The number of people hospitalized with COVID-19 in Oregon rose to 318 Monday, straining hospital resources and passing a state-set threshold that puts several counties on track for the “extreme risk” category. Oregon Gov. Kate Brown is expected to announce updated risk levels early this week, and counties that qualify will see increased restrictions on businesses and gatherings starting Friday.

The new hospitalization figures come as COVID-19 variants are becoming more established in Oregon. Cases have risen dramatically over the last week. “In the race between vaccines and variants, the variants are gaining ground and have the upper hand,” Brown said in a press conference Friday.

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Today, that wave appears to be a rising number of hospitalizations in Oregon. Only Montana and Washington have seen sharper spikes. Oregon’s cases rose by 51% over the last two weeks: that’s the fastest increase in the United States.

For counties to be placed in Oregon’s “extreme risk” category, they must meet certain metrics. On April 6, Josephine and Klamath counties met the threshold. To stop restrictions from being imposed, Gov. Brown added an additional requirement: at least 300 hospital beds must be occupied by COVID-19 patients in the state.

Now, a dozen counties are set to move to “extreme risk” status this week. In addition to Klamath and Josephine counties, Baker, Clackamas, Columbia, Crook, Deschutes, Jackson, Linn, Marion and Polk counties meet the criteria for “extreme risk.” Brown indicated a twelfth county could be on the threshold, but did not name it.

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Although some counties are harder-hit than others, the surge in hospitalizations is impacting hospitals around the state. “An increase in hospitalizations, especially among young, previously healthy individuals, is once again stressing our bed capacity,” Oregon Health & Science University Chief Medical Officer Dr. Renee Edwards said in Friday’s press conference.

“Already, we are caring for a number of extremely ill patients with COVID-19 that require a therapy called ECMO,” Edwards said. ECMO therapy filters a patients’ blood through a membrane, sort of like an external lung. “ECMO treatment is only offered in a few select hospitals in our state. It remains a precious and limited resource.”

Edwards blamed the increase in part on the presence of new COVID-19 variants, including the variant, B.1.1.7, which was first identified in Great Britain. The Centers for Disease Control and Prevention previously said that B.1.1.7 had become the most dominant strain in the United States.

The variant appears to be more likely to cause severe symptoms in young people. B.1.1.7 and other variants have been linked to a spike in COVID-19 hospitalizations in young adults throughout the country and around the world. And it’s not just that young people are less likely to have had a chance to be vaccinated: the people being hospitalized are sicker than normal, too.

“In the past few weeks we are caring for more patients with COVID in our (intensive care units) who are sicker, younger, and without underlying medical conditions,” Edwards said.

Another variant, B.1.351, has been detected in wastewater samples from Albany and Corvallis, Oregon State University researchers said Monday. That variant, also highly contagious, was first detected in South Africa.

Hospitals in the Portland metro area have resumed regular COVID-19 planning meetings so they can coordinate care and resources as a region.

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