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“We're going to be living with COVID-19 for some time” health commissioner says: 927 cases in Cuyahoga County, 42 deaths

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April 17, 2020
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The Cuyahoga County Board of Health holds press conference updating citizens on the coronavirus pandemic on Tuesday and Friday mornings.

Cuyahoga County Board of Health (CCBH) health commissioner, Terry Allan, removed his mask as he walked to the podium to begin the Friday briefing, by stating that we now have a “new normal.” The new normal will require change, Allan said, as we begin to accept the “ongoing reality that we're going to be living with COVID-19 for some time to come in our community and in the country.”

The new normal will require change…as we begin to accept the “ongoing reality that we're going to be living with COVID-19 for some time to come in our community and in the country.”

Allan said things will need to evolve and adapt, including educating children and working. He went on to say that we are at the end of the beginning stage of this but really just at the beginning of the new normal. He stressed that people at the CCBH are thinking about the essential workers who are continuing to work through the pandemic, including doctors, nurses, health care workers, road maintenance crew workers, construction workers, retail employees, mail carriers, truck drivers, other delivery personnel, folks working at the restaurants, safety forces and local health department employees.

The performance of their jobs is vital in everyday life to keep our society with some sense of normalcy to meet basic needs,” said Allan.

He then went on to thank social service agencies like the Greater Cleveland Foodbank, who have been helping those who have been significantly impacted by the pandemic.

“We think it's important to recognize that this that the COVID-19 pandemic has also illuminated the disparities that exist in our society and in the end justices in our society as it relates to people of color,” said Allan.

Allan then pivoted to address Governor Mike DeWine’s plan to gradually reopen the State of Ohio on May 1.

We need to know and are all asking ourselves exactly what will that mean and I think as we know those details are forthcoming we know it will be a phased and approach,” said Allan. He said that it is a part of a national dialogue about how to adapt to the new normal and, “begin to stand back up the components of our society that are vital to our economy to our citizens and do that in a way that is safe and protected.”

The new normal will include guidance around wearing masks and will continue to include social distancing.

Allan said that the new normal will include guidance around wearing masks and will continue to include social distancing. He stressed that even when the weather gets warm doesn’t mean that the precautions go away. People in Cuyahoga County need to remain vigilant until there is a widespread vaccine. Allan also said testing needs to be expanded.

He then went on to address COVID-19 in long-term care facilities. “The presence of COVID-19 in these facilities is not a surprise for Public Health,” said Allan. He said that settings where there are a lot of people who have a lot of contact with many other people, like jails and long-term care facilities, are places where people are more at-risk of catching the contagious virus.

He stressed that long-term care facilities are also more at risk because patients are likely older and possibly also dealing with other chronic conditions in addition to COVID-19.

We shouldn't be treating this list like a scorecard or a tally sheet and we should not be stigmatizing these long-term care facilities because they have cases.

“We shouldn't be treating this list like a scorecard or a tally sheet and we should not be stigmatizing these long-term care facilities because they have cases. In fact it is inevitable that we knew we would see cases. So every entry on the list and every number is a human being is a face, a family member, maybe your family member. It could be a friend or a neighbor, so please keep this in mind as the information is released,” said Allan.

He said that CCBH anticipates as the county opens back up that there will be additional cases and clusters of illness, but said it’s the job of public health to “stamp out” those clusters.

The CCBH anticipates as the county opens back up that there will be additional cases and clusters of illness.

CCBH medical director Heidi Gullett then began her briefing, removing her mask as she walked up to the podium. She started her remarks, as she always does, by thanking members of the community – Friday she thanked the media and members of public health departments at the state and local levels. She also thanked organizations that CCBH has contacted where there have been multiple cases identified – including long-term care facilities.

You have represented what is the very best of our community during this incredibly difficult time you have led with a lot of poise composure and perseverance to fight for the people you serve on a daily basis,” said Gullett.

CCBH staff have been able to contact trace 2,244 cases in the county.

Gullett then shifted to present the county data, with the caveat that the CCBH is trying to present data while respecting both transparency and privacy.

Gullett said the number of COVID-19 cases in the county (excluding the City of Cleveland) is 927, with an additional 336 probable cases. The ages of those who have gotten sick range from one week old to 101 years old. CCBH staff have been able to contact trace 2,244 cases in the county, and 224 people have recovered from COVID-19. The date of illness onset is February 29 through April 13 said Gullett, which indicates that there is still ongoing virus spread in the community.

Forty-two people between the ages of 46 and 93 years old have died in Cuyahoga County from COVID-19.

Forty-two people between the ages of 46 and 93 years old have died in Cuyahoga County from COVID-19, and Gullett stressed those are only lab-confirmed cases and do not include people who died who showed symptoms of COVID-19 but did not receive a test. The median age of those who have died is 78-years-old, two percent identified as Asian, 20 percent as Black, 63 percent as white and 15 percent were unknown.

“We have lost 42 people in our community who can never be replaced we've lost people whose families are grieving their friends are grieving and we as a community need to grieve with them,” said Gullett. “We have to continue to rally around those who are most affected.”

In lab-confirmed cases, 24 percent of people had to go to the hospital at some point, nine percent were admitted to the intensive care unit, there have been 1,263 isolation orders and 2,244 quarantine orders.

Gullett then presented data about both lab-confirmed and probable cases by gender, race, ethnicity and age of those who have tested positive for COVID-19.

There’s still unknown data about race and ethnicity.

Gullett said there is a pretty even breakdown between men and women. In terms of race and ethnicity, 29 percent identify as Black, 54 percent identify as white and 14 percent are unknown. She said there’s still unknown data about race and ethnicity, 28 percent of cases are unknown ethnicity. In terms of age, Gullett highlighted the percentage of cases go up for ages 50 through 69-years-old. She said that in terms of probable cases there is a higher number of kids under the age of 19, because they may be living with someone who tested positive for COVID-19.

The biggest risk for transmission for most people is living with someone who is positive and that’s why we take isolation within a home so seriously,” said Gullett.

Gullett then showed an epidemiological curve and urged people to not interpret lower numbers in the most recent week as being on the other side of the curve as there may be people who haven’t contacted the CCBH or haven’t been tested yet.

Gullett then shared the ZIP code map of cases for the county, stressing it only represents the number of confirmed cases due to testing being restricted only to those in the hospital, health care workers and first responders.

Twenty-eight percent of COVID-19 cases are health care workers.

Twenty-eight percent of COVID-19 cases are health care workers and 64 percent of those who tested positive had pre-existing conditions said Gullett.

She cautioned that the data is limited since “the people who've been tested are the people who are sickest, who often have pre-existing conditions so this is likely to be lower if we were testing the general public because we know that this virus also affects lots of people who have no pre-existing conditions.”

In terms of hospital use, adults who are sick enough to be in the hospital but not to be in the ICU are 62 percent full, beds for pediatric patients are 35 percent full, ICU beds are 63 percent full and 29 percent of ventilators in the county are in use.

Allan then returned to respond to a question about communicating COVID-19 illnesses to family members of those in long-term care facilities by saying he thought each facility was doing its best to communicate to families. He also highlighted that those who are working in those facilities are “often folks who aren't making much, and these are folks who are often people of color and are on the front lines and they're scared, but they come back every day, back to work, to try to serve those residents because they know that they need their help, and that's heroic. That's truly heroic.”

Gullett also addressed the question and shared how the long-term care facilities have been receptive to CCBH’s efforts. In terms of communication at the facilities she said that even during press briefings, “the numbers I gave you have changed in the time I've been standing in front of you and that happens for our facilities too.”

Responding to a question about if the county will be ready to reopen on May 1, Gullett said that they are still seeing new transmissions in the county.

Unless we stop transmission that's still happening we're gonna continue to need to address this in a very robust way. This is a long-term proposition for all of us. This is a marathon not a sprint,” Gullett. “Given the continued transmission we need people to wear masks we need people to socially distance we need people to not have parties we need people to not have gatherings we need people to work remotely whenever possible and so we will continue to work with our state leaders around what we're seeing on the ground but the message for our community today is that we can't let up and we'll continue to see what happens over the next few weeks.”

Testing is critical to identify potential risk and to prevent future cases.

Allan said that it’s hard to set a date on what day would be best to start reopening the county and said that there needs to be a lot of guidance set up to address many different things and he said that the county expects more testing to become available but with more testing there will be more cases.

Testing is critical to identify potential risk and to prevent future cases,” said Allan. “It’s about protecting the public health our collective health.”

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