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New MetroHealth modeling shows COVID-19 cases will increase through May as businesses reopen

New MetroHealth model
New MetroHealth model
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Posted at 1:58 PM, May 19, 2020
and last updated 2020-05-19 13:58:48-04

CLEVELAND — MetroHealth has released new models that project an increase in COVID-19 cases in Ohio and Cuyahoga County later this month and into June as the state reopens businesses, then a decrease in cases in late June, according to a news release from the organization.

“With more people going back to work, dining out and interacting with others, of course we expect an increase in cases,” said MetroHealth CEO and President Akram Boutros, MD. “Economic activity has to return, but we remind people to take necessary precautions.”

During the time since Gov. Mike DeWine and Ohio Health Director Dr. Amy Acton issued the stay-at-home order, it is estimated that Ohioans limited contact by 65 to 80%. The reopening of the state’s businesses is expected to increase contact between individuals by 200-350%, according to MetroHealth. Increasing contacts will result in clusters, which will continue to be the predominant driver of new cases.

New MetroHealth model
The newly-released MetroHealth model showing total cases, based on a significant increase in contacts as businesses reopen in Ohio.

MetroHealth was the first health system in Ohio to release a model predicting the number of cases in the state and Cuyahoga County, which was much lower than originally predicted by the Ohio Department of Health. MetroHealth said those projections were proven to be largely accurate because they were based on clusters of infection that captured the extent to which Ohioans were social distancing. The clusters in the model were represented by jagged increases and decreases on a graph, as opposed to a larger bell curve representing community-wide infection.

The forecast model used by the Ohio Department of Health was developed by The Ohio State University in early April and showed two curves – one that projected an unmitigated spread of the disease, and another that factored in preventative measures like social distancing. While it accurately predicted the peak of new cases in mid-April, the projections of new cases this week are lower than what is being reported. The Ohio State model predicted 222 new cases on May 18, while the actual reported number from ODH on May 18 was 531 new cases.

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A model develeoped by epidemiologists at The Ohio State University, last updated in early April, showing the curves of new cases with and without mitigating measures.

The MetroHealth model, on the other hand, uses actual case data through May 15 and had a more accurate forecast of new cases on Monday. That model forecasts a second peak of new cases at the end of May, with cases dropping to the 200 to 300 range by the end of June.

New MetroHealth model
MetroHealth's new model showing the predicted number of new cases each day.

However, new cases aren’t the only concern.

“One of our concerns has been the increased rates of illness and mortality as people put off necessary medical care and procedures,” Boutros said. “There’s likely to be a significant increase in impairment and number of deaths if people continue to defer crucial health care services. ”

MetroHealth’s doctors and health officials have seen clusters of COVID-19 infection among people who attended funerals, religious celebrations, in nursing homes, in the Cuyahoga County Jail and in confined work spaces, the release states.

With the opening of bars, restaurants and businesses this month, MetroHealth’s revised modeling predicts an increase in clusters of infection throughout May, which will ebb and flow, but gradually decrease throughout June.

“We know this will be a sustained issue that our hospitals and community will work together to address for many months to come,” Boutros said.

It is important to note that all models are merely predictions, and not an accurate portrayal of actual cases in the future. A number of factors could drastically change the spread of coronavirus in Ohio, such as adherence to social distancing and other measures, or even the introduction of a new treatment. However, these models serve an important purpose.

“The models have serious policy implications and raise important questions about how to best provide health care to our community,” Boutros said after MetroHealth released its revised model in April. “If this scenario continues to play out over several months, one question we as health leaders must address is, at what point do should we resume preventive screenings such as mammograms and colonoscopies? We will need to provide health care treatment that is now being put on hold, while at the same time containing the spread of coronavirus.”