variant was able to get around the vaccine’s initial defenses and infect about half of vaccinated people who were exposed, according to the Institute for Health Metrics and Evaluation at the University of Washington.

Most vaccinated people who became infected experienced mild illness or had no symptoms at all. But the sharp increase in breakthrough cases compared to early versions of COVID-19 has led Pfizer and Moderna to work on new boosters that specifically target the omicron variant.

More variants are expected. The original COVID-19, now called the “ancestral” strain by scientists, had fallen off sharply by late spring 2021. In Oregon, Gov. Kate Brown lifted many mask requirements and other restrictions put in place at the beginning of the pandemic.

But the delta variant hit the United States in June, leading to record numbers of severe cases and deaths. The delta wave peaked Sept. 1 and was beginning to decline.

Hopes that the delta wave would dissipate by the end of the 2021 were swept away as omicron cases went up while delta was still going down.

Now optimistic projections about the omicron wave show very low infection and hospitalization levels by mid-March.

But after two surprise waves from variants, officials are restraining any announcement of defeat of COVID-19.

The spotty vaccination record around the globe because of access to vaccines, along with many areas in the United States where people have refused to be vaccinated, leaves openings for future variants.

Omicron spread incredibly fast but had a weaker impact on individual cases.

The nightmare scenario is a variant that spreads rapidly, can circumvent vaccine defenses, but is severely more virulent. 

The World Health Organization has three categories of variants. So far, variants have only been classified in the two lesser levels.

Variants of Interest, the lowest level, display equal or less contagiousness and virulence than the original COVID-19 strain. The virus that started in Wuhan, China at the end of 2019 has had dozens of spin-offs.

Most of the earliest cases in Oregon were from a California variant with slight differences to the original COVID-19 that was infecting the eastern and middle portions of the nation.

Variants of Concern have markedly different characteristics than the original COVID-19 virus, presenting new medical and public health impacts. These variants can be at least partially managed by current vaccines and safeguards such as wearing masks.

These variants began appearing in the spring of 2020 and have continued to pop-up around the globe — England, Brazil, India and southern Africa were among the places where the new variants were first reported.

The World Health Organization reclassified the naming of these variants to use Greek letters. Delta and omicron are two of the most recent variants of concern. 

Variants of high consequence are the third and most dangerous category. The World Health Organization has not classified any variant at this highest level as yet. Such a variant would be able to spread despite vaccination and would cause widespread severe illness and death.

Though omicron is less virulent than earlier versions of COVID-19, that does not mean that future variants will also cause less illness and death than earlier versions in the pandemic.

But the best case scenario is that what has been learned so far about the virus can be applied to control but not eradicate COVID-19.

A group of medical experts wrote to President Biden last week that the unique nature of COVID-19 called for a new public health strategy. The earlier goal of “herd immunity,” in which the virus runs out of people to infect was unlikely. COVID-19 would continue to challenge the United States because of the large number of unvaccinated people, the waning of vaccine effectiveness against initial infection, and the unique way the virus mutates.

The letter urged Biden to create a risk tolerance response in which emergency measures could be implemented when especially high infection rates or virulent variants appeared.

But the rest of the time, the nation would keep its guard up, but return to regular patterns of business, travel and social life.