COVID-19 update— For first time, Greene is ‘red’
- Published: October 21, 2020
Greene County has gone “red.”
Last Thursday, Oct. 15, Ohio elevated Greene County to “red” on the Ohio Health Advisory System for the first time since the system was put in place in early July. The state flagged four different indicators of increased COVID-19 spread here, out of a seven-indicator risk profile.
Greene County’s indicators of concern are new cases per capita, cases in non-congregate settings, outpatient visits and hospital admissions. While new cases per capita and cases in noncongregate settings have been flagged for months, outpatient visits and hospital admissions are new areas of increase for Greene County, according to the state advisory system.
Twenty-nine of Ohio’s 88 counties are now “red,” the third level in the four-level system. No county has yet shown up “purple,” the highest level. While “red” counties dot the state, there is presently a concentration of higher-risk counties in western Ohio.
The state’s guidance for “red” reads as follows: “Very high exposure and spread. Limit activity as much as possible.”
Greene County Public Health epidemiologist Don Brannen amplified that guidance in an interview this week.
“We should be limiting our activities as much as possible. Repeat. We should be limiting our activities as much as possible,” he said.
Brannen acknowledged that the message was hard for some to hear. Young people in particular may be flouting such limits. According to Brannen, the 18-to-22-year-old age group is driving recent case increases in the county.
“The virus is tricky. It takes advantage of our social nature,” he said.
Mass testing at area colleges and universities, as reported in last week’s paper, is turning up scores of new cases. For example, Cedarville University is now up over 70 cases, with 200 total contacts involved in the heath district’s investigations there, according to Brannen.
Yet young people aren’t the only ones reacting to loosening restrictions and what the media is calling “pandemic fatigue” by gathering in groups and spending more time in public venues. Community-based transmission is increasing in all of the county’s more densely populated urban areas, with Bath Township, where Fairborn is located, contributing the most new cases.
People are getting infected at family and church gatherings, according to Brannen.
“Some of the most vulnerable people in our community go out to church one time a week and get infected there,” he said.
And the virus is coming into families when one member gets infected at work. Brannen said the county has many conscientious employers, where social distancing, masking and hand sanitizing are being practiced, but it also has workplaces where such measures aren’t in force.
“These measures work. Places that don’t use them are coming down with cases,” he said.
Greene County is now adding about 35 new cases a day, based on a seven-day moving average tracked by the News. By contrast, until early June, the county was adding about one case daily.
Since the start of the pandemic, 2,140 county residents have had confirmed or probable cases of the virus, according to state reporting from Monday, Oct. 19. The true number of people with prior or current infections may be 3.5 times higher, or 7,500, based on a new statewide prevalence study.
In Greene County, at least 166 people have been hospitalized with COVID-19, and there have been 40 deaths, according to state figures.
Miami Township, which includes the villages of Clifton and Yellow Springs, continues to be an area of low occurrence within the county, according to Brannen. (County data is tracked by township, not municipality.) Since the pandemic’s start, there have been 20 confirmed cases and three probable cases here, for a total of 23 cases. That equates to less than 0.5% of the population, lower than the approximately 1.3% occurrence in Greene County as a whole.
Three people have been hospitalized in Miami Township, and one has died.
Yellow Springs reported two new cases this week and one from the prior week, for a total of three active cases in the village, according to Police Chief Brian Carlson. Infected individuals are isolating at home. A second case from last week is no longer on the list because the individual has completed the two-week isolation period for the illness.
A closer look at the indicators
The News contacted Brannen on Monday to gain a clearer understanding of the content and significance of the four flagged indicators.
On the new cases per capita indicator, Greene County added 312 cases over the past two weeks, or 184.68 cases per 100,000 residents. Anything over 50 cases per 100,000 residents over two weeks triggers the indicator. This indicator has been flagged for Greene County for months.
Brannen said that while the “cut point” of 50 cases is somewhat arbitrary, the indicator provides a useful comparative look at where a county is relative to other counties in Ohio. With its latest new cases per capita, Greene County is 21 out of Ohio’s 88 counties in terms of COVID-19 occurrence, according to the most recent state rankings.
A related indicator that Greene County has yet to trigger is the new cases increase indicator, a measure of disease spread. Counties hit this indicator if they’ve seen increases in new cases by onset date for five consecutive days during the prior three weeks.
“It’s probably the most important indicator, and it’s good we haven’t met it,” Brannen said.
The county’s second flagged indicator is noncongregate cases. This indicator relates to the percentage of COVID-19 cases that occur outside of congregate settings, such as nursing homes and other long-term care facilities. A high percentage of noncongregate cases indicates that the virus is spreading in the community at large, according to Brannen.
To trigger this indicator, a county must see its proportion of noncongregate cases exceed 50% in one of the past three weeks. Greene County has reported a high proportion of noncongregate cases in two of the last three weeks.
This indicator correlates with the county’s recent case rise among younger people and on college campuses, Brannen said. But it also reflects the decrease in cases among vulnerable populations in long-term care facilities after several clusters reported earlier in October and in September.
“That’s a good thing,” he said of the latter change.
The third flagged indicator relates to outpatient visits. This indicator comes into play if a county sees an increase over five or more days in outpatient visits by people with COVID-19 symptoms during the prior three weeks. Greene County has seen such an increase for the past two weekly reporting periods, with daily outpatient visits peaking at about 22, based on a seven-day moving average. At their lowest point in the past three weeks, in mid-September, the number of daily visits was about 11.
This indicator also correlates with the recent rise in younger and healthier people testing positive, according to Brannen. Such people are more likely to seek outpatient care, as compared to older and sicker individuals, who might require hospitalization.
“It’s an indicator that people are healthy enough to go home after being tested,” he said of the latter change.
And the fourth flagged indicator is hospital admissions, new to the county’s risk profile last week. It is triggered if a county sees hospital admissions due to COVID-19 rise for five or more days during the prior three weeks. Greene County is now seeing just under two daily hospital admissions, based on a seven-day moving average.
In Greene County, this indicator may correlate to the overall case rise, rather than pointing to a trend of more severe cases of the illness, Brannen speculated. Area hospitals continue to have sufficient capacity, he added.
“It’s probably just being carried along by the high numbers,” he said of the hospital admissions indicator.
Brannen predicted Greene County will continue to see rising cases, especially as the weather turns cold. The reproductive rate of the virus in the county is currently about 1.1, meaning that each resident infects, on average, just over one other individual.
Infection happens person-to-person, he emphasized. And that means it’s up to each person to prevent the virus from leaping to a family member, friend, neighbor, coworker or stranger.
“We have to break the chain of transmission,” he said.
The article has been corrected from the print to accurately state the number of cases and contacts at Cedarville University.