COLUMBUS, Ohio — During a brief news conference Thursday called on short notice, the Ohio Department of Health announced the sudden end of the Public Health Advisory System, the Ohio state map color-coded based on the risk and severity of COVID-19 spread by county.
“We're in a very different point in this pandemic and the need for this kind of urgency has kind of passed,” said ODH Director Stephanie McCloud. “So we're looking to move on.”
The system was put in place on July 2, 2020, and its discontinuation was effective on Thursday, the same day as the announcement.
“It was to warn communities of increasing concerns related to COVID-19,” McCloud said. “And it did this by providing counties with data related to the spread of covid and assigning risk alert levels and colors. And this allowed them to respond accordingly as they saw fit.”
The system tracked seven metrics related to COVID-19: new cases per capita, sustained new case growth, proportion of cases that are non-congregate cases sustained increase in emergency room visits, sustained increase in outpatient visits, sustained increase in new COVID-19 hospital admissions and ICU bed occupancy. Counties would be assigned a color based on how many of those seven metrics were exceeded – yellow for zero or one indicator flagged, orange for two or three, red for four or five, and purple when six or seven indicators were flagged.
“The system was built as the pandemic, of course, was intensifying and we needed to keep close track of certain information,” McCloud said. “This helped limit the spread, save lives and ensured our hospitals were able to accommodate all patients who needed care. It had several factors to it, as you may recall, different elements that were included that helped us track that information.”
By December, Governor Mike DeWine began moving away from use of the advisory system, McCloud said, instead focusing just on COVID-19 incident rates around the state.
“The public health advisory system, as you may have heard him or me say in the past, it was more of a storm predictor,” McCloud said. “By the time we got to December, I think we all remember, the storm was here. We didn't need any more predictions. And now we're at a point where other we're looking at other things moving forward. We're looking at vaccination numbers. We're looking at those total average numbers. We're watching the cases.”
McCloud said with the state edging closer to having half of all Ohioans vaccinated with at least one dose, and cases declining statewide, the department is “looking to move on” from the advisory system.
“The increasing number of Ohioans who have been vaccinated really reduces the numbers that are available within the alert system,” said Jeff Brown, a data analyst with the Department of Administrative Services. "And what that means is the alert system was built again, as Director McCloud said, as an early warning system. And a lot of the focus within it is sustained increase in numbers and certain metrics to show that upward trend that helps identify that the storm is coming. But over time, as we've got more folks who have been protected through vaccines, the numbers within those sustained increases are just not as meaningful as they once were, where you see may be cases ticking up by a case or two a day. And that may happen over a sustained period of time, which triggers some of the alerts. But at the aggregate level, for that community, given the actual volume within that increase, it's not relevant to use within the alert system anymore as it as it was designed.”
The state has been consistent in its use of the alert system since its been rolled out, Brown said, and the state did not want to begin changing the rules of the system in this new phase of the pandemic, but to instead focus on the measures that are most important now.
“The data are different now, given the stage that we are in the pandemic and there's different data that we need to be looking at as far as understanding what's happening in communities,” Brown said. “And we didn't feel like the alert system really captured that as effectively as it once did.”
Counties shifting focus to local data
“Well, it is somewhat of an encouraging sign, right?” said Kevin Brennan, communications director for the Cuyahoga County Board of Health. “I think people should be encouraged by the fact that now the focus is changing from a statewide view where we were all very concerned about us as a larger region. So now we can really concentrate more on our individual counties and cities and neighborhoods.”
Brennan said even with the map being retired, CCBH plans to keep operations at status quo.
“Creating weekly summaries, posting them on our website, sending our information to the state health department so that they can convey that information,” Brennan said.
Summit County Public Health Commissioner Donna Skoda said she wishes there was more of a warning.
“I wish it would have ended slowly because it was sort of abrupt for people, like it's gone now. So you're probably wondering, how do I know what my risk is now?”
But she said people shouldn’t worry about how to evaluate their risk. ODH will continue to share data about COVID-19 cases, hospitalizations, deaths, current trends, key metrics, and vaccinations online, and Skoda said her team will be tracking it too.
“We're going to keep just monitoring hospitalizations, positivity, and that case rate just as a way to tell folks what's going on,” Skoda said.
Dr. Amy Edwards, a pediatric infectious disease specialist at University Hospitals, said there are multiple sources for COVID-19 information.
“ODH has long had incidence rates by zip code and so that's still available. They're not changing that,” Edwards said. “We here at UH are still tracking COVID in Northeast Ohio in our patient population. So your health care workers can be a good resource for you.”
Advisory system could return in a different form
McCloud did leave the door open for a different advisory system, should the need arise.
“I would I think it's important to note that we will not hesitate to implement a different or similar system that better suits our needs at any time, if we should decide that we need to do that,” she said. “We've never hesitated in the past and certainly won't hesitate again.”
But, McCloud said, with the rising vaccinations and dropping case rates, the advisory system, along with the bulk of COVID-19 health mandates, will be going away.
“Hopefully what we'll see now that we're getting a little more comfortable as we move toward the summer, that we're comfortable that the light in the tunnel is not, in fact, a train heading toward us, that we may look to more things next week,” McCloud said. “We're excited to have the orders — a lot of the orders regarding masking and social distancing — expire.”
On June 2, most state health orders and mandates put in place due to the COVID-19 pandemic, including masking and social distancing requirements, will expire.