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5 more Northeast Ohio counties now at purple Level 4, highest on Public Health Advisory System

Cuyahoga County back on watch-list
Public Health Advisory Dec. 3
Posted at
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COLUMBUS, Ohio — The Ohio Department of Health announced that five Northeast Ohio counties were moved to purple Level 4 on the Ohio Public Health Advisory System as of Thursday, joining our two already purple counties. The spread is now so severe, said Gov. Mike DeWine, that the effort to map it is beginning to lose value.

Richland, Medina, Summit, Stark and Portage counties were increased to Level 4 on the color-coded map on Thursday. Lake and Lorain counties remain at purple Level 4 after being ranked at the highest level on the alert system last week.

Level 4 (Purple) is the highest on the advisory alert, and it's for counties where residents have the highest risk of exposure to the coronavirus.

For a county to be moved to a level four or purple status, it needs to have six or seven coronavirus indicators for two weeks in a row.

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.

In Medina and Portage, all indicators other than sustained new COVID-19 hospital admissions were met. In Summit, all indicators other than non-congregate cases were met.

Richland and Stark counties met all seven indicators, according to the state.

Three counties were added to the watch list, at risk of turning purple next week if the indicators have sustained increases next week as well. Those counties are Cuyahoga, Fairfield and Madison.

Franklin County was decreased to red Level 3 on the state's advisory system, but that does not mean the county is "out of the woods," said Dr. Andrew Thomas of The Ohio State University Wexner Medical Center.

DeWine said the color-coded advisory has lost some of its value because of the surge of all indicators across the state for every county.

"Today, we are in a storm, so, quite candidly, this map has less value for us," DeWine said. "It does not have as much relevance as it did when we started."

DeWine said that monitoring hospital utilization and ICU capacity is the most important indicator at this point of the pandemic. We share those numbers in our daily reporting on state data, which you can find in our Coronavirus section.

RELATED: Lake, Lorain counties turn 'purple' Level 4 in state's alert system due to sustained COVID hospitalizations