The Oregon Association of Hospitals and Health Systems is now among those pushing for the governor to enact a "shelter in place" order to decrease the spread of the disease statewide—or at least in the Portland region.

"Absent widespread testing and the ability to isolate patients, the public health tool we must use to avoid a rising patient surge is social distancing," says Becky Hultberg, president and CEO of the hospital association. "Yesterday, our board recommended that the governor take the strongest possible action when it comes to social distancing measures now. We support action on the state or local level to further limit retail commerce, unnecessary travel, and adopt 'shelter in place' strategies."

The hospital association met with Gov. Kate Brown yesterday.

The governor cited the advice she's getting from public health experts as a reason not to move ahead with a shelter in place order.

Brown told reporters this morning that it would be unnecessary to enact a shelter in place order at this time if people follow her existing social distancing measures. She's closed schools and, as of last night, in-person classes at universities. She's already recommending that people over 60 or who are otherwise at risk of the disease to stay home.  The governor has also limited any meeting to 25 or fewer people.

"I'm asking Oregonians to apply the aggressive social distancing measures we have in place," she says. "My message to Oregonians is that by complying with these measures you will save lives, and one of these lives may be your own."

But that decision was not enough for the hospital association.

"The coronavirus is dangerous because, although we can't see it, the virus is in our community and it is lethal," says Hultberg.

"Hospitals and health systems are preparing for a surge in COVID-19 patients, and it is critical that we have the capacity to care for those patients and others who present at our facilities. Mortality is higher when the health system gets overwhelmed. We must act now to save lives."

The decision comes after Portland Mayor Ted Wheeler circulated a draft March 18 of a similar order that would apply only to Portland.

Oregon Health & Science University's chief medical officer told reporters last night that OHSU would support a shelter in place order.

"We would be supportive of that measure, if the governor chose to move in that direction, because we're facing the type of surge in need for hospital capacity, including ICU beds and ventilators," said Dr. Renee Edwards, chief medical officer for OHSU, the Portland Tribune reported.

"We want to make sure that we will be able to deliver upon the care that the citizens of Oregon need facing this concern. We would absolutely be supportive if the governor's office made this determination," Edwards added.

The governor seized on the wording of Edwards' statement that OHSU would support shelter in place if the governor "chose to move in that direction."

Others dispute the advice Brown is apparently receiving.

"There is actually broad consensus in the medical community that shelter in place should be instituted now," says Multnomah County Commissioner Sharon Meieran. "This includes the recommendation of the state's leading academic medical institution, OHSU.

"Shelter in place is one of those options that, if it's being considered, then it needs to be done as soon as possible. The entire point is early intervention, and we are already behind the eight ball in terms of our response to COVID-19. Indecisiveness is no justification for inaction. Our failure to act now will later be measured in lives lost."