PORTLAND, OR (KPTV) - It's going to be an uphill climb to the light, according to state health experts, to get back to pre-pandemic life in Oregon. But that light is close.

Friday's COVID-19 update was both hopeful and dire, as Governor Kate Brown said the state is dealing with a fourth surge of rising case numbers and hospitalizations. The numbers have been steadily rising since early March.

According to Dr. Dean Sidelinger with the Oregon Health Authority, the state's weekly COVID-19 case counts have increased by more than 20 percent for the fourth consecutive week and hospitalizations have more than doubled since March 1.

The good news, OHSU Chief Medical Officer Dr. Renee Edwards said, is that vaccinations will likely reach a critical percentage in about three weeks. She said that should prevent the virus from spreading rapidly.

Meanwhile, 23 Oregon counties, including the tri-county Portland metro area, are now in the high risk category effective Friday. Eleven counties moved up from less restrictive categories.

"This is essentially your warning," Governor Kate Brown said. "Should cases continue to rise and should we reach capacity in our hospital systems, there will be several counties moving into extreme risk next week."

Edwards said hospitals are starting to see units filling up again, adding that two hospital systems in the metro area are already starting to scale back elective surgeries because of the strain on resources.

An OHSU ER physician told FOX 12 that the emergency department there hit a tipping point earlier in the week.

"On Monday we overflowed into the surge space in the emergency department because of the increased demand," Dr. James Heilman said.

He also said OHSU has had to divert ambulances to other hospitals the past couple weeks, which he said is unusual for this time of the year.

Part of the reason hospitals are seeing increased demand is that more severe COVID-19 patients have been coming through the doors the past few weeks, state health leaders say.

According to Edwards, more people have been needing life support treatment like ECMO, and patients with severe COVID-19 symptoms are trending younger with no underlying conditions and no vaccine.

"We have a busy ECMO service right now," Heilman said, "it'd be more along the lines of one or two available."

According to Sidelinger, the biggest percentage increase in COVID-related hospitalizations has been in the 50-54 age group, followed by the 35-49 age group.

On Friday, OHSU reported that about 60 percent of its hospitalized COVID-19 patients are under the age of 60.

Not every hospital is seeing the same patterns. FOX 12 got a statement from Dr. John McCreary, Clinical Vice President of Medical Affairs for Legacy Health, who said the hospital is keeping a close eye on the situation, but that it has not seen an increase in younger patients and has not needed to implement any overflow strategies at this time.

"Legacy's COVID-19 census rose slightly 3-4 weeks ago but has been stable at roughly one-fourth the peak volume seen in late January," McCreary said in the statement. "Most of the increase is due to difficulty with patient placement and hospitalizations for non-COVID reasons, for instance, trauma and other critical needs."

If numbers continue to move in the wrong direction and hospitals do start hitting capacity, Governor Brown said several counties could be moved into extreme risk next week, but she didn't specify which ones.

The extreme risk category would force businesses like gyms and outdoor venues to tighten up capacity restrictions even more, and restaurants would have to close indoor dining rooms once again.

"I just spoke to the employees again today, if we close we're going to have to adjust the hours again," Boriken Restaurant owner, Sam Vasquez, said.

The Beaverton restaurant owner said going back to takeout-only would knock his earnings by more than 50 percent.

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