COLUMBUS, Ohio — There are now a total of 45,537 COVID-19 cases in Ohio after 729 new cases were reported Monday, the highest number of new daily cases in the state since May 21.
The number of new cases reported Monday is nearly 300 more than the 21-day average of 455, and a significant jump from the number of cases reported over the weekend.
The surge of new cases was at least partly driven by coronavirus in Cuyahoga County; the 101 new cases reported there on Monday is the highest number of daily cases since May 29, and a continued upward trend of new cases.
While new cases appear to be on the rise in the county and the state, Monday marked one of the lowest new death counts since the start of the outbreak—just four new COVID-19-related deaths were reported in Ohio.
Hospitalizations and ICU admissions are also below the 21-day average; there were 50 new reported hospitalizations on Monday, compared to the average of 56, and just eight ICU admissions, compared to the average of 13.
The City of Cleveland reported 27 new cases, bringing their total to 1,962.
The median age for patients with the disease is now 47 and they range in age from less than 1 year old to 109. In all COVID-19 cases so far, 51% of patients are male and 48% are female.
To date, 656,318 Ohioans have been tested for coronavirus.
Although more than 700 cases were added to the state's total on Monday, doctors emphasized the state hasn't experienced an increase in hospitalizations or deaths.
Dr. Kristin Englund, a staff physician in infectious disease at the Cleveland Clinic, said there are a lot of factors contributing to the increase.
"We have seen more availability of testing, which is a good thing," Englund said. "We need to make sure that we know how many people are infected so that they can take the proper precautions and isolate themselves and not infect others."
However, she said more people across different states are going out to places like shopping malls and restaurants.
"We’re seeing more and more people getting out into public, and when they do, they’re not practicing proper precautions," Englund said. "We’re not seeing people wearing masks like they used to. We’re seeing people gathering together. You know, families want to get together and see each other, instead of just over the fence. They want to do it in the backyard with a barbecue."
In that situation, Englund said keeping six feet of distance is difficult, especially with children who want to get together and play.
As mandates in Ohio are loosened, "that means that we have to take that responsibility on ourselves and make sure that we’re practicing proper precautions, or we’re going to need to go back to putting on state-mandated precautions, as they’re starting to do in other cities and other states already," Englund said, citing Miami and other Florida cities as an example.
Englund said she believes that this is still the first wave of COVID-19, as does Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases.
"Is this the second surge? No, I’m very concerned about what’s going to be happening in the fall, as we start to see people getting more and more together, when schools start to reopen when people are back at work even more," Englund said. "And then when we start to mix that with the influenza virus that will be out at the same time, we’re gonna see things get a lot worse."
Englund also cited an increase in people traveling and going on vacation as a potential factor for the increase in cases.
She urged people to think beyond the near future.
"I know you’re tired of wearing masks," England said. "I know everybody’s tired of living away and isolated from everybody else. Look at the long term, look at things a year from now. You’re still gonna have your parents and your grandparents with you because we’ve all done the right thing and kept them healthy and away from any of these illnesses."
Of masks, she said, "It’s a way of saying to somebody else, 'I care about you and I want to make sure that you stay healthy.' And we should all be taking care to make sure that we’re doing that."
Dr. Keith Armitage, medical director of the Roe Green Center for Global Health through University Hospitals, said a number of states are seeing increased numbers of COVID-19 cases among young adults in particular.
"People are tired, they’re worn out I get that. Pandemic fatigue has set in," Armitage said. "But this should be a wake-up call that if we let our guard down, this can happen."
Armitage said he thinks the uptick is from people "not observing social distancing, particularly [in] bars, restaurants, indoor venues."
"There was some concern that the protests might lead to an increased spread, the protests that I saw were outdoors and pretty heavily masked, and so I think that’s lower-risk, [but] it could contribute," Armitage said.
While people in their 20s and 30s are "at low risk for having a serious illness," Armitage said, "the more the virus sort of propagates in the community, the more likely you are to start to see hospitalizations, people on ventilators and deaths, and so it’s very disappointing."
Armitage said that there tends to be a lag of two to three weeks in deaths and hospitalizations after an increase in COVID-19 cases, so the fear is that there will be more hospitalizations, more ventilators, and more deaths in a few weeks.
He said he would tell people who don't want to wear masks that it is important in making sure numbers remain low.
"I find wearing a mask annoying, but a lot less annoying than I do seeing someone get coronavirus, a hundred times less annoying than someone in the hospital, a thousand times less annoying than someone on a ventilator and ten thousand times less annoying than someone dying," Armitage said.
Of those who might see mask-wearing as an intrusion into their lives, he urged them to think of it as a societal norm or expectation.
"You can’t go into a restaurant with no pants on, you can’t go into most restaurants with no shirt on. You can’t drive drunk. You can’t drive 200 miles an hour," Armitage said. "These are things our society accepts as rules because we know driving drunk, driving 200 miles an hour puts other people at risk. And we’ve accepted things like being fully clothed in a restaurant as a societal norm. And I think until we get to the end of the pandemic, people should think of wearing masks indoors, in public, as a societal norm, not as a government regulation or government rule, but something we all adopt as a way to try to get through this."
He also urged people to understand that the way to get the economy moving again is to open up businesses safely, with masking as one way to do it.
"It would be very unfortunate if the cases spiked so much we had to reimpose a shutdown," Armitage said. "So I think, for people that want to see the economy growing and growing, the unemployment going down, which we all do, they should support masks. You know, masks are a way to do that safely without having this increase in cases."
Armitage, like other doctors, expressed concern that a busy influenza season and a second wave of COVID-19 cases in the fall could take place at the same time in the fall and strain the health care system.
"A bad influenza year fills up the ERs, fills up the hospitals," Armitage said. "If you combine a bad influenza year with a surge or second wave or a third wave, could really put a stress on our capacity to take care of people."
Dr. Mark Cameron, an associate professor in the School of Medicine at Case Western Reserve University observed that there is currently a "slow burn of the virus" and described it as "kind of the worst-case scenario for us."
While it's too soon to know the impact of the increased number of cases, and the numbers are only about half of what they were daily during Ohio's peak, Cameron said people can't become complacent, especially with concerns about a second wave in the fall.
"Coughing and fever and malaise and muscle ache. How do we separate all of that cold and flu activity from COVID-19?" Cameron said.
With Ohio currently experiencing a plateau in cases, and people experiencing some fatigue in mask-wearing and observing social distancing, Camera said Ohioans must "think in terms of national and global scale, in terms of how we prevent the transmission of infections here in Ohio."
"We have to know how to do this," Cameron said. "We have to know how to truly break this virus’s back before we all come back in for the cold and flu season in the mid-fall."
He urged people to continue taking easy precautions, such as masking and social distancing.
"Our most effective way of stopping our first wave from peaking higher than it did was stay-at-home orders, and nobody wants to go back to that," Cameron said.
He said there will be bad days, with increases in cases, like Ohio has experienced the last few days.
"We have to learn from them," Cameron said. "We have to perhaps change our behavior, we have to remind people that the virus is still out there and everybody still has a chance to fight this, to be a hero in their community, to block new infections and save people’s lives. We also have to remember that the virus can be controlled and that the chains of transmission can be blocked."