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MURPHY & BUCHAL LLP
3425 SE Yamhill Street, Suite 100
Portland, OR 97214
Tel: 503-227-1011
Fax: 503-573-1939
E-mail: jbuchal@mbllp.com
Attorneys for Plaintiffs
EUGENE DIVISION
Plaintiffs,
v.
Defendants.
Oregon, and make this Declaration in support of plaintiffs' motion for equitable relief
concerning the emergency Executive Orders of the Governor. I practice adult psychiatry
in the Goose Hollow neighborhood and have been self-employed full time there for
at Legacy Good Samaritan Hospital, Legacy Emanuel Hospital, and Providence St.
Vincent Hospital. I have enclosed my curriculum vitae which outlines my education and
experience and judgment, and knowledge of available data from states and governments.
in the complaint. Initially we had concerns that COVID-19 would cause so much illness
that our hospitals would not be able to provide the care that was available. We have
learned that we can cope with the medical aspects of COVID-19 and have enough of bed
space, ventilators, and supplies to manage the current patient loads. Hospitals have surge
plans in place and we have the resources both locally and federally to help, should there
be need in the future. We know that the major risk of COVID-19 is among those who are
elderly and who have comorbid illnesses like hypertension, asthma, COPD (chronic
obstructive pulmonary disease), Diabetes, and Obesity. We know that people with
developing from this illness and when it develops further in the population the incidence
of the disease will decrease. We have one expedited FDA approved drug for COVID-19,
remdesivir, which lessens the duration of illness. The infection fatality rate (number of
people who have been infected with the virus and have died) as estimated by the World
Health Organization is .94 percent. Oregon’s current estimate of the number of people
19 have utilized precedents in 1905 based on the case fatality rate during the smallpox
epidemic. The case fatality rate is based on the number of people who have become ill
with the virus and have died. Smallpox had a case fatality rate of 30 percent. The case
fatality rate in Oregon is currently 4 percent.1 The impact of the decisions that were
made during the course of the epidemic and today, will not fully be understood and
appreciated for two to three years. Oregon has been required to make decisions based on
living with this illness from this time forward. Oregon hospitals have provided good care
for our citizens and are prepared to continue providing care in the event of future surges
which are likely. There have not been massive serious infections among our health
personnel in hospitals which might imperil our ability to cope with this virus. Our
citizens for the most part have been very compliant with government recommendations
both federally and on the state level. The majority of Oregon citizens have been
sacrificing their liberty and pursuit of happiness for the benefit of people in the most
vulnerable populations. The very structural integrity of our country was questioned
seriously by a variety of statisticians around the world who have fortunately been wrong.2
Many of our statistical models have been proven wrong and statistical models cannot,
with certainty, tell us what will happen in the future. Different statisticians working with
1
Oregon Health Authority Website updated 5/8/20
2
Osborn, MD The Scientist Whose Doomsday Pandemic Model Predicted Armageddon
Just Walked Back The Apocalyptic Predictions The Federalist 3/26/20
science in making its decisions about when and how to move forward.
4. Oregon has not shown that there is consensus within the medical
community at large in Oregon that the measures it is taking are necessary. Oregon seems
few because of its complexity and has high variance among its professionals. Oregon’s
reliance on statistical modeling, a very complex endeavor, likely not fully appreciated by
the political office holders making the decisions, represents a significant concern for it
being misused for political purposes. Politicians are putting their trust in statisticians
without the education and background to fully understand their reasoning. This allows
political figures to empower statisticians who may or may not have significant biases. In
with the same data can come to very different conclusions from that data. The statistical
modeling that is used is often dramatically changed over time by emerging new
assumptions and data. It is known that statistical modeling failed during the HIV
models will always turn out to be wrong in some way or other, because they rely on very
addition, the utility of the science of COVID-19 is limited and over reliance on science
that is not integrated with clinical judgment can cause negative impacts on mortality and
morbidity.
3
Culshaw, R. Mathematical Modeling of AIDS Progression: Limitations, Expectations,
and Future Directions Journal of American Physicians and Surgeons Volume II Number
4 Winter 2006.
and are easily obtainable from state and federal websites.4 I have included two charts,
one which shows the number of fatalities as of 5/6/20. By a simple calculation, I have
been able to arrive at the number of cases per one hundred thousand based on the
cause of death per 100,000 of various Oregon diseases compiled by the Oregon Health
France 25,531 39
Illinois 2,838 22
Colorado 903 16
Georgia 1,299 12
Washington 862 11
Oregon 113 3
4
Center For Disease Control Website, Oregon Health Authority Website, Washington
Health Department Website, Illinois Department of Public Health Website, Colorado
Health Department Website, Georgia Health Department Website.
5
Oregon Health Authority Fatalities, Vol. 2, Table 3 (2018).
Cerebrovascular 2,027 97
Disease
Suicide 843 41
the causes of death. It is currently the 18th leading cause of death in Oregon. As deaths
rise from COVID-19 it will move up the chart. The COVID-19 statistics are based on
approximately 2 months when the first Oregon fatality occurred. The infectious nature of
COVID-19 makes its incidence dynamic over time and not static like most of the other
numbers in the chart. As such it is not possible to extrapolate accurately what the death
will be over a 12-month period. How far COVID-19 moves up the chart over the year
will depend on the role of known variables. These include whether the virus subsides in
the summer, whether it will return and surge, whether effective treatments will reduce
whether herd immunity is established, the current extent of people who have immunity,
and the extent to which physicians refine current treatment efforts and other factors.
7. Oregon’s use of police powers to abrogate the liberty of our citizens has or
will cause an increase in emotional, mental, and behavioral illness. There are statistics
6
Based on only 2 months and not strictly comparable to the data from other causes of
death which are based on 12 months
are associated with mental health mortality and morbidity that pertain to an assessment of
1) The Oregon Liquor Control Commission says state-controlled liquor stores sold
close to $66 million in distilled spirits in March, a 20% increase compared to the
reached nearly $85 million last month. That's more than a $20 million increase,
the United States of 8.5 percent. It is much greater among men than women (12.5
percent versus 4.9 percent). Race/ Ethnic subgroups vary in prevalence with Hispanics
6.0 percent, Native Americans and Alaskan Natives 5.0 percent, Whites 5.0 percent,
African Americans 1.8 percent, and Asian Americans and Pacific Islanders 1.6 percent.
Alcohol use disorder is associated with the risk of accidents, violence, and suicide. It is
estimated that one in five intensive care unit admissions in some urban hospitals is related
to alcohol and that 40 percent of individuals experience an adverse event at some time in
7
Sickinger, Ted “Oregon liquor stores see record March sales”, The Oregonian/Oregon
Live, 4-14-2020 file:///D:/COVID%2010/Coronavirus%20-%20Wikipedia.html
8
“Oregon marijuana hits breaking-record sales in March, liquor sales see increase during
COVID-19 pandemic” Fox12 new, 4-8-2020
file:///D:/COVID%2010/Oregon%20marijuana%20hits%20breaking-
record%20sales%20in%20March,%20liquor%20sales%20see%20increase%20during%2
0COVID-19%20pandemic.html
in alcohol sales are likely leading to increased consumption, relapse in alcohol use
use disorder in the population. Stress levels are an associated risk factor for the
development of alcohol use disorders as well. Oregon has consistently ranked in the top
ten states for alcohol use disorders.10 We can expect increased rates of fatal car
accidents, violence, and suicide all related to the stress associated with actions instituted
by Oregon during COVID-19. The increase in alcohol use disorder prevalence will likely
problems. Higher cognitive functions are compromised in cannabis users and the
relationship appears to be dose dependent both acutely and chronically. This may
prosocial goal directed activity which has been labeled by some as the motivational
syndrome which manifests itself in poor school performance and employment problems.
Suicide Rates:
1) The U.S. suicide rate was 12.1 per 100,000 from 1920 to 1928 during the
Roaring Twenties. After the stock market crash of 1929, the suicide rate skyrocketed
50% to 18.1 per 100,000. The suicide rate over the next decade of economic
9
DSM-5 American Psychiatric Association
10
Recovery Connection Website
2) After the 2008 economic crisis, rates of suicide increased in the European and
American countries studied, particularly in men and in countries with higher levels of
job loss. The increases in suicide mainly occurred in men in the 27 European and 18
American counties; the suicide rates were 4.2% (3.4% to 5.1%) and 6.4% (5.4% to
7.5%) higher, respectively, in 2009 than expected if earlier trends had continued.12
who die by suicide are unemployed at the time of their deaths. For every one-point
increase in the unemployment rate, the suicide rate tends to increase .78 points. One
of the silent drivers of our current suicide crisis is the high percentage of working-age
10. The suicide rates in Oregon are elevated compared to other states in the
US. If we extrapolate data from the stock market crash of 1929, the Great Depression,
and the recession of 2008 we can make estimates about the suicide rate as associated with
COVID-19 in Oregon. There were 864 suicides in Oregon in 2019. A fifty percent rise in
the suicide rate like what was associated with the stock market collapse would indicate
that the number of suicides would be 1,296. The number of additional suicide deaths
11
Sullivan, Glen“Will COVID-19 Make the Suicide Crisis Worse?”, Psychology Today,
3-22-2020 file:///D:/COVID%2010/Oregon%20marijuana%20hits%20breaking-
record%20sales%20in%20March,%20liquor%20sales%20see%20increase%20during%2
0COVID-19%20pandemic.html
12
Impact of 2008 global economic crisis on suicide: time trend study in 54 countries,
BMJ 8-17-2013
file:///D:/COVID%2010/List%20of%20U.S.%20states%20by%20population%20-
%20Simple%20English%20Wikipedia,%20the%20free%20encyclopedia.html
recession in 2008 the additional deaths would be 46 by suicide per year and the total 910
suicide deaths. If we use the great depression of a 15.4 percent increase the suicide
additional suicides per year would be 133 for a total of 997 per year. Financial stress is
associated with the risk of suicide in our culture. Oregon will experience an increase in
during COVID-19.
Domestic Violence:
percent over levels in 2018 and 2019 during the COVD-19 lockdown13
March 23, Portland Police Bureau Chief Jami Resch said Wednesday, and a 12%
declaration14
IPV, says sexual and gender minorities are also at an increased risk for domestic
13
Andrews, Garrett Domestic violence calls rise in Bend during quarantine KGW8
4/28/20
file:///D:/COVID%2010/Domestic%20violence%20calls%20rise%20in%20Bend%20duri
ng%20quarantine%20_%20kgw.com.html
14
PPB Continues to Monitor Data During Pandemic; Domestic Violence Arrests are Up,
Portland Police Bureau, 03/25/2020
4) Children are also especially vulnerable to abuse during the pandemic, says child
Network at Penn State. Research shows that increased stress levels among parents is
often a major predictor of physical abuse and neglect of children, she says.16
5) The percentage of women who consider their mental health to be poor is almost
three times higher among women with a history of violence than among those
without.17
15
Abramson, Ashley How COVID-19 may increase domestic violence and child abuse,
American Psychological Association, 4/8/20 file:///D:/COVID%2010/How%20COVID-
19%20may%20increase%20domestic%20violence%20and%20child%20abuse-
LGBT.html
16
Abramson, Ashley How COVID-19 may increase domestic violence and child abuse,
American Psychological Association, 4/8/20 file:///D:/COVID%2010/How%20COVID-
19%20may%20increase%20domestic%20violence%20and%20child%20abuse-
LGBT.html
17
Boseley, Sarah, Domestic Abuse Victims More Likely to Suffer From Mental Illness -
Study 05/07/2019
18
American Psychological Association, Intimate Partner Violence Facts and Resources,
2012
19
Bureau of Justice Statistics Crime Data Brief, 02/2003
with the issues which interfere with their social and occupational functioning and also
their distress. In addition, childhood sexual abuse, physical abuse, emotional abuse, and
neglect are common and can be a major contributor to the outcome in their lives. Child
abuse is a risk factor for many mental health problems including Intellectual Disability,
and other disorders. By definition, these disorders are associated with varying elements
mental health disorder burden associated with the rise in domestic violence caused by
unable to keep themselves, their neighbors, and their community safe by voluntary
means. State recommendations rather than police powers would have been less
Oregonians in their interaction with government. Oregon citizens run the very real risk
continued use of Executive Order. The result of this deprivation of liberty in the future
will be anger. How Oregonian’s deal with that anger is unknown. They may turn it
against themselves and become self-destructive. They may develop a passive and
fatalistic attitude about their capability to be in control of their life. They may direct it
20
DSM-5 American Psychiatric Association 2013.
harder to build a more democratic, rather than a more totalitarian government, a less top
down and a more grassroots and collaborative relationship with its citizenry.
13. The effects of the Executive Orders will likely have effects on worker
motivation and productivity well into the future which will affect the states revenue and
capacity to meet its financial obligations to its most vulnerable and ill citizens. Sustained
people. It is likely that suicide, homicide, child abuse, alcoholism, drug use, and
criminality will increase because of the stress associated with a government, deeply in
debt, which can’t prove that it will put food on the table, pay a mortgage or rent, and
provide employment. While Oregon has relied on science, the science is not established
has been counterproductive to deciding what is best for Oregonians' health. Oregon has
failed to reach out to all the states physicians, nurses, naturopaths, and osteopaths, across
private, public, and charitable health efforts and figured in the input into decision making.
Oregon has not shown that there is consensus within the medical community at large in
Oregon that the measures it is taking are necessary. In a circumstance such as this,
requiring clinical judgment, the state has overly relied on the refined knowledge of
statistical modeling which is understood by few because of its complexity and it also has
high variance.
detrimental to the mental, emotional, and behavioral health of Oregonians. The use of
the Executive Order and Oregon’s Police Powers during COVID-19 will have long
capability of dealing with the realities of a communicable disease without being forced to
act the way in which the government instructs. Oregon could have utilized its capacity to
engage in a sustained and balanced public information campaign to educate and provide
guidance to its citizens as we moved through this pandemic. It could have reserved its
police powers to those who exhibited gross negligence in their conduct. Instead Oregon
has treated its citizenry as people who can’t be trusted to understand the public health
issues and to do what is right for their neighbors, community, and themselves. Whether
the anger associated with this violation of liberty will be directed in positive ways,
the form of passivity in relation to government or aggression toward their fellow citizens
or themselves are yet to be determined. Oregon should drop the Executive Orders
available science which needs to be tempered with its utility in making this decision, and
I certify under penalty of perjury that the foregoing is true and correct.
I hereby attest that I have on file all holographic signatures corresponding to any
MEDICAL EXPERIENCE:
EDUCATION:
COMMITTEES:
TEACHING:
PROFESSIONAL AFFILIATIONS: