Next phase of COVID-19 interventions will be local


By Mackenzi Klemann - mklemann@limanews.com



Mel Hackworth, a medical assistant with Health Partners of Western Ohio, holds a COVID-19 nasal swab test while working at the Bradfield Community Center drive-up testing site in Lima.

Mel Hackworth, a medical assistant with Health Partners of Western Ohio, holds a COVID-19 nasal swab test while working at the Bradfield Community Center drive-up testing site in Lima.


Craig J. Orosz | The Lima News

LIMA — Ohio has seen a rise in new COVID-19 cases reported in the past three days.

For weeks, the state has witnessed a plateau, rather than a rise or decline in new daily cases, as businesses reopened. But on Thursday, the state on the current trends tab of its main website reported 700 new cases, which fell slightly to 609 new cases on Friday and 531 on Saturday, all of which exceeded the 21-day average of 439.

Is that a sign of things to come, or a statistical anomaly?

“It’s hard to know with just a day or two of data whether that is a real increase or just a statistical blip that will go back down in a couple of days,” Dr. Tara Smith, a professor of epidemiology at Kent State University, said on Friday. “But it’s something I’m certainly keeping an eye on over the next few days.”

For weeks, Ohio has witnessed a plateau in which new cases were not rising or falling, even as businesses gradually reopened.

Dr. Brian Fink, an epidemiologist and professor of population health at the University of Toledo, said he worries that such “good news” could give the false impression that the virus is no longer a threat, which in turn could lead to people returning to their pre-pandemic lives and “lead to big spikes.”

That appears to be happening in states like Texas and Arizona, which have seen new cases rising quickly.

While it’s unclear whether Ohio will see a similar situation unfold soon, Smith said those trends should be taken as a warning for what can happen when the public becomes complacent about the virus.

“The virus isn’t gone,” she said. “(And) warm weather doesn’t seem to be deterring it.”

A key tool in determining how quickly the virus is spreading, the basic reproduction number, is now being publicly released, which could help counties and cities develop their own strategies to mitigate spread of the virus.

The Ohio Department of Health shared this data last week, showing that the R0 (pronounced R-naught) was at or below R1 in most parts of the state.

In March, Gov. Mike DeWine said that number was closer to R2 in Ohio, meaning for every person infected with COVID-19, another two cases were created, signifying exponential spread.

DeWine intends to release this data at the county and city level to help communities and Ohioans assess their risk and develop locally targeted interventions.

But the R0, while an effective tool to show how quickly the virus is spreading in different communities, is a lagging indicator, DeWine acknowledged.

“To keep these numbers where we would like to see them, we urge everyone to continue to wear masks, social distance and just be careful as we are opening the economy in Ohio,” he said.

What’s next?

It’s unlikely that DeWine, after facing sustained criticism from members of his own party in the Ohio Legislature, will pursue another statewide stay-at-home order. But locally targeted shutdowns in cities or counties where rapid spread of the virus is happening may be on the horizon.

“Now that we have more testing,” Smith said, “I do think we can do those more targeted shutdowns if they’re needed instead of doing something statewide.”

That could mean temporary school closures when school resumes in the fall, or local bans on large gatherings or certain businesses where social distancing is not possible.

But much depends on the willingness of Ohioans to comply with the voluntary mitigation strategies — social distancing, staying outdoors when possible and wearing a face covering when social distancing is not possible — as well as the willingness to self-quarantine when a person has been in close contact with a confirmed COVID-19 case, which could help prevent these localized shutdowns.

The most dangerous environments are those where people are crowded together in a confined space with limited airflow, according to Dr. M.G. Finn, a professor with the School of Chemistry and Biochemistry at the Georgia Institute of Technology.

“Just think about the primary mode of transmission being droplets that are emitted from breathing, coughing or sneezing,” Finn explained. “Those droplets, if they are circulating in a closed space with a lot of people, there’s a lot more chance they will carry the virus to someone else.”

The more time people spend in crowded enclosed spaces, Finn said, the more at-risk they are for contracting the virus. The virus is less likely to spread via contact with surfaces.

“The physical distancing that many people have been practicing is very effective at slowing the spread of the virus,” he said. “We just have to make sure we keep doing that.”

Changing recommendations

The recommendations have evolved since the pandemic took hold in February, a fact which has concerned Dr. Wilfred Ellis, an infectious disease specialist in Lima and president of the Allen County Combined Health District.

“Initially, we were told that masks won’t be necessary in February. And in June, they’re encouraging masking,” Ellis said. “I’m concerned that in February, they said that solid counters and other objects could be where the virus is housed, and in June they said, well, it doesn’t live on countertops or large objects.

“I’m really concerned when they said we could have person-to-person transmission in February and then in June, the WHO says it’s not transmitted from one person to another very well. Those are things that caused great difficulties in trying to set policy or do epidemiology, because if the assumptions are false then you really can’t make good policy. We have to make sure that whatever we do is in the best interest of our population.”

Ellis said he still considers social distancing, or maintaining six feet of separation between people who do not live together, the most effective tool.

“If you can maintain that distance,” he said, “a mask may not be necessary. But if you can’t, then you should wear a mask.”

Mel Hackworth, a medical assistant with Health Partners of Western Ohio, holds a COVID-19 nasal swab test while working at the Bradfield Community Center drive-up testing site in Lima.
https://www.limaohio.com/wp-content/uploads/sites/54/2020/06/web1_Covid-19-Nasal-Swab-Test_01co.jpgMel Hackworth, a medical assistant with Health Partners of Western Ohio, holds a COVID-19 nasal swab test while working at the Bradfield Community Center drive-up testing site in Lima. Craig J. Orosz | The Lima News
https://www.limaohio.com/wp-content/uploads/sites/54/2020/06/web1_20200617_Spike_states.jpgCraig J. Orosz | The Lima News
https://www.limaohio.com/wp-content/uploads/sites/54/2020/06/web1_CoronavirusComparison.jpgCraig J. Orosz | The Lima News

By Mackenzi Klemann

mklemann@limanews.com

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