The Omicron variant of COVID-19 is poised to overwhelm Oregon's hospital system, the state’s top health care officials said Friday.

Now the question is how much strain it will place on the state’s hospital system—and how the state’s pandemic-weary residents will respond.

Newly-issued projections from Oregon Health & Science University forecast that hospitalizations as a result of the fast-spreading, more transmissible Omicron variant could hit 3,000 by February, or twice the level of the Delta-variant fueled spike that peaked in August.

(Other models may surface different outcomes; the OHSU forecast drew largely from data coming from the United Kingdom and Denmark, both of which are several weeks ahead of Oregon in their Omicron experience. Peter Graven, who models the forecasts for OHSU, acknowledged Friday that other agencies, including the Centers for Disease Control, may have different projections, but said they were, “unlikely to be much lower,” than his data.)

As a result, the state is mounting a furious campaign over the next five to six weeks to get another million Oregonians boosted with a third dose of a COVID vaccine, which would be a huge ramp-up from current booster rates. Currently, only about 28 percent of eligible Oregonians have gotten a booster shot, which offers very strong (though not bulletproof) protection against the virus, particularly against getting a severe case of COVID-19 that would require hospitalization.

The state will be opening more high-capacity vaccination sites, sending mobile clinics to long-term care homes, beefing up staff at local public health organizations, receiving an increased supply of booster doses from the federal government, and increasing outreach about booster shots, especially in communities of color, which have been especially hard-hit by COVID-19.

Gov. Kate Brown says that “at this time” she is not currently considering other restrictions, like capacity limits at businesses; she also said she wants to keep schools open “to the extent that we can do so safely.” (Public schools have not been the source of major outbreaks this fall.)

Brown also said she would not be requiring state employees to get booster shots, instead focusing on particularly vulnerable residents, but added that “everything is on the table,” as the weeks progress. State employees who were being called back to work in person after the first of the year will be able to keep working remotely until the Omicron threat has clearly passed, Brown added.

“Folks should be aware, this is going to impact how businesses operate, because this variant spreads so easily,” Brown says. But ordering a shutdown in businesses is less likelier this time, she added, because there isn’t federal aid available for impacted business owners, and because vaccines and boosters are widely available, though have been hard to find on occasion due to high demand in the metro area.

Nationally, a few universities and performing arts venues have already announced booster requirements for students or patrons; locally, organizations from the Portland’5 Centers for the Arts to Portland State University say they aren’t ready to follow suit, but are keeping a close eye on the science and government recommendations.

“We are also concerned about accessibility, and cutting certain demographics out of being able to come to shows.” says Robin Williams, the Executive Director of Portland’5. “It’s the big picture that we wrestle with. We are watching what is going on. If things shift, we will pivot in that direction.”

Along with hospitalization levels, overall cases in Oregon could rise under Omicron to previously unseen levels. One piece of good news is that the variant does appear to be causing less severe cases and fewer deaths than the Delta variant did; Graven says it is likely that those who are hospitalized will have shorter stays and need fewer high-level interventions than those in the summer. Still, it’s a numbers game, and with so many likely to be infected—albeit many with mild, moderate, or no symptoms—case numbers overall will rise in the months to come.

Patrick Allen, the director of the Oregon Health Authority, said the state will continue to consider a range of different metrics, including case numbers, vaccination levels, and hospital capacity before it decides when and how to lift its indoor mask mandate.

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