It’s been a month since masks came off in most public spaces in Oregon and things are going exactly as expected with the coronavirus, said Dr. Paul Cieslak, the medical director for communicable diseases and immunizations at the Oregon Health Authority.

“We are now seeing cases start to increase and hospitalizations start to increase,” he said. “This was predictable. In fact, that was predicted by our modeler, Dr. Peter Graven at (Oregon Health & Science University).”

Despite the rising cases, which are due largely to the lifting of the mask mandate and the increased transmissibility of the now dominant omicron subvariant, Cieslak said, “I’m very optimistic that we’re not going to see the kind of surges in hospitalized patients that we saw with omicron and delta.”

His primary reason for that optimism is that immunity is very high. Seventy-six percent of Oregonians are fully vaccinated, according to the Oregon Health Authority, and many who are not, including young children, have already been infected, whether they know it or not, Cieslak said.

About 75% of children had contracted COVID-19 as of February, according to a study by the federal Centers for Disease Control and Prevention that collected blood samples from tens of thousands of people to test for antibodies. The rate was nearly the same for children younger than 12 and those aged 12 to 17. More than half, 58%, of all people tested had antibodies indicating prior infection.

Since children younger than 5 have been hospitalized at such low rates despite their high exposure level, Cieslak said he would be paying close attention to the CDC’s discussions about the recently submitted vaccine performance data for this age group.

“They’re going to need to look at disease rates. They’re going to need to look at protection and they’re going to need to make some estimates about how long does that protection last,” he said. “Is it really going to be worthwhile for young children to get vaccinated? What’s their likelihood of ending up in the hospital with COVID-19? Especially given that many of them have already been infected and have at least some immunity from that prior infection.”

The other reason for Cieslak’s optimism, is that while omicron is more contagious, it’s decidedly less severe. That holds true for both the original omicron variant and the BA.2 subvariant, which now account for 100% of the COVID-19 cases in Oregon, according to state data.

“It seems to be more like a really bad cold,” said Dr. Melinda Muller, the associate chief medical officer at Legacy Health, a statewide hospital network. “Not to downplay it, but I think the vaccines are working and doing what they’re supposed to do and helping us even if you get it you’re not going to get super sick.”

Muller said she’s had a lot of patients, including many who have avoided contracting it so far by “doing everything right,” come down with the disease in recent weeks. “They’re getting it but they’re not getting really, really sick,” she said of her vaccinated patients who have carefully followed masking and distancing recommendations and yet are getting sick now anyway.

Vaccinated adults are especially likely to have mild symptoms if they catch COVID-19 these days. Fever, sore throat and fatigue remain common, but Muller said she has seen fewer of these patients present with shortness of breath, debilitating fatigue, or other more severe symptoms.

“Definitely talk to your doctor, like if you have diabetes or some other illness,” such as an underlying lung condition, said Muller, “but even people who have that don’t seem to be getting too much sicker.”

Muller is still wearing a mask in the grocery store and plans to don one for an upcoming flight, but said she is loosening up in other areas of her life, like going out to eat.

“I think we’re starting to come into some kind of equilibrium,” Muller said, noting that it’s still unclear if there will be a few more surges soon or if there will be a yearly surge pattern, like with the flu. But it has been almost three years, she pointed out, the same length of time it took the 1918 flu pandemic to run its course.

“I think we’re getting close to ‘this is just going to be part of life,’” she said. “We just don’t know to what degree a part of life it is yet.”

In Clatsop County, the Oregon Health Authority recorded 77 cases of coronavirus from April 1 through April 26.

Case counts rose as the month wore on. April 1 through April 10 saw 10 new cases; the 11th through 20th saw 34 new cases; and from the 21st through 26th, the county saw 33 new cases.

The Clatsop County Public Health Department’s public information hub that reports on virus news tracked one outbreak, at Clatsop Care Health & Rehabilitation, that was originally reported to the health authority in late March. One resident, a woman in her early 90s, died after testing positive.

As of April 26, the health authority had recorded 4,672 virus cases in Clatsop County.

On Monday, the county reported a 50th death related to the virus.

A 70-year-old man died at an area hospital on April 7, the county said.

It is unknown whether he had been vaccinated against the virus, the county said.