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Despite record number of COVID-19 cases, Cuyahoga and other counties avoid Level 4 'purple' status

COVID Map 10/29
Posted at 2:41 PM, Oct 29, 2020
and last updated 2020-10-29 19:02:01-04

On Thursday, Ohio saw its highest number of daily COVID-19 cases to date, with 3,590 reported — 25% more than Saturday’s previous record high. Despite this, no counties in the state were increased to purple Level 4 on the Public Health Advisory System, according to Gov. Mike DeWine.

RELATED: 'The virus is raging with no place to hide' — Ohio again breaks record with over 3,000 COVID cases for first time

DeWine called the fact that no counties were moved to the highest level “the one bright spot” in the COVID-19 update.

Cuyahoga was one of three counties that were put on a watch list last week for hitting indicators that would put them at the purple Level 4—but like Hamilton and Clark counties—the county “plateaued” and the indicators did not see a significant enough increase to move up a level.

For a county to move to the highest level on the alert system, DeWine said that the county has to see the flagged indicators increase, and while the three counties are still seeing a “disturbing trend” in COVID-19 cases, they have been removed from the watch list as of Thursday.

Cuyahoga County was headed to the purple zone, but the governor said things leveled off.

"Our alert system is designed to flag indicators that are getting worse. What we're seeing is in these three counties plateaued at high levels. In Cuyhaoga County, outpatient emergency visits are at an elevated plateau, hospital admissions have been increasing,” DeWine said. "What we see in these counties is similar to what we're seeing in the rest of the state, case numbers are continuing to go up. Health care utilization is trending upward."

For a county to be moved to a level four or purple status, they need to have six or seven coronavirus indicators.

The seven data indicators are:

  1. New cases per capita - When the data shows that a county has had an average of 50 cases per 100,000 people over a two-week period, that will trigger a flag for increasing case rate.
  2. Sustained new case growth - If the data shows at least a five-day period of sustained new case growth, that will trigger a flag.
  3. Proportion of cases that are non-congregate cases - When there are a large number of positive cases from those living in the broader community, more than 50% of new cases originating from non-congregate settings during at least one of the past three weeks, that will trigger a flag on this indicator.
  4. Sustained increase in emergency room visits - When there is an increase in the number of people who visit an emergency department with COVID-19 symptoms or COVID diagnoses over a five day period, that will trigger a flag on this indicator.
  5. Sustained increase in outpatient visits - When there is an increase over a five-day period in the number of people in outpatient settings, including telehealth appointments, with suspected or confirmed COVID-19 symptoms, that will trigger a flag on this indicator.
  6. Sustained increase in new COVID-19 hospital admissions - When the numbers show at least a five-day period of sustained growth in the number of county residents with COVID-19 who are admitted to a hospital, the county will be flagged for meeting this indicator.
  7. Intensive Care Unit (ICU) bed occupancy- A county will be flagged for the indicator when the regional ICU occupancy goes above 80% for at least three of the last seven days.

Cuyahoga County has met four of the seven indicators. It has not met emergency room visits, outpatient visits or ICU bed occupancy. Last week, when it was placed on the watch list for purple, it had met six of the seven indicators.

While Cuyahoga County is not purple, DeWine said that there are still serious concerns, as there are across the rest of the state.

The average age of COVID-19 cases in Cuyahoga County, as well as Hamilton and Clark counties, has continued to increase, as have cases and hospitalizations.

DeWine said that healthcare utilization is trending upward and called the increasing numbers “concerning” and said, “This is not good.”

He’s now calling for county leaders to form a COVID defense team.

"It should be in each county representative of the community,” said the governor. "I am asking the COVID defense team and each of our counties to assess and understand their situation. To inventory their assets in the community and to focus on what steps to take to turn the situation in their community around.

Meanwhile, the City of Cleveland says it's going to continue its efforts of enforcement this weekend at bars and restaurants.

We will be out there enforcing making sure that we are in compliance with the face-covering ordinance, we're in compliance with social distancing, we're in compliance with making sure that we're adhering to all of the local and state regulations,” said interim director of the Cleveland Department of Public Health Brian Kimball.

Cleveland has seen more than 6,000 cases since the pandemic started.

The city has been averaging 50 new cases a day for about a week, which is double the number of cases it’s seen in the past.

Mayor Frank Jackson says the city will continue doing what it's doing to keep cases down. He’s open to a new plan but is unsure of what that might be.

"I don't know going forward, what new things we will do,” said Mayor Jackson. "We will evaluate that as if we're moving forward. And if we are declared a level four today or in the near future, we will determine whether or not we will take any additional actions, or we'll double down on whatever it is we're doing.”

The governor said that 78% of all Ohioans are living in a red county while less than 1% are living in a yellow county.

In Northeast Ohio, all counties other than Erie, Huron, Sandusky, Holmes, Ashland, Medina and Carroll are at red Level 3. The aforementioned counties are all listed at orange Level 2.

Ashtabula and Trumbull counties were increased to red Level 3 this week, joining a total of 43 counties at that level.