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Ohio creates color-coded public health alert system to monitor COVID-19 spread across each county

Ohio Public Health Advisory System
Posted at 3:24 PM, Jul 02, 2020
and last updated 2020-07-02 23:55:07-04

COLUMBUS, Ohio — Gov. Mike DeWine announced that a Public Health Advisory Alert System has been created to help state and community leaders collect information that they can layer with enhanced safety measures to combat flare-ups and case increases in an area.

The system will be color-coded to assess the level of spread in the area to better guide officials to determine appropriate actions.

There are four levels with seven indicators, with three more to come, to determine the level an area is in, DeWine said.

The four levels include:

  • Level 1 - Yellow: Zero or one indicator have been flagged active spread exposure, All current health guidelines to be followed as ordered. 53 counties are currently listed at Level
  • Level 2 - Orange: Two or three indicators have been flagged, there is an increased risk for exposure and spread. There are 28 counties currently listed at Level 2.
  • Level 3 - Red: Four or five indicators have been flagged, there is a very high risk for exposure and spread. Ohioans should limit activities when possible and wear a mask in public. As of Thursday, counties that are Level 3 include: Cuyahoga County, Trumbull County, Huron County, Butler County, Montgomery County, Hamilton County, Franklin County
  • Level 4 - Purple: Six to seven indicators have been flagged, there is severe exposure and spread. Residents in these counties should stay home as much as possible. No counties are currently listed at Level 4, but Franklin County has been flagged as approaching this level.

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.

Regardless of the alert level, DeWine said that high-risk individuals, which make up around 60% of the state’s population, should take every precaution they can. DeWine also said Ohioans should also assume that if one person in a household is sick, all others may be sick as well.

DeWine said that the increase in cases is largely caused by large family gatherings like birthday parties and graduations; protests; spread in the workplace; bars and restaurants; tourist destinations like Put-in-Bay; people with symptoms not staying home and people not social distancing.

“All the great actions Ohioans have taken to this point are in danger, frankly, of being reversed,” DeWine said, which is what he hopes the new Public Health Advisory Alert System will be able to prevent from happening.

Based on the data collected in this new system, DeWine said that mandates may be issued on a county-by-county basis, including wearing masks or face coverings. The governor said that the state's intent, at this point, is to not have to issue a state-wide mandate on face masks and coverings—but with new data and information, if the state deems it necessary, they’ll be able to do that.

Dr. Claudia Hoyen, Co-Director of Infection Control at University Hospitals, says the spread of COVID-19 was bound to increase with as the state continues reopening the economy.

"We really need to be mindful of making sure that we're not getting to a point where we’re really starting to get that exponential rise in cases every day," she said.

Hoyen says the new alert system could help slow the spread as it holds Ohioans accountable.

"A lot of controlling disease is done very locally and to be able to kind of let parts of the state that are doing better continue what they're doing I think overall is going to keep the state in a healthier place and again focusing on those hot spots where people need to be paying more attention is really important," Hoyen said. "we're all at a level one and so really nowhere in the state should people not be washing their hands, social distancing, wearing masks. As we move through this COVID epidemic truly the things we are trying to protect is the healthcare system. At no point do we want the healthcare system to become overwhelmed because then it's not just about COVID patients. It's about people having heart attacks. It's about people having strokes. So we can't allow that t happen because then we're going to have people who are having everyday regular things not be able to get the healthcare that they need."

Hoyen says moving forward Ohioans have to resort back to what was done well at the beginning of the outbreak, which includes limited public activities as recommended by the governor.

"We’ve all seen I think pictures on people’s Instagram of people being in downtown Cleveland and you know not really social distancing, clearly not wearing masks," she said. " When we see large groups of people interacting that’s when we’ll get spread."

DeWine did not mention any restrictions for counties rated through the new system. However, the system could be updated with indicators surrounding contact tracing and testing rates.

RELATED: Cuyahoga County rated alert Level 3, second-highest, for COVID-19 outbreak