A resident of Clatsop Care Health & Rehabilitation in Astoria who had tested positive for the coronavirus died on Friday morning.

The 92-year-old woman, who lived at the care home for a few years, had contracted the virus along with several other residents and staff as part of an outbreak first reported to the Oregon Health Authority on March 22.

The most recent round of tests revealed 16 virus cases: nine among residents and seven among staff, according to Clarissa Barrick, the administrator of the facility, which is under the umbrella of the Clatsop Care Health District.

Of the nine residents, three were unvaccinated against the virus and six were vaccinated and had received an additional booster shot. The woman who died was unvaccinated.

Of the seven staff, one was unvaccinated, two had received their initial vaccine doses and four were boosted, Barrick said.

At the facility, 49 of 54 staff — 91% — have received their initial doses; of those vaccinated, 36 — 73% — are boosted. Several staff members received medical or religious exemptions to vaccination, Barrick said.

The facility does not know the source of the outbreak, which occurred as the state lifted pandemic restrictions amid declining virus case counts and hospitalizations.

Gov. Kate Brown’s emergency declaration over COVID-19 ended Friday after more than two years.

Early in the pandemic, the federal Centers for Disease Control and Prevention cautioned that care homes posed a special risk of virus outbreaks. The communal living situations, coupled with age-related health conditions, make the environments vulnerable to sudden case spikes that can lead to severe illness and death.

Over two years of the pandemic, residents at other care homes in the county have died after outbreaks. Until last month’s outbreak, Clatsop Care had experienced little more than a dozen virus cases, overwhelmingly among staff.

Friday marked the first COVID-related death at the facility.

Barrick said the care home offered COVID-positive residents Paxlovid, a Pfizer-brand oral antiviral medication to treat their virus symptoms. “It looks like it’s been very helpful in lessening symptoms,” she said in an email.

The Clatsop County Public Health Department has asked the state to investigate whether the outbreak was caused by the omicron variant, the new omicron subvariant, or both, Margo Lalich, the department’s interim director, said.

Two years ago, during pandemic shutdowns, residents were isolated to their rooms.

“We can’t do that anymore. That’s just not appropriate,” Barrick said. “So while we’ve got people on isolation, we also have people that are going out into the community and having dinner with their families, which is great.

“I think everybody wants to move forward and move away from COVID, and what that looks like is very different for the people inside this building,” she continued.

Attitudes toward treatment of the elderly through the pandemic have been fiercely polarizing. Some people worry that care home residents will suffer from loneliness and isolation, while others are more afraid for residents’ safety as the virus circulates.

Earlier this year, the federal Centers for Medicare & Medicaid Services issued guidance to care homes saying, “the bottom line is visitation must be permitted at all times with very limited and rare exceptions, in accordance with residents’ rights.”

“So we’ve had lots of visitors in the building, which is wonderful,” Barrick said, “but with it comes some give and take.”

The care home continues to offer vaccines to unvaccinated residents.

Barrick said she hopes the community is understanding toward the care home’s dilemma. “We are doing everything within our power while trying to respect the rights of the residents to see their families, to engage in the community, to visit their primary care physicians, and with that comes a certain amount of trade-offs,” she said.

She added: “We have to acknowledge that these residents have emotional and social needs, as well.”

Lalich said the county is closely monitoring the outbreak. The care home is “doing absolutely everything they’re supposed to,” she said.

The question, she said, is whether more outbreaks can be expected in the community.

The Oregon Health Authority reported two new virus cases for the county on Thursday and seven new cases on Wednesday.

Since the pandemic began, the county had recorded 4,592 virus cases as of Thursday. The county has recorded more than 45 deaths related to the virus.

Lalich emphasized, as she has before, “The health and well-being of the community is a shared responsibility, and that still remains the case.”

She said, “The pandemic isn’t over, and if people navigate day-to-day life as if it’s over, the mitigation efforts that have been adopted over time” — vaccines, masks and quarantining — “that we know work, will become less important or even forgotten.”